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Authors: Claire Rayner

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For once, Jamieson put up a very poor fight. His application for the extra beds made available by the conversion of the old Light Department had been automatic. Jamieson always applied for everything that was going, but this time, he was not really ready for a new unit. So, he looked at Sisson, and contented himself with a sharp dig of the sort that had made him the most justifiably disliked member of the consultant staff.

‘I doubt it’s the shortage of beds that makes the G.P.’s send their medical work to the Central. They’ve well-known physicians there. We mustn’t—underestimate—the G.P.’s appreciation of that fact. They’ll use the best unit, no matter how slow the turnover. We get plenty of surgical work because we’re known to be good surgeons here——’

Sisson reddened and opened his mouth to hit back, but Heston, with many years of diplomatic experience behind him, cut in evenly with a request for nominees and seconders for the allocation of the beds.

Jessolo and Goldman, embarrassed and hot at Jamieson’s gratuitous rudeness to Sisson, stirred and spoke almost together. ‘Propose Mary Cooper for a medical unit under Sisson,’ Jessolo said, and ‘Seconded’ cut in Goldman.

‘Hmm. Well, before we can vote on that we must hear Dr. French, gentlemen. You put your application in without elaborating on your need for them.’ Mr. Heston looked down the table at French and nodded. ‘If you want them, now is the time to put your request formally.’

French leaned forward. ‘Thank you. I preferred to explain verbally rather than in writing. This way, I feel I can answer any queries you may have on the spot. I’ll be as brief as I can. Well, I’m right behind Mr. Sisson when he asked for more weight on the medical side—and it’s not just because I’m a physician, believe me. But, with respect, Mr. Sisson, you’ll agree you already have ten gastric beds, as well as your other general medical beds?’

‘So?’ Sisson grunted.

‘It’s been a long time since we turned any original research out of the Royal. Not since Sir Peter’s great work on endocrine influences on neoplastic disease——’

Sir Peter moved heavily, almost bowing in French’s direction.

His paper in the
Lancet
, and the interest it had aroused, was ancient history now, almost twenty years old. It had gained him his knighthood, providing the laurels on which he had rested comfortably ever since. He approved of younger men who remembered his past glory, and reminded others of it. And James French, who had fully intended to get this response from him, smiled deferentially at the old man, and went on smoothly.

‘I’d like to see us build on the reputation Sir Peter made for us here. I’d like to see these ten beds allocated to another piece of original research.’

‘Like what?’ Sisson said roughly. ‘Takes more than beds to do research, French. Money. Lots of it—I’ve told you that before. Where do we get it? And for what sort of research? Sir Peter got twenty thousand or more to spend on his little job—and that was before this bloody N.H.S. You tell me what research you can do in ten beds, and on peanuts, and I’ll listen.’

Sir Peter moved angrily in his chair and glared down the table at Sisson, his wet eyes in his St. Bernard’s dog face showing more intelligence than they had for a long time.

‘My “little job”, as you put it, Sisson, cost five thousand, not twenty. Get your facts straight. And most of it was spent on equipment we’re still using in the pathological department. So there’s no need for you to try to stop a young man with a bit of enterprise by moaning about money. If there’s a good piece of research to do, the money’ll be found.’ He turned in his chair and glared at Heston. ‘Propose we hear Dr. French’s application without unnecessary interruption, Heston. Let French get on with it in peace.’

James, careful not to show his pleasure, murmured his thanks up the table, and then leaned forward, his arms folded in front of him, every line of his body depicting the young man of vision and enterprise. Sir Peter seeing, as French intended him to see, a vision of himself in youth, nodded encouragingly.

‘I’m interested in something rather similar in some ways to
the matter that interested Sir Peter. He wanted to investigate endocrine effects on neoplastic disease. I want to investigate metabolic effects on mental disease. You’ll have seen that there have been several papers already on organic causes of the cyclical mental disorders—the surgical treatment of the psychoses, drug therapy for the schizophrenics and paranoids, and so on. What I’d like to do is see what effect controlled diet can have on some of the neuroses—I think Freudians may be barking up the wrong tree. I’d like to use those ten beds for ten neurotic patients—admitted to be non-responsive to traditional pyscho-therapy and other treatment, and see what happens to them on particular dietary regimes——’

Jamieson snorted with sudden laughter, opening his mouth wide as he stared insultingly across at French.

