Chapter Four

20:00

The hospital was a twenty-minute walk from the accommodation. By car, it was doable in less than five. Tonight, Philippa Haven chose the latter method of getting to work.

For a moment, she sat in silence. The warmth of her hatchback’s interior was like a friend visiting from abroad. Here they were clinging to each other, delaying the inevitable separation as if at the airport.

She had parked up on an unfamiliar road. An elderly lady was violent with her curtains and when she was no longer visible, Philippa took that as a signal to bid farewell to her freedom for the next thirteen hours.

Within the space of a few hours, the temperature had diminished significantly; she was able to see her breath emerging from her mouth. Philippa wrapped her coat tighter around her as splashes of rain harassed her face. She saluted a solo magpie searching for nesting material in a neighbourhood garden.

The path leading up to the hospital was lined by lampposts spread over great distances and many of them had long stopped working. Creeping weeds, inhabiting the cracks within the pavement lay spread-eagled beneath the subtle moonlight.

Two nurses identifiable from the azure dresses peering through their unzipped fleeces stepped aside dramatically to allow Philippa to pass. One had rosy cheeks and tomato conjunctiva. The other was whispering in her ear with an arm around her shoulders.

In some ways, she was relieved for the doors of the Princess Royal Hospital to swallow her up and she felt a tingle down her spine as the hot air blowing from above snaked its way between her layers. There was a single shop with household essentials which had closed for business but Philippa spied the shop assistant through the haggard shutters still unpacking boxes.

At this time, people tended to file through the exit than the entrance, exaggerating the depression of working a night shift; that sensation of being left behind…

She scanned the signposts leading to the Ops Room. Then her phone buzzed.

Good luck in the new hospital, Pips!

It was Rachel, a girl who was in the same year as Philippa. They had also shared their experiences as first year doctors in the same hospital – experiences that led to a persistent friendship.

Thanks, Chel! How’s New Zealand?

Amaaaazing. Still loving it here after all these years. Best career choice I could have made. Now just waiting for you to join me!

Philippa smiled. You’ll never guess who is working here with me.

Not your ex, James surely!

No! Tim Chung?

From uni?

Yep.

Didn’t he have a crush on you?

Not unless you’ve always known something I don’t!

I’m sure he did, before he got with that nurse.

Do you think the rumours were true? I couldn’t ask him about it today.

I remember seeing pictures from his wedding on Facebook. Then some cryptic announcement that suggested they had broken up or she had died.

I think she died. He mentioned how he knew a nurse in the past tense and got all upset. I think he was referring to her.

Could still be broken up.

Well I guess I’ll find out before the end of the year and fill you in on the goss. I’d best go. Speak soon xx

Come visit me soon please! Our lives are a lot better over here xx

The Ops Room hardly lived up to the important label and it proved surprisingly thin on tech with three retro desktops and little else.

‘You must be Philippa!’ a strong French accent greeted from behind her, as she entered the room and pocketed her phone.

The man who had called to her introduced himself as Alfred. He brushed past her to reach the core of the room and pulled a chair close.

Philippa had made a conscientious effort to be early yet three other people had already reported for duty.

‘Come, sit down with us,’ the man instructed. ‘It’ll be the last chance you get to do so until the morning.’

Philippa knew he wasn’t exactly joking. As she approached the nearest chair, her eyes darted between the four walls, searching for somewhere to place her belongings – somewhere other than the floor.

A dead fly was waiting to be swept away next to a small trolley with tea-making facilities. The trace of steam fizzing from the lip of the kettle suggested it had only recently been utilised.

Momentarily, her eyes focused automatically to the ceiling lights reflected upon the window but then she saw a cemetery with a spire extending to the night sky as if trying to retrieve the moon.

‘Hi I’m Gemma, the site nurse practitioner.’ Site nurse practitioners or SNPs were highly skilled nurses who had the know-how to troubleshoot most things in the hospital.

Philippa acknowledged the rest of her team; Karan, a senior house officer two years from becoming a medical registrar and Justin Hills, a first-year doctor, fresh out of medical school, who seemed far too collected at this stage of career. That was usually a good sign unless he turned out to be one of those arrogant first-years…

‘What specialty are you?’ asked Alfred.

‘D&E. You?’

‘Geriatrics.’

‘Ah, so you must work with Dr Steer then?’

‘Have done but she’s usually on a different ward to me. She’s nice,’ he replied with a poker-face.

‘Which part of France are you from?’

He chuckled and replied, ‘Not France dear, Sierra Leone.’

That would explain his interesting choice of attire and perhaps why he thought favourably of Dr Steer. Alfred was wearing a traditional looking African tunic in a deep shade of orange decorated chaotically with black zigzags.

‘Have you heard?’ Karan said suddenly before any awkwardness arose from Philippa’s embarrassing assumption.

