Doctor On The Boil (2 page)

Dr Lionel Lychfield, Fellow of the Royal College of Physicians and dean of St Swithin’s Medical School, was a little man with a bald pointed head, large pointed ears and a lined brow, resembling a short-tempered garden gnome. He was nervous and jumpy at the best of times, though inclined to be vague and forgetful – had he chosen to be a surgeon rather than a physician, much of the contents of his operating theatre would assuredly have finished up inside his patients. His awareness in the past week that Sir Lancelot was not only back in England but intending to call at St Swithin’s had made him jumpier and shorter-tempered than ever. That morning, he could hardly bring himself to leave his house. But a letter waiting on his hospital desk put all thought of Sir Lancelot, or of anything else at all, clean out of his mind.

He sat on the edge of a high-backed leather chair in an office lined with mahogany cases of leather-bound books, decorated with busts of Plato and Lord Lister and a handsomely-framed reproduction of Luke Fildes’ picture
The Doctor
. The letter which had so affected him lay alone on the blotter. The dean bounced gently, hands clasped tightly under his chin, staring fixedly at the handwriting and the torn envelope marked ‘Strictly personal’. He read it yet again, with delight undimmed by familiarity.

It was addressed from the Garlick Club in St Martin’s Lane, one of the most aloof in London. Its message was simply:

Dear Lionel,

Keep your nose clean!

Yours,

Willie.

‘So it’s all fixed!’ The dean’s eyes glowed behind his large round glasses. ‘It just shows how useful it is, cultivating the right sort of friends in the right sort of places. Not
what
you know but
who
you know brings success. How alarming to think that applies even in medicine.’

He read it through again, as though the few words had some cryptic meaning so far eluding him. He drew a sheet of writing-paper from the rack, and pencilled on it, ‘Sir Lionel Lychfield’. He looked at it admiringly, then added ‘KBE’.

‘Good morning, Sir Lionel,’ he said to himself. ‘How do you do, Sir Lionel? Your car is waiting, Sir Lionel. Is that Sir Lionel Lychfield speaking? Now students, three cheers for Sir Lionel…’

He added underneath, ‘Lord Lychfield’. Feeling it looked elegant, he added, ‘The Earl of Lychfield’. With a smile he went on, ‘His Grace the Duke of Lychfield’.

‘No knowing where these honours might stop, once one gets started,’ he muttered, pencilling in ‘HM King Lionel I.’

The door opened. ‘Ah, Dean. Good to see you.’

The dean jumped up, cramming paper and letter as a ball into his jacket pocket.

‘My…my dear Lancelot. I had quite forgotten you were coming.’

‘Oh? You had my cable from New Delhi?’

‘Yes, I’m sure I did… I’m afraid for the moment my mind was on other things. You see, I heard only this morning with much gratification that I am shortly to be–’

He stopped, horrified at his indiscretion. He was vague about the protocol, but he felt that leakage of the glad news would so upset Her Majesty the honour would automatically be cancelled. The word ‘knighthood’ had only to drop from his lips for his cup of happiness to be snatched away from them.

‘I am shortly to be…to be…’ he said unhappily.

‘Good grief, you haven’t put Josephine in the family way again at your age?’

The dean shook his head. ‘To be given a free introductory lesson at a dancing school.’

‘That hardly seems a cause for jubilation, I must say.’

‘How was the Far East?’ the dean went on hastily.

‘Bloody.’

‘Oh. Did you see the Taj Mahal by moonlight?’

‘I did not see the Taj Mahal at all.’ They both sat down. Crossing one knickerbockered leg over the other, Sir Lancelot observed, ‘You’ve still got that ghastly sentimental picture by Fildes on the wall, I see. You know it was described by our late professional colleague and playwright James Bridie as depicting “a middle-aged man scratching his beard and wondering what the devil is the matter with a sick child he is expected to cure”?’

‘I happen to like it.’

‘I must say, Dean, I expected a rather more substantial welcoming committee. After all, I have been away from the hospital for some time.’

‘Several members of the consultant staff have gone unexpectedly on holiday.’

