The night shift, p.11
The Night Shift, page 11
‘No – right.’ Violet laughed self-consciously. ‘That’s okay. I – right…’ The conversation had taken an unexpected turn – it must be bad if even she realised that Anjali had said something awkward. Keen to get back on familiar turf she pulled her list out of her pocket and scanned the patient names while Anjali rearranged her face. ‘So, who do you want me to see first,’ she said eventually. ‘The shortness of breath, the chest pain or the swollen leg?’
They parted ways and Violet allowed herself a small smile. It wasn’t often that she was the innocent bystander while someone else put their foot in it. But as she strode down the corridor to ward five she began to process Anjali’s words and consider them a little more deeply. The fact that Anjali had mentioned autism chimed with a conversation she’d overheard her parents having many years ago. She’d been unable to sleep one night, she wasn’t sure why, something had happened, one of those occasions where she’d misjudged a situation, and she’d tiptoed downstairs to get a glass of water. Her parents’ raised voices had surprised her, she remembered that, because it was so unusual to hear them disagreeing. Her father had said something about ‘traits’ and ‘the spectrum’ and Violet’s mum has said something like, ‘doesn’t seem to be a problem’ and ‘no different to your brother Dave,’ and her dad had said, ‘What? Dave with his collection of Lord of the Rings figurines and his spreadsheet of Chelsea’s goal average spanning the past twenty years?’ And her mum had gone quiet for a bit.
During her time at medical school Violet had paid attention to their one lecture on neurodiversity a little more attentively than her classmates, but one of the key points was that autism occurred much more commonly in boys, and besides, she wasn’t prone to anxiety, she wasn’t hypersensitive to noise, and she didn’t think she’d ever had a meltdown or a shutdown episode. The criteria didn’t really seem to apply to her any more than the ones for polycystic ovaries or irritable bowel syndrome did, and she knew there was always a danger of medical students convincing themselves they had every condition under the sun. Now, as on those two previous occasions, she stored Anjali’s comment away for later analysis. After all, there was a hell of a lot going on in her head already without having to consider a self-imposed diagnostic category to add to the ‘geek’, ‘frigid’ and ‘odd’ labels of her youth. Those were words she had worked hard to distance herself from – she didn’t want to deliberately unearth another one.
Later, after she’d clerked in two new patients and reviewed the blood results of several others, she bumped into Gus on ward seven. He was writing up his notes at the nurses’ station and looked up as she approached.
‘Hey! I forgot to ask earlier. How was your swim?’ He smiled one of his easy grins and her heart gave a little lift of relief. He didn’t seem to have made any negative judgement following her earlier outburst in the MAU office.
‘Yeah, it was good thanks.’ She smiled back shyly as she took a seat next to him. ‘I slept much better today. Could you just pass me one of those continuation sheets?’
Gus leaned across the desk and gave her the paper with a dramatic flourish.
‘How about you, did you – errr – sleep well?’ Violet asked, the image of a drowsy tousle-haired Gus wearing very few clothes immediately popping into her head. On the previous night shifts she’d noticed little details that might indicate fatigue – the heel of his hand pressed into his temple in the early hours of the morning, the wide expansive yawns as dawn approached, arms stretched over his head, scrub top lifting just enough to catch a glimpse of toned midriff – but now she wondered what he looked like when he was deeply asleep, how the muscles in his neck and shoulders would relax into the pillow, how his lashes would flicker and come to settle brushed against his tanned cheeks, how his lips would part, just slightly, enough to feel his breath against your ear if you were lying next to him… She drifted in this thought for so long that she missed his response and had to ask him to repeat it.
‘I was just saying that I’m looking forward to joining you later,’ he said.
‘For a sleep?’ she said without thinking.
‘Err – no. I meant for a swim.’
‘Of course.’ She looked down at the desk, her cheeks burning and a pulse thudding in her throat.
‘A swim at the lido,’ he continued quickly. ‘Like you’d suggested?’
Violet was still staring hard at the desk surface as if intending to commit the pattern of ink splodges and mug-circles to memory. If she kept her mouth closed, then maybe she wouldn’t say something even more stupid. She heard Gus’s voice falter slightly.
‘Or – would you prefer it if I didn’t?’ he said. ‘It’s no bother. If it’s, you know, your special thing – something that you like to do on your own. I don’t want to be in the way…’
‘No, that’s great,’ she said, looking back up. She felt a slight sense of panic at the idea of his not accompanying her and wanted to say the right thing. ‘I do usually prefer to be on my own, you’re right. But I want you to come. I wouldn’t have asked you otherwise.’
‘Of course.’ He grinned again. ‘I forget that Violet Winters is one of those rare individuals who says what they actually mean. I take it if you do change your mind, you absolutely will tell me?’
‘Yes, I will,’ she said. ‘But I don’t think I’ll change my mind. I don’t tend to do that very often.’
‘Steadfast and honest.’ He closed the cover on the notes he’d been writing in. ‘Rare indeed.’
