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  Also by Claire Rayner

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  Death on the Table

  A Time to Heal

  Dangerous Things

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  DEATH ON THE TABLE

  CLAIRE RAYNER

  ebook ISBN: 978-1-84982-033-2

  M P Publishing Limited

  12 Strathallan Crescent

  Douglas

  Isle of Man

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  Copyright © Claire Rayner 1969, 2010

  All rights reserved.

  Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of both the copyright owner and the above publisher of this book

  a novel in 13 chapters

  e-ISBN 978-1-84982-033-2

  The moral right of the author has been asserted

  CHAPTER ONE

  FOUR A.M. The pool of light from the Casualty entrance spilled across the main courtyard, making the consultants’ car park look even blacker and filling the dark corner by the transport office with menace. But only the pharmacy cat, stalking arrogantly across the tarmac, moved out there. Above it the main ward block loomed heavily against the cloud-scudding sky, the even pattern of dim windows breaking its façade into a satisfying checkerboard design.

  In the private block, the buzzer from room 204 shrilled sharply in the ward office and Staff Nurse Kennedy, who had been sitting huddled in her cape in the low armchair, woke abruptly from an uneasy doze and swore softly before padding along the corridor to see what the wretched man wanted.

  He had a pain, and he knew a cup of hot milk would settle it. Please? But Nurse Kennedy plumped up his pillows and tucked him in firmly, pointing out brightly that no, he couldn’t have a drink now, since he was having his operation at eight thirty, and that meant nothing by mouth whatsoever. And, no, no drugs either, she was afraid, not until he had his pre-med at seven thirty. He was just to try to go back to sleep, and remember that after the operation his stomach wouldn’t bother him any more, seeing he wouldn’t have much of it left, would he? With which cold comfort the man in room 204 had to be content.

  On the doctors’ residential floor, just behind the main ward block, Barnabas Elliot stirred in his sleep and then buried his head more deeply into his pillow as the sounds from the next room indicated that the obstetric registrar had at last completed that difficult high forceps, and was coming to get some sleep in while he could—although it hardly seemed worth going to bed, seeing he’d have to leave it to take an ante-natal clinic at nine am.

  On the other side of the corridor, Derek Foster lying on his back snored heavily, and dreamed frankly erotic dreams, while next door young John Hickson lay tidily and silently sleeping the sleep of the just, his stethoscope, torch, patella hammer and ophthalmoscope lying neatly arranged on his bedside table. Hickson prided himself on the speed with which he answered any calls the night staff made on him, so much so that when the rather flighty girl on Casualty once said, ‘Our young doctors are so handsome and dress so well—and so quickly!’ he had genuinely thought she meant it for him; hadn’t realised she was making a lewd joke until Derek Foster, with Australian coarseness, pointed it out to him.

  Far beyond the main ward block, in the nurses’ home, Lucy Beaumont lay sprawled deep in sleep, her curly black hair rumpled against the pillow, looking absurdly young to be anyone as important as a Medical Ward Sister and dreaming of Barney Elliot with a wealth of detail that would have surprised him considerably had he known of it.

  Four fifteen a.m. The courtyard seemed to move and slither as an ambulance curled round the sharp corner of the entrance, sending its headlights streaming across the windows of Female Medical (waking senile old Mrs. Chester, who immediately set up a thin whining cry that effectively woke the rest of the ward) and stopped in front of Casualty.

  The tired Staff Midwife up in private maternity heard it, and wearily wrapped up the last of the new babies after its bath and told the pupil midwife on duty with her that if that was another admission she for one wasn’t going to do another delivery, and the day people would just have to be called out. There was a limit to what one midwife could do, saddled as she was with a brace of useless pupils.

  Staff Nurse Griffiths on the third floor of the private wing heard it too, and wondered if it could possibly be that suspected ectopic Sir Douglas had mentioned to Day Sister, and then huddled into her cape again as a sharp draught whistled under the office door and curled round her ankles.

  The main theatre doors must be open again she thought petulantly. That was the only place that draught ever came from. She’d have a few things to say to the theatre porter next time she saw him. Those theatre people thought the hospital only existed for them, arrogant lot——

  Four forty-five a.m. The telephone on Derek Foster’s bedside table shrilled insistently, and then again, dragging him irritably from the delectable depths of a sleep full of dreams of that smashing girl on Male Surgical.

  He grunted his usual indecipherable noise into the phone, and tried to wake himself properly as he listened to the thin voice of Casualty Staff Nurse clacking at him.

  ‘Can’t he wait until morning, Nurse Graham?’ he said, his voice a little slurred. ‘It can’t be that—oh, all right. I just wondered if this was a real bill or just another nursing flap—no, I’m—oh—all right, I’m sorry! I’ll be down in a minute——’

  He slid out of bed, pushing his long feet into fur lined slippers, and shrugged his white coat over his pyjamas, shivering a little. The heating in this place is the most inefficient ever created, he thought irritably, even in June, and went out and along the dimly lit corridor with his hands thrust deep into his pockets, his tousled head sunk so far into his shoulders that he looked like a bad tempered penguin.

