Trauma (12 page)

Lafferty noted the absence of any 'mister'. Society was putting 'McKirrop' back in his place already. 'Yes,' he replied. 'How is he?'

'Not so good, I'm afraid. It's pretty amazing he survived at all after that kind of head wound. He's stable for the moment and we’ll be transferring him to the Head Trauma Unit as soon as he can be moved but as for when he might, if at all, regain consciousness, that's in the lap of the gods I'm afraid.'

'Thank you, Doctor. I'll phone in the morning if that's all right?'

'Of course.'

As he made to leave, Lafferty saw one of the policemen at the tea vending machine and stopped to speak to him. 'You're staying?' he asked.

'Yep,' answered the policeman with an air of resignation. 'Once they have him on one of these machines we could be here for the next six months on the off chance he'll come round.'

'That won't please your colleague too much,' said Lafferty, remembering their earlier conversation.

'Kevin's all right Father. It's just that the job gets to you some times. Some of the things you see every day . . . well, you start to see things differently.'

Lafferty nodded and said, 'I know.' He glanced at his watch as he stepped outside and shrugged his shoulders against the cold. It was eleven thirty. He looked up at the sky to see that it had cleared completely. As a consequence the temperature was now below zero.

* * * * *

At three a.m. Sarah Lasseter's bleeper went off and she responded almost automatically. Her room was freezing as she pulled on a sweater and slacks - the hospital turned the heating in the residency off at eleven and it didn't come on again until six in the morning. Before getting into bed she had laid all her clothes out in order so that she could dress quickly and in complete darkness if need be. She reached under the bed for the pair of flat slip-on shoes she kept there and pushed her feet into them. She put on her white coat and clipped the bleeper to her top pocket before patting the other pockets to check that she had everything she should have. Satisfied that she did, she whispered, 'Off we go again,' and slipped out of her room, closing the door quietly behind her to avoid waking anyone else on the corridor.

The coldness of the air outside almost took her breath away as she crossed the courtyard from the residency to the main hospital; she had to watch her footing on the frosty cobbles as twice she nearly came to grief. It was a relief to enter through the swing doors and find herself met with a wall of warmth but she was still rubbing her hands together when she entered the Head Trauma Unit and sought out the night staff nurse. 'You rang, Madam?' she joked in a deep voice when she saw the nurse approach.

'Sorry Sarah, we have an admission from A&E.' The nurse handed over a clip-board with a single sheet of paper on it.

'John McKirrop?' exclaimed Sarah. 'The same John McKirrop?'

''Fraid so,' answered the nurse. 'He's really bad this time. Depressed fracture of the skull. The police think it was a bottle. He almost certainly has serious brain damage but A&E say he's stable for the moment so they're keen to pass the buck.'

'Poor man,' said Sarah, reading the notes. 'Is he here yet?'

'On the way up,' answered the nurse.

Sarah heard the lift doors open out in the corridor and turned to see the night porter manoeuvre out a trolley. He had to swing his body wide to counteract the wanderlust of the front wheels as he wheeled it in through the primary unit doors. A nurse accompanied him.

'All yours,' said the nurse when the secondary doors had been opened to allow the trolley to enter. 'Where do you want him Staff?'

'Alpha four,' replied the staff nurse, turning to lead the way to a bay in one of the three small 'wards' that comprised the Head Trauma Unit. Each of the three patient service areas, alpha, beta and gamma, could accommodate four patients and each individual bay was equipped with life support and monitoring equipment at the very leading edge of technology. At this early hour the unit was only dimly lit by night-lights which gave off a peaceful, green glow. For some reason Sarah found that the lighting at night always made her think of an aquarium.

The three other beds in Alpha were all occupied, the patients having earned admission by sustaining head injuries which demanded that they have intensive care or brain monitoring or both. Each bed was surrounded by electronic equipment and chart recorders. Apart from the gentle hum of the heating and air conditioning, clicking relays decided who would breathe and when. The A&E trolley was positioned parallel to the bed and McKirrop's body was lifted gently to its new home. The porter wheeled away the trolley followed by the nurse from downstairs leaving Sarah and the staff nurse to deal with McKirrop.