‘That makes me sound quite dull,’ she said, checking his face – was he making fun of her? ‘Makes me sound like a donkey, or a really boring side character in a novel, the one who hankers after being a bit more interesting.’
‘Oh, no,’ he said, standing to leave. ‘You are plenty interesting, Dr Winters.’ He smiled as he brushed past her chair. ‘Plenty interesting. I’ll see you later.’
Violet looked back down at her notes as her cheeks flushed again. Really, she was going to have to stop responding to his gentle teasing in this way – it was most out of character from her point of view, and it wasn’t as if he meant to flirt with her. She was again reminded of Anjali’s words at the start of the week about how Gus made people feel special without really trying. About the fact that this was just his manner, nothing intentional. She mustn’t let herself get sidetracked into thinking she was in any way significant in his life. He was engaged and therefore had obviously found the person who he thought was really, properly special – anything else was just a result of his ability to establish an easy rapport.
But she did find herself wondering exactly who this amazing fiancée was, the one woman who Gus had chosen to spend the rest of his life with. She must be pretty impressive to have netted this particular catch because any normal girl on the receiving end of the full beam of his affections would surely spontaneously combust, given that mere mortals such as Violet herself were capable of falling under his spell simply from the peripheral fallout. Still, she shook her head crossly. No point in wondering any further about this mysterious goddess who’d captured Gus’s heart. It was none of her business and Dev would have a field day if he knew she was mooning about like an absolute tragic. She was no romantic heroine, overlooked or otherwise. She was a doctor with a clinical mind and a scientific outlook – romance was neither a topic she was familiar with, nor an item on her ‘to-do’ list. Her response to Gus was purely physical – simple biochemistry playing out in the laboratory of real life. The fact that he made her feel good about herself, and that she really enjoyed his company, was neither here nor there. As she’d already told herself a mere twelve hours earlier, there were myriad reasons as to why she couldn’t be with someone like Gus, even if he hadn’t been engaged to a glamorous television executive, but the main one was that charming, good-looking men were not to be trusted.
Violet risked a quick look down the corridor and saw his figure receding into the distance. He glanced backwards over his shoulder, threw a megawatt smile in her direction and exited the ward like a film star leaving the stage. Annoyingly she felt that same little flutter in her throat, despite her own personal pep talk. She wondered idly about having Never Trust A Charmer tattooed on her lower back to match Dev’s Aztec Don’t Be A Dick warrior motif – because having stern words with herself currently didn’t seem to have sufficient effect.
Gus
Gus made his way along the dimly lit corridor to arrive at the high dependency unit. His registrar Karen had bleeped him earlier about a nineteen-year-old girl who’d been admitted with sepsis. ‘She’s stable,’ Karen said. ‘Family are on their way. Mum sounded pretty shaky so give me a call if you need moral support – not that I think you will.’
From what he could see of the notes, the girl who’d been admitted was an intravenous drug user who had been stable and managing on a methadone programme until her ex-boyfriend had returned on the scene a few days ago, bringing with him a festive bag of contaminated heroin. This had been cooked up and injected directly into one of her scarred veins in significant quantity along with a few bacteria who set up home in her blood stream and multiplied until her system was completely overwhelmed. The result seemed more like bad luck than anything else, sepsis from a faulty batch rather than an intentional overdose, although you never knew for certain what was going through people’s minds when they took a massive amount like this following a period of complete abstinence. Were they chasing a high or did they simply want it all to be over? Gus sighed as he read through the paramedics’ report. Cases like these were always so depressing: kids who should have had their whole lives ahead of them but instead wound up in hospital, gambling with long term disability and death.
Barbara stuck her head around the office door. ‘Mum’s here,’ she said. ‘In the visitor’s room. I’ve made her a cuppa.’
‘Thanks, Barb – tell her I’ll just be a moment.’
He scrolled through the notes on the screen, bracing himself for the conversation he was about to have. He knew that this girl’s mother would be less concerned with the medical information: how badly her daughter’s liver and kidneys had fared, whether her risk of clotting was now reducing, what her lung function was doing. He would be able to tell her that there was unlikely to be lasting damage and knowing that her daughter was alive and being cared for was baseline reassurance – the very fact that the girl was in HDU meant that these things could be assumed. No – what would be troubling this mother was the more nebulous question of why?
Why did my daughter do this?
Was it an overdose or simply a mistake?
Why would she want to end her life?
Why did this happen to us?
Gus knew her pattern of this woman’s thoughts before he’d even met her. Because he’d had very similar thoughts himself.
He recalled the first time he’d been told his father was in hospital. He and his sister, Dot, huddled up on the sofa under the watchful eye of Mrs Greenham from next door. His mother returning, pale, weary with guilt and lack of sleep. Taking his hand in hers as she spoke to him a hushed voice, anxious not to wake his sister who was dozing by his side.
‘Tata will be home soon,’ she’d said, trying to smile. ‘He misses you both very much.’
