Doctor On The Job Read online

  ‘Nothing, Daddy. But you’ve spoken of him. Often.’

  ‘Have I? Well, he was always up to some lunacy or other. Last Christmas, he brought the roast turkey into the ward in obstetrical forceps. Thank God we shan’t be suffering from that particularly painful affliction any more.’

  ‘But he might have been a simply wonderful doctor,’ said Faith, whose big grey eyes had grown rounder.

  ‘Rubbish. He doesn’t know his coccyx from his epicondyle.’

  ‘But what will he do now?’ she asked, her pink cheeks becoming rosier.

  ‘That is a matter of supreme indifference to me.’

  ‘With all his years of studying wasted?’ she insisted, her generous bosom heaving faster.

  ‘The amount of medicine which Chipps learnt at St Swithin’s hardly fits him for scrubbing the hospital floors, I assure you. In fact, today I have done the young man a service. I have stopped him becoming an utter disgrace to the profession.’

  ‘Are you sure you don’t know him, Faith?’ asked her mother, carefully setting down the final fork.

  ‘Oh, no, Mummy. I never mix with the students. Daddy doesn’t like me to.’

  ‘I merely want to spare you from the molestations of a bunch of drunken sex-maniacs who drive their cars too fast,’ the dean explained in a reasonable tone. ‘By the way, you’re off from the destitutes tomorrow evening?’ Faith nodded. ‘I’d like you to come on the platform with your mother when I present the nurses’ prizes. It will be a good opportunity to present yourself in public, being an extremely genteel one.’

  ‘Daddy, I may have another engagement.’

  ‘No excuses. This is a duty. You understand?’

  ‘Yes, Daddy. I would always do whatever I see to be my duty. You taught me that,’ she told him meekly.

  ‘What are you doing in that cupboard, Josephine?’ he demanded.

  ‘Finding the sherry.’

  ‘I told you, I’m examining this afternoon.’

  ‘But I’m not. And please don’t stare at me like Mr Pecksniff.’

  The dean’s prickly eyebrows rose slowly towards the point of his head, like a pair of caterpillars crawling up a turnip. ‘Are you implying that I am a hypocrite?’

  ‘Oh, no,’ his wife replied lightly, producing the bottle. ‘Only in danger of becoming one. You get toffee-nosed about students who might disgrace your noble profession, then you make as much money out of it as you can pocket from your private wing filled with opulent Arabs.’

  The dean glared. ‘Now you should like Pince, that horrible little union man.’

  ‘There’s every reason I might. He was expressing the views of a large number of people who work in St Swithin’s.’

  ‘My God,’ muttered the dean. ‘My wife a Communist. I’m in bed with a red. When that bottle of sherry’s finished, there’ll be no more, not these hard times,’ he warned her as she poured a glass for herself and her daughter. ‘I only bought a case of it to outwit the Chancellor of the Exchequer before the last budget. There is only one certainty one can grasp in this life, and that’s the price of drink always goes up.’

  ‘Nonsense, Lionel. You’ve bottles and bottles still hidden upstairs from outwitting successive Chancellors of all political hues. The whole attic looks like a skittle-alley. I think this is cuvée Healey,’ she decided, sipping delicately. ‘Though I don’t think yet we’ve exhausted the cuvée Barber, or even the cuvée Jenkins. Which was particularly good, as I remember. Now calm down, Lionel, and let’s all have a peaceful lunch.’

  ‘I’m not very hungry, Mummy,’ announced Faith. ‘I had a disturbed night.’

  ‘You shouldn’t go to bed with something heavy lying on your stomach,’ the dean snapped at her.

  ‘I don’t often get the chance, Daddy,’ she told him demurely.

  At that moment, Pip Chipps himself was drooping disconsolately at one end of the St Swithin’s residents’ bar. This was on the ground floor of the housemen’s quarters, which with the nurses’ home and the rebuilt medical school formed a screen of separate buildings set round grassy squares to the rear of the thirty-storey hospital itself. The bar was an oblong room the size of a prosperous pub, with a fruit machine, bar billiards and darts, its decorations largely portable items of corporation equipment which had appealed to the hospital rugby team as keepsakes. Along one wall were pinned a number of girls from the gonadal magazines, added arrows and technical comments indicating the customers’ easy command of anatomy and gynaecology. In one corner stood a snarling, stuffed grizzly bear, Percy, the St Swithin’s mascot, in whose defence against other medical schools after football matches blood had been lost, noses fractured and even richly promising girlfriends abandoned.

