Nightingale (14 page)

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Authors: Fiona McIntosh

BOOK: Nightingale
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Claire cleared her throat. ‘Has he regained consciousness?'

‘Briefly,' he answered crisply. ‘Wondered about you, actually.' His face shifted briefly towards her, filled with enquiry.

She felt warmth spread from her churning belly and ascend to her throat in a surge of reassurance.

‘Matron didn't want you to attend; obviously this soldier is known to you?' He looked up again from where he was staring at Jamie's abdomen – the old wound by his shoulder had reopened, there was a fresh wound at his arm, his other shoulder, and in his side. She nodded, saying nothing. ‘Well, I can't be worried about that. If we're going to save his life, I need my best nurse working with me. Get him under.' She watched him pull off his gloves. ‘These bloody things make me move around a man's insides like a bull in a china shop. I'll scrub with carbolic. Have him ready.'

It required all of her newly honed skill to calculate the amount of anaesthetic to use on a weakened man.

‘I'm not going to use the Schimmelbusch alone,' she said, reaching for the wire-screened vaporiser. ‘I'm going to try something.'

‘This may not be the moment for experiments, Nightingale,' the surgeon warned.

‘I've read about it. It's a gentler way of delivering the sedation.'

‘He doesn't care,' he said, nodding at the tray of instruments on the trolley. She pulled them towards her.

‘Its effect is lengthened but apparently with less impact on the patient. He's lost blood, he's weak.' She folded up a towel several times and placed the mesh over it. ‘He'll need to be under for a while.' She dripped the chloroform onto the mask. ‘He could wake up again if I don't give him enough.'

‘Forget whoever this man is to you and just work with me now to save a soldier's life.'

Claire steadied herself with a slow deep breath and having finished with the chloroform, began administering the ether. The two drugs would work together to keep Jamie unconscious. ‘He's ready.'

‘Then let's begin.' The surgeon probed the ugly wound to the right side of Jamie's abdomen and Claire blinked at Rosie, who had arrived to assist, refusing to allow another tear to drop.

But despite their best intentions, before the doctor could so much as offer his thoughts, Jamie Wren's heart gave out.

‘There's no pulse, doctor,' Rosie confirmed glumly. ‘He's gone.'

Claire gasped and realised that the brief shriek echoing off all the hard surfaces was her own.

________

Even the surgeon had blanched above his mask at the suggestion that Claire had just put forth. ‘Absolutely not. It's too risky.' He tore off his mask and pointed at Claire. ‘I mean, for you. It's dangerous enough in sterile conditions and in a proper theatre of a proper hospital.' He shook his head. ‘No, I don't wish to risk you or waste time trying to save the life of someone who is technically already dead,' he said as Claire pushed up and down on Jamie's chest, willing his heart to start again.

She looked over at Rosie, who had her fingers on the artery at his wrist. She nodded, her eyes lighting with excitement for Claire. ‘I've got a pulse again.'

But the surgeon shook his head. ‘His heart will stop once more, I assure you.' He didn't say it unkindly but he was firm.

Claire was hearing none of it. ‘It's my decision to risk my life. It's his only chance. Rosie, help me, please.'

Rosie looked unsure of defying the chain of command, glancing at Matron, who had arrived to hear the serious news, but with another glare from her friend, she hurried to help Claire get ready.

‘Claire!' Matron breathed out in disbelief, all protocols apparently being dispensed with in the collective shock gripping the theatre. ‘What exactly does this man mean to you? We've lost hundreds of others.'

‘And he's already died once,' the surgeon added wearily. ‘We've revived him but his blood pressure is failing again.'

‘That's why we have to do this now!' Claire insisted, glaring at all of them. ‘Let me give him my blood and give him a chance.' She searched the faces of those in charge, pleading with her gaze. ‘I already know we're compatible from the blood testing in Australia,' she said, her final words wept rather than spoken.

Rosie chipped in, worried. ‘Claire, this endangers your life. Don't you understand?'

‘Of course I do! But his life is clearly over if we don't do this. And I don't want a life if Jamie's not in it.' There, it was out for every­one to examine. The shock of her words hit them all and slapped them from the stupor.

The doctor reacted fastest. ‘Claire, listen to me now. The risks outweigh any potential chance he has.' He began to list them as Claire started rolling up her sleeve. ‘Blood clots too fast, your arteries are too small for this sort of transfer, we have no way of knowing how much is being transfused, or —'

Claire crossed all the protocol boundaries when she clutched at the surprised doctor, her voice shaking as she snapped. ‘Doctor, it's his only chance anyway . . . so any obstacles you suggest are purely academic. I'm going to do it, and for all the countless hours I've assisted you, do this just for me.'