‘But they knew perfectly well I was coming.’ The dean said nothing. ‘That, I presume, is why they went unexpectedly on holiday? Well, I can only hope it keeps fine for them. Professor Bingham’s here?’

The dean smiled. ‘I don’t think our new professor of surgery ever takes a holiday. Young and keen, you know. Bags of drive and energy. An excellent choice for the job.’

I bet that keenness is spilling a few basinsful of unnecessary blood, Sir Lancelot thought. But he said nothing. He was a fair man, who never made a professionally slighting remark behind others’ backs. To their faces, of course, he allowed himself to be as colourfully offensive as possible.

‘I gather from the newspapers you and young Bingham are in cahoots over this transplant business?’

‘I am the physician, and he is the surgeon heading the team, certainly,’ said the dean guardedly. ‘A very good team, too. We have had some excellent results.’

‘Yes, your last picture in the papers looked as though you’d just won the Cup Final.’

The dean looked offended. ‘It is the surgery of the future.’

‘In my old-fashioned view, we would be better employed trying to perfect the surgery of the past. My dear Dean! These surgical fashions – I’ve seen them come and go, like women’s hats and skirts. Once we used to fill the patients up with liquid paraffin until they leaked. We tried to remove every organ compatible with the continuance of life, for every complaint from constipation to mother-fixation. After that, we invented the floating kidney, and lashed down everything inside the abdomen like deck-cargo in a storm. Do you remember the septic focus, Dean? I never saw one, quite honestly, but I seemed to have removed several hundred of the nasty little things. That was at the end of the war, when we thought they caused every bodily condition possible except pregnancy. Then we all forgot about them – I fancy because of the horrifying distraction of Nye Bevan with his National Health Service–’

‘Where are you staying in London?’ asked the dean. Sir Lancelot’s reminiscences, though authoritative and captivating, quickly grew impregnable to interruption.

‘I booked a room at the Crécy. I’ll drive round later.’ Sir Lancelot pulled a large red-and-white spotted handkerchief from his pocket and coughed into it.

‘I only wish I could offer you hospitality. Josephine and I would be absolutely delighted if you could stay with us. Absolutely delighted! But we’re quite full, right to the eaves. There’s not only Miss MacNish, but now we’ve an
au pair
girl from Sweden, and the only spare bedroom the two children use for studying.’

Sir Lancelot grunted. ‘How are your kids, anyway?’

The dean’s expression, so far in the conversation resembling a man in the dentist’s waiting for the drill to hit the nerve, relaxed into a proud smile. ‘Muriel won the gold medal in anatomy, and George has got through his second MB – admittedly after one or two tries he is never at his best in examinations, being a somewhat nervous lad. So both have started work in our wards.’

The dean’s fingers, feeling idly in his pocket, discovered a ball of crumpled paper. Mystified, he drew it out and spread it across the blotter. He read the message, hastily screwed it up and pocketed it again. ‘To what must we be grateful for this – er, brief visit?’ he asked Sir Lancelot, who was staring at him with raised eyebrows.

The surgeon helped himself to a pinch of snuff. ‘I am here for two reasons. Firstly, I have a cough.’

‘Oh? I’m sorry.’

‘It’s not frequent. Worse in the mornings. No haemoptysis, or anything sinister like that. It came on towards the end of my eastern tour. That’s what prevented me from seeing the Taj Mahal – it seemed best not to risk the expedition, and anyway you can always look at the place on picture-postcards. I don’t think I’ve anything serious. But of course, one must have any persistent cough investigated.’

‘Most certainly.’

‘So I’ve come to you. You’re a member of the physicians’ union. I’m a surgeon, and therefore know nothing whatever about the chest, except as a convenient shelf for your instruments while you’re operating.’

‘My dear Lancelot, of course I’ll do what I can.’ The dean was flooded with the sympathy of all medical men towards others undergoing the indignity of being ill themselves. ‘Come up to my ward after lunch. I’ll examine you and fix up X-rays and so forth, if necessary. There’s a side-room empty at the moment, getting ready for the class examinations on Monday week.’ He rubbed his hands. ‘I’m really going to stretch the little blighters this time. There’s been far too much slacking in the medical school lately, nothing but girls, poker, and electric guitars.’