  There were scrawled notices on a board offering for sale items as varied as motor-bikes and microscopes, guitars and gastroscopes, amplifiers and articulated hands and feet. Even the graffiti were specialized, like You Are Never Alone With Schizophrenia, An Obstetrician is a Man who Sews Tears in Other Men’s Fields, and Why Did the Hormone? Because She Had to Spend Her Oestrin Bed.

  Whenever the bar was open – it seemed to have developed an immunity to the licensing laws – it acted as a powerful polarizer in the St Swithin’s social life. It was available to the doctors and clinical students, most of its denizens men and women under thirty. Hospitals may be depressing places to contemplate, but they are staffed essentially by the ebullient young. The residents’ bar was not below a visit from the senior consultants like Sir Lancelot Spratt, or even austere professors. Dr Bonaccord, the remote, other-worldly St Swithin’s psychiatrist, wandered in to relieve his inner tensions. The dean regularly tried to close it down.

  ‘Console yourself that it was just terribly bad luck,’ Hugo Raffles was sympathizing with Pip over their pints. ‘After all, it was an evens chance that you picked the wrong eye.’

  Pip complained in reply, ‘It wouldn’t have happened, if you’d never told me about that patient in the first place.’

  ‘What ingratitude,’ objected Tony Havens. ‘After we’d gone to all the trouble of nosing out the cases, not to mention poncing you up when you reeled into the hospital looking like a long-lost swab.’

  ‘You’re always getting me into some sort of a mess,’ Pip declared self-pityingly. ‘Apart from Sir Lancelot’s operating boots, there was the time you told me the dean wanted his rear bumper chained to the hospital railings because of car thieves –’

  ‘What’s a little harmless fun, dear boy?’ Hugo slapped him on the shoulder. ‘Surely you can take a joke?’

  ‘No, I can’t. Not really. I’m very sensitive. I think I inherit it from my mother.’

  ‘Oh, come on,’ Tony disagreed. ‘We used to pull your leg because we thought you never minded. That’s what made you so popular in the medical school.’

  ‘We all love you,’ Hugo assured him.

  ‘Do you? Then find me a job.’

  The two stared thoughtfully at their beer. ‘That could be a problem,’ confessed Tony. ‘What do most ex-medical students do?’

  ‘Go round GPs doing high-pressure salesmanship for expensive and generally useless products from the big drug companies,’ Hugo told him. ‘Just like the struck-off doctors do.’

  Pip shook his head. ‘That doesn’t appeal. I’m too honest.’

  ‘The Church?’ suggested Tony. ‘You wanted to be a psychiatrist. Religion these days is only practical psychiatry with singing on Sundays.’

  ‘The Law?’ added Hugo. ‘You’ve the makings of a great coroner.’

  ‘Don’t you have to be a doctor as well?’ Pip objected. ‘My father says that coroners are exceptional drop-outs, who have managed to fail in two professions, not one.’

  His two friends sipped their beer in nonplussed silence.

  ‘It seems such a scandal that all the medicine I have managed to pick up here should be wasted,’ Pip pointed out miserably. ‘Just because I got an unfair reputation in the hospital for hamfistedness. I admit, I always somehow see
med to drop on the floor instruments and X-rays and the notes –’

  ‘And sometimes the patient,’ Tony reminded him.

  ‘But I do honestly want to help people who can’t help themselves. I know that’s not a thing any of us care to confess at St Swithin’s – particularly in the bar – but I can’t see any other reason why we’re here at all.’

  ‘Anyone come up with other suggestions?’ asked Hugo.

  ‘Yes. The dean. He advised me to become a hospital porter.’

  ‘But that’s a magnificent idea,’ said Tony, grinning.

  ‘Do you think so? But what sort of hospital should I apply to?’

  ‘Here. St Swithin’s,’ Tony told him. ‘Just imagine the scene – you pushing a stiff down the corridor and running into the dean. It would make Stanley and Dr Livingstone look a very casual encounter.’

