The Angels of Lovely Lane (43 page)

Still holding both the girl’s hands in hers, she leant in yet again and whispered, ‘Don’t you worry, love. You aren’t alone. We are here with you and we won’t be leaving you.’ Her reward was an almost imperceptible squeeze of the fingers.

‘Right, all systems go. I am about to inject, so do not move a muscle. It will feel like a sharp scratch to begin with, but I’m injecting into a sac of fluid and you won’t feel anything after the first minute. It will be just like a bee sting.’

The mysterious Miss Smith still didn’t look at Mr Scriven, but kept her head turned away and her eyes tightly shut.

He lowered his tone to almost a whisper. ‘She needs to be kept calm.’ Ignoring Pammy again, he spoke directly to Staff Nurse Bates. ‘There will be some wriggling. The foetus always kicks up a fuss when the amniotic sac is penetrated, but she won’t feel much at this stage. All she has to do is keep perfectly still. You need to keep absolutely still,’ he said more loudly, as though the girl was deaf. He studied her, waited for a response. She gave a slight nod of her head to indicate that she understood. Now both Pammy and Staff Nurse Bates noticed that Mr Scriven was trembling. Staff Nurse Bates had never seen that before and it made her even more convinced that all was not as it should be. She had never seen any doctor carry out a procedure such as this before and even though she was yet to be placed on Maternity, she had also never heard of a pregnant woman being injected into the uterus through the abdominal wall.

‘Right, hold her still, nurse,’ he said to Pammy. ‘Staff Nurse Bates, you had better move to the opposite side of the bed.’ He winked knowingly at the staff nurse, as if to indicate that things could become difficult. That was when Pammy realized he was lying about the pain, the bee sting. That wasn’t true either.

As the needle pierced the abdomen, the girl let out a small scream. It was her first audible display of emotion and it erupted from somewhere within her heart. Mr Scriven was right. The baby within thrashed and flailed about as the needle pierced the uterine cavity and Mr Scriven roughly palpated the abdomen. Pammy, feeling slightly sick, thought it looked as though he was trying to locate the foetus, to inject it. At last he appeared satisfied.

‘There, we have it,’ he said. Pammy saw him begin to depress the syringe, and the solution gradually moved down the markers on the glass, disappearing as slowly as the life that was ebbing away within.

Tears now threatened to stream from Pammy’s own eyes. She saw that Staff Nurse Bates’s face was white and set. They were assisting in the ending of a life. A life that Pammy knew could thrive if allowed to settle down, to repair and grow. To be born.

Dr Mackintosh had said that the girl’s cervix was as hard as a rock on examination. Surely, if she was just allowed to rest, there might be a chance? A slim one, perhaps, but a chance at least? The atmosphere in the cubicle suddenly felt so thick and hot it was unbreathable. Pammy felt compelled to release the hands she was holding, open the curtains, throw back up one of the sash windows and gulp in some fresh air. And still the young mother had not spoken a single word. With each moment that passed, the atmosphere in the cubicle became more suffocating. At last Mr Scriven removed the cannula with a flourish and threw it into the kidney dish with a clatter.

‘There, done,’ he said. ‘It won’t be easy, but she should repel the foetus at around eleven o’clock this evening.’ He pulled on the sterilized rubber gloves, pulled up her knees, and almost roughly performed a PV examination. The girl flinched and again squeezed Pammy’s hand tight.

‘As I would have expected, her cervix is still hard. There is no dilatation. The surface of the cervix is burnt and blistered. We have to get this baby out as a measure to save her life. We have no idea how bad she is internally. It will take at least the full twelve hours, but if it hasn’t happened by this time tomorrow we’ll take her to theatre.’

Pammy wanted to place her hands over the girl’s ears. She had flinched as Mr Scriven spoke.

‘The thrashing about,’ he inclined his head towards the convulsing abdomen, ‘will stop within a couple of minutes. I’ll telephone in a few hours. If Sister Antrobus returns, tell her to ask the switchboard to put my light on and I’ll pop down for a word.’ Without so much as glancing at the patient again, he turned on his heel and left.

Staff Nurse Bates stood rooted to the spot. Pammy pushed the girl’s hair back from her head and wiped her brow with a cloth she had soaked in cold water and placed on the trolley, ready. The young mother cried silently and the two nurses watched her abdomen settle as life slowly left the seven-month-old baby in the place which was meant to be the safest of all.

Pammy marked the hours that passed by the clock on the wall and by her religious fifteen-minute observations that she never failed to complete on time. She continued to try to engage her patient in conversation.

