Chapter 30
Somehow Alice had made it to work, and somehow she’d dodged Gracie, who’d looked positively bursting to talk with her when she’d pushed through the doors and headed straight to the sample-sorting bench in the nurse practitioner’s room.
All she had to do was put the different patient sample tubes in the correct envelopes and posting bags for the collection driver who’d be here at one, and in order to do that she had to not think about Bastian, or the fact he’d told her own father the thing she was most ashamed of in the whole world, her biggest secret.
Their big secret. The terrible thing Bastian had told her never to tell anyone, and now her father knew, and he’d sent Bastian up here to check she wasn’t losing her mind.
And she couldn’t truthfully say that she wasn’t.
She sorted through the sample bottles, organising them by sticker colours, checking the attached docket matched the name on the stickers. The nurse’s handwriting was clear but still, Alice had a hard time focusing.
How could he? And he’d smarmed his way back in and slept in her bed last night!
Thank God nothing happened. But, Alice dreaded to think what could have happened if he had not made the mistake of banging on about his special relationship with her dad, and all his ambitions to be part of the family.
Maybe they’d have had a good day? Maybe he’d have wheedled his way into staying another night?
‘Ugh!’ She brought a bottle closer to her eyes.
‘Is that McDonagh or McDonald?’ She couldn’t tell.
‘Come on, Alice,’ she told herself. ‘Red goes in the white bag, orange ones go in individual white envelopes, or is it the blue bag…?’ She didn’t seem to know, even though she’d done this task last Monday and she hadn’t made any mistakes then, or had she?
The tubes on the table before her seemed to lose their shape, and she felt the pins and needles feeling at the back of her neck, the one that made it difficult to hold her head straight. ‘Oh.’ She bent double, head to her knees. ‘I was getting better,’ she told no one at all, her chest tightening.
The knock at the door brought her round and she found herself on her knees on the floor. ‘I’m fine, Gracie. Let me concentrate on this…’
‘It’s me,’ tolled Dr Millen, as he opened the door. ‘Now, are we going to talk about all of this, or am I sending you home on leave?’
Alice looked at him through teary eyes and he locked the door and came to sit cross-legged before her.
‘Ooft, my knees! Well, now we’re both down here, and there’s very little chance of me getting back up any time soon, you’d better start explaining why my new doctor is crying on the floor, surrounded by poo, blood and wee samples. ’
* * *
Alice’s words, once unstoppered, came out in a gush, and since she was ending her career, she figured she might as well unburden herself fully.
‘It was about,’ she stopped to think, ‘about nine months ago now. I was in General, and a patient who’d come back in for wound care after surgery suddenly turned morbidly unwell in Bastian’s clinic.’
‘Bastian was the fellow that turned up last night at the Burns Supper?’ the old doctor confirmed.
‘That’s right. Well, this patient, it turned out they were having a major internal haemorrhage and needed theatre right away.
Me and Bastian were supposed to be clocking off, but of course he scrubbed in immediately and headed in to support the surgeon and I stupidly offered to assist and observe, even though I was tired.
We both were. The surgeon asked me to start the major haemorrhage protocol… ’
‘Preparing for a transfusion?’
‘That’s right. I had the patient’s blood tested for a match with the donor blood, and I was bringing the bags down myself to hand over but I… I don’t know how it happened…’
Dr Millen wasn’t saying a word, only listening like she was a patient in his office and this was a normal consultation.
‘I get… caught up in these dreams. I get distracted, or confused. And before I knew it, I wasn’t coming down the stairs from the blood bank, I was in theatre scrubbed in and in charge of the instruments, counting them in and out and imagining myself miscounting and how awful it would be to leave a clip in the patient’s stomach and how it would be all my fault, and…
I was still daydreaming about how I’d break it to the family, telling them that I shouldn’t even have been assisting, I wasn’t qualified, and that’s when I realised I was just standing there being shouted at by Bastian, outside the theatre, and he was dragging me into the scrubs room and barking at me, showing me the labels on the blood as if I was crazy, which I…
I really think I must have been, because I was about to give A plus to an O minus patient and in the state they were in… ’
‘A haemolytic transfusion reaction could have killed them,’ Dr Millen finished her sentence gravely.
