The night shift, p.31
The Night Shift, page 31
She nodded and gulped.
‘Okay, Mai-Lin, do you think you could tell me a bit about what’s been going on with this gentleman?’
‘He’s – he wasn’t breathing. And I shouted for help and Sheena put the crash call out.’
‘Uh-huh.’ Gus had found the bag and mask and lowered the bed. ‘Could you turn the oxygen on for me please? And carry on.’
Mai-Lin nodded, glad of a job to keep her occupied. ‘And so then we—’
‘What’s the story?’ Anjali had arrived, a little breathless but composed. She immediately started attaching the defibrillator pads to the patient’s chest, using the safety razor to strip away the wiry strands of white hair before she applied them.
‘Can you take over compressions?’ she asked Mai-Lin and the healthcare assistant pummelling the patient’s chest looked up in relief.
‘Have we got his notes?’ said Gus. The health care assistant darted out behind the curtain and returned a moment later with the mobile desktop.
‘Thank you, Sheena,’ said Gus looking down the screen. ‘Right – we’ve got Mr Jakub Z—’
‘Zeller!’ came a voice from behind the curtain and Violet suddenly gusted in, crashing into Mai-Lin and nearly knocking over the resus trolley. ‘Sorry!’ She looked around herself, put a hand out to Mai-Lin and steadied the trolley with her foot. ‘Sorry, sorry,’ she said. ‘It’s Mr Zeller – what’s going on? Why are you attaching those?’ she asked Anjali. ‘He’s not for resus.’
Anjali paused. ‘Is he not?’
‘He is,’ said Mai-Lin hotly. ‘There’s nothing on his chart. That’s why we put out the crash call.’
‘No,’ said Violet struggling to catch her breath. ‘No. I promised him. I wrote it all up. Look…’ She turned to Gus who was scrolling through Mr Zeller’s notes. He could see the entry from a few days ago where Violet had clearly documented Mr Zeller’s wishes to not be resuscitated in the event of a cardiac arrest.
He lifted the bag and mask away from Mr Zeller’s face. ‘Dr Winters is right,’ he said turning the screen around so Anjali and the nursing staff could see the precise documentation, so characteristically Violet in tone that he felt his own heart give a little squeeze as he read it. Just then Cindy’s face appeared around the curtain.
‘Oh! Jakub!’ she said, crossing to the bed to take Mr Zeller’s hand in hers. ‘You’re not trying to put the defib on, are you?’ She turned to Anjali, her face accusative. ‘Because he’s not—’
‘For resus. We know,’ said Gus. ‘Thanks, Cindy. I think maybe there was no sticker on the obs chart, hence the arrest call going out.’
Mai-Lin looked down at the floor with tears in her eyes. ‘Sorry,’ she said. ‘Did we do the wrong thing?’
Gus was surprised to see Violet reach out to Mai-Lin. ‘No,’ she said, her voice gentle. ‘You did nothing wrong. You correctly diagnosed a cardiac arrest, you checked the chart, there was no sticker, you put the crash call out. Exactly as per protocol. Exactly what you should have done. If in doubt, it’s much better to call the resus team than not – okay?’
Mai-Lin blinked back her tears and nodded sadly. ‘Thanks, Dr Winters,’ she said.
‘It’s Violet,’ said Violet. ‘And if it’s anyone’s fault, it’s mine. I didn’t check that he had a sticker. I wrote a whole bloody essay about his wishes but that’s no use when it’s stuck on the computer at the other end of the ward, is it? You need that information at the bedside.’
The rest of the team peeled away, back to their jobs on the ward and Gus looked at his bleep which had sounded twice during the aborted resuscitation attempt. Violet was loitering near the bed but he guessed she was there for Mr Zeller rather than himself.
‘That was kind,’ he said. ‘What you said to Mai-Lin.’
She turned to face him. ‘I just told her the truth,’ she said. ‘She hadn’t done anything wrong, and I told her that.’
‘Yes, but it was the way you told her,’ he began, but she put her palm in the air to silence him.
‘Don’t,’ she said. ‘Please. Just get on with what you were doing before.’
