Doctor On The Job (5 page)

‘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 member 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.’

Mr Grout left Mr Clapper staring pleasantly at his rows of buttons, wondering who to summon next.

‘The duties appertaining to the hospital porters,’ said Mr Grout, sitting behind his cheap desk and screwing up his eyes while Pip in turn stood respectfully opposite, ‘are one, the movement of patients, two the movement of meals, three the movement of drugs and laundry Oh, and bodies. And of course cleaning. We have a porters’ pool.’

He opened his eyes to stare at Pip. ‘It’s in the basement. A highly efficient system evolved by Mr Clapper, after extensive time-and-motion studies. There must always be a porter or two standing by for emergencies, but Mr Clapper has so arranged the work-schedules that none of you remain idle for more than a minimum period of time. Mr Clapper is very proud of it. Did you know that each patient in St Swithin’s enjoys one-twentieth of a porter? It’s well below the national peak. Mr Clapper is very proud of that, too. Report to the head porter,’ he continued in a businesslike voice. ‘Who will organize your training in accordance with DHSS Circular HM bracket sixty-eight bracket ninety-six. Which is of course based on the Report of the Advisory Committee on Ancillary Staff Training.’

‘Training? For pushing the laundry?’

‘If the Ministry say training you need, training you get,’ Mr Grout told him firmly. ‘National Insurance number? Tax coding?’ Pip confessed himself as ignorant of both as of the Zodiacal configuration under which he was born. ‘You’ll have to join ACHE, of course. They operate a closed shop. See Mr Sapworth. He’s due to be down in the pool in exactly two minutes.’

‘I haven’t a watch. It’s wonderfully liberating. I wish I’d given them up years ago.’

‘Never forget that the patients see more of the porters than of the doctors. As Mr Clapper says, your attitude and efficiency are of great importance to the reputation of St Swithin’s. Sign here, please, for this brown coat.’

Pip left the office feeling that entering St Swithin’s as a porter was more inspiring than entering it as a student. He decided that with his new status he had better take the service lift. Buttoning up his brown coat, he joined the wide, lumbering conveyance descending with bundles of dirty laundry, a refuse bin trailing blood-spattered bandages, a trolley loaded with drugs, another loaded with congealed dirty dishes, eight brown-coated porters, and two patients, one of whom was dead.

Pip wedged himself next to the porter in charge of the covered mortuary trolley, a man younger than himself with untidy dark hair, a large stylish moustache and square glasses. ‘You’re one of the students, ain’t you?’ the man asked at once, looking puzzled.

‘I was. I got the chop this morning. I’ve just been taken on as one of you.’

‘Go on?’ He shook Pip’s hand vigorously. ‘You’re the poor sod what kept getting the stick from Sir Lancelot. I reckon you’re better off for the change. More free and easy, this life. I’m Harold Sapworth. Pleased to meet you.’

‘I was told to report to the head porter.’

‘You’ll have to take a bus. There ain’t one. Left last Christmas. Got a better job in a hotel. Patients don’t leave tips, see.’ He nodded down at his charge. ‘Especially dead ones.’

‘But Mr Grout in the office said –’

‘Listen, mate.’ Harold Sapworth grinned. ‘First thing you learn about St Swithin’s, them geezers in the office wouldn’t know they’d been born, if they hadn’t got a belly-button to prove it. Which is what they spends most of their time looking at, if you asks me. Give us a hand with this,’ he invited, pushing out the trolley as the lift reached the basement.

Pip had never wasted thought on what the hospital porters got up to. They were to him simply anonymous men with complexions either black, hairy or leathery, forever pushing recumbent patients or large unidentifiable bundles on trolleys. It had never occurred to him that they were organized, the troops of a brilliantly generalled army deployed with well-drilled precision. Or were they?

‘I was told to see you too, Mr Sapworth,’ Pip said, pulling the front of the trolley along the wide, white-tiled, brightly lit basement corridor. ‘With a view to applying for membership of ACHE.’

‘No trouble. You’re in.’ They edged their way against a line of trolleys bringing the patients’ teas from the kitchens. ‘I’m filling the hole for our shop steward. He had a little accident in Piccadilly Circus.’

‘I hope it won’t keep him off work long,’ said Pip solicitously.

‘Yes, three years.’

‘It must have been a nasty one.’

‘It was. He was flashing. The accident was letting the coppers see him.’

‘But how dreadful,’ Pip commiserated over his shoulder as they continued towards the mortuary.

‘Go on? What’s a bit of bird?’ Harold asked in surprise. ‘My old dad and my brother spend most of the year inside. That’s why I’m always sweating me guts out on overtime, just to keep me poor old mum.’

‘Aren’t you ashamed?’ Pip asked involuntarily.

‘Ashamed? Why? In winter, the nick’s not too cold. In summer, it’s not too hot. That’s all there is to it.’ He added in a more abrasive tone, ‘You’ve got to get rid of all them finicky middle-class attitudes, if you’re going to do a job along with us, mate.’

‘I assure you I haven’t any attitudes at all,’ Pip replied hastily. ‘I’ve taken great care to train myself for an open view of life. I’ve read a lot of Freud and Jung. I accept everybody just as they come. Most medical people do. Even Sir Lancelot.’

‘That’s correct,’ Harold agreed thoughtfully. ‘I suppose everyone looks exactly the same, seen by the tripes.’

‘It’s just that I haven’t met many people in my sheltered life who’ve got fathers in jail.’

‘Go on? Well, I sensed you was a good bloke,’ Harold complimented him. ‘The way you took all that chivvying from Sir Lancelot and that lot. If it had been me, I should have toed him in the goolies.’

They arrived at the post-mortem room, pushing through the double doors into the cool, quiet, tiled interior, its contents lying in neat sheeted rows. ‘I mind your face,’ said the only living occupant to Pip.