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Lesley kept her hands clenched tightly behind her back to conceal from him that they were shaking. She was glad that he finally pushed open the door for himself.

Numbly, she followed him out to his car. He paused with his key in its door handle.

"When I say 'senior on call' I mean, of course, the man who's on duty for our own unit. If for any reason you can't get one of them," he hesitated as though the possibility might just have struck him, "I prefer to be called myself."

Afterwards Lesley was to read all sorts of meanings into that last remark. Could it be that he had guessed the truth? But if he had, surely he wouldn't have let the doubt pass without exploring it further? Meantime, as she watched his car drawing out of the courtyard, there was only this strange desolation of the spirit. Why was it, that of all the people she knew, only this man's reproaches could hurt so much?

 

CHAPTER NINE

Bank
Holiday Sunday turned out to be another of those nights. When the Chief arrived on Monday morning Jim had to apologise for not having shaved and Lesley had barely had time to sketch her lips lightly with lipstick and to pull a quick comb through her hair.

"You've had another busy night, Doctor?"

No doubt he had noticed how crumpled she looked. "Yes, sir. But I'm beginning to get my second wind now." She spoke quickly to cover her embarrassment. Now that he was here she found she was still smarting from yesterday's dressing- down. "Dr. Brown's unit was full just after midnight. We've been receiving since one o'clock this morning." She handed him the list of new admissions.

"I don't know where we're going to put them today." Sister Bishop bustled ahead of them into the ward. "We've already got thirty-eight beds in a space meant for thirty-two."

"You'd better let me see your unconscious patient first, Sister. Then we can go round together and see if there are any we can discharge home early."

Miss Twill had been moved up the ward. The white screens now shielded Miss Hamilton. Like most very ill patients she'd been kept near the door. This unspoken acknowledgement that someone might die always communicated itself to the ward. Everyone was subdued. Even those who were recovering shared a sudden fear as they realised how close to death they, too, might have been. The newspaper boy had little enthusiasm for his wares. It was an occupational hazard he had come to accept. He slipped unobtrusively from the ward, trying to avoid Sister's eye. She liked him well clear of the place before the white coats arrived in the morning.

Nurse Obanyke, the special, rose as the screens were pushed "Has there been any change, Nurse?"

"No change." She replied to the Chief's question, but directed it through Sister.

Sir Charles began his examination. When he had finished, the little procession retreated. The flaps of the screens were pulled shut behind them.

"What age is she, Doctor?"

"Thirty-eight, sir." Lesley watched his face closely.

"What is your provisional diagnosis?"

Lesley hesitated. "I thought the signs might add up to subarachnoid haemorrhage," she said tentatively.

He nodded slowly. "I'm inclined to agree. It's almost certainly into the subarachnoid space. It's massive and I think it's progressing. You'd better do a confirmatory lumbar puncture." He paused. "Though I don't hold out very much hope, I'm afraid."

They moved still further out of earshot of patients.

"Have the relatives been summoned, Sister?"

"They are in the corridor now, Sir Charles."

"They had better be admitted. I shall speak to them myself first." He left them briskly and Lesley made to accompany him, but he held her back with one hand. "I'll speak to them alone, Doctor, if you please."

When he rejoined them Lesley was surprised to see how strained he looked. He intercepted her glance.

"It never gets any easier, Doctor - telling a mother that her only daughter's going to die."

Lesley nodded. She had been living so close to illness in the past few days that she no longer marvelled at the things which went wrong. Instead it seemed amazing to her this morning that anything ever went right.

They finished the ward round in comparative silence.

As they were about to leave the unit, Staff Nurse Bell caught up with Lesley. "When do you want to do the lumbar puncture, Doctor?" she asked breathlessly. "We're about to serve lunches."

Lesley halted. It was the old problem back in a new guise.

She had never done a lumbar puncture before. With any other registrar she wouldn't have hesitated.

"Set it up for two o'clock, Nurse, please. That way we can fit it in before Outpatients."

"It's all go, isn't it?" Carol Bell sighed gustily. "I'll be glad to get off my feet tonight, I can tell you." She rushed back towards the ward kitchen.

