Surgeon at Arms

13

'I want to see Brigadier Haileybury,' said Graham to the sergeant in the hall. 'My name's Trevose. I'm a surgeon. The brigadier knows me well.'

'Have you an appointment, sir?'

'No. But I'm aware that he's in the building and I don't intend to leave until he gives me an interview.'

The sergeant looked uneasy. The wild-eyed civilian seemed an unlikely crony of the austere brigadier. 'If you'll wait here, sir, I can but pass on your message.'

'Please do.'

He left Graham alone in the hall, which like the inside of all requisitioned houses had bare walls and floor, was furnished with trestle-tables and fire-extinguishers, and had the decorations badly knocked about. Haileybury now held sway in a country mansion fronting the River Itchen south of Winchester, in preparation for the 'Second Front', Graham supposed, whenever that might be established. Within a minute the sergeant came clattering down the oak staircase, announcing that the brigadier would be delighted to receive his visitor at once.

The office upstairs was large, warm, and bright, overlooking the river, where in season Haileybury amused himself fishing for trout. There was a neat, busy-looking desk, filing cabinets, maps and charts on the wall. A lieutenant with twined-serpent R.A.M.C. badges, who hovered in attendance, was gently waved from the presence.

Haileybury extended his large red hand. 'An unexpected pleasure, Trevose.'

'Is it so unexpected?'

The brigadier pursed his lips. 'Won't you sit down?'

Graham took a small hard chair and began, 'Haileybury, do you know the one thing the powers-that-be in this war could do with me? They couldn't court-martial me. They couldn't put me in jail. They couldn't even tell me off. The only way they could save themselves the nuisance of my existence was to sack me. They have.'

Haileybury put his finger-tips together and blew on them, rather noisily.

'You're perfectly aware of that, of course,' Graham added accusingly.

'It has come to my ears.'

'Why did you do it? Why did you throw me out?'

Haileybury looked shocked. 'I?'

'I've a certain right to know, you must admit.'

'But, my dear fellow, I couldn't possibly be responsible for your dismissal. That would be a civilian matter, quite outside my province.'

'In all the years we've been squabbling, Haileybury, you've invariably done two things that I often enough have not Told the truth and been honest.'

There was a silence. 'I see,' said Haileybury.

He got up, crossed silently to a filing cabinet, and still without speaking removed a folder.

'Your suspicions are correct, Trevose, I must agree,' he admitted, sitting down. 'Though only partly correct. I certainly made representations to the proper authorities. And I can hardly pretend otherwise than that my views were bound to carry some weight.'

He opened the file. My God! thought Graham, he's more of my cuttings than I've collected myself. He imagined Haileybury painstakingly snipping each one out, muttering to himself and shaking his head sorrowfully.

'Very well, the annex has been getting some publicity,' said Graham. 'And what of it? It's cheered the patients up. It's encouraged my staff to keep working flat out. It's given the civilian population something to feel proud of. Hasn't it put up the morale of your own men? At least they know there's a unit to look after them efficiently, if they get their faces smashed up. It's made a hell of a difference in the R.A.F., I happen to know for a fact.'

'That isn't the point,' said Haileybury.

'You don't imagine it's done me any personal good, do you?' demanded Graham irritably. 'I've neither the desire nor the need to push my own interests. I'm only concerned with those of my patients.'

'I think we know each other's views on these matters too well for the need of repetition. I will only emphasize that mine have remained quite unchanged by the war.'

'Oh, you're stupid, ridiculous, blind, smug. Of course I can't help getting into the papers. I'm part of the scene. Nobody objects if General Montgomery or Vera Lynn or whoever you like gets photographed for the front pages, do they?'

'I think you're putting it rather extravagantly, Trevose.'

'Then tell me why you're getting me kicked out? No, don't bother. I know. Through spite, that's all.'

Haileybury drew a deep breath. 'You must be perfectly aware,' he said calmly, 'that there has been a great weight of complaint. However understandable your enthusiasm-perhaps even commendable-you have rather created the impression…well, the impression that nobody else in our profession is doing anything for the war at all. It has all been brought very sharply to the notice of the Ministry and the Service departments. And to myself personally.'