He nodded, suitably admonished and turned to leave the curtained area. As he looked back over his shoulder he saw Violet leaning against Mr Zeller’s bed, her body heaving with silent sobs as she held her patient’s hand for the last time. All he wanted to do was sit with her, tell her she’d managed to carry out Mr Zeller’s wishes. She’d stopped an unnecessary and undignified exit for this patient who she obviously had cared a great deal about and she’d managed to reassure a junior nursing colleague that her actions had been appropriate. All this rubbish about Violet not being good with people… She wasn’t cold and unfeeling. Quite the opposite.
But he realised as he walked back to the nursing station that he had no right to compliment or comment on her behaviour, professional or otherwise. She didn’t want or need his opinion. He was just another colleague attending a cardiac arrest, nothing more. The intimacy they’d shared only twenty-four hours earlier was gone.
Once he had written in Mr Zeller’s notes and Anjali had recorded time of death, they made their way along the ward corridor together, chatting briefly about the arrest and particularly Violet’s reaction.
‘It’s quite an uncharacteristic display of emotion for her,’ said Anjali, frowning as she glanced through the window to one of the side-rooms. ‘I’ve not seen her get particularly attached to a patient before, I wonder why Mr Zeller struck a chord. Funny, isn’t it? How some of them get to you more than others?’
Gus nodded. ‘Yeah. It is odd how some people get under your skin. She’ll be worried about the fact that she didn’t check the sticker on his observation chart though – Violet, I mean. She likes to do things properly, doesn’t she. No room for error.’
Anjali laughed. ‘God, yes, that’s Violet in a nutshell. She sets herself very high standards. Expects the same of her colleagues too, sometimes rubs people up the wrong way.’ She smiled fondly. ‘You can imagine.’
‘Oh, yes she told me about that.’
Anjali looked surprised. ‘She told you about the complaints?’
‘Oh,’ he said. ‘No. She didn’t mention anything specific… I just meant in general she knew that her attitude to work wasn’t to everyone’s liking. That she was perceived as a bit confrontational.’ He paused. ‘I didn’t know about any actual complaints.’
‘Shit.’ Anjali looked cross with herself. ‘Look, forget I said anything. It’ll probably all be fine anyway. She’d be mortified if she thought I was telling everyone.’
But – but I’m not everyone, Gus wanted to say. Why didn’t she tell me? Poor Violet – what else had she been going through that he’d been completely oblivious to?
He had to admit that he’d found that particular cardiac arrest call difficult. Seeing Violet so distressed while also realising that his presence there may have made the situation awkward for her – the thought of that saddened him beyond words. Anjali was right. Violet wouldn’t want him knowing about the complaints. She had her own barriers and secrets, much as she tried to deny it, and although he had been making some progress in breaking those barriers down, she could rebuild them much more effectively now he was out of the picture. He had created the distance between them, the blame lay squarely at his feet and perhaps related to his earlier actions just as much as the conversation in the surgeons’ coffee room.
He hadn’t really considered how she would react to the news of Amelia’s return, partly because he was unsure of his own response to this fact. But he knew Violet well enough after only a week to understand that she would find his ambiguity about Amelia troubling. She liked things to be clear and straightforward and the problem was he had told her unequivocally that he and Amelia were over, only a few days earlier. He hadn’t admitted his doubts at that point. Perhaps if he had he wouldn’t be in this mess now. Because he could see that for Violet, this was the biggest of his crimes – not the fact that he had doubts, but that he had hidden them, lied about them. And that was why the look she had thrown him just before he’d left Mr Zeller’s bedside had been one of contempt and distrust. He’d blown it, instantly relegating himself to the outer circle of Violet’s acquaintance, little realising how much he might miss being inside it.
Violet
Violet was devastated. And furious with herself. And guilty. Guilty of being so sidetracked by her blossoming relationship with Gus that she had taken her eye off what she was good at, which was, as she had told Mr Zeller only a few nights ago, precise and accurate notetaking and documentation. How could she have forgotten to add a little red sticker to his observation chart? Her methodical approach to work had obviously fallen by the wayside of her infatuation with a colleague, who it turned out wasn’t anywhere near as infatuated with her, and it had also likely suffered as a result of her more relaxed approach to patients – chatting with people was all well and good if you wanted to establish a rapport but it wasn’t much help if you forgot to undertake the necessary clinical admin.