  The two housemen started laughing so heartily that everyone near by asked to be let into the joke.

  ‘I can just see the dean’s face,’ Hugo managed to say. ‘As you catch him in the epigastrium with a trolley of the patients’ dinners.’

  ‘He might throw me out all over again,’ said Pip, not joining in the fun.

  ‘Impossible, dear boy,’ Hugo told him. ‘Porters come under the hospital administrator. The dean can’t sack porters any more than Mr Clapper up in the office can reach for a scalpel and dig into the patients.’

  ‘It could be rather humorous,’ Pip agreed doubtfully. ‘But Mr Clapper might not take me on.’

  ‘Don’t be stupid.’ Tony Havens swallowed the remains of his pint. ‘You speak English, and you’re pink.’

  6

  ‘Ah, Mr Grout.’ Mr Clapper, senior administrative officer of St Swithin’s Hospital, stared across his broad desk at the junior administrative officer of St Swithin’s Hospital early that same afternoon. ‘Please sit down. I should like to go into conference with you for a few minutes.’

  Mr Clapper was chubby cheeked and blue jowled, dark suited and white shirted, his black hair and shoes shining equally at both poles of his globular body. He had dark rims to his glasses, pink ones to his eyes. A faint smile always stretched his rubbery moist lips. He looked like a cat which had just eaten the cream and knew where there was plenty more.

  The administration office occupied the entire first and second floors of the main St Swithin’s block, and Mr Clapper was busily advancing it into the wards on the third, which he had been obliged to close to patients through shortage of domestic staff. His own room was large and airy, well-windowed on a corner of the building. Mr Grout’s was a small one just outside. Mr Clapper could have summoned Mr Grout by shouting, ‘Charlie!’ through the door. But he had preferred to press one of the long double row of different coloured buttons on his desk, by which he could instantly demand people all over the hospital through a complicated adaptation of the normal bleeping system.

  ‘You speak German, I believe, Mr Grout?’

  ‘No, just a little French, Mr Clapper. Il fait beau temps, où est les messieurs, that sort of thing.’

  The administrator frowned briefly. ‘I expect both languages have many words in common. I am not a linguist. It is really an extraordinarily disorderly system, people talking quite incomprehensibly to the ears of others across the remarkably small and easily traversed area of modern Europe. I really don’t see why they can’t all switch to English.’ He broke off, frowning more severely. ‘Mr Grout –’

  ‘Mr Clapper?’

  ‘That shirt, Mr Grout.’

  His junior peeked downwards. He was young and skinny, with sandy hair and a droopy moustache. He too was dark-suited, standing against Mr Clapper’s desk with hands respectfully clasped behind him.

  ‘I do not think, Mr Grout, that a shirt with such bold pink stripes is appropriate for our position.’

  ‘I succumbed to temptation in the boutique,’ Mr Grout apologized humbly.

  ‘I know you are unmarried, and possibly dress to attract the other sex,’ Mr Clapper said indulgently. ‘But we must draw the line, surely?’

  ‘I’ll change it next washday, Mr Clapper.’

  ‘Good. Always remember that you and I are the two most important personages in St Swithin’s. Without us, the hospital would grind to a halt. Worse, it would utterly disintegrate, like a driverless express hitting the buffers. Neither forget that we are Civil Servants. The St Swithin’s doctors are all Civil Servants, too,’ he added, with a contemptuous little puff of his lips. ‘But they refuse to recognize the fact.’

  ‘As you often say, Mr Clapper, only eccentrics become doctors.’

  Mr Clapper nodded solemnly. ‘A doctor, not of medicine but of philosophy, is arriving from Hamburg on Thursday to study the working of the National Health Service. I should like you to look after him. I am of course far too busy. You may find it a somewhat uphill task, I warn you,’ he continued frankly. ‘I met a German doctor of philosophy once. Very eminent in his university. I thought he was a bit cracked. Well, show him round St Swithin’s. You may entertain him to lunch in the canteen,’ the administrator added generously. ‘As long, of course, as you do not exceed the scheduled limit, and submit the appropriate docket.’

  ‘I’ll do my best to impress him, Mr Clapper,’ said Mr Grout with dutiful eagerness.