The doctor looked vaguely helpless and then at Matron, who shook her head, looking suddenly redundant. ‘Matron?' he pressed. ‘Please, she's in your charge.'

‘No, I'm afraid Nurse Nightingale has a mind of her own,' Matron said in a hard voice but the look she cut Claire told her that she was impressed, proud even.

Claire would face any punishment later; right now Jamie's life was all that mattered. ‘It's my decision, my risk. No one here is responsible for these actions except me. You've all heard it. Now, please . . . Rosie, can you do it for me?'

Rosie nodded with a soft smile and a glance at Matron, who acquiesced.

The doctor blew out his cheeks, giving up the fight. ‘Right, well, we've only got minutes,' he said, looking suddenly flushed and excited. ‘Let's get some space around them both. We need Claire lying down beside this soldier so their arms are together but we need her slightly elevated. Nurse Parsons, I want you to use the radial artery in her wrist.'

‘Surely the median basilic?' Rosie wondered, gesturing towards Claire's elbow.

The surgeon glared over the top of his mask. ‘Don't question me. This is hard enough as it is. We haven't performed a single transfusion on the ship. The radial is accessible – just do it!'

Within moments, Rosie had conquered her shaking hands and pressed the needle deftly into Claire's wrist, reaching the tiny artery. ‘Thanks,' Claire whispered.

‘You're definitely buying the drinks next time we hit Egypt,' Rosie warned.

The surgeon pushed past Rosie to wave a gloved finger in Claire's face. ‘Right, we're going to move slowly on this. Claire, any tightness in your chest, difficulty breathing, if I sense you losing too much colour or getting dizzy, it's over, do you understand?'

She nodded.

‘Right. Nurse Parsons, if you want your friend to survive this, you must scrutinise her colour. The first sign of paleness or nausea and you pull that needle out, all right?'

‘Yes, doctor,' she replied in a meek tone. She turned back and winked at Claire. ‘This is really going to cost you a big night out.'

Claire closed her eyes, and to stem her racing fear and to keep her blood flow calm, she disappeared into recollections of nursing school and the physiology of her blood vessels. She conjured the image from her textbook and then imagined tracing the path from her chest wall to under her arm and along to her wrist, where her strong heart that was full of love now pumped her lifeblood into Jamie's network of vessels.

‘Well, thank heavens they insist on compulsory blood grouping before these boys leave Australia,' she heard Matron mutter, but Claire didn't open her eyes. She focused on the image of their bloods welcoming each other as happily as their lips had. They were compatible, they were in love and were both going to survive.

‘His colour is improving,' the surgeon murmured into the tense quiet a short while later.

‘Claire's isn't.'

‘A minute more, then, and we'll call it,' he said. ‘This will be the first and last direct transfusion I'll be performing.' Nevertheless, hiding beneath the bluster there was still a hint of excitement to have performed the difficult procedure.

Claire heard his voice close to her ear and yet somehow it seemed to be coming from a distance, as though she was drifting. ‘You leave him to us now, Claire. You've done something very special and no doubt prolonged his life – I shall do everything in my power to save it now.'

She sensed him moving away.

‘Now, get Claire out of here. She needs sugar – sweetened tea is the best way.'

9

Matron arrived by the cot where Claire sat in a bubble of silence. The patient she tended was tied to the bed for fear of him rolling off in the swell of the seas that carried them away from Gaba Tepe towards Mudros Harbour.

‘Nightingale, what possible use to me are you if you're not going to rest, eat, drink or even stretch those limbs?'

Claire dropped her shoulders from the tensed, hunched position they'd adopted and she straightened, pulling them back with a soft sigh as her shoulderblade made a clicking sound. She checked the clock on the wall. It was nearly time for another flushing out.

‘Well, he has good colour.' Claire cut her a smile. ‘Who was in this bed before?' Matron continued, frowning at Jamie's slack face.

‘A captain. I gave his disc to the chaplain.'

‘Pity. I thought he might just make it.' Matron sounded genuinely anguished. ‘They worked very hard on this young man too. How is he doing?'

‘I can't tell yet. His colour suggests his blood pressure is well improved, and we seem to have his fever under control, but even I can't fight the shock that might potentially take him.'

‘That was an extraordinary decision you made back there. Most nurses would never have even seen a direct transfusion performed.'

‘I had a brilliant training, Matron, and I can't imagine you'd have done any less.'