‘Would you like a cuppa now?’ She had changed the draw sheet and nightdress, washed the girl’s face and pulled up the bedclothes to tuck them around her. Once again she brushed the now wet and matted hair back from her face, almost overcome by an urge to bend down and kiss her. The patient shook her head. ‘Come on now, there’s a good girl. I’ll go and fetch you one, and something to eat. Might be best to get something down you now.’ The words
because very soon you may be in too much pain to feel like eating and need every ounce of energy you have
weren’t spoken, but hung in the air.

Pammy slipped into the kitchen and began to lay a tray. ‘What’s going on in there?’ asked Branna, nodding towards the ward.

‘I wish I knew,’ said Pammy. ‘We have a young girl who won’t speak a word or tell us anything. Sister Antrobus has gone missing. Staff Nurse is barking so many orders she seems to be practising for national service. Mr Scriven is in a very bad mood and Staff Nurse Bates and I don’t know if we are coming or going. Apart from that, everything is fine.’

‘Jesus, this place might as well still be an asylum. ’Tis mad so it is. I can tell ye where Sister Antrobus is. That was this morning’s mystery. She’s on the sofa in Matron’s sitting room. Throwing up something terrible, she is. Elsie says her and Matron downed a few bottles of some disgusting wine last night. Elsie knows how bad it was, she finished off the last one. She said she had never tasted anything so awful in all her life. Nothing like Guinness so it isn’t. I tried a bit too. ’Twould peel the paint off the walls it would and God alone knows, it would be the day Elsie disappears off the face of the earth. Dessie can’t find Jake either. You couldn’t make it up, could you? Mad this place is, mad.’

Pammy tried to disentangle the thread of Branna’s story to decide what was relevant enough to comment on.

‘Sister Antrobus is on Matron’s sofa?’ she said. ‘Well that’s very good of Matron. Would she do the same for any of us, if we was sick?’

‘Ah, well now, that’s not the best of it. Dessie tells me Sister Antrobus rolled out of Matron’s flat last night, as drunk as a coot, and it was gone midnight. What Dessie didn’t know when he told me that was how many bottles of wine they had drunk.’ Branna winked at Pammy. ‘I don’t believe what the porters say about Matron and the Anteater. Sister Antrobus is too fond of the men by half, she is. Beats me why she wanted to work on a women’s ward. She has not a drop of sympathy for the women’s troubles.’

‘My head won’t take any more, Branna,’ said Pammy, totally confused now. ‘I need to concentrate on what’s happening here.’

She and Staff Nurse Bates took it in turns to sit with their patient while she slept. ‘Are you all right with this?’ Staff Nurse Bates asked when they had slipped outside the cubicle for some fresher air. ‘It’s pretty full on. I was just wondering, after what you were telling me about your Lorraine being born at twenty-eight weeks, whether this was all a bit much for you. I can ask Staff if she could put someone else on to special, if it is.’

‘God, no. Don’t be daft,’ said Pammy. ‘It’s not easy, I’ll admit that, but I can’t leave her now. I want to see this through and get this poor girl better. I don’t believe she’s twenty, do you?’

‘Not in a million years. I don’t believe her name is Jane Smith either. Look what I’ve got.’ Staff Nurse Bates took one of the empty glass vials Mr Scriven had used earlier out of her apron pocket.

‘What are you doing with that?’ Pammy’s eyes widened in surprise.

‘I’ve just been into the office to look it up in the British National Formulary. What Mr Scriven did to her, I have never seen done before.’ Staff Nurse Bates lowered her voice. ‘It’s oxytocin, and it should have been given either as an intramuscular injection or IV. It doesn’t say anywhere in the BNF about injecting it into the amniotic sac, or into the baby, as I’m sure he was trying to do. The contra-indication is a ruptured uterus. We need to watch her like hawks.’

‘Why didn’t he just take her to theatre?’ asked Pammy.

Both nurses inclined their heads to check on their sleeping patient, and Staff Nurse Bates leant in closer to whisper, ‘Because if he did, the baby might have been pulled out alive, that’s why. Or that’s what I think, anyway, and don’t ask me why he wouldn’t want that to happen, I have no idea. I just know this is all wrong. I’ve never seen a doctor try to inject a baby when it was in the uterus. Did you see the way he was palpating her abdomen?’

Pammy let out a long sigh.

‘Flamin’ heck,’ she said. ‘And here was me thinking the worst thing that could happen to me today would be working with the Anteater. I’m not leaving her, you know. I don’t know what time this will all be over, but I’m not leaving this ward until it is. Matron will have to throw me out first.’