‘You mean you want to put ten lunatics in those beds, and feed ’em on some weird vegetable diet, like a spa proprietor or something? What is this? A hospital, or a home for cranks? Research, by all means, but for Christ’s sake, French, think of something a bit better than that! I never heard such a lot of cock in my life!’

‘You’ll forgive me, Mr. Jamieson,’ French said smoothly, ‘if I point out that this idea is hardly a new one, or particularly cranky. It’s no more cranky than the idea that leucotomy may relieve schizophrenia, or that electroconvulsive therapy can relieve depression. Some patients have already been helped by dietary treatment—take the children with phenylketonuria, for example. All I want to do is to take the idea a bit further, and work on the neuroses as well as the pyschoses——’

‘Can’t be done here,’ Norton said suddenly. ‘I’m not going to argue about whether the idea’s cranky or not—there’ve been cranky ideas that have come off before—but I for one won’t countenance the setting up of any mental unit here at the Royal. Bad enough the Ministry tried to make us do it last year. Well, we scotched ’em then—nursing establishment wouldn’t wear it. We’ve got a mental unit out at The Copse, and as far as I’m concerned, that’s enough. Once get mental patients in a ward here at the Royal, and you’ll have the Ministry turning us into one of their fancy new hospitals. No, French. Anything else I might go along with, but not if it
means mental patients
inside
the Royal. We’ve got a bad enough shortage of nurses as it is—and once we let it get around there’re psychiatric patients in the place, the nursing recruitment will go down even more.’

‘Norton’s right there, French,’ Sir Peter grunted. ‘Can’t afford to upset the nursing, and well you know it. Sorry, but I can’t support you on this. Find another piece of research, and I’ll be with you—but not this——’

‘Your point about the attitude of the nursing establishment last year is well made, Norton,’ French said. ‘And I must agree with you, Sir Peter—we can’t afford to upset the nursing. But we have a new nursing establishment now. A new Matron
is
a new establishment, I’m sure you’ll agree. Perhaps Miss Manton could give us her views on the effect of a research unit here? She may feel that a research unit, even though it’s handling pyschiatric patients, could be an attraction that would lift the recruitment figures——’

‘There’s still the money question,’ Sisson said sharply.

‘One thing at a time, Sisson!’ French said. ‘Sir Peter has already indicated that money can be found if necessary. Could we hear Miss Manton at this stage?’

The eleven faces turned to look down the table at Elizabeth, sitting calmly at the foot. She waited a second for complete silence, and then spoke, her voice pitched to an attractive softness, yet quite audible.

‘This is a little difficult for me, gentlemen. I have been here only a week—not really long enough to assess the true causes of the nursing shortage as it applies to the Royal. You must all realise, of course, that this isn’t a problem unique to the Royal. Every hospital, apart from the big teaching hospitals, suffers from it——’

‘But perhaps a research project here will make the Royal seem rather more like a teaching hospital, make it more attractive——’ French said quickly.

She smiled. ‘The attraction of a teaching hospital, as far as potential nurses are concerned, is rather more basic, Dr. French.’ She saw momentary surprise on his face, and was amused.

‘That isn’t to say that a certain type of girl—the well
educated thoughtful girls, who are the ones we most want to attract, would not in fact find a promise of lively interest in working with a piece of original research,’ she went on smoothly, and saw French’s shoulders relax slightly. ‘Really, it was almost like playing a fish,’ she thought maliciously. ‘I’m not sure I
want
to attract the girls who go to the teaching hospitals because there are rugger playing medical students about to enliven the scene——’

There was a ripple of laughter, and she smiled at the men round the table, pleased with herself.

‘As I see it, the question I must answer is: will the presence of mentally ill patients in the Royal upset the existing staff, and cause some to leave? And could such upsets lead, in turn, to a diminution of new applications for training?’

‘Exactly,’ Sisson said, looking at her in approval. ‘You’ve hit it on the head, Matron. Now, a gastro-intestinal ward——’

‘Forgive me, Dr. Sisson.’ Elizabeth’s interruption was polite but firm. ‘I only put the question. I haven’t yet answered it. Before I attempt to do so, may I ask a rather important question?’