  Casualty was bright and quiet, the light reflecting cheerfully from chrome and glass and racks of instruments and bottles, and it was warm. Faint tendrils of steam rose from the bank of big sterilisers hissing gently against the far wall, and the whole big central area was filled with th
e heat, making Derek straighten up a little and feel more alert.

  The curtains that closed off the far cubicle swished and opened and Night Sister came out, followed by Staff Nurse Graham. Sister nodded sharply at Derek.

  ‘Good morning, Mr. Foster!’ she said, an edge to her voice. ‘I hope you will agree with me that this is a true bill and worth getting up for! Nurse Graham, let me know what is decided, will you? There is a bed available in semi-private, by the way.’ She turned back to Derek.

  ‘I took it upon myself to assume he would have to be admitted for immediate surgery, and since the main theatres are already heavily booked there is no point in putting him in Male Surgical, which is overcrowded anyway, when there’s an available NHS bed in the private wing. Anyway, Sir James is the consultant on take-in tonight, and he’s operating in the wing in the morning. It is altogether better to arrange things this way. Now, I’m wanted in Maternity, so I’ll leave you to Staff Nurse. Good morning!’

  And she swished away, her rubber heeled shoes thwacking firmly on the tiled floor.

  ‘Efficient old bag,’ muttered Derek, and Nurse Graham giggled softly and said, ‘Sorry about that—she came in to the office while I was talking to you, and got highly shirty because you seemed a little unwilling to get up.’

  ‘Well, who wouldn’t be? Anyway, what’s the story?’

  ‘Patient’s a man of about thirty-odd. Acute abdomen, as far as we can tell. Thing is, he’s Polish—a sailor. They brought him up from the docks where his ship berthed tonight. There’s no interpreter, I’m afraid, so you’ll have to manage as best you can. But he’s pretty ill—obviously in pain, and with a temp of 101 and a very rapid pulse—hundred and thirty. I’ve made up some notes——’

  The man in the cubicle was lying with his knees drawn up, and a look on his face that was eloquent of sick anxiety. He turned his head sharply as Derek came in, and shrank back a little as the covering blanket was pulled back.

  ‘Nothing to worry about, feller,’ Derek said cheerfully. ‘Let’s just have a look at this belly of yours——’

  His hands moved gently over the man’s body and the patient winced sharply once or twice as the square-tipped fingers probed and slid over the tense skin. After a while, Derek grunted and straightened up.

  ‘Pretty obvious, isn’t it?’ he said to Nurse Graham who stood hovering at his side. ‘Look at it—as strangulated a hernia as I have seen this many a day. And if we don’t release it soon he’ll be in a right mess. Who’s on, did she say? Sir James?’

  ‘Mmm. Sister says he’s got a list in the morning—um—there’s a gastrectomy first, I think, then an appendix, and a couple of odds and ends—hernias, and a varicose vein or two. All private patients.’

  Derek looked cheerful. ‘Good oh! Then maybe he’ll let me do this one. What time is he due to start?’

  ‘Half past eight.’

  Then I could do this feller at half past seven, couldn’t I? Night staff could set up, and the day staff take it. Great. I’d better let the old boy know, though. He’s liable to get very upstage if I go ahead and act on my own diagnoses. Which is bloody silly when you consider how much money and effort has gone into preparing chaps like me to take the initiative and all that——’

  ‘You talk as much in the small hours as you do all day,’ Nurse Graham said dispassionately. ‘And I’d like to get this man settled one way or the other. If you put a move on, I’ll get some Ovaltine for you before you go back to bed. If you do.’

  ‘You’re on,’ Derek said, grinning at his patient and patting him on the shoulder with what he hoped was a reassuring gesture before going across Casualty to the office, to sit sprawling over Sister’s desk while he waited for the night switchboard man to get Sir James Custerson-Weller’s home number.

  ‘Do you suppose people are really born with names like that?’ he asked.

  Nurse Graham shrugged and shook her head.

  ‘I swear surgeons are like actors—make up fancy names for themselves because they look good over a Harley Street address on an envelope.’ Derek yawned suddenly. ‘I’m tired—I bet the old whatsit’ll do his pieces, being woken at this hour. It’s his own fault, though. Ought to give junior people like me a bit more leeway, let us use our own initiative and—oh. Good morning, sir. Sorry to wake you at such an unearthly hour, and on such a chilly night, too, but—er, yes, sir.’ He listened for a moment, grimacing at Nurse Graham.

  ‘Er, yes, sir. Well, he’s a Polish sailor——’ Derek launched into an account of the history and findings of his examination, and when he’d finished said in a diffident voice that seemed odd coming from someone so normally ebullient, ‘As your list starts at eight thirty I could take this man to your theatre at seven thirty and get him out of the way in plenty of time for you to start, sir—no, sir, I don’t think he can wait till the end of the morning. That’s why I called you now. He’s pretty shocked—yes, sir. In excellent shape otherwise——’

  He listened again, and then looked so surprised that Nurse Graham almost giggled aloud at the sight of his face.