‘That’s very good of you,’ said Sir Lancelot amicably. ‘My second reason is another complaint, one from which the whole world suffers. Boredom.’

The dean gave a sigh, drumming his fingers lightly on the desk. ‘It is the blessing of our arduous profession, the unending flow of interesting work.’

‘Exactly,’ Sir Lancelot agreed firmly. ‘As you know, I retired prematurely. At the height of my powers. But I felt I’d done my bit for both humanity and the tax-collector. I wanted to enjoy my country house in Wales. Perhaps it was selfish of me.’

‘All of us here thought it an estimable idea,’ the dean assured him warmly.

‘Then of course my poor wife died. Now I’m lonely. One can fish only during the season. One cannot continually orbit the earth as a tourist. As an Englishman, I would not presume to interest myself in local politics, and anyway they are totally impossible to comprehend. I need an object in life.’

The dean nodded. ‘They say philately can be most interesting. Or the collecting of butterflies and moths. Possibly bird-watching? Or pot-holing?’

‘My dear Dean.’ Sir Lancelot rose, with his hands behind his back, starting slowly to pace the room. ‘You are of course familiar with the charter of our distinguished hospital?’

‘Granted by Her Majesty Queen Elizabeth the First,’ the dean recited fondly. ‘I have often studied the original parchment. Quite awesome how its terms still govern much of our life here.’

‘
Quite
awesome.’ Sir Lancelot paused to cough. ‘Then you will remember that the hospital’s physicians and surgeons, though retired from active work, are fully entitled to return, to take over the care of such patients in the wards as they feel inclined to, with no questions asked. Clearly, our founders felt it desirable for the long experience of a retired surgeon never to be wasted–’

‘Lancelot!’ cried the dean.

‘Of course, in those days people were always retiring to serve the Queen or explore the American colonies–’

‘That right has never been exercised in the entire history of St Swithin’s,’ exclaimed the dean, turning pink.

Sir Lancelot fixed him with his eye. ‘Well, it is now, old cock.’

‘But…but…this is outrageous. Absolutely outrageous. What do you imagine in this day and age the patients would say? Supposing you walked into Professor Bingham’s ward and simply told one of them that
you
were going to remove his gallbladder–’

‘As my fees used to be the highest in London, they’d be getting better value for their National Health Insurance stamps.’

The dean slapped his desk-top. ‘I shall have the charter amended.’

‘That’ll need an Act of Parliament. Ask the Prime Minister if you like, though there may possibly be more important things on his mind.’

‘Really, Lancelot, this is most unreasonable of you,’ the dean continued angrily. ‘It’ll raise all manner of problems with the Ministry. And just at the time I particularly want to keep my nose clean because–’

He stopped. ‘Yes?’ demanded Sir Lancelot.

‘I happen to have mislaid my handkerchief. No, no, it’ll never do.’

‘We’ll see about that. Meanwhile, I think I’ll have a prowl round the old place. See you in the ward after lunch. And do provide a decent-sized jar for a specimen, there’s a good chap. From some of the receptacles you physicians produce, you seem to imagine a camel could widdle through the eye of a needle.’

‘Good grief,’ muttered Sir Lancelot Spratt. ‘Ruddy sacrilege.’

He felt a lump in his throat. A tear formed in the corner of his eye, ran down his rugged cheek and soaked into his beard. He dabbed it away with the red-and-white handkerchief and adjusted his features manfully.

‘One mustn’t mourn for bricks and mortar,’ he told himself severely. ‘But it’s sad to lose the shrine of your memories.’

