SIMMONS, THE TWENTY-EIGHT-YEAR-OLD MALE with mild jaundice and knee pain who had briefly turned into a seventy-two-year-old woman with cerebellar dysfunction and inframammary candidiasis, was a scabby, drug-addicted hepatitic who, Goldblatt soon decided, needed to be an inpatient about as much as Goldblatt did himself.
It’s a sad fact of the profession that most doctors dislike drug addicts, and dislike even more having to deal with them. Experience soon teaches that a drug addict generally values only two things about a doctor – his prescription form and his signature – and more particularly the combination of the two, which is the key to a garden of a thousand delights for which they will cheat, lie, threaten, and deceive. Goldblatt treated them when they were genuinely ill, as he would treat anyone, and as soon as they were well enough he kicked them out.
It wasn’t that he had no sympathy for them. How could you not feel sorry for these chemically corroded shipwrecks of humanity – when you didn’t actually have one of them in front of you alternately begging and physically threatening you for a Temazepam capsule? It was the fruit of practice, one of the many lessons medicine had taught him. After feeling for lymph nodes deep in someone’s armpit, for example, the smell of sweat will linger on your fingers for twenty-four hours, no matter how often you scrub your hands. That was one of the lessons medicine had taught him, and it saved a lot of fruitless and repetitive handwashing. Never write off a stroke patient in the first two days. That was another important lesson. Avoid drug addicts and kick them off your ward. That was just one more lesson, like all the others.
Medicine had started educating him in this particular lesson quite early in his career. Three weeks after he had started as a house officer, to be precise. Psychologically, Mother Medicine chose a perfect moment to begin her instruction, the first Sunday night that Malcolm Goldblatt ever spent on call.
When Goldblatt looked back on himself as he was then, Goldblatt the HO, that Goldblatt of his first Sunday night on call nine years before, he saw an almost unbearable vulnerability. It was almost too excruciating to contemplate. He wanted to cup his hands around his mouth and shout across time to that earlier, innocent self, shout all the things that he had been forced to learn since then, save himself some of the pain that awaited him. But it was impossible, of course. And it wouldn’t have made any difference even if it were possible, that was the tragic thing about it. The Goldblatt of that night nine years before, the current Goldblatt knew, wouldn’t have listened. The Goldblatt of that night hadn’t thought of himself as inexperienced and vulnerable. He had thought of himself as rough, tough, and ready – a lot rougher, tougher, and readier than the current Goldblatt thought of himself.
But in reality, of course, he wasn’t.
Just after two o’clock in the morning of that first ever Sunday night of his career on call, after he had already been on call on the Saturday night as well and had had a total of about an hour’s sleep, the first ever drug addict of Goldblatt’s experience as a doctor walked into Emergency.
The fact that this man actually walked in was pretty astonishing since he was sick enough to be dead, and logically speaking the fact that he actually walked out again three hours later after the nurse on duty took away his Distalgesic tablets should have been even more astonishing – because if some miracle had taken place to cure him in the intervening time, Goldblatt, for one, had missed it – but by that stage Goldblatt couldn’t care enough about him to be astonished or even moderately interested. He had spent half the night with this prematurely aged, wizened, tattooed, and self-abused homunculus of twenty-five who had emerged from whichever cardboard box he had been inhabiting with earrings through his nipples and track marks down his arms, a fever of forty-one degrees, and a heart that shuddered and heaved and shook 120 times a minute as it tried to pump blood into the vessels of his lacerated circulation. Most of it was going the wrong way. There are four valves in your average human heart and at least two of the four in this particular human were half eaten away by infection. Or endocarditis, as the medical terminology goes. Goldblatt’s registrar told him to do an ‘endocarditis work-up’, told him what antibiotics to give, and went to bed. The ‘endocarditis work-up’ should have taken forty-five minutes. It took three hours. The drug addict, whose name was Bates or Bent or something else that was short and began with a B, kept begging for morphine. Every time Goldblatt asked a question, all he got was a whining supplication for the drug.