  ‘I’m sure little effort will be necessary.’ A dreamy look intruded behind Mr Clapper’s glasses. ‘The administration of our National Health Service is a very beautiful thing, Mr Grout. You are fortunate in being too young to remember the bad old days, when St Swithin’s was run in an appallingly slipshod way. There was something called a Board of Governors – rank amateurs! Well-meaning City bankers, ladies in big hats, the hospital secretary some thickwitted old Admiral or General. They convened in the Founders’ Hall once a month, and had tea with buttered toast. You won’t believe this, Mr Grout, but if the hospital wanted anything – a new houseman, a new scalpel, a new bedsheet – the governors had to proceed with no help from outside whatever.’

  He leant back in his well-padded leather chair for effect. ‘But today, Mr Grout, our National Health Service enjoys the most sophisticated system of administration. We know exactly where we are. The chain of command runs from the Elephant – we used to call it the Elephant and Castle, but we seem to have dropped the Castle – which contains the Department of Health and Social Security. On to the Regional Health Authorities –’

  Mr Clapper extended an arm dramatically. Mr Grout knew this to be his favourite recitation. ‘Then to Area Health Authorities, which may be Ordinary or Teaching. To District Management Teams! To Sector Management Teams! Finally, the power which pours from the Minister seeps into each individual hospital. All splendidly staffed by thousands upon thousands of highly trained – and, I must admit, fittingly remunerated – professional administrators. Were the whole country wiped out by plague tomorrow, the National Health Service would still be justified by the perfection of its administrative machinery.’

  ‘New housemen or new bedlinen today,’ Mr Grout reflected, ‘need fourteen separate approvals.’

  ‘Exactly,’ Mr Clapper told him proudly. ‘Unlimited outside help.’

  ‘And take about four months to get.’

  ‘Naturally, it needs time to communicate from the bottom of this ingenious structure to the top and back again. But it ensures that no action is taken with reckless haste. That will be all,’ he said, with the air of a cat dismissing its mouse. ‘Don’t forget the shirt.’

  ‘There’s one of the students to see you, Mr Clapper.’

  ‘He’s not my pigeon, Mr Grout. Send him to the dean.’

  ‘He’s not exactly a student, Mr Clapper. He’s failed his finals, apparently. He wants a job as hospital porter.’

  Mr Clapper leant back, pudgy fingertips together. Mr Grout saw at once that he had presented his superior with an administrative problem, and one as diverting as a clue from some untaxing crossword puzzle. ‘He has been expelled from the medical school? Right. Therefore he is simply a me
mber of the general public. Agreed? Therefore he is eligible to be employed by the National Health Service, in the appropriate grade at the appropriate salary and with the appropriate deductions for his eventual old age pension. I see no difficulty. None whatsoever. We shall have the advantage of his knowing his way round the hospital.’ Mr Clapper hesitated. ‘Is he, er, ah – ?’

  ‘He comes from Somerset, Mr Clapper.’

  ‘Good!’

  In the Bertram Bunn Wing few of the patients could speak English, in St Swithin’s itself few of the domestic staff. The hospital enjoyed a regular supply of home-grown young graduates from its medical school, so avoiding the necessity in less favoured institutions of issuing their doctors with phrase books explaining in Oriental languages what British patients meant by such alarming complaints as, ‘I’ve got a frog in my throat’. The St Swithin’s overseas recruits were largely research workers, who could be kept harmlessly in laboratories until it was time to go home again. And everyone agreed that Sir Lancelot Spratt was unfair in claiming that, to be sure his basic surgical instructions were followed over the years, he had been obliged to learn a smattering of Hindi, Tamil, Chinese – embracing Mandarin, Cantonese, Hakka, Swatow, Foochow, Wenchos, Ning-po and Wu – Arabic, Spanish, the Pitsu of the Afghanistans, which was distinct from their Persian and unwritten Turki, Serbo-Croat, Hebrew and Gaelic. It was Mr Clapper who wished he had command of all these languages, or at least that their speakers would learn English.

  ‘You deal with him,’ directed Mr Clapper. ‘I’m busy. How about references?’

  ‘He gave the names of two West Country bishops.’

  ‘That sounds quite reliable. Don’t forget to see that he signs for his brown coat.’