The cause of his distress was the surgical block of St Swithin’s. It was never a handsome building. It had been erected about the time Lord Lister was introducing a lot of new-fangled nonsense called aseptic surgery, when architects believed institutions catering for the sick poor should have a forbiddingly ecclesiastical appearance, to put the patients in a pliable mood of terrified gratitude. It had resembled the cross between a Thames-side warehouse and Dr Arnold’s thunderous chapel at Rugby School, but like so much of London’s richness in Victorian curiosities it was no more. The wards Sir Lancelot once strode in surgical majesty had almost unbelievably vanished. So had the operating theatre in which he had won – and sometimes lost – so many bloody battles. Even the poky ill-lit lecture room, where he had hammered the finer points of surgery into the skulls of countless students, had been unsentimentally crushed to a heap of rubble. Now there was nothing left. Only a hole in the ground, with a bulldozer nosing up piles of mud and half a dozen men in white helmets drinking tea.

Sir Lancelot was about to revert from the harrowing sight when his eye caught something in the morning sunshine amid the brick fragments at his feet. He picked up a rusted scalpel – the old-fashioned sort with a fixed blade, the surgical equivalent of the cut-throat razor. He stroked his beard thoughtfully. ‘I fancy that’s the one I threw at my theatre sister during a nephrotomy in 1939,’ he decided. ‘Often wondered what became of it.’

He slipped the relic into the top pocket of his tweed jacket, and turning his back on the past made briskly for the new St Swithin’s surgical block, which had risen on the site of the old kitchens and mortuary beyond the demolitions.

‘Looks like a ruddy supermarket,’ he grunted at the plate-glass-and-concrete tower. ‘Strange, how in another hundred years that, too, will be thought a first-class eyesore. Though perhaps a medical supermarket’s what’s wanted,’ he reflected. ‘Push your little basket round the doctors, and complain like hell if the latest line of treatment isn’t in stock. How different in my early days, when you didn’t have to tell people what was wrong with them, you just told them what was good for them.
And
sent ’em away with a flea in their ear if they dared to ask any questions.’ He sniffed as he entered the automatically sliding main doors. ‘No smell. Nothing at all. I liked the old stink of antiseptic and stewing cabbage. It gave the place an atmosphere.’

He took the shiny staff lift to the top floor, where the professor of surgery had his wards. His intention was to see the sister in charge of the male patients, who on his own ward had for twenty years somehow tolerated his idiosyncrasies without even one attack of hysterics. He felt that she and Harry the porter, who had placed his bets and provided highly unreliable turf information over the same period, were the only people on the St Swithin’s staff who interested him.

He walked along the short, plastic-tiled corridor frowning. The strangeness of modern wards was a shock to him, split into small rooms, hardly large enough to contain the surgical courtiers he liked following him. They were filled with the latest electronic equipment, which he cheerfully recognized he had no more hope of understanding than the latest pop singers’ lyrics.

‘Why, it’s Sir Lancelot!’

Sister Virtue came fluttering joyfully towards him in her new-style uniform. It occurred to him that for the first time in his life he had seen the middle of her calves.

‘My dear Sister.’ He eyed her keenly. ‘You’re wearing make-up. On duty.’

‘Oh! Yes. It’s allowed now. The new matron, you know. In moderation, of course.’

He stroked his beard. Amazing, he thought. She didn’t look such a bad old hag after all. ‘A lot of things seem to be changing.’

She clasped her hands. ‘Everything. The dean, the professor, the whole medical council, want us right up-to-date. All our equipment seems plastic and disposable – the syringes, the bedpans, the masks and gowns. I sometimes long for those lovely old chipped enamel washing bowls and the solid porcelain bottles.’

Sir Lancelot was inspecting the label on her uniform. ‘In all these years you never told me that your name was Esmeralda.’

‘Didn’t I?’ She blushed and looked at the floor.

‘Pity. I rather like it.’

‘Oh, Sir Lancelot!’

He smiled. He had always been aware of two weaknesses in his character – a tendency to go into an abdomen too easily, and a fondness for the ladies. Fortunately, he often told himself, he managed to keep both failings reasonably in check.

‘Here, I say. It’s Sir Lancelot. Sorry I wasn’t at the door to greet you. Unbelievably busy these days, you know.’

The gallant conversation was interrupted by Professor Bingham himself, in a white coat and carrying a long ribbon of punched computer tape. Sir Lancelot did not gaze on his colleague affably. He had admittedly expressed the belief that Jimmy Bingham would end up as a professor of surgery when the young man was one of his own students. But he had hoped that the chair might be in Sydney, Vancouver or some other academic centre well away from St Swithin’s.