‘Morphine, doc,’ BatesorBent kept saying, feigning dizziness, nausea, and even death, which Goldblatt feared was imminent. ‘I’m withdrawing. I’m going cold turkey.’
‘Where’s the pain?’ Goldblatt kept demanding.
But the cold and cringing turkey in front of him didn’t have any pain, and didn’t have the presence of mind to pretend that he did. All he would say was that he was withdrawing. Goldblatt couldn’t give him morphine for withdrawal, and BatesorBent should have known it. It’s one of the basic facts of any self-respecting drug addict’s existence that a doctor can prescribe opiates only for pain. BatesorBent really must have been sick to have forgotten it. But that didn’t help Goldblatt, who was new to the job and still remembered things they had told him at medical school, like the fact that he could be struck off for inappropriately prescribing opiates to addicts. Apart from that, if it meant he could get the work-up done and get some sleep, Goldblatt wanted to give BatesorBent the stuff probably even more than BatesorBent wanted to get it. Over and over Goldblatt asked him if he was in pain, but the dumb bastard simply refused to say the magic word.
Eventually Goldblatt grabbed a fistful of BatesorBent’s paltry flesh and squeezed it hard on the pretext of examining his thigh.
‘Where’s the pain?’ he demanded desperately.
‘I don’t have any pain, you fucker!’ cried BatesorBent, wincing. ‘I’m fucking withdrawing! Don’t you know anything?’
‘Then I can’t give you morphine,’ Goldblatt said.
‘Fuck you, you fucking fucker!’ yelled BatesorBent, whose range of obscenities was proving to lack both inventiveness and variety.
Goldblatt shoved a needle through a minefield of track marks into a vein to draw blood.
‘Is that morphine, doc?’ he asked.
‘No,’ said Goldblatt.
‘Fuck you, you fucking fucked-up fucker,’ shouted BatesorBent, and jerked his arm away, spraying blood teeming with viruses and bacteria over Goldblatt’s face and in a long, speckled arc across the screens around the bed. Goldblatt wiped his face with his sleeve and picked up another needle with grim determination.
He did the work-up. It was five o’clock in the morning by the time he finished it, and he was ready to fall into bed with BatesorBent and his FleasorLice if there was even a moderate chance of getting some sleep – but he did it. Somehow he had even managed to get BatesorBent to let him site a drip in one of the few veins that hadn’t been destroyed by years of drug injection, and had given him his first doses of antibiotics, and there was some chance that this treatment would start to save the tattered remnants of his heart valves and possibly his life. And that was when Goldblatt made his mistake: not only did he allow himself to feel that he had achieved something, but he allowed himself to expect appreciation.
He really was vulnerable and inexperienced. Mother Medicine had one of her lessons in store for him and was about to pour it all over his head like a big tub of lard.
He had left BatesorBent after the triumphant conclusion to his three-hour endocarditis work-up, and was on his way to wash the dried blood off his face. A nurse passed him, going in the other direction, and smiled mechanically before disappearing behind the screens around the bed. An August dawn was beginning to brighten the windows. Goldblatt came out of the bathroom and sat down at the nurses’ station to write his notes. Suddenly he heard a familiar voice.
‘Fuck you!’
Goldblatt froze.
‘Fuck you!’ he heard again from behind the screens. ‘Let go of that!’
The nurse said something.
‘Fuck you, you cunt!’
Goldblatt wondered whether he should go behind the screens to rescue the nurse. The voice kept swearing. It was coming to him as if from somewhere in the distance, from behind clouds. Goldblatt felt an immense tiredness sweep over him and begin to drown him. The effect of two consecutive nights of almost total sleep deprivation suddenly hit him. The nurse was being murdered by the drug addict behind the screens, but he couldn’t be bothered getting up. It wasn’t physical. He was awake. But something inside him had laid its head down and given up.