‘What?’ asked Gemma, in a throaty tone.

‘We’re one down tonight. This is getting ridiculous; I was one down on my last set of nights and now again. Mental,’ he groaned. ‘You know, I can’t even remember the last time I did some night shifts here when we were fully staffed.’

‘I’ll make you a cup of tea later,’ Gemma said.

‘Yeah, if I’d get the chance to drink it. If I do, I’ll take that as a result any day.’

Justin remained hushed, perhaps due to his lack of seniority. Or maybe he was not the loquacious type.

‘Don’t worry,’ Alfred said, ‘I’ve tried to do you guys a favour; only two patients waiting.’

‘Nice one Alfred; the only silver cloud was I knew you were on-call during the day.’

‘Did you get much sleep, Philippa?’

‘Not a wink, Alfred; our induction finished at half-four and then I accidentally had a coffee.’

‘Did they not let you out of induction early?’

‘Not a chance – mandatory rubbish.’ Philippa rubbed her eyes and tied her hair back into a ponytail. ‘I’ve done this job for eight years and it’s the same boring stuff on fire safety and data protection and whatnot. Yes, I know to log out of my programmes…’

Alfred kissed his teeth. ‘I know,’ he said with a defeated manner.

Philippa sighed then asked: ‘Any words of wisdom? Dr Steer looks like fun to work with…’

‘She likes to push her registrars, especially the new ones; put them under pressure and see how they cope. It’s like a rite of passage. But she’s not the worst of your worries tonight unfortunately.’

Philippa raised a curious eyebrow.

‘Dr Balsack is the A&E consultant tonight.’

Philippa worked out from Karan’s swearing in the background that this was a terrible name to mention.

‘Let’s say his name is a pretty appropriate description,’ Karan snarled.

Gemma laughed and tutted the senior house officer.

Karan tried to defend himself. ‘What? He makes being an A&E consultant easy; he refers everyone to medics and tries to admit every single patient.’

‘Dr Steer said that A&E were quite good here,’ Philippa said.

‘Rest of the time it’s alright, not when Dr Balsack is in charge. But if he’s on tonight, it means he won’t be on for the rest of your nights, if that makes it any better.’

‘Some consolation, I suppose,’ said Karan.

Alfred handed over the two patients who he mentioned were waiting to be seen, before wishing her good luck. ‘I’ll see you in the morning,’ he added as he departed to catch the next train into London, much to Philippa’s envy. How she longed to be in bed right now…

‘Karan, you’re on Take with me, right?’

‘Yep, I’ll get cracking and see the two waiting.’

‘And Justin, you’re covering all the wards?’ she asked, almost sympathetically.

He nodded.

‘Any problems let me know sooner rather than later please. Karan, I want you to discuss every case you see with me and I will try and review them as the night goes on.’

‘It’s okay, I’m not that bad,’ he responded with a subtle flinch.

‘It’s not about that,’ Philippa told him. ‘Just keep me informed. And you as well, Justin. I’ll probably check in with you every few hours.’

‘Right, and then there were two,’ Gemma commented as the juniors disappeared in opposite directions.

Philippa forced a smile and followed Gemma out before her bleep went off.

‘Trust me, that’s good for A&E; usually they will have bleeped you several times even when they know it’s our handover. Don’t understand why they can’t just be a bit patient.’

Philippa backtracked into the Ops Room. ‘It says 88888. Is that A&E?’

Gemma looked surprised. ‘No that’s an external call – probably another hospital or a GP trying to get hold of you. You’d best answer that before they give up waiting. Oh, and we hold a meeting at one in the morning to gauge how things are going and split any of the workload if possible. I’ll bleep you in case you forget.’

‘Where?’

‘Here.’

Philippa sat by the nearest phone and felt a cold breeze crawl over the back of her hand. She traced it back to the window which was slightly ajar but with the receiver in her hand, it was too distant to shut. She dialled the number.

‘Switchboard.’

‘It’s Philippa, the medical registrar. I got a bleep from this number: 88888?’

‘Yes, hold the line; let me put you through.’

There was a pause followed by the faintest of crackling.

Philippa rapped her fingers against the table impatiently. She was already wondering how Karan was getting on with the first patient.

Then at last, someone spoke: ‘Hello, Dr Haven.’ Only the voice was eerie, almost electronically modified or perhaps the patient had previously undergone radical throat surgery?

‘Hi, can I help you?’ If this is a patient, switchboard shouldn’t be putting them directly through to this bleep, she thought.

‘Every two hours tonight, you will be put to the test.’

‘Who is this? What do you mean?’ Was this a joke?

‘Your time starts at nine. Goodbye and good luck, Dr Haven.’

‘Wait!’

But the caller hung up leaving nothing but a low-pitched tone.