Shroud for a Nightingale (3 page)

She glanced quickly at the remaining students. There was a calm, bespectacled girl with a plain intelligent face. Miss Beale’s immediate reaction was that she would be glad to have her on any ward. Next to her sat a dark, sulky-looking girl, rather over-made-up and assuming an air of careful disinterest in the demonstration. Rather common, thought Miss Beale. Miss Beale, to her superiors’ occasional embarrassment, was fond of such unfashionable adjectives, used them unashamedly and knew precisely what she meant by them. Her dictum “Matron recruits a very nice type of girl” meant that they came of respectable middle-class families, had received the benefit of grammar school education, wore their skirts knee length or longer, and were properly aware of the privilege and responsibilities of being a student nurse. The last student in the class was a very pretty girl, her blonde hair worn in a fringe as low as her eyebrows above a pert, contemporary face. She was attractive enough for a recruiting poster, thought Miss Beale, but somehow it was the last face one would choose. While she was wondering why, Nurse Dakers came to the end of her recital.

“Right Nurse,” said Sister Gearing. “So we are faced with the problem of a post-operative patient, already seriously under-nourished and now unable to take food by mouth. That means what? Yes, Nurse?”

“Intra-gastric or rectal feeding, Sister.”

It was the dark sulky-looking girl who answered, her voice carefully repressing any note of enthusiasm or even interest Certainly not an agreeable girl, thought Miss Beale.

There was a murmur from the class. Sister Gearing raised an interrogative eyebrow. The spectacled student said:

“Not rectal feeding, Sister. The rectum can’t absorb sufficient nourishment. Intra-gastric feeding by the mouth or nose.”

“Right, Nurse Godale, and that’s what the surgeon has ordered for Mrs. Stokes. Will you carry on please, Nurse. Explain what you are doing at each step.”

One of the twins drew the trolley forward and demonstrated her tray of requirements: the gallipot containing sodium bicarbonate mixture for cleaning mouth or nostrils; the polythene funnel and eight inches of tubing to fit it; the connector; the lubricant; the kidney bowl with the tongue spatula, tongue forceps and gag. She held up the Jacques esophageal tube. It dangled from her freckled hand obscenely like a yellow snake.

“Right, Nurse,” encouraged Sister Gearing. “Now the feed. What are you giving her?”

“Actually, it’s just warm milk, Sister.”

“But if we were dealing with a real patient?”

The twin hesitated. The spectacled student said with calm authority: “We could add soluble protein, eggs, vitamin preparations and sugar.”

“Right. If tube feeding is to continue for more than forty-eight hours we must ensure that the diet is adequate in calories, protein and vitamins. At what temperature are you giving the feed, Nurse?”

“Body temperature, Sister, 38° C.”

“Correct And as our patient is conscious and able to swallow we are giving her this feed by mouth. Don’t forget to reassure your patient Nurse. Explain simply to her what you are going to do and why. Remember this, girls, never begin any nursing procedure without telling your patient what is to happen.”

They were third-year students, thought Miss Beale. They should know this by now. But the twin, who no doubt would have coped easily enough with a real patient found it embarrassingly difficult to explain her procedure to a fellow student Suppressing a giggle she muttered a few words at the rigid figure in the bed and almost thrust the esophageal tube at her. Nurse Pearce, still gazing fixedly ahead, felt for the tube with her left hand and guided it into her mouth. Then shutting her eyes she swallowed. There was a convulsive spasm of the throat muscles. She paused to take breath, and then swallowed again. The tube shortened. It was very silent in the demonstration room. Miss Beale was aware that she felt unhappy but was unsure why. It was a little unusual perhaps for gastric feeding to be practiced on a student in this way but it was not unknown. In a hospital it might be more usual for a doctor to pass the tube but a nurse might well have to take the responsibility; it was better to learn on each other than on a seriously ill patient and the demonstration doll wasn’t really a satisfactory substitute for a living subject. She had once acted as the patient in her own training school and had found swallowing the tube unexpectedly easy. Watching the convulsive movements of Nurse Pearce’s throat and swallowing in an unconscious sympathy she could almost recall, after thirty years, the sudden chill as the tube slid over the soft palate and the faint shock of surprise at the ease of it all. But there was something pathetic and disturbing about that rigid white-faced figure on the bed, eyes tight closed, bibbed like a baby, the thin tube dragging and wriggling like a worm from the corner of her mouth. Miss Beale felt that she was watching gratuitous suffering, that the whole demonstration was an outrage. For a second she had to fight an urge to protest.