He could still remember it now, all these years later, exactly as it felt. Everything was disembodied. Voices came from far away, sound and image dissociated, perceptions floated in and bounced off him and floated away again. The things that happened next seemed as if they were taking place somewhere else, far away, beyond his reach.
From his position behind the high ledge of the nurses’ station, Goldblatt saw the screens around the bed jerk open. BatesorBent appeared in the gap like some kind of feverish stick-creature, dressed once more in his filthy black jeans and T-shirt, his blond hair standing on end all the way down to its black roots, and the drip that Goldblatt had inserted still protruding from his arm. He tottered towards Goldblatt and stopped in front of him, mistaking him for someone who cared about what happened to him.
‘That fucking cunt took my Distalgesic tablets away.’
Goldblatt stared at him.
‘Did you hear me? What right’s she fucking got? Cunt! They’re mine. I’m not staying in this fucking place without my fucking tablets!’
‘You’re in no fit state to leave the hospital,’ the nurse’s selfless voice called after him, as she emerged from behind the screens where BatesorBent had probably knocked her over and stomped on her face to get away. ‘We can’t be held responsible for the consequences. That’s our medical advice, isn’t it, Dr Goldblatt? I’m warning you, you’ll have to sign a self-discharge form!’
BatesorBent obviously didn’t appreciate the full seriousness of having to sign a self-discharge form. Someone should have told him before they let him on to the ward.
‘Fuck you! Fuck the whole fucking lot of you fucking fuckers!’ he shouted, and walked out.
‘Dr Goldblatt!’ demanded the nurse.
Goldblatt watched BatesorBent bounce against the swinging doors of the ward a couple of times before he made it out. Three sleepless hours of his work disappeared.
Goodbye, Three Hours of Work. It was nice to have met you at two in the morning.
The nurse glared furiously at Goldblatt. He was still watching the ward doors that BatesorBent had left swinging, mesmerized by the pointless inertia of their diminishing movements. There was nothing left inside him but exhaustion, emptiness, and resentment. The weekend on call, the two nights of sleeplessness he had already endured, had cleaned him out of anything higher and more human, reducing him to the level of bare, snivelling, animal survival.
Goldblatt thought, Three Hours of Work, I hope you fucking die.
And at that moment, he meant it.
A folder appeared under his nose.
‘Make a note!’ ordered the nurse.
Goldblatt made a note, watching his hand move the pen, and wondering what difference the words were going to make.
The nurse tore the folder away and examined it.
‘I’m going to record this in the nursing notes,’ she said. ‘You can be sure of that, Dr Goldblatt. That man’s ill. Seriously ill. I’m going to record exactly what you did to stop him leaving.’
‘That won’t take very long,’ Goldblatt observed listlessly.
The nurse shook her head in disgust. ‘That man may very well die.’
‘True.’ Goldblatt turned to the nurse, suddenly awakened, intrigued by her attitude. ‘Why do you care? He called you a cunt.’
‘Dr Goldblatt!’ she screamed. ‘I’ve never been so insulted in my entire life. I’ve worked as a nurse at this hospital for seventeen years and—’
Goldblatt had worked there for barely seventeen days and already it felt as if it had been too long. ‘It was him who called you a cunt,’ he pointed out with useless logic. ‘Not me.’
‘Dr Goldblatt!’ she shrieked again, her voice rising an octave. She began dialling for the security man.
Goldblatt got up and walked away. He could hear the nurse shouting at him. Something in his brain refused to register the words. He didn’t want to hear anything more from her or from BatesorBent or from any of them.
He did hear more, of course, when the nurse’s formal complaint made its way to the medical director. That took about a week. By then Goldblatt couldn’t see the point in the whole matter because unless he had sought urgent medical help elsewhere, BatesorBent was almost certainly dead. Without treatment, the infection in his heart would have blown one of his valves completely within a couple of days of walking out of the hospital. He was probably lying lifeless under a pile of refuse somewhere with a needle stuck up his arm. Possibly the same needle Goldblatt had put there.
