Violet #2
‘Right.’ Violet looked down again. Was he flirting with her?
He really shouldn’t be, not if he was engaged– but maybe that was just his way, maybe his fiancée didn’t mind.
She knew that she would mind but maybe that wasn’t especially relevant.
‘Uhm,’ she said, eyeing him with more suspicion, ‘it’s just I’ve had no luck with the…
’ She gestured to her tray just as Gus reached out to touch her gently on the arm.
‘Honestly, Violet, it’s fine. Getting IV access takes practice.
Anaesthetists are only good at it because we do it so often.
Here…’ He took the tray from her. ‘Do you want me to show you? I’m not trying to be patronising and if you’ve got other jobs to be getting on with it’s fine, but if I talk you through my technique, it might make it easier to do on someone else, help your confidence. ’
‘I’m not sure as anyone’s going to be able to make me feel more confident about procedures,’ said Violet gloomily. ‘I just seem to be completely incapable.’
‘Rubbish,’ said Gus. ‘There’s no skill involved– just practice, like I said.
And when you’re halfway through your first ever week of nights in your first ever acute medical job, and you feel utterly knackered, and the medical admissions are piling in, and every patient on the wards has new and exciting problems to attend to, getting a line in, or doing blood gases or whatever, it feels impossible– like someone’s asked you to perform lifesaving cardiac surgery blindfold with your hands tied behind your back. ’
Violet nodded and felt her throat go tight.
She did feel like that. She was tired, and overwhelmed, and saddened by the stories of old people abandoned over Christmas, and anxious about whether Mr Zeller had really liked his present or not.
Gus’s deep sonorous voice, gravelly with lack of sleep but gentle with its inflections, soothed her frayed nerves.
What he said made sense. He’d been through it himself.
Maybe she wasn’t hopeless, maybe it was normal to feel utterly incompetent from time to time.
‘Thanks,’ she said, hoping that he could hear the depth of gratitude packaged up in that little word. ‘If you could show me, that would be really helpful.’
He took her by the elbow and steered her gently along the corridor. ‘Right, where is she? Let the archer see the target.’
‘Let the hunter see the hare,’ said Violet, giggling along as she did a dreadful Lancashire accent to impersonate Paddy McGuiness from the television show Take Me Out .
‘Let the harpooner see the whale.’ Gus’s accent was even worse and they both laughed.
‘Bit harsh,’ said Violet, relieved that they were back to their usual silliness. ‘Mrs Chambers is quite slim.’
* * *
Violet introduced Gus as ‘the best cannula-siter in the hospital, if not the world’, and Mrs Chambers smiled with the weary wisdom of one who has been subjected to multiple attempts at venesection over the years.
‘My veins are a mess, sweetheart,’ she said confidentially to Gus as he leaned over to look at her arms. ‘They weren’t good before but the chemo’s completely rogered them and now I’m on warfarin I bruise if I so much as walk past a needle. But you’re welcome to give it a try.’
Violet watched as Gus put Mrs Chambers completely at ease, talking her through everything he was doing and treating her as if she was the most important person in the universe.
He asked questions about how her Christmas had been, what she and the grandchildren were hoping to do once she got out of hospital, what she’d thought of the pantomime she’d been to the night before she was admitted.
He seemed to know instinctively that this was a woman who often felt defined by her multiple medical conditions, and who resented it.
She was somebody who wanted to talk about anything other than medication and treatment regimens– and getting her to do just that while he tightened the tourniquet and tapped the back of her hand with his fingers was the perfect distraction.
Violet was aware that she was in the presence of a master.
‘Right.’ Gus turned his caramel eyes to Violet and gave her a reassuring smile.
‘I’ve found somewhere we can try, but I’m going to get you to do it, okay?
I’ll be right here, I’ll guide you through it.
’ He turned back to the bed. ‘Is that okay, Mrs Chambers? Dr Winters is an extremely competent clinician and I’ll be assisting her. We’ll make sure that we get a line in.’
‘You do whatever you need to do,’ she said kindly as she offered up her arm to Violet.