Her carefully compiled list of good things from her earlier bike journey to Gus’s house had dwindled to a blank page. She had thought her skills as a doctor were improving. She’d been wrong. She had thought that getting close to one of her patients and taking an interest in their story might be a good thing. She’d been wrong. Look at her now, an emotional mess just because a cantankerous, elderly, dying man had actually died. And what good had her involvement and interest done Mr Zeller? None. She hadn’t been able to cure him. She hadn’t been able to ease his suffering, and it was only luck that had enabled her to facilitate his one expressed wish, that of a dignified and peaceful death. Luck was not a good thing to rely on in medicine.
And lastly, the biggest item to cross off the list with a leaking splodgy old marker pen: Gus. She had thought that letting her guard down – allowing herself to trust a charmer, relaxing her own rules – might have been a positive change, a force for good in her own life, allowing her to move forward into some sort of meaningful relationship. She’d been completely and utterly wrong. Dammit! What was the point in trying to be better when the universe just conspired against you at every turn? In her mind she crumpled up the now empty list of good things and slam-dunked it into the waste-paper basket (although even that failed and it bounced off the rim).
She made her way to the mess, knowing that she should probably head straight back down to the admissions unit but feeling as though the death of a patient justified at least five minutes of recovery time with a milky tea. As she dunked the teabag into her mug (once only) she was reminded of Gus’s phrase that very first night when he’d made her a drink. How he said he’d brutally whisked the teabag away to make it in exactly the way she’d specified. She smiled at the memory before bursting into fresh tears. Right from that moment he’d been so good to her. So kind, so funny, and so easy to be with. He didn’t mind her prickliness – like Dev, he seemed to actively enjoy it – but he also smoothed her out somehow, rounded off her sharp edges. He made her feel as though she could fit in, like a badly made jigsaw piece that just needed a little bit of love and attention, tidying up and sanding down, to help it sit more snugly inside the bigger picture.
‘Hey, Violet,’ a familiar voice called behind her and she turned to see Barney, an unreadable expression on his face. ‘Are you okay?’ He crossed the small kitchen and put his hands on her shoulders, turning her to face him. She could feel the weight of his palms through the cashmere of his jumper that she was still wearing.
She nodded and made a little positive murmur hoping to indicate that despite all outward appearances everything was okay, but he clearly wasn’t fooled.
‘It’s the second time this shift that I’ve found you in tears,’ he said in an admonishing tone. ‘And don’t try and tell me you got caught in another hailstorm. What’s happened?’
His voice seemed so warm and full of kindness, his expression so sincere, that Violet felt the relief of dropping her guard a fraction – letting go. She allowed herself to be drawn into Barney’s arms for what felt like a soothing and companionable hug, similar to the one she’d had with Marvin, just with fewer broken bones to navigate.
‘My patient,’ she said. ‘The one – you know – the man I asked you to clerk in again?’ She could feel him nodding, his chin near her ear.
‘The one you told me off about?’ His voice was tight for a moment but then he said, in a rush, ‘Quite rightly.’
‘Mr Zeller,’ she sniffed, her face resting near his shoulder. ‘He died.’
Barney was quiet for a moment. ‘Oh, Violet,’ he said eventually. ‘I’m really sorry. You were clearly quite attached to him.’
She nodded and pulled away slightly. He held her by the shoulders as he peered into her eyes. ‘Is it just that though?’ he said. ‘You seem really quite upset.’
Her lips crinkled together as she tried to smile and say, no, there’s nothing else going on, but she couldn’t lie. ‘It’s been a bit of a crappy night,’ she admitted. ‘For a variety of reasons.’
He continued to hold her and raised his eyebrows. ‘And those reasons are…?’
‘Somebody I cared about,’ she said. ‘Not a patient. Someone I really, really liked. And he – he doesn’t feel the same way.’ She gave a half-laugh, half-sob. ‘It’s all a bit basic really. I’m just a massive cliché. Falling for the bad boy. Except – he’s not really like that…’ Her eyes squeezed together again as the tears threatened to spill and Barney pulled her back into his chest.