'By whom?' Twelvetrees at Smithers Botham, Graham thought, perhaps even Crampers.

'You might prefer me not to name names. The last time I unwittingly did so, I understand it led to a good deal of remorse on your part.'

The reference to Tom Raleigh made Graham shift uneasily in the chair. He continued in a more subdued voice, 'You might at least tell me why the Ministry should have chosen this particular moment to pounce. It couldn't have come at a more awkward time for me personally.'

Haileybury reflected that most times were awkward for Trevose personally. 'I fancy people had to decide when matters had gone a little too far,' he declared. He paused and added, 'As I have been frank, will you perhaps let me make my motives clear?'

Graham nodded curtly.

'I assure you there was no suggestion of spite on my part. Surely you don't really think that of me? Not in your heart? There was no spite on anybody's part. But medicine is entering upon difficult times. You must know that, if only from the newspapers. When we raise our eyes from the war, what do we see? The future of our profession is in the balance. The politicos are concocting a large number of recipes for cooking our goose, believe you me. There's talk of forcing us into some sort of State health scheme-pure socialism.' Haileybury seemed to shudder. 'That would never do. We should lose our professional freedom. We should become mere civil servants, with the Government our taskmaster. The doctor-patient relationship, as we have known it for centuries, would be lost for ever.'

'All that's nothing to do with me.'

'But it is.' Haileybury leaned forward earnestly, his eyes shining. 'We shall have to fight these people. Fight them at every turn. And what shall be our weapons? We shall need every scrap of dignity, of integrity, of professional correctitude that we can muster. We must make it plain to the public that we stand above the ordinary commercial motives of life, that we seek no vainglory for ourselves, that we have no thought but for the welfare of our patients. None of us must falter-or appear to falter-from the rigorous discipline we have imposed on ourselves. None of us! We must fight not as individuals, but as a profession. Oh, politicians are slippery people, Trevose. I know. I've had dealings with plenty of them. We mustn't give them the smallest stick to beat us with.'

Graham replied by holding his hands before his face. 'So that is why these must be lost to the country like a torpedoed munition ship?'

'You're taking too dramatic a view, as usual,' said Haileybury shortly. 'Your unit will continue as before. That Canadian Tudor Beverley is a perfectly sound man. You should be the first to admit that none of us are indispensable. If I may say so, in peacetime you had rather a procession of assistants. Anyway, you remain on the staff of Blackfriars. Some beds will be found for you, either at Smithers Botham or elsewhere. Perhaps the Ministry of Pensions would have something to offer. You might like to know that I have made a point of assuring myself you wouldn't be left in the cold.'

'I am not going to treat a single casualty outside the unit that I have built up.'

'Then I fear you will find little else to do. Women are not given much to having their faces remodelled these days.'

'You're wrong.' Graham got up. 'Once released from my contract, I'm allowed to take on as much private practice as I can handle. Right? Well, women are continuing to give a great deal of thought to the new area I'm treating. I've been working with O'Rory at Smithers Botham on a reconstruction procedure for congenital absence of the vagina. It isn't a particularly unusual condition, you know. The operation's extremely interesting. You dissect the pelvic tissues from below, then put in a skin-graft on a mould. Sometimes it takes, sometimes it doesn't. You have to cut the graft extra thin or you'll get a crop of hair, which would be highly uncomfortable for all concerned. So, Haileybury. You don't want me. Nobody does. I shall therefore spend the rest of the war making new pussies.'

Without another word he clattered down the oak staircase and out to his Morris. The sergeant stared after him anxiously. Whatever had happened, it seemed likely to put the brigadier in one of his moods.

Graham wanted to leave the annex as soon as possible. Tudor Beverley and his staff offered to resign _en bloc,_ but Graham wouldn't hear of it. Desmond, who seemed more shocked by his father's dismissal than by his second stab at paternity, suggested he withdraw from the Blackfriars medical school-the ridicule was liable to break out afresh, he suspected inwardly. Graham told him not to be stupid. His patients suggested getting up a petition, but Graham knew that official minds couldn't be swayed by even a snowstorm of paper. Anyway, he was suddenly weary of battling with authority. He'd lost, and he wanted to leave the field, just as soon as he could tidy up his work.