'Let's get him plumbed in,' said Sarah, starting to connect the first of a range of tubes and electrodes to McKirrop's unconscious body. The staff nurse had turned on a small spotlight above the bed which provided a circular pool of white light on the patient without it encroaching on the dim green glow of the neighbouring bays. Sarah and the staff nurse worked silently until McKirrop was wired into the system and electronic information was now available for Sarah to note down on the patient admission sheet. When she had finished Sarah looked down at McKirrop and said, 'Just how you're still alive John McKirrop is a mystery to me. You must want to live very much.'

'God knows why,' said the staff nurse.

Sarah smiled as they both watched McKirrop's chest rise and fall in response to the ventilator equipment. 'Maybe he's an eccentric millionaire?'

'Or very much in love,' said the nurse.

'Or very angry.' Sarah looked at her watch and noted down the time on the sheet. 'Patient admitted to HTU and stable at three forty-six,' she said.

The nurse looked at the fob watch pinned to her apron. 'Check,' she answered.

'I think that's all we can do for the moment,' said Sarah, stepping back from the bed. How are the others?'

'No problems,' replied the nurse. 'Everyone's behaving tonight ... so far.'

'Long may it continue,' said Sarah. 'I'm going back to beddy-byes.'

'I'll try not to disturb you,' smiled the nurse.

Sarah had an undisturbed four hours sleep before she was up again to begin the business of the day. It was Tyndall's ward round today so Logan would be particularly edgy and anxious to ensure that the unit was running smoothly. Sarah decided on a dark pencil skirt and a black roll neck sweater. She tied her hair back in a bun. Finally, she chose to wear her large-framed spectacles with this outfit, knowing full well the ensemble would make her look like a schoolmarm or Audrey Hepburn playing a nun as Paddy Duncan had put it once before. Sarah deemed the measure necessary. Images were important and without such forward planning she could be mistaken for a schoolgirl.

Tyndall's ward rounds always started at nine thirty precisely so Sarah was surprised when Logan was still absent at twenty five past. She was beginning to think that she would have to brief Tyndall on her own when a breathless Logan appeared, cursing his car for having a flat battery. He smoothed his hair back with both hands and tugged his shirt cuffs down below his white coat before taking the patients' files from Sarah's hands without comment. Sarah watched the unit Sister and the day staff nurse exchange glances in response to Logan's rudeness.

Logan had not had time to read more than a paragraph before Murdoch Tyndall entered the duty room dead on the half hour.

'Morning everyone,' said the smiling consultant whose eyes moved quickly round the room taking everything in. Logan let the asynchronous chorus of good mornings die down before he said, 'Good morning sir. All ready for you.'

Tyndall rubbed his hands together and said, as he always did, 'Right, let's get started.'

Sarah smiled at Sister Roche, the unit sister, as Tyndall led the way followed by Logan at his elbow. The rest of them followed in single file in what Sarah always saw as a feudal procession. The Lord of the Manor being shown around his policies by his retainers. They stopped at each bay in turn and Logan read from the case notes which he hastily referred to for values and figures. Tyndall would nod and ask questions either of Logan or the nursing staff. Questions regarding nursing care were relayed through Sister Roche who would answer herself or refer the question as she saw fit.

When the group arrived at Alpha 4, the bay where McKirrop lay, Logan became flustered. He thumbed his way through the papers in his hand without finding what he was looking for. 'This is . . .' he began.

Sarah knew that Logan had no idea who the patient was. There had been no time to brief him beforehand. But, as Logan had chosen to ignore her throughout the ward round, she decided to let him sweat as long as possible. She noticed Sister Roche look down at her feet to conceal a small smile and looked away in case it became infectious.

