Bad Case of Loving You

I stalked off down the ward. Hopefully she’d page Dr. Jackson. He wasn’t on strike; he was at his private practice on Mondays. And he’d rip her a new one if she disturbed him there. He was rabidly pro-euthanasia, had even gone to the Netherlands to a euthanasia conference at his own expense, and he was on Jack Kevorkian’s personal mailing list.

I pushed the door to Mrs. Silva’s door open quietly. David, one of the ward nurses, was specialing her, and he looked up from where he was doing mouthcare. John was asleep in a chair beside the bed, his sister’s hand in his own, his face on the bed beside her hand. God, I hoped somebody would care for me so conscientiously in my last few hours.

David stood up and handed me the fluid balance chart and pointed at the tally. I nodded my agreement, flicked through the file to find the IV orders, and ceased the hydration. Her kidneys had shut down; there was no point in continuing to hydrate her.

I could trust David to keep Mrs. Silva’s skin moisturised and to treat her eyes with the tear replacement drops.

David turned the hydration IV off and I just stood for a moment. Mrs. Silva looked younger now, some of her deep wrinkles plumped out by the fluid that was overloading her.

Her colour was bad, her breathing irregular. I didn’t disturb her by listening to her heart and lungs; there was nothing to be gained, there was nothing I could do now.

Good nursing care was what she needed.

“Wake him,” I whispered to David. “He’ll be heartbroken if he’s not there.”

David nodded, and I slipped out of the room.

Clive was the CN on duty, and he was in the treatment room when I went looking for him.

I stood in the doorway while he drew up the antibiotics he was making up and waited for him to finish. Never startle a nurse with a loaded syringe, just in case.

He looked up at me and nodded a greeting as he squeezed the IV bag to mix it.

“Dr. M,” he said. “You came up to see Mrs. Silva? The agency nurse demanded we call you and wouldn’t be talked out of it.”

“Yeah,” I said. Fuck, I was tired. “I’ve put her on oxycodone and methadone. I’ll go and do the request form for the methadone now. Send someone down for me when she dies and I’ll pronounce her.”

Clive nodded. “Will do,” he said.

I left him and went and sat at the nurses’ station where I filled out the requisition form for the methadone, and called the pharmacy to expedite it. The stuff was horribly addictive and pharmacy always wanted to check the usage and counter-approve before dispensing. Paranoid bastards.

I looked up to find myself being smiled at by one of the administration’s flunkeys. He was a human resources case manager according to his ID card, and it sounded ominous.

“Dr. Maynard?” he said.

I nodded and he handed me an envelope and walked off.

Looked like I wouldn’t be pronouncing Mrs. Silva after all. I pushed my dismissal notice into my pocket and got into the elevator.

Matthew was sitting on the pavement, waving what I suspected was a curry sandwich around with one hand as he talked to Lizzie from Micro. The sun was making his hair shine and it was the most gorgeous colour. Not brown at all, more like titian.

Being sacked certainly made one thing easier.

F was drinking a takeaway cup of coffee and it smelled great. I spotted the boxes of coffees lined up beside the statue of some git in a greatcoat with an inadequate gun. I agreed with the pigeons.

I took my coffee back to F and handed him my letter for him to read.

He scanned it and handed it back to me, then took my elbow and walked me across the courtyard to the dank walkway where the homeless lived.

Two shaggy old men looked up at me and one of them grinned toothlessly and held up his cup of takeaway coffee. I held my own up in greeting. Guess it was a good day for them; no rain and free coffee.

F said, “Had you thought about a change?”

“Looks like change has been thrust upon me,” I replied.

“No, a real change. London have headhunted me, offered me a consultancy there, along with a research grant. Come across with me, change to renal.”

I stared at F.

“Nephrology?” I said.

He nodded.

I looked at the two old men in their grimy clothes, made happy by an unexpected free cup of coffee.

“I don’t like nephrology,” I said. “All those blood levels to monitor. Transplants to manage.” I shook my head.

“No?” F said disbelievingly.

I knew that in his little world, there was nothing better than a dodgy kidney, but I’d rather be a general practitioner than deal with renal.

“What do you want, then?” he said. “Go on, tell me what you want. I’ve not accepted their offer yet, I can always counteroffer and include you in the deal.”

“And Clarissa,” I said. “If they sacked me, they’re going to sack her, too. And there’s no shortage of surgical residents out there.”

“Sure, Clarissa, too. So, what do you want? Name your specialty.”

I blinked. F was kidding, right? He couldn’t possibly be serious about this.

“Gastro?” F asked. “Hematology? Rheumatology?

Endocrinology? Take your pick.”