‘Morning, Bingham. A few innovations in the hospital, I see.’

‘Even such a venerable institution as St Swithin’s must recognize the progress of the twentieth century.’ The professor pushed his glasses up the bridge of his nose, a habit which had irritated Sir Lancelot since he first interviewed the man for entry to the medical school. ‘The adaptation has become a little easier with the retirement recently of so many older members of the consultant staff.’

‘H’m,’ said Sir Lancelot. The same attitude of mind, doubtless, he mused, enjoyed by Macbeth when he’d cleared away Duncan and Banquo. Well, if there’s any haunting to be done, I’ve had a lifetime’s experience in making flesh creep. He said nothing about the charter. It would be more amusing simply to snatch a patient or two and let Bingham work it out afterwards. ‘What’s that contraption in the corner?’ he asked. ‘Electrified bingo?’

Bingham’s face took on a knowledgeable expression which Sir Lancelot found barely tolerable. ‘That contraption, as you call it, is connected to the central computer. The days are passing when we had to examine patients with our bare hands, assemble the facts in our heads, and hit on a diagnosis. Quite out of date, like quill pens and inkpots. Now we do the requisite chemical investigations, feed them into the computer on punched tape, and within seconds receive the diagnosis. No possibility of error, to which all human beings are liable – even you, Sir Lancelot, eh?’ Bingham smirked. ‘In a few more years, of course, it’ll be commonplace.’

‘No need for dreary old flesh-and-blood doctors, you mean, except to sign sick notes and hold the vomit bowl? And what are you intending to do with that dirty great hole where the surgical block was, may I ask?’

Bingham’s glasses seemed to flash with pride. ‘That will be a new sterile unit entirely devoted to transplant surgery.’

‘Good grief,’ muttered Sir Lancelot.

‘I take it you don’t approve?’ Bingham asked in a pained voice.

‘I most certainly do not. The whole world’s gone crazy about transplants. All sensationalism is deplorable, and in surgery it is unforgivable. Besides, it is all too experimental for
my
peace of mind.’

‘You cannot turn back the advance of science,’ said Bingham, shaking his head sagely.

‘You take my advice and switch the money to something useful, like finding a cure for the common cold. Where’s the cash coming from anyway? God knows, there’s little enough of it about these days. The country can’t even afford a regiment of Argylls and a decent motorway to Wales.’

‘The dean handles all that. I cannot allow myself to be distracted by mere problems of finance. But we don’t have to go begging to Whitehall. The Blaydon Trust is supplying our funds, on, I understand, a generous scale.’

‘The Blaydon Trust?’ Something seemed to amuse Sir Lancelot. ‘Well, well.’

‘I gather Lord Blaydon is no longer alive, but the millions which he made from Ploughboy’s Beer – which, being teetotaller even as a student, I regret that I have never tasted–’

‘It’s weasel’s water,’ observed Sir Lancelot. ‘I suppose his widow controls the till? I once knew the lady socially.’

‘We deal only with her lawyers. She appears to be a rather mysterious person. But she certainly seems to entertain an attachment to St Swithin’s, for which we must be truly grateful.’

Sir Lancelot’s eye fell on the patient in the nearest bed. ‘What’s the matter with that feller?’

A faintly shifty look came into Bingham’s pink and chubby boyish face. ‘He was admitted last night with abdominal pain and pyrexia.’

‘What’s the diagnosis?’

‘I’m afraid the computer seems rather to have let us down. After all, we hadn’t given it much to go on. But we shall be performing some twenty or thirty more tests on the patient this afternoon – punctures in various places for specimens of his body fluids, you understand – which doubtless will extract the answer.’

‘Ask your computer if he’s a Chinaman.’

‘I beg your pardon?’

‘Otherwise, to my old-fashioned bloodshot eye, he has the first faint tinge of jaundice. Good morning.’