When he said that, the medical director asked if that made him happy.
‘No,’ said Goldblatt. ‘I pity the poor rubbish collector who’s going to find him. He’ll probably need therapy for years.’
The medical director growled. He was an old-school type and didn’t set much store by therapy.
For a while after that, Goldblatt often thought about BatesorBent, wondering if he should feel guilty at his own indifference when he had watched that tottering stick-figure staggering out of the hospital. Or disturbed by it. Or ashamed of it. He told himself that surely BatesorBent would have gone somewhere else for treatment. He wouldn’t have just buried himself under a pile of rubbish and died. But that comfort – or delusion – didn’t change what he had thought at the time. Goldblatt didn’t see himself as the kind of person who didn’t care if another person died. But that was what he had become, at least for that moment. It worried him. He grappled with the realization. Eventually he came to the conclusion that if you reduce a human being to such a state of exhaustion, stress, and terror at having to cope with tasks far beyond his competence in conditions of such physical brutalization – as he had been reduced on that long distant Sunday night – then you can’t expect him to feel anything. Anything but indifference, which is precisely the point he had reached.
But it took a long time, and many more nights on call, for Goldblatt to arrive at that conclusion. And in the meantime it didn’t occur to him to wonder that no one spoke to him – no one apart from the medical director who wanted to know if he was happy that BatesorBent was probably dead in a cardboard box – to ask him how it felt to have been reduced to that state of catastrophic indifference, worse, how it felt to have watched that man walking out and to find himself actually wishing that he’d die. His thoughts, his guilt, the conclusion he eventually reached – he went through all of it alone.
BatesorBent wasn’t the last of the drug addicts that Goldblatt had treated over the years, not by a long shot. Like any hospital physician, he had seen an unending parade of them. They checked into hospital when it suited them, and they discharged themselves just as soon as they thought they had wheedled and whined, cajoled and cheated as many different drugs out of the staff as they could. They practised an incredible pharmacological promiscuity, taking anything they could get their hands on, narcotics, stimulants, opiates, depressants, antidepressants, hypnotics, analgesics, anaesthetics, anxiolytics, antispasmodics, anything that had a chemical in it and was rumoured to have an effect on mood, perception, or coordination. They took them in any formulation they could get hold of, tablets, solutions, suspensions, injectables, powders, pills, suppositories, anything that could be swallowed or snorted, injected or inserted.
In a way, you had to admire them. The lengths to which they went in order to obtain a few chemicals were nothing short of fantastic. And the precautions they took to conceal their caches were almost unimaginable. Many were the rectums in which a few pilfered, foil-wrapped tablets of codeine had been stashed to be retrieved when needed. It was almost funny. But not funny enough to outweigh the satisfaction of kicking one of them off your ward.
Goldblatt didn’t know what Simmons had stashed up his rectum. He had no intention of finding out.
Simmons had dyed blond hair with an inch of black root, shifty brown eyes, a square face, and one quarter of what appeared to be an unfinished dragon tattoo etched across his thin white chest. He had a mild case of hepatitis, presumably induced by one of his pharmaceutical adventures. Emma Burton had seen him in clinic with a referral for knee pain – Simmons, no doubt, was hoping to score a six-month prescription of codeine that would last him about a week – had noticed a slight tinge of yellow in his eyes, and had rushed him in, writing up a four-hourly order for a huge dose of codeine in the process, which was a great inducement for Simmons to stay and enjoy the hospitality. So perplexed was Goldblatt by Emma’s action that he had spent a good twenty minutes on his first day on the unit looking through Simmons’s notes to try to work out why he wasn’t simply the mild, kick-me-out-of-hospital hepatitis that he appeared to be. He was the mild kick-me-out-of-hospital hepatitis that he appeared to be. The fact that he had been sitting in bed one on the Prof’s ward for almost a week said a lot more about Emma Burton than it did about Simmons.
