Chapter Three

The Education Centre, where the local induction was being held was supposedly the newest part of the hospital but it hardly lived up to that hype. The fresh white paint struggled to conceal the jaundiced undercoats and the floor was in desperate need of a thorough hoovering. A set of automatic doors played open sesame with a class of rotting leaves. They were supposed to be the only modern feature yet the glass panes dragged themselves apart like the feet of a whingeing child.

Every year for as long as she could remember, Philippa Haven had worked at different hospitals, as the people at the top played chess with doctors’ rotations and she had seen how those at the absolute top of the food-chain poked and prodded with the lives of junior doctors and nurses like pin-cushions. 

The year ahead at the Princess Royal Hospital seemed insurmountable with the upcoming night shifts but it was nice to see a familiar face.

‘What can I get you?’ asked Tim, who had evidently sprinted out before the end of Dr Steer’s talk to queue up. Philippa remembered he was a particularly sporty student.

‘Flat white would be great please. How much is it?’

‘Don’t be ridiculous.’

‘Thanks, I’ll grab seats.’

They had attended university together but the year groups were huge; over three-hundred in fact. They had not shared any small group sessions nor had close mutual friends but most of the year knew Tim Chung; he was one of the brightest and was awarded distinctions for most of his modules. Life as a doctor was plain-sailing before he was struck by tragedy, but that was only a rumour and Philippa was not a close enough ally to probe on day one.

Philippa took a sip of coffee as Tim straightened his checked trousers and added two sachets of sugar to his tea. The scent of coffee beans made her regret her order instantly; now she would never get any sleep before her shift.

‘Thanks, Tim.’

‘Don’t mention it,’ he replied softly, ‘besides, I’ve got a loyalty card so I’m only a couple of drinks away from a free one. So, where are you staying?’

‘Hospital accommodation.’

‘How is it?’

‘Small… hardly value for money but it will have to do. Mind you, I’ve not had the chance to unpack fully yet.’

‘I’ve got a place just around the corner, no more than ten minutes’ walk so feel free to pop over for dinner or something.’

‘Bought?’

‘No, I wish; renting. Unless you’re getting paid out of line. You’re welcome to pop over tonight if you fancy it?’

Philippa smiled. ‘I best try and settle in tonight but next week?’

‘Of course; we’ll catch up before then, I’m sure.’

‘Thanks in advance.’ Perhaps the year might not be so painful after all, she thought as they exchanged numbers.

‘We’re out in the sticks a bit so it gets lonely quite a lot.’

Tim added his third sachet of sugar to his tea and stirred before nestling the hot cup in between his palms. His spectacles misted as he brought the drink close to his face.

‘Careful with that, or you’ll be coming to see me in my clinics before long,’ Philippa warned playfully.

‘You D&E?’

She nodded.

‘How do you find that?’

‘I enjoy aspects of it. What made you choose Infectious Diseases?’

‘The epidemiology is interesting and you get to do some work abroad – get away from this nightmare healthcare system once in a while.’

It was no longer a privilege to work as a doctor and the respect for the profession had evaporated. The system had become shackles and hospitals that failed to cope with soaring patient numbers were fined instead of supported. Yet on top of these time pressures, litigation and the wizardry of the internet had transferred power from the profession to patients, allowing the services of the NHS to be ruthlessly abused on occasions – cue the couple dumping their vulnerable demented mother at the doors of A&E just before their holidays for instance…

‘But what really interests me is virology, I mean these things are invisible to the eye, small bubbles of genetic material but their destructive power is incredible – way more interesting than insulin right?’

‘Let’s agree to disagree on that one,’ replied Philippa. ‘When you said earlier: if you survive the year, is it really that bad?’

‘Last year has been tough,’ Tim admitted, leaning in. ‘There were fifteen of us but by the end of the year, two registrars had quit and another four were signed off from doing night shifts.’

‘Signed off?’

‘Too stressful.’

Philippa sighed.

