It was three, not really morning at all, but I went through the motions, in the hope my brain would eventually catch up with my body and start working. Preferably before I got to the hospital and had to make any decisions.
I showered quickly, dressed in the clothes I’d left ready, and went downstairs to a beautifully warm house. Guess we’d left the heater on all night.
I turned it off, and put the coffee percolator on. There was leftover curry, which reheated very nicely in the microwave. I wasn’t sure that curry was a good option for breakfast, but this counted as a late night snack anyway.
I left my spare house key on the kitchen bench, along with a note and the alarm system code.
Rhonda yawned tiredly and looked at me in confusion when I poked my head around the staff room door.
“Dr. Maynard?” she said, sounding surprised. “Um, I haven’t paged you or anything. I paged the night reg about Mrs. Silva, but I thought it was Ghastly George this week.”
“It may well be Ghastly George; I just came in early to do rounds. Want to walk around the ward with me?”
Rhonda nodded, put her shoes back on, and we started out on rounds. Ghastly George was a plump, vivacious young woman, competent and cheerful, and no one was quite sure how she got her name, but it had stuck so firmly to her that even the patients called her that. I hadn’t known she was on nights; it was a subject I tried my hardest to remain oblivious to, just in case it happened to me.
“What’s wrong with Mrs. Silva?” I asked Rhonda, hand on the door of her room. “I mean, that wasn’t wrong on Saturday when I saw.”
“She’s Cheynes-Stoking,” Rhonda said. “That’s why I called George.”
I pushed open the door of Mrs. Silva’s room, lit by the subdued lighting that the nurses used on the critically ill. Kira, the other night nurse, was sitting quietly in the corner of the room, and Mrs. Silva’s brother was sitting beside the bed, holding his sister’s hand. Mrs. Silva’s breaths filled the room.
Each one shuddered in and rasped out, and the pauses were erratic. Her brother was in tears.
I touched his shoulder and said, “Come outside and we’ll talk.”
While I led Mrs. Silva’s brother to the staff room, which was the only private place on the ward, I searched my brain for his name. John, that was it.
We all sat around the stained table.
“She’s dying, isn’t she?” John said, his pale eyes weary.
I nodded. “She is.”
“Is there nothing you can do for her?”
This was the tricky part.
“There are interventions we can use that might extend her life, but they may be painful for her. What do you think she would want us to do? Keep her alive if she was going to suffer? Or let her as gently as we can?” I asked him.
A surprising number of people, when offered this choice, could put their own need to hold onto their loved one aside and make the right decision, and I didn’t doubt that John was one of them.
“She won’t suffer, will she?” he asked. “When she dies?”
I patted his hand. “No. We’ll make sure that she just slips away.”
Rhonda was studiously avoiding my line of sight, and I understood why. We were about to do a tricky and illegal thing, and we had to do it in such a way that there was no possibility of either of us being charged with conspiracy to commit grievous bodily harm.
John went back to his sister’s room, and sat beside her bed, and I stood outside the room, Mrs. Silva’s medication chart in my hands. “I’m going to adjust her pain management,” I told Rhonda.
Rhonda nodded. “Yes, doctor.”
“Page me or ring me, if you need me.” Argh, I was striking today. “Up until eight a.m.. After that, my pager and cell phone will be off, but I’ll be down at the front entrance to the hospital. Make sure you let the day staff know they can come and get me any time. I’ll cross the picket line if I’m needed.”
“I’ll put that in the handover, make sure they know.” She very carefully didn’t look at the medication order I’d just written, and I was glad she knew the process well enough not to ask difficult questions.
She put the chart back in the holder, and we moved onto the next patient.
I’d made ‘a mistake’ while changing Mrs. Silva from morphine to pethidine, and hadn’t ceased the morphine order.
It wasn’t euthanasia, not quite, since the combined doses still weren’t fatal, but it was certainly over-prescribing, and it meant Mrs. Silva would slip away in a drug-induced fog very quickly.
We shuffled around the ward, waking the patients that I really needed to examine, leaving the others resting while I reviewed their notes. It took a while, and Rhonda had to keep darting off to answer bells since Kira needed to sit with Mrs.
Silva.
I was leaving the ward when Ghastly George walked up to the nurses’ station, and, as always, she made me smile. She was prone to luridly bright clothing, and tonight was no exception. She trailed a purple scarf over a lime green T-shirt, and was wearing black and silver harem pants and red sneakers
I loved someone who didn’t take the hospital’s dress code too seriously. ‘Professional attire’ this was not. I felt like a sell-out in my sedate pale blue shirt and grey trousers.
She smiled widely at me and said, “Hey, Andrew. You answering my pager for me tonight?”
I shook my head. “Nope, just doing rounds before the industrial action starts.”
“Figured as much.” She leaned against the nurses’ station to take the weight off her feet a little. “Lucia is down on orthopedics doing rounds, too, and I ran into Cecelia in the lift.” She smiled tiredly at me. “Do I need to look at the patient I was paged for? Did you check her out?”
I nodded. “Yeah. Mrs. Silva is Cheynes-Stoking. I altered her analgesia.”
Ghastly George nodded. “Good.”
She walked to the elevator with me, and rode down a couple of floors before disappearing into the unlit hallways and gentle snores of the wards.
It was six now and I needed coffee. The house physicians’
common room was the only place in the main building that had coffee at this time of the morning, and I couldn’t be bothered hiking through the corridors to my own office, so I punched the pass code into the lock, confident that it wouldn’t have changed since the last time I’d used the room.
There were a couple of doctors asleep on the couches so I left the lights off and crossed the darkened room to the lit alcove containing the kettle and cups. There was no milk, of course, but I could drink black coffee.
Hell, right at that moment, if there was no water, I’d eat the spoonfuls of instant coffee I needed.
I was tired. While there were real advantages to having a young lover, it was seriously affecting my sleep. Then I thought of the bar through Matthew’s cock, and what the beads could do. I could get by without sleep. I’d survived interning; I’d survive Matthew.
Chapter Twenty Seven
When I woke, it took a few moments to work out where I was.
Everything was wrong; there was sunlight streaming around the edges of the blind, the bed was too soft and too clean and it smelled deliciously of sex, not of sour, unwashed sheets.
Andrew’s Ikea bed. Which had withstood our attempts to shake it to pieces.
I hugged the other pillow contentedly. Andrew had left hours ago. I vaguely remembered him getting up in the middle of the night.
It wasn’t time to get up yet; there was no clinical today because of the strike. I’d arranged to meet Lin and Nevins, and a couple of the other students from the stop work meeting, at nine. For someone who woke up at five-thirty every morning, that was a late start.
I rolled out of bed and found my robe. It was even better than borrowing Andrew’s. It might not smell of him, at least not yet, but he’d bought it for me.