French was staring at her in puzzlement. He had been almost certain, since their conversation at his house, that she would co-operate with him. What was she trying to do now? Show him her independence, show him she had not in fact been inviting him to pick up their old friendship?

‘Bloody devious bitch,’ he thought, with sudden venom. ‘She’s enjoying this——’

‘By all means, Matron.’ Heston sounded very agreeable, but he injected a sense of ugency into his voice. It was getting late, and the yellow lights over the table showed their reflections in the dark panes of the window, reminding him that it was past five o’clock, and time he was at home.

‘How essential is it that you reach a decision on this matter today?’

Heston looked round the table. ‘Not
essential
today, I suppose. It would be rather better to deal with it now if we could. There is always so much to do, and time is always at a premium——’

‘I realise that. It’s just that I feel it would be wrong of me
to offer an opinion about this matter without having the opportunity to—sound out senior nursing opinion. As Matron, I must of course remember that I speak for all the nurses and their interests—and I hope I am no autocrat. I would much prefer to ask you to put this matter in abeyance, until I can give you an answer that would be of real value to you. If I produced a facile reply at this point, I would be in danger of misleading you. I don’t want to do that. So——’

‘Very wise, Miss Manton, very wise. It was hardly fair of us to ask you for a judgement on such an important matter so soon after your appointment.’

Heston looked severely at French, but French, now looking down at his papers, paid no attention to him.

‘Shall we leave this over to next month, then, gentlemen, and give Miss Manton a chance to sample opinion? Perhaps you will report back to us then, Miss Manton——’

‘Thank you,’ Elizabeth said. ‘I hope Mr. Sisson, Dr. French, you will forgive me for this delay?’ It was French she looked at, and he raised his eyes. ‘I would not wish to—jeopardise your interests in any way, by being too precipitate.’

French smiled now. ‘Of course, Miss Manton. I for one fully appreciate your—wisdom. Sisson?’

‘I suppose so,’ Sisson said sulkily, and stood up. ‘Leave it like that then. Unless someone wants to nominate and second Jamieson’s application?’

He sounded belligerent, and there was an awkward silence, while Jamieson sat quietly. He was happy enough to have scored off Sisson, and made no attempt to push his own application any further.

‘All right then, I’m going, Heston, unless there’s something under Any Other Business. I’ve got work to do if no one else has.’

‘I don’t think so,’ Heston said, only too glad to end the meeting, ‘I’ll notify you all of the date of the next meeting, gentlemen, Matron.’

The room emptied rapidly, Sisson pushing in front of Jamieson as he went, his whole body rigid with dislike of the other man.

Elizabeth watched them go, still in her chair, and looked up
at French, who was taking his time over collecting his own pile of papers.

‘Do they always treat each other so—in such a cavalier fashion?’

‘Frequently,’ French said, and waited until they were the only two people left in the room before turning his body so that he could sit on the table, one leg swinging as he looked consideringly at her. She sat quietly, smiling in friendly composure.

‘I had hoped for more—shall we say, co-operation?—this afternoon, Elizabeth,’ he said softly.

‘But my dear James, I gave it, surely?’

‘Did you? Perhaps I’m being obtuse, then.’

‘I rather think you are. You didn’t honestly expect me to jump on my chair and shout “Up with French, down with everyone else” did you?’

He laughed. ‘Hardly. But I did think——’

She stood up, and spoke with some briskness. ‘It would have been foolish in the extreme if I had answered the question about the nursing attitude to your plan. After just a week, how could I? If I’d come down on your side, surely the committee would have suspected collusion between us? You mustn’t forget, Heston knows we are—old friends. Do you suppose he hasn’t told others that? You mustn’t underestimate his taste for gossip, or your colleagues’ powers of intelligent surmising. You surprise me, James. I thought you were more patient.’

He rubbed his face, staring at her over his fingers, his eyes calculating.

‘I see. You—are not then, going to—shall we say, oppose me?’

‘I can’t ally myself on one side or the other just like that, James—you must see that. I have a job here, a responsibility to the hospital and to this committee. You wouldn’t ask me to make snap judgements that would go against that responsibility, now would you?’

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