A twelve-year-old Gus had thought this unlikely. His father had been like a bear with a sore head for days, growling at the children whenever they entered the dark fetid atmosphere of his cave-like bedroom. He knew how it was when Tata was in one of his black moods. Best to stay away until the cloud passed and the fun-loving, playful version of his father returned. Except that this was the first time his father had actually disappeared during one of the black moods. And the blue lights flashing outside his bedroom window a few hours earlier, the trembling voice of his mother echoing up the stairs, telling them that she just had to pop out and that Mrs Greenham would be looking after them until she got back – none of that was normal. None of that was good. He’d heard the policewoman. Brisk and efficient. There was something reassuring about her tone, even if the content was anything but. Words like ‘railway bridge’, ‘passers-by’, ‘note in the car’. Hearing the crumpling of paper and imagining the reciprocal crumpling of his mother’s face as a sob escaped her mouth. That one word, echoing around the walls of the sitting room long after she’d gone. Why?
And for years after, every time it happened. Every near miss. Every botched attempt. Every cry for help. Always the same question. Why? Why isn’t he living here with us? Why did he and Mum have to split up? Why aren’t we enough to make him happy? As Gus grew older he learned more. Began, not to understand exactly, but to at least appreciate how the trauma in his father’s past had caused the darkness inside. How it wasn’t Gus’s fault, or Dot’s fault, or even his mum’s fault that Tata was the way he was. And his father was still here, many years later, still battling his demons, but now managing them with medication and therapy and the healing distance of time. Gus didn’t see him very often – not as often as he should. But when they spoke on the phone there was warmth and always a little note of relief – relief from Gus that his father was still alive, still getting on with the day-to-day business of existing, and relief from his father that he, Gus, was settled and happy. That he had a successful career, yes, but mainly that he had found someone to love, someone who loved him back, a happy marriage on the horizon. He heard the same note in his mother’s voice, and in Dot’s. A feeling that no matter how much everyone else screwed things up, Gus would be okay, safe, secure and content. And that was why he’d been unable to tell them the truth. To admit that this perfect life of his was a lie would have been devastating for all concerned.
He would get around to it of course, he’d have to. But he couldn’t face it over Christmas. His mum would be so disappointed, she was already choosing outfits for the wedding. And Dot was hoping that Amelia might invite her to the hen party, not that they got on particularly well, but she’d convinced herself that Amelia must know lots of celebrities through working in television and was sure that some of them would be in attendance. The idea of having to lie to the two most important women in his life for an extended period, avoiding questions about why he hadn’t brought his fiancée home for Christmas, why she hadn’t called him, why there was no present… even for him this would have been too much of a stretch, and he was someone well practised in pretending things were better than they were. That was why he’d chosen to work the week of nights. He knew it was only kicking the can down the road. But this was a can full of guilty worms, a can laden with the weight of his family’s expectations, and to his mind it needed kicking as far away as possible.
‘You got the septic girl, then, Gus?’ A voice from the door drew him back to the present. Barney Snell, one of his surgical colleagues and another acquaintance from medical school stood in the doorway flicking idly through a set of observations charts. He must have been coming to check on the post-operative patient who’d been transferred from theatre earlier.
‘Hi, Barney. Yeah.’ Gus moved his chair in case Barney wanted to sit down. ‘She’s stable, thankfully. You know how quickly these things can deteriorate but looks like we caught it in time.’
‘Druggie, is she?’ There was a dismissive tone to Barney’s voice.
‘Ex,’ Gus said, with emphasis. ‘She was on a methadone programme until this one episode.’
‘Well, I expect that’s what she told everyone,’ said Barney, laughing almost fondly at Gus’s naivety. ‘More likely she was cadging the methadone off the GP, flogging it on the street and using the proceeds to buy smack. We had another one of them in a few days ago – below-knee amputation, circulation absolutely destroyed by injecting shit into his veins.’ He shook his head as if disappointed that his surgical time had been wasted in such a fashion. ‘It was a nightmare trying to sort out his pain relief – he had the tolerance of a rhino, nothing touched him. And then of course he wants a whole bagful of tramadol and codeine when he leaves the ward. I told the foundation year not to write him up for it, he’d have only traded it in for ketamine as soon as he got out. I said to her, the foundation doc – pretty thing, she was – I said, I wouldn’t trust an addict as far as I could throw them.’
Gus wasn’t quite brave enough to raise his objections at this little speech, only his eyebrows. He knew what Barney meant, of course he did. He’d seen addicts who would have said anything, told any lie, if it meant they got what they needed. But there was no reason to assume that they were all like that. And to deny someone pain relief when they were discharged from hospital was simply wrong. But it was the judgemental tone that irked him the most. After all, what would Barney Snell know about life on the streets for a heroin addict? Neither of them had a clue about what it must be like living on the margins of society. And Gus knew that the age when Barney was forming his opinions on the world had been spent in an exclusive educational establishment, surrounded by the comforting blanket of wealth and privilege. He remembered Barney dropping discreet little hints about his expensive schooling, the family money and the circles he moved in, when they’d been medical students. Of course, they would have had just as many issues with drugs in moneyed circles as they had on the rougher streets of Bristol, but somehow people like Barney always felt themselves to be insulated from the problems that beset those lower down the social orders.