Clare was wonderful. Her practical mind stood rock-like amid their sea of troubles. She decided they would move somewhere for the span of her pregnancy, perhaps up to Scotland. They could enjoy a wonderful holiday until the baby was born-Graham had no need to start work, they'd saved a bit, and she'd a little money of her own. The divorce could surely be left in the hands of the solicitors. Graham agreed with everything. He felt he wanted the child desperately. It would be an achievement, a symbol of defiance, something to show for his existence. Without a regular achievement of some sort, he doubted if he could live at all.

Then they killed Bluey.

It was stupid, unnecessary, almost criminal. A couple of years of Graham's surgery had the Australian looking more or less like a human being. Better still, his hands were mending splendidly. He had a pair of new thumbs made from chips of his hip-bone, he could light cigarettes, hold a tankard, even fondle a girl. A small operation was still needed to trim the inside of his lip. John Bickley again gave an injection, and slipped the rubber tube into his windpipe. To stop the blood from Graham's incision trickling into his patient's lungs, John packed the back of Bluey's throat with a length of oiled bandage. It was common practice, performed on the patients every operating day. Afterwards, John drew out the tube and forgot the bandage. They wheeled Bluey back to bed. The nurse who found him dusky and straining to breathe wasted away his life trying artificial respiration. John was summoned, and instantly ripped out the bandage which was suffocating him. But it was too late. Two years in hospital had so enfeebled Bluey that the survivor of a blazing Hurricane succumbed to lack of oxygen as readily as a baby.

John went back to the theatre and told Graham. The surgeon dropped his instruments, left the operation to Tudor Beverley, and strode out to sit alone in his office. John hesitated. He had better face him. At the end of the case he followed Graham to the hut, and found him in tears.

'It was a terrible mistake,' John admitted at once. 'I just don't know how it happened.'

Graham said nothing.

'I'm always so careful about the throat-packs, Graham-you know I am. I've had nightmares about leaving one in. I've been half afraid something like this might come about, ever since the unit started.'

Graham wearily moved the glass bottle containing the soldier's tattoo. 'And after all the poor devil went through,' he muttered.

'I can't begin to say how sorry I am.' Graham again made no response. 'But it's awfully difficult, you know, with two tables in the theatre. Without any proper assistants. I've told the nurses time and time again to feel for the throat-pack at the first sign of trouble afterwards. The nurse in charge of Bluey was new. She let us down.'

'If you're going to make excuses, don't shift the blame on to some poor girl who at the moment is too frightened to speak.'

'I'm not making excuses,' said John patiently. 'I'm only putting the facts.'

'Whose responsibility is it?'

John shrugged. 'Of course, mine. Ultimately, as the anaesthetist in charge of the case. I'm not denying that.'

'Of course you're making excuses,' Graham told him angrily. 'You're always making excuses, whenever you make a mess of it with a patient. If you give a perivenal injection, the vein was abnormal. If you break a needle, it was a faulty one. If your oxygen cylinder runs out, you told the orderly to change it. I only hope you'll find the coroner a more sympathetic listener.'

'I'm perfectly prepared to answer whatever the coroner feels like asking me,' John retaliated. 'I've nothing to hide.'

Graham made an impatient gesture. 'Oh, you'll come out of the inquest with your skin. Unavoidable mistake, pressure of work, patient's difficult airway. You'll continue with your job here as though nothing had happened. I shan't even be here to inconvenience you. You and Denise can go on putting out poisonous gossip about me, as much as you care. That probably helped to get me sacked, if you looked into it.'

'It's not fair to say that, Graham,' John told him patiently.

'It may not be, but it's the truth and you know it. Denise doesn't like me. She never has.'

