Chapter 9
9
T he man who stood on the other side of the reception desk was young and angry.Having kept his sunglasses on thus far during the conversation, he had now pushed them to the back of his head. In order, Helen supposed as she watched him, to demonstrate just how angry he was. She didn’t care. He wasn’t having a cardiac arrest, he washere to get a certificate for travel insurance signed, for which he would have to wait.
‘This is an emergency!’ he shouted.
It was almost as if she’d spoken out loud. She raised an eyebrow. Avoid intense eye contact which could be seen asprovocative. Straightening up she pulled her shoulders back. Put a little more physical distance between yourself and the patient. ‘I’m sorry,’ she said, ‘but an insurance form is not an emergency.’ Speak softly and abstain from being judgemental. She’d been doing the job so long, it was almost impossible not to stay calm, not to put her training into place.
He took the sunglasses off and flung them on the counter. Helen watched as they flipped over. What next? Would he snap them in half?
‘I’m leaving tomorrow,’ he snarled.
‘And if you leave it with us, the doctor will sign it this afternoon. You can pick it up first thing.’ Show your intention to rectify the situation rather than reprimanding the patient for their behaviour … For being an arsehole, more like …
‘And what time is that?’
‘We open at eight. Thank you,’ she called to his back, as he slapped the form on the desk, picked up his glassesand stalked off.
‘Next.’
A young girl sidled up to the counter, her friend lingeringbehind.‘I’ve come for the morning-after pill,’ she said, a little too boldly for Helen’s liking.
Show your intention to rectify the situation rather than reprimanding the patient for their behaviour … ‘When was the last time you had unprotected sex?’And as Helen looked up, her face softened. Closer now she could see, the girl was close to still being a child. Sixteen, maybe. Seventeen, at most. A baby was the last thing she needed.She turned to her computer. The window for effective use of the morning-after pill was only seventy-two hours; she needed to get this girl in front of a doctor as soon as possible. The way someone should have got her own daughter in front of a doctor.At least this girl was being proactive, trying to help herself.Away from home, in her last year at university, and the father, an American exchange student, long since back across the Atlantic, Libby hadstuck her head in the sand for nearly seven months. The result of which ostrich-like action had been Ben. Who nobody could regret … Even so …
‘I haven’t,’ the girl said.
Helen blinked. ‘You haven’t what?’
‘Had unprotected sex.’
‘Then why are you here?’
The girl shrugged. ‘I’m going out tonight.’
‘Try the pharmacy,’ she snapped, and using her pen as an arrow held it up. ‘Out the door on the right. Next.’
A middle-aged man shuffled up . ‘I’m telling you it’s a migraine. I need to see someone now.’
‘Are you dizzy’?’
‘No.’
‘And you can look at the lights?’
‘Those lights?’ He tipped his chin and looked directly at the glare of the fluorescent ceiling lights.
‘Please go and wait in the waiting room, sir,’ she said tightly. ‘The doctor will see you at your appointed time. It’s not a migraine.’Sir? He’d hadn’t even bothered to change from the joggers and stained t-shirt, it looked like he had slept in. ‘ Next.’
‘But it feels like I’m on fire, love.’ Grey skin, orange-rimmed teeth and the rancid breath of aheavy smoker.
‘And, as we just agreed,it sounds like a urinary tract infection. The pharmacist willbe able to prescribe something directly.’
‘I don’t want a bloody chemist. I want a doctor!’
‘You can ring tomorrow,’ she said keeping her mouth just about shut. The woman’s breath was foul. ‘Or as I said, try the pharmacy.’
‘If I die it will be your fault!’
‘Next.’
‘I want them out now.’
’You were told yesterday,the doctor won’t remove hospital stitches. You can wait all afternoon to hear that for yourself, or you can listen to me and go back to … Ouch.’ She ducked as a pen flew past her ear.
‘It’s my daughter, she has this rash …’
‘I’ve had this cough for three weeks now …’
‘I think it’s piles, I’m walking like I’ve shit my pants. Excuse my language …’
‘ Next.’ As the morning wore on, so did Helen’s voice, and by the time she looked up to see a small, neatly dressed woman, it was barelymore than a bleat. ‘How can I help you?’ she croaked.
‘I really don’t want to bother you …’
It wasn’t just the polite tone, that sent a shiver down her spine. Plenty of patients were polite and timewasters. No, it was the terror in the woman’s eyes, the panic that Helen could see had made a rag doll of her. She watched as the woman put her hand out to the desk, gripping it likeit was the last solid thing in the world. ‘It’s my husband,’ she whispered. ‘I’m really concerned. Could you …’ Her arm wavered as she raised it to point toward the waiting room. ‘I did ask if we could be seen earlier.’
‘You have an appointment?’
‘At twelve forty.’
Helen glanced at the clock. ‘That’s another twenty minutes.’ Turning back, her eyes narrowed. ‘How long have you been here?’
‘An hour and a half. I didn’t want to wait at home. I thought if we came in there’d be a chance to get seen earlier, but the girl said no and he’s only getting worse.’
‘OK.’ And hurrying out from behind the reception desk, she followed the woman into a waiting room that was noisy and full. As it always was. A waiting room where, despite the huge sign on the wall that read, Please your phone considerately, she counted at least three people, using their phones inconsiderately: talking blithely, talking loudly, talkingas if they were in the privacy of their own homes. Scowling, stepping over a pile of Lego bricks that no-one had bothered to return, she headed straight for what was obviously the sickest patient in the room.A heavily built man whodespite the heat of the afternoon, shivered uncontrollably. He had fallen into a hunched position, his skin white as satin, shiny with sweat, his breathing shallow and ragged. ‘Was he like this when you arrived?’ She bent low, her hand on the man’s shoulder. He was freezing.
The woman nodded.
Helen pressed her lips together. Having spent the first part of the morning answering the phones, she hadn’t seen this patient arrive. If she had, she wouldn’t have dismissed him to the waiting room, she’d have called one of the doctors. It wasclear he was very sick. Who, and she was thinking fast, had been on the desk this morning? ‘Are you in pain?’ she said.
Hemanaged a nod. ‘Where am I?’
‘OK.’ Helen straightened up, no doubt now about the urgency of the situation. ‘I’ll be right back.’
The first door she knocked at was Dr Ross’s. She didn’t wait for an answer, before opening it and sticking her head in. ‘We have an emergency,’ she said. And then Dr Ross was on her feet and a minute later she was eye to eye with the patient, removing her glasses, examining him, standing again and moving Helen just far enough away, so Helen felt she could whisper, ‘Sepsis?’ without the either the man or his wife overhearing.
Dr Ross nodded. ’I’m going to call an ambulance. Can you print off an encounter report?’
‘Of course.’
‘An ambulance?’ the woman said, her face draining of colour.
‘Try not to worry,’ Helen hurried back across the waiting room. As she reached the door she turned back. ‘Can I have your attention please?’ she called to the dozen or so heads that had looked up. ‘There is a phonespolicy in here. Please observe it!’ And she raised an arm stiff with anger to point at the sign.