Lesley continued on her way to the staff room. The sun had come out. It was another of those hazy summer days. She didn't know whether to be glad or sorry. It was unsettling if you had to be on duty. She shook herself mentally. What a lovely day on which to leave the world. Poor little Miss Hamilton, had she really any chance? In her own half-muzzy state from lack of sleep, her mind jumped from one thing to another. What if I can't get into the canal? ("I don't want to arrive some day to find the Procurator Fiscal... ") There was no shirking it this time. She would have to ask Dayborough. Already she could hear his snarl.

She vacillated through lunchtime, then finally screwed up her courage.

"Dr. Dayborough." She waylaid him on his way out of the dining-room. .

"Well?" He always managed to convey the impression that she'd just crawled out from under a stone.

"I was wondering if you'd be good enough to do the lumbar puncture on Miss Hamilton. I mean, would you show me? I haven't done one before."

"What do they teach you in that infernal college of yours?" he snapped. "How to crawl to titles, I shouldn't wonder."

"I don't crawl."

"Oh, no? That's not how it looked from where I was standing yesterday morning."

(Where had he been standing yesterday morning?) "Would you do it this time, please?" She refused to be drawn into another scene.

"All right, all right," he said testily. "I take it you've got everything laid on. They'll have taught you that much, I hope."

"Staff Nurse is preparing the trolley for two o'clock."

He made an impatient gesture. "It would eat into my outpatient time, of course. Sometimes I think you do it on purpose." He slammed his way into his own corridor.

Lesley heaved a sigh of relief. Although he was being his usual disobliging self, at least he'd agreed to do it: that was something.

At two o'clock promptly he appeared in the ward.

"O.K., let's get this over with." He moved to the basin and began to scrub up. Staff Nurse Bell hovered near with the bag of sterile towels. He deftly extracted one without touching the outer cover.

There was no visible change in Miss Hamilton's condition. She lay motionless in deep coma. Behind the screens Carol Bell folded back the bedclothes. With the help of Nurse Obanyke she turned the patient on to her left side.

Watching him in action, Lesley had to admit that his technique was beautiful. With the deceptive ease of long experience he went straight for the space between the third and fourth lumbar vertebrae. He knew exactly what he was doing. The needle slipped into the central canal.

Instead of the normal clear watery fluid, falling slowly one drop at a time, blood-stained fluid rushed out under pressure.

"It's a massive subarachnoid, all right," he muttered under his breath. "Light jugular pressure, Nurse, please."

Lesley looked up sharply. Surely he wasn't going to risk that?

"Nurse," he repeated.

Carol Bell pressed her hands very lightly on the neck veins. Suddenly, and without warning, respiration ceased.

"My God! Coning of the mid-brain." Dayborough let out the expletive.

There was nothing any of them could do. Sir Charles had been right. The patient hadn't stood a chance.

For a moment Lesley was too stunned to think of anything else. Then the thought came unbidden. "Thank God it wasn't me." Suddenly she saw what Sir Charles had meant - how it would have looked to a Procurator Fiscal if a junior doctor like herself had been carrying out the procedure.

And then she caught sight of Dayborough's face. His lips were drained of all colour. For the first time she knew what they meant when they described someone in shock as ashen grey. She felt a rush of pity for him. What a selfish pig I am, she thought. All I could think of was my lucky escape. It didn't help matters that there was nothing she could say to him. Reassurance was impossible at a time like this.

"Will you make the necessary arrangements, Staff Nurse? We'll need a post-mortem." Although he had. momentarily lost his nerve, she saw that he had kept a sort of dignity. He turned and left the ward without a word to her.

There was a scared look on Nurse Obanyke's face.

"There was nothing anyone could do. She was going to die anyway, Nurse." (Where had she heard those words before?) She put a hand on the girl's sleeve. "No one ever recovers from a big haemorrhage like that."

"But it was so sudden, Doctor - just when Staff's hands -"

"We'll need to hurry, Doctor Leigh." Carol Bell's voice was urgent. "Visiting hour's at three. We want everything straightened out before then."