'If Denise has sometimes been…well, indiscreet,' John admitted, 'she's been careful nothing could go further. Not outside the hospital. But now you're talking as if we were sworn enemies. Of course we're not. You're imagining things. Haven't we been friends, you and I, close friends, for years? Ever since the E.N.T. days? We've been through enough together, God knows. We've lost patients before.' He hesitated. 'We've even covered up for each other before. I wouldn't like to think that, however tragic, this incident meant the end of our personal relationship.'

'Be that as it may, but never in your life will you give another anaesthetic for me,' Graham told him angrily. 'At this particular moment, I doubt if that strikes you as much of a penalty. I'm down, I know it. But I won't stay down. When the war's over there'll be fifty anaesthetists in London breaking their necks chasing after my work. I'm going to make my fortune again. And this time you won't get ten per cent of it. Now please leave me in peace.'

That night, Clare woke with pain in her back. When she looked, she saw there was some vaginal bleeding. Graham telephoned Mr O'Rory. Then he carried her outside in a blanket, tucked her into the back of the Morris, and drove the ten miles to Smithers Botham. The gynaecologist was already waiting, greeting them with some mild joke about plastic surgeons working at the right end to avoid calls from their sleep. He put Clare into his ward, tipping up the foot of her bed on wooden blocks. He surrounded her with hot-water bottles, ordered an injection of morphine, prescribed doses of bromide, and added well-polished reassurance.

'Is she aborting?' asked Graham, outside the ward.

'Well, now, it's a threatened abortion,' Mr O'Rory said amiably. 'It's just eight weeks since the end of the lady's last menstrual period. So it wouldn't be an unheard-of occurrence at such a time, would it?'

'Could anything have caused it?' Graham asked anxiously. 'Mental distress, that sort of thing? You know what worry we've been having.'

'Oh, these things happen, they just happen. To tell the truth, none of us knows really why.'

'What's the chance of saving the foetus?'

'I'd say quite good. Yes, quite good. Though the lady will have to take life with queenly ease for quite a while afterwards.'

'That's nothing to bother about, nothing at all.'

'And anyway,' smiled the gynaecologist, 'the lady isn't necessarily destined to repeat the performance on a second occasion, is she? If all is lost, there's plenty more where that one came from. Eh, Graham?'

Graham began to wonder if he really liked Tim O'Rory after all.

The bleeding went on. The following day Mr O'Rory shook his head and said he feared the lady must visit his operating theatre. They gave Clare another dose of morphine and wheeled her along the cold concrete corridor. Mr O'Rory's anaesthetist administered gas and trichorethylene, they stuck her legs in the air, Mr O'Rory settled himself comfortably on a metal stool between them, and with a curette removed Graham's latest achievement for good.

Graham spent the night alone in the bungalow. Depression was no stranger at his side, but he had never known such misery before. Everything was running against him. When he told John Bickley that he wouldn't stay down he'd meant it. But for the first time he now sensed he was finished for good. He'd never recover professionally. Not when everyone could point to him as the man who was sacked in the war. The child was lost, and in such straits they'd be insane to start another. He wondered if Clare would stay with him. He had really little to offer her, and at her age she must surely expect something rewarding from life. It never occurred to Graham how much she might love him for himself. He always expected to take so much from others, he sometimes felt obliged to offer more than he possibly could.

Haileybury would not have been surprised at this mental turmoil. He knew Graham's moods well enough. He was unaware of the pregnancy, and only faintly aware of Clare, whom he had dismissed as another of Graham's pick-ups. The following morning a car arrived at his mansion, containing a general. Haileybury knew the general well. They had been to the same public school, they belonged to the same London club, before the war they had been off golfing and mountaineering together. The general marched up to his office, saying nothing. He laid on Haileybury's desk a slip of typewritten paper, which declared simply,

_Pray, why has one of our most famous and able doctors been dismissed his post? The news of his work has vastly heartened men and women in all the Allied Services. He will be reinstated immediately. I wish to know who is responsible._

Haileybury gave a deep sigh. It was useless to fight Trevose. When they both got to Heaven he was bound to get God on his side.

'Abortion?' said Mr Cramphorn to Denise Bickley at Smithers Botham. 'I'll bet Graham did it himself. With a knitting-needle.'