One of the twins was now attaching a 20-ml. syringe to the end of the tube, ready to aspirate some of the gastric juices to test that the end of the tube had reached the stomach. The girl’s hands were quiet steady. Perhaps it was just Miss Beale’s imagination that the room was preternaturally silent She glanced across at Miss Taylor. The Matron had her eyes fixed on Nurse Pearce. She was frowning slightly. Her lips moved and she shifted in her seat Miss Beale wondered if she were about to expostulate. But the Matron made no sound. Mr. Courtney-Briggs was leaning forward in his chair, his hands clasping his knees. He was gazing intently, not at Nurse Pearce. but at the drip as if mesmerized by the gentle swing of the tubing. Miss Beale could hear the heavy rasp of his breathing. Miss Rolfe sat bolt upright her hands folded loosely in her lap, her black eyes expressionless. But Miss Beale saw that they were fixed, not on the girl in the bed, but on the fair and pretty student. And for a fleeting second the girl looked back at her, equally expressionless.

The twin who was administering the feed, obviously satisfied that the end of the esophageal tube was safely in the stomach, lifted the funnel high over Nurse Pearce’s head and began slowly to pour the milky mixture down the tube. The class seemed to be holding its breath. And then it happened. There was a squeal, high-pitched, horribly inhuman, and Nurse Pearce precipitated herself from the bed as if propelled by an irresistible force. One second she was lying, immobile, propped against her mound of pillows, the next she was out of bed, teetering forward on arched feet in a parody of a ballet dancer, and clutching ineffectually at the air as if in frantic search of the tubing. And all the time she screamed, perpetually screamed, like a stuck whistle. Miss Beale, aghast, had hardly time to register the contorted face, the foaming lips, before the girl thudded to the floor and writhed there, doubled like a hoop, her forehead touching the ground, her whole body twitching in agony.

One of the students screamed. For a second no one moved. Then there was a rush forward. Sister Gearing tugged at the tube and tore it from the girl’s mouth. Mr. Courtney-Briggs moved resolutely into the melee, his arms wide. Matron and Sister Rolfe bent over the twitching figure hiding her from view. Then Miss Taylor rose and looked round at Miss Beale.

“The students… could you look after them please? There’s an empty room next door. Keep them together.”

She was trying to keep calm but urgency made her voice sharp. “Quickly please.”

Miss Beale nodded. The Matron bent again over the convulsed figure. The screaming had stopped now. It was succeeded by a piteous moaning and a dreadful staccato drumming of heels on the wooden floor. Mr. Courtney-Briggs took off his coat, threw it to one side, and began to roll up his sleeves.

IV

Muttering gentle encouragement, Miss Beale shepherded the little group of students across the hall. One of them, she was not sure which, said in a high-pitched voice: “What happened to her? What happened? What went wrong?” But no one replied. They moved in a shocked daze into the room next door. It was at the back of the house, a small, odd-shaped room which had obviously been partitioned from the original high-ceilinged drawing-room and which now served as the Principal Tutor’s office. Miss Beale’s first glance took in a business-like desk, a bank of green steel filing cabinets, a crowded notice board, a small pegboard fitted with hooks from which hung a variety of keys, and a chart along the whole of one wall showing the teaching program and the progress of each individual student. The partition wall cut the mullioned window in half so that the office, unpleasing in its proportions, was also inconveniently dark. One of the students clicked down the switch and the central bar of fluorescence began to flicker into light Really, thought Miss Beale, her mind clutching desperately at the comfort of its normal preoccupations, it was a most unsuitable room for a Principal Tutor, or for any other tutor, come to that.

This brief remembrance of the purpose of her visit brought a second’s comfort But almost immediately the awful reality of the moment reasserted itself. The students—a pathetic and disorganized little bunch—had crowded together in the middle of the room as if incapable of action. Glancing quickly around Miss Beale saw that there were only three chairs. For a moment she felt as embarrassed and nonplussed as a hostess who is not sure how she is going to seat all her guests. The concern wasn’t altogether irrelevant. She would have to get the girls comfortable and relaxed if there were to be any chance of keeping their minds off what was happening next door; and they might be incarcerated for a long time.