In the meantime, Simmons was sturdily recovering from his illness through a concentrated lack of medical intervention. Exactly how long Emma was planning to continue this policy wasn’t clear – perhaps until the last faint tinge of yellow had disappeared completely and, like William Prescott at Bunker Hill, she could see the whites of his eyes. Or at least until the Prof saw them on her next round.
Simmons strongly supported this policy, and had already taken steps to reinforce it, overdosing on a bottle of antidepressants that he had snatched from the nurses’ drug trolley two nights after he had been admitted to the ward. This initiative had earned him a day on the intensive therapy unit in case his heart seized up. It didn’t, of course. As an experienced practitioner, Simmons knew exactly how far he could go before he overdosed on an overdose. Back on the ward, he was probably already planning his next manoeuvre. In case there had been any doubt, this proved that Simmons obviously had an uncontrollable predilection for swallowing large amounts of chemicals with unpredictable effects, and for his own protection, if nothing else, Goldblatt reasoned that the kindest thing any doctor could do was to remove him from this drug-rich environment.
Simmons disagreed. When his three new doctors turned up with the notes trolley on their second day on the unit he immediately identified Goldblatt as a seasoned opponent. Like most people, he didn’t know what to make of Ludo. With the instinct of a true street-fighter he identified the weakest link in the chain.
‘It was a suicide attempt, that thing with them tablets,’ he said to the HO, scratching at his quarter-tattoo and lying shamelessly.
The HO looked at him sympathetically, remembering all the things she had been taught in medical school about showing sensitivity, empathy, and understanding to suicide attempters. The first thing was to gain their trust, she remembered, and to gain their trust you had to listen patiently and be perceived as non-judgemental. The HO put Simmons’s notes down on the bed and listened patiently with her most non-judgemental expression on her face – a conspicuous frown and a fixed stare. She looked as if she was trying to contain a fart. Her gullibility shone from her eyes and Simmons latched on to it with an unerring grasp.
‘You’re the house officer, aren’t you?’ he asked, just to be sure.
The HO nodded.
‘I couldn’t go on,’ Simmons continued, giving the HO a beseeching look and shamelessly batting his stye-bulbed eyelids. ‘This hepatitis and all.’
The HO nodded again.
‘I didn’t tell them,’ said Simmons. ‘I told them it was a mistake. But it wasn’t,’ he confided. ‘I feel I can talk to you. It was a suicide attempt. I should have told them before, I know, but I couldn’t.’
‘I understand,’ said the HO.
‘Do you?’ said Simmons, with a maudlin display of halting gratitude, so pathetic and contrived that even an HO should have picked up on it. ‘I didn’t tell them before. I felt... ashamed.’
‘It’s all right,’ replied the HO soothingly, ‘you’ve told us now.’
The HO picked up Simmons’s notes and took her pen out of her pocket.
‘Stop,’ said Goldblatt. It was always advisable, he had learned, to find out how much work an HO was going to need. This particular pantomime had gone on long enough. ‘What are you doing?’
‘I’m just going to make a note of what Mr Simmons said,’ replied the HO.
‘Don’t make a note,’ said Goldblatt.
‘Make a note,’ said Simmons.
‘Don’t,’ said Goldblatt.
‘Do,’ said Simmons
The HO looked around in confusion. She glanced at Ludo. Ludo gravely shook her head. If Simmons’s assault on the bottle of antidepressants was officially recognized as a suicide attempt they’d be obliged to arrange a psychiatric review before he left. It would take days to get the psychiatrists to see him. Simmons would be on the ward for ages, regardless of the whites of his eyes.
Goldblatt took the pen out of the HO’s hand. He turned to Simmons. ‘Mr Simmons,’ he asked, ‘do you think you can manage by yourself at home?’
Simmons guffawed.
‘Do you have anyone who can look after you at home?’
Simmons leered cynically. What kind of a stupid question was that? He began to think he had overestimated Goldblatt, who was turning out to be one of the most naive registrars he had ever faced.