'I'm sorry sir . . . I don't seem to have any information about . . .' Logan stammered. He looked at Sarah and said, 'Do you have any details on this patient Dr Lasseter?' he asked.

'Yes sir,' smiled Sarah innocently. 'Mr McKirrop was admitted in the early hours of this morning after being involved in a drunken fracas. She unclipped the new admission sheet that Logan had failed to notice on the end of the bed and handed it to him.

'No, you tell us Doctor,' interrupted Tyndall.

Sarah took the sheet back from Logan who looked daggers at her. 'Mr McKirrop was close to death when he was found on the canal banks last night. The A&E team managed to stabilise him and referred him to us because of his head injury. He has a depressed fracture of the skull with a concavity of over ten centimetres at the mid point. I admitted him to HTU at a quarter to four this morning and assigned him to level one life support system.'

Tyndall took a pace forward and looked down at McKirrop. 'Level one life support,' he repeated thoughtfully. 'No need for the patient to do anything at all for himself eh? Do you think the day will come when we can do away with bodies altogether Doctor?'

'We're a long way from that sir,' replied Sarah. 'The machines are really very basic.'

'But they're getting better,' said Tyndall, a little frostily thought Sarah. She bit her lip as she suddenly remembered Tyndall's love of technology.

Tyndall frowned. He said, 'The patient seems familiar Doctor, or am I mistaken?' He looked closer at McKirrop’s unconscious form.

'No, you're not sir,' replied Sarah. 'Mr McKirrop was our patient briefly last week because of concussion he received after being beaten up. He was the man who disturbed the grave robbers in Newington Cemetery.'

'Ah yes, the man who lived in the cemetery,' said Tyndall.

'The tramp,' added Logan.

'Not having the best of luck is our Mr McKirrop, is he?' said Tyndall.

'Goes with the lifestyle,' said Logan sourly.

Tyndall looked at him and said, 'There but for the grace of God, Doctor Logan.'

Logan smiled wanly. Tyndall turned to Sarah again and asked, 'What are the plans for Mr McKirrop today?'

Sarah looked quickly to Logan, expecting him to interrupt but he didn't so she said, 'I think the full range of cerebral function tests sir. It seems probable that he suffered extensive brain damage from the impact fracture.'

'Do we have X-rays?'

'Yes sir. A&E had then done last night. They're in the side room.'

'Let's have a look, shall we?'

The party adjourned to a small room with a series of light boxes mounted along one wall. Sarah pinned up McKirrop's skull X-ray and stood back. Tyndall adjusted his spectacles on his nose and tutted under his breath. 'Quite a wallop,' he said. 'A wonder he survived at all.' He turned to Sarah and said, 'Can I have a look at his admission stats?'

Sarah handed him the sheet and Tyndall ran his eye down the figures. He said 'I'd go ahead with the tests but I don't think we should formulate any long range plans for Mr McKirrop.'

'No sir,' answered Sarah.

Tyndall went back to looking at the sheet and read out loud, 'John McKirrop, Age, fifty-three, no fixed abode, no relations, next of kin . . . Father Ryan Lafferty?' He looked over his glasses at Sarah.

'I understand Father Lafferty arrived in the ambulance with Mr McKirrop sir. He wanted to be kept informed about his condition so A&E entered his name as next of kin. He has no one else.’

'What's Father Lafferty's interest in the patient?' asked Tyndall.

'He wants to interview Mr McKirrop about what happened in the cemetery with the Main boy.'

'Really,' said Tyndall distantly.

'The police are also waiting to interview Mr McKirrop. I understand the other party involved in the fracas died,' said Sarah.

Tyndall gave a gesture of distaste and Logan did likewise. Tyndall's took the form of a little shake of the head while Logan's lip curled in disdain. 'Jeez!' he exclaimed.

'Well I suspect they'll all be disappointed but you never know,' said Tyndall. 'Some of us have been in this business too long to be surprised by anything the human body can do. I'd like to be kept informed of Mr McKirrop's condition please.'