“Come along,” she said brightly. “Let’s move Sister’s desk back against the wall, then four of you can perch there. I’ll take the desk chair and two of you can have the easy chairs.”

At least it was activity. Miss Beale saw that the thin, fair student was shaking. She helped her into one of the easy chairs and the dark, sulky-looking girl promptly took the other. Trust her to look after number one, thought Miss Beale. She busied herself helping the other students to clear the desk and push it back against the wall. If only she could send one of them to make some teal Despite her intellectual assent to more modern methods of combating shock, Miss Beale still put her faith in warm strong sweet tea. But there wasn’t a chance of any. It wouldn’t do to upset and alert the kitchen staff.

“Now suppose we introduce ourselves,” she said encouragingly. “My name is Miss Muriel Beale. There’s no need to tell you I’m a G.N.C. Inspector. I know some of your names but I am not really sure who is who.”

Five pairs of eyes gazed at her with startled incomprehension. But the efficient student—as Miss Beale still thought of her—quietly identified them.

“The twins are Maureen and Shirley Burt. Maureen is the elder by about two minutes and has the most freckles. Otherwise we don’t find it easy to tell them apart Next to Maureen is Julia Pardoe. Christine Dakers is in one armchair and Diane Harper in the other. I’m Madeleine Goodale.”

Miss Beale, never good at remembering names, made her customary mental recapitulation. The Burt twins. Bonny and bouncing. It would be easy enough to remember their name, although impossible to decide which was which. Julia Pardoe. An attractive name for an attractive girl. Very attractive if one liked that blonde, rather feline prettiness. Smiling into the unresponsive violet-blue eyes, Miss Beale decided that some people, and not all of them men, might like it very much indeed. Madeleine Goodale. A good sensible name for a good sensible girl. She thought she would have no difficulty in remembering Goodale. Christine Dakers. Something very wrong there. The girl had looked ill throughout the brief demonstration and now seemed close to collapse. She had a poor skin, unusually so for a nurse. It was now drained of color so that the spots around the mouth and over the forehead stood out in an angry rash. She was huddled deep into the armchair, her thin hands alternately smoothing and plucking at her apron. Nurse Dakers was certainly the most affected of all the group. Perhaps she had been a particular friend of Nurse Pearce. Miss Beale superstitiously made a quick mental amendment of tense. Perhaps she was a particular friend. If only they could get the girl some hot reviving tea!

Nurse Harper, her lipstick and eye shadow garish on the whitened face said suddenly: “There must have been something in the feed.”

The Burt twins turned to her simultaneously. Maureen said:

“Of course there was! Milk.”

“I mean something beside the milk.” She hesitated. “Poison.”

“But there couldn’t be! Shirley and I took a fresh bottle of milk out of the kitchen fridge first thing this morning. Miss Collins was there and saw us. We left it in the demo room and didn’t pour it into the measuring jug until just before the demonstration, did we, Shirley?”

“That’s right It was a fresh bottle. We took it at about 7 o’clock.”

“And you didn’t add anything by mistake?”

“Like what? Of course we didn’t”

The twins spoke in unison, sounding sturdily confident, almost unworried. They knew exactly what they had done and when, and no one, Miss Beale saw, was likely to shake them. They weren’t the type to be tormented by unnecessary guilt or fretted by those irrational doubts which afflict less stolid, more imaginative personalities. Miss Beale thought that she understood them very well.

Julia Pardoe said: “Perhaps someone else mucked about with the feed.”

She looked round at her fellow students from under lowered lids, provocative, a little amused.

Madeleine Goodale said calmly: “Why should they?”

Nurse Pardoe shrugged and pursed her lips into a little secret smile. She said: “By accident Or it might have been a practical joke. Or perhaps it was done on purpose.”

“But that would be attempted murder!” It was Diane Harper who spoke. She sounded incredulous. Maureen Burt laughed.

“Don’t be daft, Julia. Who would want to murder Pearce?”

No one replied. The logic was apparently unassailable. It was impossible to imagine anyone wanting to murder Pearce. Pearce, Miss Beale realized, was either of the company of the naturally inoffensive or was too negative a personality to inspire the tormenting hatred which can lead to murder. Then Nurse Goodale said drily: “Pearce wasn’t everyone’s cup of tea.”