‘Don’t be stupid,’ he said.
‘All right,’ said Goldblatt, ‘I won’t be stupid. Instead of sending you home today, we’ll send you home tomorrow.’
‘But I won’t have anyone at home tomorrow either,’ he protested.
‘Then make arrangements, Mr Simmons,’ said Goldblatt reasonably. ‘That’s why we’re letting you stay an extra day, remember?’ Goldblatt turned to the HO and gave her pen back. ‘Write that down,’ he said.
‘What?’
‘That we discussed discharge plans. That Mr Simmons is going to make arrangements. That he’s going to be discharged tomorrow.’
‘Like fuck I am,’ growled Simmons. ‘I need a social worker!’ he yelled, trying another old ploy to extend his stay. ‘Write that down. Go on, write it down.’
‘Don’t,’ said Goldblatt.
The HO didn’t. She wasn’t sure she knew what was going on, but she was fairly certain that when it came to taking orders, and she had to choose between her registrar and a patient, she should probably listen to her registrar. ‘Malcolm,’ she said, ‘does he need any bloods?’
‘No,’ said Simmons quickly.
Goldblatt had been about to give the same answer. He looked at Simmons with interest. He glanced at Simmons’s arms. Simmons hid them under the sheet.
‘Hmm,’ said Goldblatt portentously, taking the notes from the HO and pretending to read. He handed them to Ludo. ‘What do you think, Dr Madic?’
‘No!’ shouted Simmons.
Ludo turned the pages. ‘There’s all kinds of tests we haven’t done yet.’
‘Rubbish!’ yelled Simmons.
‘And we haven’t even been monitoring his liver function,’ added Ludo.
‘We really ought to monitor his liver function,’ said Goldblatt.
‘The other doctor said she didn’t have to!’
‘Really?’ said Goldblatt. ‘What did she say?’
‘She said we could see how I felt and whether I was showing signs of getting better. I said I didn’t want no bloods done and she said we’d try to manage without them.’
‘Would that be Dr Burton?’ asked Goldblatt.
‘Yes.’
‘Very sensible approach.’
‘See!’
Goldblatt sighed. ‘Regretfully, Mr Simmons, I’m not Dr Burton.’
‘Which ones should we do, Malcolm?’ asked the HO eagerly, pulling a piece of paper out of a pocket of her white coat.
‘Let’s see. LFT, U&E, FBC, CKMB, PT, APTT, Hep B and C, gamma GT, ALP, acid phosphatase.’
‘No!’ shouted Simmons, glancing frenziedly from Goldblatt to the HO, who was scribbling furiously. ‘No no no!’
‘He’s right,’ said Goldblatt. ‘Cancel the acid phosphatase.’
‘Why?’
‘It doesn’t rhyme.’
Simmons stared at Goldblatt with naked hatred. Goldblatt knew what the problem was, and Simmons knew that he knew. After years of self-injection, Simmons had no veins left. Nothing you could hit without doing a deep, penetrating and truly unpleasant puncture.
‘Have you had much experience taking blood?’ Goldblatt asked the HO, still staring back at Simmons.
‘No,’ said the HO.
‘Good,’ said Goldblatt, and he smiled.
‘From his groin?’ asked the HO in disbelief, when they had wheeled the notes trolley back into the doctors’ office at the end of the round and Goldblatt told her what she was going to do. ‘How do I take blood from there?’
‘I’ll show you,’ said Goldblatt. ‘It’s an important technique. You need to be able to do it. When you can’t get access to any other vein, you can always get into the femoral vein in the groin.’
‘Don’t worry, it’s easy,’ said Ludo.
‘Of course it’s easy,’ said Goldblatt. ‘Every technique is easy except swabbing the male urethra.’
‘Rubbish. Swabbing the male urethra’s easy,’ said Ludo.
‘Not if you’re the male,’ replied Goldblatt.