  ‘You, sir? But it’s only a strangulated hernia, sir. Surely there’s no—no, sir, of course. Yes. Yes—anaesthetist—I’ll tell him—Elliot. Yes, sir, Om and scop pre-med, and—the list, sir? Just a moment, will you——?’

  He covered the mouthpiece with one hand and hissed urgently, ‘What did you say was first on? The gastrectomy?’

  Nurse Graham nodded, and Derek returned to the phone. ‘Partial gastrectomy, sir. Put him second? Very well, I’ll fix that—yes, sir. Goo——’ and he winced as the phone produced a decisive click.

  Graham giggled again. ‘Was he livid?’

  ‘Silly old basket. If he doesn’t like being woken up he ought to let people do their jobs. Then he could snore his fat head off to his heart’s content. Honestly, he really is a louse. Does his pieces at me for waking him, and then says he’ll do the man himself, first on the private theatre list. I’ll have to tell the ward people, I suppose, to shift the list one patient up—oh, and Night Sister had better know because of the pre-meds. Aw, nuts——’ and he produced a few pungent words that made Graham purse her lips in genuine disapproval.

  ‘Shall I tell Mr. Jackson, or will you?’ she asked.

  ‘Mmm? Why Jackson?’

  ‘He’s Resident Surgical Officer—and Sir James’s registrar. He organises the operating lists. He ought to be told——’

  Derek shook his head and produced another of his jaw cracking yawns. ‘No, leave him snooze. Bad enough I’m missing my beauty sleep. He’ll find out at breakfast—I’ll see him then.’

  ‘Well, make sure you do,’ Graham warned. ‘He can be pretty bloody minded if people forget his status, and all that. You’ve got to keep him informed of anything to do with the surgical firms, or he raises merry hell——’

  ‘Ah, status, peanuts!’ Derek said, and went back across Casualty to the man in the cubicle. ‘I much care for status or anything else like it. I’ll tell him at breakfast. I’ve got better things to do than sit around here phoning people to bolster up their own sense of importance. If the old buffer changes the list it’s his business, and Jackson knows what he can do if he doesn’t like it. Here, give me those notes will you?—and what about that Ovaltine you promised?’

  And after making a hopeless attempt to explain to the worried Polish sailor that he was to have an operation, but that it would be perfectly safe since it was to be performed by one of the country’s most eminent surgeons, Derek Foster went padding back to bed, clutching the beaker of hot Ovaltine Nurse Graham had provided for him. He’d made a date with her, so even though he hadn’t been given the chance to prove his surgical prowess on the Polish hernia, the night hadn’t been entirely wasted.

  Seven thirty a.m. Derek, inevitably, ignored the insistent tapping on his door, and went back to sleep. Which meant he missed his breakfast and had to report to Outpatients for a clinic in a state of bad temper induced by a badly cut face resulting from too hast
y shaving and a coffee-less interior.

  But the rest of the resident medical staff breakfasted, John Hickson looking polished and fresh as he read his Times (Top People take The Times. It only took me half an hour to become a Times reader, he often reminded himself smugly) in strong contrast to almost everyone else.

  Barney Elliot looked fresh enough, but far from lively. He wouldn’t have much to say to anyone until a sizeable breakfast filled his hollows, any more than would Colin Jackson. Not that Jackson ever had much to say to anyone, apart from shop talk. A bad tempered chap, Jackson, Barney thought, as the older man removed the Telegraph from Barney’s place at the table, as though it belonged to him by right.

  Sister Beaumont reported for duty in a sunny mood. She usually was a happy person anyway, but this morning she felt more than usually cheerful. They were doing a retrograde pylogram on Mrs. Chester this morning (and maybe she’d be discharged soon? A hopeful thought, that. She did disturb the other patients’ sleep so badly) and that meant a light general anaesthetic. Which in turn meant that Dr. Elliot would be coming to the ward. It wouldn’t do to let anyone know just how delightful a thought that was—least of all Dr. Elliot—but it made her whistle softly between her teeth as she settled herself at her desk to take the report from the night staff.

  The man in room 204 greeted the arrival of the day staff with a mixture of relief and anxiety. Of course he’d be better once he’d had his operation. No doubt about it he needed it. Life had been pretty grim lately, what with the complications of the Business (he grinned a little wryly as he thought about the Business that was lucrative enough to make him a private patient) and the general awkwardness of suppliers and all. Suppliers. Yes. He’d have to do something about that man, soon. Getting a bit above himself he was——

  He submitted with what grace he could to the ministrations of the rather harassed junior nurse who came to dress him in long woolly socks and a gown, and said with as good a display of calmness as he could manage, ‘Well, not long now. Just another hour, eh?’