‘Are you going to tell me about him?'

‘I know so little, there's not much to share,' she said. ‘I barely know him at all, except . . . he's come to represent every soldier for me.'

‘I thought he was a family friend?' Matron replied, her tone bewildered.

In the barely lit dullness of the ward, surrounded by mostly sleeping, hurting men, she told her senior an abridged version of events, leaving out the romance and her aching heart since.

‘These are certainly extraordinary times and we're witnessing events not even encountered in our nightmares. It's understandable that you are feeling so unsettled.' Claire blushed, guilty that Matron didn't know the half of it.

‘But you have to go deep within yourself and find extra strength, extra courage. If those men out there can, we must. Now, promise me you'll go up on deck and breathe something other than stale air.'

Claire nodded. ‘I'll go up in ten minutes.'

‘All right. How is that sweet young Francis doing?'

Claire glanced over to where a lad, just seventeen, lay in a cot, having lost both legs.

‘I don't know whether to be pleased he's as strong as he is or to wish he never wakes up.'

‘Don't be that honest with him when he does wake up, Nightingale.'

‘Sorry.'

‘Gather all that pain up and lock it away.'

‘Matron? May I request a longer shore leave?'

‘No, you may not.' It was not said unkindly.

‘No one will care for this man's wounds as I will . . .'

‘My, that's a low opinion you have of your fellow nurses.'

Claire's lips parted in shock as she struggled to find the right words. She couldn't. ‘I . . . I didn't mean —'

‘I know you didn't,' Matron replied. ‘But that's how it sounds. You're no good to me on this hospital ship if your mind is going to be elsewhere.'

Claire put her hands up in appeal. ‘Will you spare me a few moments, please, up on deck? I'll just tend to Trooper Wren's wound but I would appreciate your advice about something.' She watched Matron nod tiredly and was reminded that not only did her superior worry about the patients but she had the additional burden of worrying about the welfare of her nurses. Claire knew she was adding more weight to the woman's duties.

She began gathering up the equipment she needed to irrigate the deep shrapnel wound in Jamie's side.

As Matron left she said back over her shoulder, ‘And only if you show our youngest nurse how to do this procedure properly; we must all share our skills.'

‘Yes, of course,' Claire said, gesturing to the young nurse arriving on duty.

‘Meet me on deck in fifteen minutes, Nightingale,' Matron said.

Claire nodded while she affixed the tube to the bottle of Dakin's solution. ‘Like this,' she said to the nurse. ‘You don't want to deepen the wound but you need just enough pressure for the liquid to flow freely. Back in Alexandria – in a decent hospital – I would prefer to do this manually with a syringe.'

‘Why?' her student said, holding a lamp over the wound as Claire cut away the dressing.

‘Because you can manipulate the application to precisely where it needs to go. The mixture is obviously caustic and can horribly irritate the patient's skin. Most are too ill to notice. We're flushing this out every hour.'

‘That's a lot of work.'

Claire looked up from Jamie's body where his rib cage protruded in ghastly outline. It was no different to those of the other soldiers, but it was no easier to accept how thin he had become. ‘This routine could save his life. It's worth the effort; you must always go the extra mile.'

The youngster was genuinely inquisitive. ‘Does it hurt?'

‘Yes, extremely painful. But this patient is still too concussed to worry about it.'

‘Is it true he's your sweetheart?'

‘Gosh! Where did that come from?'

The girl smiled. ‘I don't know about Matron, but the rest of us think it's wonderful.'

Claire knew she had no business feeling indignant. ‘I have to meet Matron now,' she said, checking the clock again. ‘Are you all right to wait here for Rosie?'

‘Of course. What could go wrong in a minute?' she replied breezily.

Everything
, Claire thought silently. Kissing Trooper Wren had taken less time and her life had turned inside out since. She helplessly rested her hand against Jamie's arm, allaying her fears by touching his warmth, telling herself that as long as he was here within reach she could keep him safe.

________

Claire escaped the ward quickly, moving swiftly up the levels until she could drag salted air into her lungs. The
Gascon
lumbered slowly through the heaving waters, the captain mindful of its delicate cargo. Claire had found her sea legs quickly but even so, she could feel the lift and drop beneath her shoes as the ship groaned softly. There were sailors moving around their duties and she saw two doctors smoking quietly in a nook. Once the ship picked up more speed and the breeze stiffened, the deck would clear but for now the air was coolly welcoming with the capacity to blow away her confusion.

‘You wanted to see me, Claire?'

She turned and smiled haltingly at Matron, only now realising she hadn't thought through what needed to be told.