‘Gus,’ he said, a statement of fact. ‘Oh, Violet.’ He sounded disappointed although she couldn’t tell whether this was directed at Gus or at her.
‘It was always just going to be a fling for him,’ he said after a while. ‘He was never going to give up the fiancée for a bit of fun at work. I’m really sorry to say it. I’m sorry to be so brutal.’
‘No, you’re right.’ Violet swallowed hard. ‘It’s what I need to hear. The brutal truth. I’m usually a big fan.’ She laughed sadly into Barney’s expensive shirt. She could feel the warmth of his shoulder against her cheek. It was nice but also a little bit too much – it suddenly occurred to her that she barely knew this man. She wasn’t usually so cavalier with her personal space.
She made a tiny movement backwards and felt Barney’s arms tighten fractionally against her back. Nothing frightening, just a reminder of his proximity, more of a friendly squeeze than anything else. She didn’t want to cause offence by pushing him away. After all, she’d been the one to pour her heart out and he was only trying to comfort her. And she couldn’t afford to upset another colleague by misjudging a situation. She decided to tone down how upset she was, make light of it and extricate herself from the situation. She really had to get back to the wards anyway.
‘It’s okay,’ she said, trying to make her voice matter-of-fact. ‘I’m just being melodramatic. Overtired. I knew it was only a bit of fun. It was the same for me really. Nice while it lasted but I always knew it was just a short-term thing. More about the sex than anything else.’ She laughed self-consciously, suddenly aware that by mentioning the word sex she’d somehow made a mistake, changed the mood. Barney’s breath felt hot against her ear and his arms were definitely tighter now, one of his hands sliding down her back to her bottom.
‘There’s nothing wrong with a bit of workplace sex after all,’ he murmured. ‘Good for morale.’
She registered the change in his tone. She’d got this wrong, misled him. It was her error and she had to rectify it immediately. She moved her face away from his shoulder but he seemed to take this as an invitation and inclined his head towards her, bringing his lips to her cheek as his hands strayed further down her back, over the curve of her bottom, drawing her pelvis towards him.
‘Barney – I…’ She wasn’t sure what to say but her body had gone rigid. He didn’t seem to notice and his mouth continued its progress from her cheek to her lips. She could smell the stale coffee on his breath and went to turn her face away but somehow he managed to spin her around so her back was against the wall and now, no matter how far she twisted her neck she couldn’t get away from that roaming mouth. His lips clamped down on hers and when she tried to make a noise it only seemed to encourage him. He thrust his tongue in her mouth and at the same time slid one of his hands up the front of her body, his fingers poking roughly in the general direction of her breasts despite the fact that their bodies were pressed so tightly together that she could barely breathe. After what seemed like an eternity she managed to get her head at such an angle that she was able to say No and Barney pulled back a fraction.
‘No?’ he said, as if he’d never heard the word before. ‘Really?’ He looked incredulous that she might be turning him down. ‘I thought this was what you wanted?’
‘No – I’m – I’m sorry,’ she said. Her throat felt tight, her lips bruised and sore. ‘I didn’t – I’m not sure how I gave you that impression. I just want… to be friends.’
He looked unabashed. ‘Yes, same. I was thinking friends who like a little bit of action on the side. I’m not talking about anything serious.’ He shrugged. ‘Where’s the harm? You’re young, free and single. A good-looking girl. I can, you know, help you out, career-wise. Friends with benefits, isn’t that what it’s called?’ He smiled in a way that reminded Violet of Josh, the ex-boyfriend of her sixth-form days.
‘It’s not what I want, Barney,’ she said, her voice firm despite the fact that her nerves were jangling.
His expression changed in an instant. ‘Oh, come on,’ he said. ‘It’s exactly the set up you had with Gus Jovic. You scratch my back, I’ll scratch yours. I can tell you find me attractive. True I don’t have the exotic cachet of our Eastern European friend, but I can be more useful to you than he would have been. And besides,’ he laughed mirthlessly, ‘he definitely doesn’t want you anymore.’