Staff Nurse Bates grinned. ‘Some of us pray for that to happen, some days.’

Six hours later, towards the end of Pammy’s official shift, the girl began to complain of bad pains.

‘Are you going for tea?’ Staff Nurse Bates popped her head around the curtain. ‘Is she still sleeping?’

‘No,’ Pammy replied. ‘She’s just woken up.’ As she spoke, the young girl let out an enormous groan, struggled to sit upright and vomited across the bed.

From that moment on, Pammy felt as though her heels were winged and her feet never touched the ground. The girl they could only call Miss Smith developed a high fever. She shook and shivered. She asked for a bedpan, which remained almost permanently underneath her as the diarrhoea poured, and she screamed and cried and begged for someone to take her pain away. Pammy knelt on the side of the bed and tried to adjust the back rest behind her and stuff pillows down to bring some relief. She felt the pain in the small of her own back as she attempted to hold the girl up on the bedpan. She knew that if she let go she would surely fall off.

Staff Nurse Bates whacked up the metal cot rail on one side of the bed, giving the girl something to hold on to for support.

‘Is there nothing she can take to relieve the pain?’ Pammy begged, while the girl screamed and clutched at her in agony.

‘I don’t think we have anything that will touch it. Let me see if we can get some Entonox from the maternity ward.’

‘Why is it so bad if she is only seven months?’ A rare moment of calm had descended upon the cubicle as the girl closed her eyes and laid her head against the snowy white pillow.

‘I think it’s because the womb doesn’t really have a great deal to clamp down on, I suppose, so it’s having to push down harder to eject the baby. I don’t know, Nurse Tanner, that’s just a guess. I haven’t done my midwifery yet. I’m going to fetch Sister Antrobus, sick or not, because she is a trained midwife and she should be here.’

Pammy wished she wouldn’t, but their first concern had to be for their patient, who with each moment that passed appeared to be more and more out of it. Pammy wrung out a flannel in the bowl of water she had fetched and wiped her brow.

‘There you are, my love,’ she whispered. ‘Not long now and it will all be over.’

The girl opened her eyes, and the look she gave chilled Pammy to the bone. Her eyes were distant, her pupils like pinpricks. Pammy took her TRRs. Her pulse was fast, her temperature 103 and her blood pressure had fallen dramatically. It was now only 95 over 65.

‘I’ll be back in a minute, queen,’ she said, squeezing the girl’s hand. Whacking up both cot sides she dashed from the cubicle to the office. Staff Nurse Bates was talking to Sister Antrobus, who appeared to have her head in her hands, but this didn’t deter Pammy as she charged in.

‘Sister,’ she said with a degree of alarm she knew a more experienced nurse would manage to contain, ‘we need a doctor. Her pulse is very fast and her blood pressure has dropped to 95 over 65.’

Sister Antrobus didn’t snap at her, which surprised her. ‘Go back to her, both of you,’ she said. ‘I will call for Mr Scriven.’ As the nurses hurried away Pammy heard her pick up the telephone. ‘Put Mr Scriven’s light on, please, and ring theatre in case he’s there. We need him urgently on ward two.’

Back in the cubicle, Pammy took the girl’s temperature again. ‘God, it’s 104 and rising. What’s going on?’

‘I don’t think the temperature is anything to worry about,’ Staff Nurse Bates replied. ‘It’s the blood pressure which is more alarming. She may be bleeding internally. That can often happen with a ruptured uterus.’ They whispered, but there was no need. Their patient was entirely unaware of her surroundings as she screamed with the pain.

The room fell quiet. The young girl was now panting, rather than screaming. For a moment, Pammy felt a calm descend upon them all. The fresh bedpan wobbled as the patient sat far forward. The nurses dropped the cot sides and placed their arms round her back for support. Only minutes before, Pammy had swabbed her down with the chlorhexidine and changed her into yet another clean gown and fetched yet another clean pan.

The girl leant forward, almost as though she was looking down into the bedpan, and without warning she groaned deeply, her groan turning into a grunt. Pammy and Staff Nurse Bates looked at each other in alarm as they heard something plop into the metal pan.

‘Jesus, lift her off quick,’ said Staff Nurse Bates. They interlinked their arms under her legs and across her back and lifted her clear, Pammy expertly slipping out the bedpan from under her before they laid her back, with as much care as possible, on to the pillows. But not before their patient had grabbed the side of the bedpan and pulled it towards her. Staff Nurse Bates picked up the Spencer Wells forceps she had ready on the trolley and clamped and cut the pulsating cord.