‘Thank you, yes,' she said, buying a little time.

Matron leaned against the deck rail and closed her eyes momentarily. ‘Out in the dark silence, skimming across the deep, I can almost convince myself that no one knows we're here and the world is not at war.'

Claire was sure everyone aboard felt a similar sense of peace during the crossings.

‘Matron, I want to tell you the truth.'

‘Always a good plan.'

She spared no detail, admitted the slip in protocol was her fault alone and owned up to feeling besotted and unanchored ever since that moment of sheer madness.

Matron surprised her with a sad smile. ‘There's no reprimand coming from me, if that's what you were dreading. Somehow I sense you are already suffering enough.'

Claire felt her eyes water and was glad the moon was not out to reflect their moistness.

‘As long as he's breathing, there's hope, but let me just caution you about that heart of yours. It's easy to get one's emotions confused in these situations. Empathy is a powerful feeling.'

‘I've never experienced anything like this before. There have been hours these last few days, even during the short leave in Alexandria, when I felt as though I haven't been able to breathe, when I've made a pact with anyone listening that I'd swap my life for just a few hours with him . . . and now he may die.'

‘The universe in its wisdom has presented him to you twice injured. Keep faith.'

‘I doubt they'll leave him in Mudros. He'll be sent on to AGH1. The Cairo wards are equipped for the care he requires.'

Matron waited to hear what Claire said next.

‘He's Light Horse Brigade. These mounted regiments are precious. I suspect they'll want him receiving the best care we can provide so he can be well enough to ride into the next battle if the Dardanelles can be secured.' Her tone had turned miserable.

‘You would be right,' said Matron.

‘About sending him to Cairo?'

‘About everything. Mounted troops are precious. And yes, he's destined for AGH1. You should go with him.'

Claire straightened, turning to face her superior. ‘I thought you said —'

‘I didn't have all the facts. Now I do. Two days, Claire. That's all. You know how much you're needed here.'

Her mood brightened instantly. ‘I just need to see him wake and be sure his memory is intact.'

‘And perhaps tell him something?'

She nodded, embarrassed, but her spirits lifted with excitement. ‘I don't know how. I'm so used to holding my feelings in check. Now I'm overwhelmed; I think I'm scared to admit how this feels.'

‘Don't be. I'm going to admit something to you now that no other nurse who works for me knows.' Matron sighed and uncharacteristically slumped her shoulders. ‘I was one of the lucky few chosen to serve at a stationary hospital in the Boer War. You know nurses weren't exactly welcome at battlefields in the early years of this century. Not like you young braves today.'

Claire half smiled.

‘I was based in Rhodesia. And there I met my dear husband, a lightly wounded but effortlessly cheerful officer in the British Army. I think I fell in love with him from the moment he first laughed, cracking a joke about getting in the way of a bayonet. He was tall, not especially handsome, but, oh, he had fine hands and a mellow voice that made my heart skip a beat and a laugh that could make a whole room light up with fun. His wound was ugly and infected but it wasn't life-threatening and he wanted no fuss. We cleaned him, sewed him up and sent him off again.'

Claire's mouth opened in surprise.

‘He was in hospital for three days and somehow he persuaded me to marry him in those seventy-two hours.'

Now Claire gave a soft gasp and Matron laughed. ‘It all happened so terribly fast but I was a spinster, not especially pretty, and I'd had no offers of marriage. I wasn't yet too old but I also wasn't young. My head was filled with the passion for my work that for the first time was challenged by the passion I suddenly felt for him. I had nothing to compare it to; it was pure instinct and I didn't care that he was a decade older. In fact, I was so eager to become Mr and Mrs that the chaplain married us in a makeshift church, beneath the clearing station's awning, and with my husband's arm in a sling.'

Matron sounded lost in her recollections, then she refocused abruptly. ‘Sadly, Ernest died. Caught an unlucky gunshot through the heart two months later and I was informed that he was dead as he hit the ground. I've never remarried, although surprisingly I have received an offer or two. I'd known what love felt like and I have never wished to tarnish that by feigning a similar affection for anyone else.' She shrugged and smiled. ‘If you feel it, Claire, trust it but be aware of how fragile life is right now.'

Claire couldn't find anything to say to follow such a touching story or heartfelt advice. She simply nodded. Matron turned away, satisfied, and Claire knew this conversation would not be referred to again.

She took a final deep gulp of the Mediterranean air and made a promise that if Jamie survived and admitted to loving her too, then she would not let anything or anyone ever get in their way.

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