Sir Lancelot stamped out of the ward. Hands in his jacket pockets, he stamped down the corridor to the lift. He pressed the button to descend then started to chuckle. Bingham was a fool, he reflected. Any man was, who imagined medicine a pure science when part of it was pure art, plus some witch doctoring and black magic. After two floors the lift stopped for a second passenger, who Sir Lancelot, lost in his thoughts, vaguely noticed as some member of the nursing staff.

‘Ground floor all right?’ he asked absently.

‘Perfectly all right.’

He stood staring straight ahead at the lift doors. But something in those three words, an inflection in the voice, made a memory stir uneasily in its sleep. He pursed his lips. Slowly he changed the direction of his glance. ‘Good God,’ he muttered.

How fortunate I was in a hurry and took the lift. Usually I go down the stairs.’

‘But what the hell are you still doing here?’

His companion smiled. ‘And what the hell are
you
still doing here?’ she asked pleasantly. ‘I heard you’d retired.’

‘I have, but–’ The significance of her uniform registered in his mind. ‘Good grief, you’re the matron.’

‘Yes, except that nowadays it’s known as the General Superintendent of Nursing and Ancillary Services. It’s supposed to be more modern – or perhaps the idea is a grand title to compensate for the poor pay. And everyone still calls me the matron, anyway.’

Sir Lancelot leant to read the name pinned on her smart green uniform dress. ‘Miss Charlotte Sinclair. Still? But what about that Mr Right you were going to marry?’

They reached the ground floor. The lift door opened to reveal the dean. ‘Ah, Lancelot–’

‘Sorry! Going up.’ Sir Lancelot pressed the button for the top.

‘Oh, I’d forgotten about
him
.’ She laughed. The new St Swithin’s matron was short and neat-limbed, fair-haired with green eyes and a turned-up nose. She was in her mid-thirties, but like all dainty women looked younger than she was. ‘One can hardly marry the invisible man, can one?’

Sir Lancelot frowned. ‘You left the hospital for that specific reason.’

‘Surely you must have thought over the incident since, Lancelot? Why, you must be simpler than I suspected. That was the only way I could cool an ardour like yours.’

The lift stopped. The door flew back. Professor Bingham was waiting.

‘Sorry,’ snapped Sir Lancelot. ‘Going down.’ He pressed the button, complaining, ‘Really, Tottie, you should have taken me more seriously. I was in love with you.’

‘I know you were, dear Lancelot. But officially you were in love with your wife.’

‘I think Maud would have given me my freedom. We were held together more by habit than affection. Like most couples, I suppose.’

‘But what would your stuffy colleagues here have said?’ The corners of Tottie’s mouth creased, which had always excited him. ‘The permissive society wasn’t a going concern in those days, remember.’

The lift stopped. ‘Lancelot, really–’ complained the dean.

‘Sorry, no room.’ They shot upwards again. ‘In those days? It was about the time of the Coronation, I recall. Then what did you do, Tottie?’

‘I got a job in America instead. It was simple enough, with the shortage of nurses. I suppose I did pretty well, because I ended up running a hospital. Then last year I suddenly gave it up, to travel and see the country. Just before Christmas I made up my mind to come home.’

He shook his head slowly. ‘It’s like a dream now. Sorry Bingham.’ He pressed the button.

‘Did anyone find out about us in the end?’

‘I’ve never had reason to suspect so. If you remember, Tottie, our affair was frustratingly discreet. Not to mention frustratingly pure. I think it was on Coronation night, in the corridor behind the old operating theatres, that you defended your honour with the left blade of a pair of obstetrical forceps.’

Tottie laughed. The lift halted. As the door slid open, Sir Lancelot shut it rapidly in the dean’s face.

‘That shows I’d more sense than is usually the case with a junior nurse,’ she said as they went up again. ‘Certainly more than the ones I’m in charge of today. Or did I? Perhaps the youngsters’ outlook is right. They get more fun.’

‘It’s all comparative. We got excited simply holding hands in the back of the pictures. If I may say so, you’re looking absolutely wonderful, Tottie.’

‘Why, thank you. And you’re exactly the same, you know.’

‘I doubt that very much. Though I shall be hanging round the hospital for a while – which may give us a chance to find out.’