"Is her mother still here?"

"She went off for a break and a bite of lunch. Said she'd be back later in the afternoon."

"We'll have to get her signature for the post-mortem. I'd better see her and tell her myself." Lesley's heart sank. "Unless Dr. Dayborough -"

Carol Bell raised her eyebrows. "I should think that's highly unlikely, don't you? He should never have risked increasing the intracranial pressure, should he?"

Lesley looked up sharply. It was almost as though the staff nurse had read her own thoughts. "There was no hope anyway." Reflexly, almost, she tried to close the ranks. "At the most it could only have hastened it by an hour or two."

Carol Bell turned back on her heel. She seemed to have forgotten that a moment ago she had been in such a hurry. "I'm not stupid, you know, Doctor. I was watching his face.

He knows that we know he took his eye off the ball, He's not likely to forget that."

Lesley stared at the nurse's retreating back. Carol Bell was right. Harry Dayborough was not the man to forgive them for having seen him make that mistake.

CHAPTER TEN

Lesley
did not enjoy the next few days.

On Tuesday there was the post-mortem on Miss Hamilton. It confirmed the diagnosis of subarachnoid haemorrhage and gave the immediate cause of death as compression of the vital centres controlling the heart and respiration.

Dayborough left the mortuary before the pathologist was finished.

Since then he'd been avoiding her. This made her feel more uneasy than the earlier nastiness had done. At no time had he referred either to the lumbar puncture or to the night of the diabetic coma.

It didn't help matters any to know that she had forfeited some of the Chief's respect. She could detect no difference in his manner towards her, but Sunday's remonstrances weighed heavily. She was still unable to meet his eyes.

The ward round on Friday morning was an unusually quick one. She had just finished entering the last of his dictation on Miss Twill's case sheet when she looked up and caught him watching her. He seemed about to add something, then apparently changed his mind. Instead, as he rose, he put his hand for a second very lightly on her shoulder. It was an unexpected gesture which brought a rush of tears to the back of her eyes. The strain of the past days was beginning to tell. Afterwards she couldn't be sure that he had touched her. Perhaps she had merely imagined it.

They walked on towards the staff room.
As
he washed his hands he said casually, "Doctor, I'd like you to come with me to Greylands this afternoon. There are a few blood tests I want done on some patients of mine."

Lesley was taken aback. She didn't know what she had been expecting, but it hadn't been this.

Some of her surprise must have shown on her face, for he added quickly, "Of course, if you'd rather not, I can always ask one of the others to do it."

"No, sir, it wasn't that." She was flustered.

"What, then? You seem reluctant."

"I didn't think you would ask me," she blurted out, "not after Sunday."

He laughed and shook his head. "Sunday wasn't the end of the world, Miss Leigh."

She looked nonplussed, and his manner changed abruptly. "This time it's a chore you get paid for." He tried to push something into her pocket.

"No, sir, please. There's no need, really there isn't." She recoiled from the envelope in his hand.

"I'm being paid for it too," he said drily.

"I'd much rather you didn't." She couldn't have explained why she was making such a fuss about it. "Please don't make me." All she knew was that she couldn't take money for doing something for him.

"Very well then, Miss Leigh." He put the envelope back in his inside pocket. "I'll be ready to leave at two o'clock." She wasn't sure if it was the quizzical expression again. "Don't bother to come out with me now. I'm lunching in the Mess. I have some business first with the Medical Superintendent."

"What was all that about?" Jim came into the room with Harry Dayborough. "I could have told you you would be paid for it."

"You can count yourself lucky he's taking a dame to Greylands at all." Dayborough spoke, but did not deign to look at her. "Half the aristocracy are amongst his private patients."

She was more than a little embarrassed to find that they had overheard any of the exchange between Sir Charles and herself.

"Don't worry about a thing." Jim obviously thought she needed reassuring. "His private patients will love you."

But it wasn't the thought of Greylands or of his patients which had set her heart racing at its present ridiculous rate.

"I suppose I can always do my ward bloods when I get back." She steered the subject on to safer ground.

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