‘I said it was unfair that a registrar from the new intake was starting on nights, especially with a shortage but they clearly didn’t listen and I couldn’t swap with you.’

‘Thanks, that’s really sweet of you.’

‘It’d be sweeter if they listened. I used to fill some of the gaps for them but I’ve stopped now; it’s not worth it. Thirteen hours on your feet being pulled from pillar to post without a break for less than three-hundred-and-fifty pounds after tax? I might as well become a private tutor… or a plumber!’

‘Like Dr Steer said; I’ll just have to cope somehow.’

‘I’m sure you will, but that’s not the point.’

‘What’s the score with that moody cow anyway? She seems to like you though.’

‘She just needs to get to know you; doesn’t give anyone the benefit of the doubt but once she’s worked with you and knows you’re decent, she’ll lighten up. Like I said, I helped out medical staffing a fair amount last year and I think she knows. That aside though, Dr Steer’s an amazing doctor.’

‘What’s her specialty?’

‘Geriatrics – hence her interest in resuscitation discussions. She was close to retiring a few years back and then the Ebola crisis happened.’

‘Why would that change anything?’

‘You wouldn’t believe it but she was one of the first to pack her things and head over to Sierra Leone.’

‘She went over there?’

Tim nodded. ‘Helped lead the response. See those teeth she’s missing? Apparently whilst she was over there, they came across some thugs who crashed their camp and you know…’ He mimed a punch.

‘Wow…’

There was a brief silence as if Tim was reflecting on his past. Philippa noticed her colleague twirling his silver wedding band. She was about to cross-reference the rumours she had heard when he asked her: ‘Have you ever thought about quitting?’

Philippa peered at the hospital exit as it got busier in response to the pending five o’clock exodus. ‘No. The NHS needs me; I’d like to think.’

‘There aren’t many of your type left in the NHS.’

‘How do you mean?’

‘Dedicated and still half-enthusiastic. It’s admirable but you’ll burn yourself out one day.’

‘Dedicated? What makes you think I’m dedicated?’

Tim laughed. ‘Weren’t you shortlisted for an Excellence in Patient Care Award earlier this year?’

‘Oh that,’ Philippa replied with a raised eyebrow. ‘I did but it’s not like I won it. Instead, I was pitted against three people who had been working at consultant level for over a decade, creating services left, right and centre. I had no chance of winning it and just confirmed my suspicions that they had only ever received four nominations!’

‘It’s still impressive to be shortlisted though, come on; give yourself some credit.’

‘I didn’t think anyone read emails from the Royal College.’

‘You’ll be surprised.’

‘Have you thought about quitting?’

‘Many times,’ Tim replied. ‘The past few years were a real cause for disillusionment.’

‘I just think it’d be a waste; you worked so hard all your life to reach where you are now and you won all those awards at medical school.’

‘Those awards mean nothing in the end. There are so many problems with the way the NHS is being run, Philippa. I was once hopeful things would change but I realise now that things can’t change. The NHS will die – it’s already dying.’

‘That’s a bit pessimistic don’t you think?’

‘Pessimistic?’ Tim shrugged. ‘The NHS is already on its knees. Look around you; everyone’s burnt out, everyone’s undervalued, everyone’s demoralised. My –’ The ring-fiddling became a little more intense.

Philippa could feel the sadness ebbing from his voice.

‘I knew someone – a nurse in fact – and when we first met, she told me how her and a few of her colleagues were using food banks. I mean, that’s how bad it is and people just turn a blind eye.’

I knew… Tim Chung had not made it obvious – perhaps he didn’t realise Philippa had heard about the rumours, but it pretty much confirmed they were true.

‘Hospitals hire senior managers in their hordes – people never seen on the frontline, who understand little about caring for people let alone actual medicine but who are on inflated salaries. They don’t care about us or the nurses or healthcare assistants! These people are nothing but so-called specialists at prioritising flow. That’s all that matters to them; how quickly somebody gets shoved along the conveyor belt. All it would take is for a new virus to emerge, spread across the world, demolish populations and once it reached here, well God save the NHS if that happened.’