Taking blood from the femoral vein is easy. All it takes is a needle, a groin, and someone to slide one into the other to a depth of an inch or two. Oh, and get the needle in the right place. That’s the twist. Like any medical procedure, no matter how easy, it takes time and practice to perfect the art. The HO needed the practice, and Simmons had the time. As Goldblatt watched, the HO slid her needle deep into the skin of Simmons’s groin, moving it this way and that, poking about unsuccessfully in search of his femoral vein until she scraped along the underlying bone or twanged a fibre of his femoral nerve and made part of his thigh twitch like the leg of a frog in a physiology lab. Goldblatt encouraged her patiently. ‘Try a little more medially,’ he’d say, or, when that didn’t work, ‘try a little more laterally.’ The HO, for her part, leaned over the bed, one hand holding Simmons’s underpants away from his groin, the other hand wielding the needle, her nose almost thrust into the humid fold of Simmons’s skin, and her face frowning in concentration. She refused to give in. Goldblatt admired her determination. Simmons squirmed and groaned and drew breath sharply each time the needle hit some particularly sensitive structure. Beads of sweat stood out on his forehead.
‘Don’t worry,’ said Goldblatt to the HO with unwavering professionalism, ‘concentrate on what you’re doing. Usually it’s much easier. This is a hard vein to hit. He’s probably shot up there as well.’
Finally dark blood rushed into the nozzle of the syringe and flooded the cylinder as the HO drew back on the plunger. When it was full the HO pulled out the needle and turned around, beaming, holding the syringe up for everyone to see.
The HO was happy. Goldblatt was happy. Simmons, if possible, was even happier. It was such a happy moment that Goldblatt almost said yes when the HO, eager to practise her new skill, asked whether she should take another syringeful from his other groin in case they didn’t have enough blood for all those tests they were ordering.
‘Not yet,’ said Goldblatt. ‘But we’ll need three sets of blood cultures to rule out infection.’
‘If I’d known, I could have used some of this blood for the first set, couldn’t I?’ said the HO.
‘Yes. Shame. We should have thought of that. Anyway, you can come back to do it this afternoon. And we’ll need another set of liver function tests tomorrow,’ added Goldblatt, ‘and every day Mr Simmons is in here if he can’t arrange to go home. And I think there’ll be some other tests we’ll require. Have you had a lumbar puncture yet, Mr Simmons?’
Simmons didn’t last much longer. Goldblatt also stopped his order for codeine, which vastly lessened the attraction of staying in. It had been good while it lasted, but it was time to go. If he had to endure needles penetrating his almost impenetrable veins, he might as well be putting some kind of chemical cocktail into them rather than have a doctor taking blood out.
When Goldblatt came up to the ward on Monday morning, bed one was occupied by a new arrival. It was a good omen for the week ahead. Then Emma Burton came up to the ward to find out how her star patient’s amazing recovery was progressing. Goldblatt told her that Simmons had left.
Emma looked at him with disbelief. After a moment her expression changed. It became hard and mistrustful.
‘The Prof was very interested in Mr Simmons,’ she said brusquely, and turned on her heel and walked off around the corner to her office.
Goldblatt listened to the sound of Emma’s footsteps clattering out a warning tattoo. He was perplexed. The Prof was very interested in Mr Simmons? That didn’t sound right. That didn’t sound right at all. No, like the presence of Simmons in the first place it seemed to say a lot about Emma and almost nothing about anyone else. Goldblatt had the feeling that it was a very bad omen, more than enough to cancel out the good omen of Simmons disappearing from the ward.
But omens, as any necromancer will tell you, can’t be undone. Once you slice the liver you have to read the signs.
‘Emma’s doing her round this afternoon, isn’t she?’ asked Ludo, as the sound of Emma’s footsteps died away.
Goldblatt nodded. The specialist registrar ward round was scheduled for Monday afternoons.
‘At two-thirty, isn’t it?’
Goldblatt nodded again.
‘Can’t wait,’ said Ludo.