‘You need to make sure you’re comfortable, as well as the patient,’ said Gus, manoeuvring Violet gently into position on the side of Mrs Chambers’ bed so that she could reach the tray as well as her patient’s arm.
She could feel the presence of his warm palms on her shoulders long after he’d removed them.
He then moved the angle-poise lamp so that it was shining directly on the back of Mrs Chambers’ hand, casting the rest of them in shadow, and crouched alongside Violet, so close that she could feel the heat of his body through his scrubs.
‘Feel just around here,’ he said, pointing towards the patient’s wrist. His voice was soft, the instruction just for her, and she was suddenly acutely aware of the bizarre intimacy of the situation, the two of them in the darkness, bodies separated only by the thin cotton of their scrubs.
She obeyed him wordlessly but after a few seconds of ineffectual prodding she threw him an anxious look over the beam of lamplight.
‘Can’t feel it,’ she whispered, feeling hopeless.
He brought his face close to hers so that they both had the same line of sight and then he brought Violet’s hand over to the patient’s wrist. ‘Here,’ he said gently.
‘Can you feel a slight give? A sort of springiness, just there?’ He pressed her fingertip down where his had been and she half-nodded.
‘I guess,’ she said doubtfully.
‘There’s one there, I promise,’ he said. ‘Trust me?’ His breath was warm against her ear and it tickled the fine hairs on her neck.
She nodded and gave a nervous laugh, her voice suddenly squeaky. He tore open the swab wrapper and gave her the square piece of gauze, the tang of its alcohol sharp in her nostrils.
‘Use the corner of the swab as a marker,’ he said once she’d cleaned the back of Mrs Chambers’ hand.
She did as he’d asked, hoping that she was right and that she’d marked the correct place, because suddenly Mrs Chambers’ hand just looked like a mass of uniform bruising with no distinguishing features. Gus seemed to sense her faltering confidence.
‘Check again,’ he said. ‘Check that you’re happy where you’re going.’ He handed her the venflon and when she leaned in towards the patient, he leaned with her.
As the tip of the needle met the skin Violet turned to him, her expression full of trepidation.
She just knew she was going to cock this up and Mrs Chambers would be left with yet another puncture site and no venous access.
Gus brought his hand back on top of hers, his fingers interlaced with her own, and applied the smallest amount of pressure so that the needle pierced the skin and the vein beneath.
They both breathed a sigh of relief as the flashback of dark red sputtered into the tubing.
‘Steady,’ said Gus, so close now that he could have been whispering anything in her ear and Mrs Chambers would have been none the wiser. ‘Just advance it really slowly. This is often the point where you can accidentally pull out.’
Violet snorted in spite of herself and felt Gus’s abdominal muscles tense against her as he held in his own laughter. ‘No giggling,’ he said. ‘This is a serious business.’
‘You two having any luck there?’ Mrs Chambers had deliberately averted her gaze and was staring at the opposite wall. ‘You got it in yet?’
‘I think…’ Gus watched as Violet pulled the needle back and advanced the plastic cannula up to the hilt. ‘I think we have. Well, Dr Winters has anyway.’
He leaned away to get the dressing pack and Violet felt the absence of his body heat immediately, despite the warm room.
Every inch of her skin where she’d been in contact with him felt somehow scorched and her breathing was definitely more rapid than it should have been– but it was probably just anxiety about the cannula and whether it was sited properly.
She smiled shakily at Mrs Chambers who had returned her gaze to the back of her hand as Violet flushed the cannula through and applied the Tegaderm dressing.
She was relieved to see no telltale bumps that would indicate the saline had gone into the surrounding tissue and not the vein.
‘Did it flush through okay?’ Gus was busy tidying the bits from the tray into the sharps container but he leaned over, looking exactly where Violet had for signs of tissuing and nodded, satisfied.
‘Good work,’ he murmured in her ear before he moved off again and Violet was left unsure as to whether having Gus there with his easy manner, his ability to reassure the patient and his practical skill had been an enormous help, or whether the fact of his physical presence, so close and warm and intimate, had in fact been a colossal distraction and set her procedural technique back a few months.