Alice swallowed hard. ‘Yes.’ Now she knew how criminals felt when they turned themselves in at the police station after years on the run because they’d been unable to keep their secrets any longer.
‘That’s a Never Event,’ she told him, pleadingly, hoping he’d berate her, as if his censure might set her free from the guilt. ‘Something that should never, ever happen.’
‘But… it didn’t happen,’ the old doctor said.
‘And we have a duty of candour to tell the patient about the mistake, to confess. I didn’t fill in a Datix report. I was a coward…’
‘Woah, hold your horses! Was anyone hurt?’
He didn’t seem to understand what she was telling him. ‘Well, no, but…’
‘Did anything actually happen that you needed to report to the patient or to officially log?’
‘I shouldn’t have got so far as bringing that blood to the theatre door. Bastian sent me home, and he sorted out the mess.’
‘And yet you learned from it?’
‘I don’t know, I never went on a blood run again to find out.’
Millen was fixing her with an impatient stare that said she knew what he meant.
‘I’ve tried to catch myself when it’s happening, the daydreaming. Sometimes it works…’
‘And is this something you’re concerned about happening here? Is that what happened last night before the Address? Is that why you are on the floor in here?’
She let her head hang. It told him all he needed to know.
‘Are you concerned enough about it to allow me to mentor you with this in mind?’ he said.
‘A weekly check-in, daily, if you like, logging when it has happened, and what triggered it? Maybe it happens at times you feel especially pressured? We could ascertain what tasks or conditions are associated with it, try to get to the root of it…’
‘I’ve daydreamed all my life,’ she confessed. ‘I should never have gone into medicine, but it was expected of me and…’
‘But the catastrophising? The panic? Did that happen to you as a child as well?’
She shook her head. ‘It started when I began my training. And it just got worse.’
‘And now? Since you came here?’ Millen asked.
‘It’s been less, much less, since I got here, but it’s not gone away.’
‘OK, well, now we have a baseline to work from. Let’s see what observations we can record, what diagnoses, and what improvements we can make.’
Alice couldn’t believe what she was hearing.
‘You’re not going to report me? Fire me?’
‘Caring about your mistakes makes you a good doctor,’ he said simply.
‘But hiding them?’ she said, tears rolling down her cheeks now the words were out.
‘I wonder if you were persuaded into hiding what happened, against your better judgement? However, we must remember no one was harmed. You caught it before anything happened.’
‘Bastian did.’
‘Who is this fellow anyway?’
‘He was my boyfriend back home. He’s in wound care. He wants to be a consultant in post-cardiothoracic surgical wound care, and I’m sure he will be.’
‘Well, he sounds like a very helpful person to have in your corner. You’re very fortunate to have him.’
Alice was about to exclaim how she didn’t have him but Millen was still talking, telling her about his supportive wife and how she would be waiting at home for him come seven o’clock with his casserole and whisky ready.
‘Fine woman. I’d be lost without her,’ he went on.
‘We must look after the ones who look after us. A doctor’s life is no’ easy, but it would be damn near impossible without our special people supporting us, eh?
You cannot do this job for another thirty or forty years without a strong network of support. ’
Instead of thinking of Bastian, or her parents, or any of her colleagues or mentors, she thought of one person only, Cary Anderson, and how all she really wanted to do now, after a long sleep and a shower maybe, was fall into his arms and tell him how much she valued him.
‘Dr Hargreave, you need to put this behind you, and you must remember this, above all else you’ve learned in your training; our motto do no harm must also be extended to ourselves.
Please take care of yourself, Alice. Starting now.
I’m dismissing you for the rest of the day.
Go get a proper lunch and a good sleep. I’ll finish these samples off, and I won’t be saying a word to Gracie about any of it. ’
His expression was so kindly and his words so sincere, Alice thought she might cry again.
‘Now, help me up off this hard floor before I have to be stretchered out of my own surgery.’