‘Maybe you’re right, I’m none the wiser. But until that day arrives, I may as well give it my best.’

‘You’re only delaying the inevitable,’ Tim said. ‘Though if you insist on that, you’d best get some rest before the shift. Take care, I’ll see you around.’

‘I’ll let you know how it go. Thanks for the coffee.’

The cool fresh air extinguished the stress in Philippa Haven’s lungs as she made her way towards the accommodation. The evening sun had long begun its descent, leaving only traces of cinnamon in the sky. Locksbottom was a quaint town with clean pavements, immaculate public lawns and even a lollypop lady for the schoolchildren. Hadn’t they become extinct?

It was twenty-past-five when Philippa reached her flat. Her fridge was bare except for a few staple items and an expired sandwich. She cooked very well in fact but right now, she could hardly be bothered – and cooking for one was always tricky. She kicked off her shoes and rinsed her face in the compact bathroom. Two dress sizes larger and she would not have been able to close the door.

She examined herself in the mirror. Her hair was in dire need of brushing and her eyes struggled to prop up her drooping eyelids. The thought of working tonight etched another crease into her forehead. In less than three hours she would have to head back outside and it would be both frosty and dark. Should I shower? Should I sleep? Sometimes it was easier to keep going…

There was no dining area in her apartment so Philippa perched on the sofa with her knees folded as she feasted on the cheese-and-pickle sandwich and a bowl of microwaveable tomato soup. Doctors were once prestigious members of society. How that had changed…

The six o’clock news was broadcasting but her view was temporarily disturbed by an eruption of steam as she lifted the lid of her soup.

Philippa was somebody who normally took great pleasure when it came to food. In fact, her dream job was to be a food critic. Though as many people would often comment, she was blessed for her guilty pleasure was not exposed by her enviable figure.

A news report piqued her interest; some cities in East China were still reeling from a typhoon nearly two months ago and a dozen people were still missing, presumed dead… strictly speaking, so was her sister, Julia…

Tonight, there was only going to be one victor in the battle between her food-baby and the daunting prospect of a night-shift; she would have to power through. It was now a matter of finding something to pass the time or someone to pass the time with… if only… maybe she should have taken Tim up on his offer.

By habit, she checked the time on her phone and for any missed messages. Her background photo made her reminisce. The snap had been taken five years ago, when Julia was so excited… when she was last seen alive…

She jumped when the phone rang.

‘Just wishing you the best of luck on your first day at the new hospital lovely.’

‘Thanks, Mum.’

‘Remember; if you can’t look after yourself –’

‘How am I supposed to look after others; I’ve been in this long enough to know now.’

‘You’re coming up thirty-three and you haven’t got yourself a husband let alone kids.’

Philippa rolled her eyes. Not right now, Mum.

‘It’s because you’re working all the time. You’re a good-looking girl, Pippa. Your sister Julia grasped life with both hands and squeezed every drop of pleasure out of it but that’s how she met people.’

Actually, it was me who set her up with Charles, thought Philippa.

Philippa Haven lost her father at a young age. Her older sister Julia had always been there for her and acted as the pillar of the household whilst their mother battled with the mental illness that ensued. She considered it a favour returned, when she played cupid in setting her up with Charles Spence-Jones – an ex-colleague and now brother-in-law. But whilst she had been a successful matchmaker for her sister, she was less than lucky when it came to finding love for herself.

‘Just think about it. Maybe take a year out like so many of your other colleagues. Try and enjoy yourself. There’s a lot more to life than work.’

‘Thanks, Mum. I’ve listened and –’

‘- hopefully, you will act,’ she added.

Philippa sighed. ‘I’d best get ready for my shift.’

‘Take care and look after yourself please.’ Then her voice tailed off: ‘I’ve already lost one of you girls; I can’t lose another.’