There were the Saturday night drunken escapades gone wrong, such as the Sloany girl who had fallen over drunk and smashed her face into a champagne glass. There was an elderly (diabetic?) black woman with her anxious wide-eyed grandchildren. The vile fragrance of her gangrenous foot preceded her like a fanfare and followed her like an echo. There was a pregnant woman in some pain; neither she nor her hippy husband could control their existing child, a horrible ginger brat who caused havoc by running about and constantly screaming ‘I don’t want a baby brother’. I found myself hoping, for the sake of the gene pool, that she wouldn’t get one.
But there was one episode that I found really moving, that I think I will remember. A drunk called Kieran, perhaps about my age, had fallen off his pushbike and sustained some cuts and bruises, none of which were particularly serious. He had been brought in by ambulance, and they had left him on the trolley opposite me to sober up. At some point he had woken up, still drunk, and wandered off and fallen asleep outside one of the operating theatres. I watched him as he walked away, scrawny and hunched and nervous, like a dog that has been beaten too much and fed too little. When he was brought back to A&E I listened as the young houseman, his eyes brilliant with tiredness, treated him and talked to him.
The Houseman asked Kieran if he was an alcoholic. He wouldn’t say that he was, but grudgingly admitted to drinking at least eight cans of lager a night. Throughout their exchange Kieran kept apologising; for being there in the first place, for using up an ambulance even though he wasn’t hurt that badly, for wandering off and making them look for him, for wasting their time when they were so busy. His apologies were quiet and strangely dignified, as was his refusal to say that he was an alcoholic, or to admit that he was homeless. The houseman gradually elicited this information from him, gently but relentlessly. I was struck by his cool professionalism – he was never over-familiar or presumptious, never condescending or patronising.
Eventually the houseman said that he thought that Kieran had some bruising to his head and wanted to keep him in overnight for observation. He clearly didn’t have any bruising, he had a very slight scratch from the bush he had crashed the bike through. But it was very quiet for a Saturday night, and I think the houseman just wanted to give him the opportunity to have a bath, some decent food and a bed for the night. But Kieran kept quietly insisting, ‘I haven’t hurt my head… I shouldn’t even be here now, I’ve only got a few bruises and scratches… what if you need the bed for someone really ill?’ He spoke quietly; he was embarrassed and struggling to maintain some semblance of self–respect, though everything he uttered was underpinned by a crushing sense of his own utter worthlessness.
The houseman finally persuaded him, by saying something like ‘I am in charge here, and it is my professional opinion that you need to remain in overnight for observation. If there is a crisis and we need extra beds, I may review that decision and boot you out’. With his posh Home Counties voice he was being deliberately officious. He managed to make the drunk believe him, managed to let him keep his meagre shred of self-esteem intact, perhaps even boost it a little.
A very quiet dignity met with a very subtle, very English compassion.
*Shakespeare, Merchant of Venice n.b. in Shakepeare's day naughty meant thoroughly wicked and bad
**Three rather dramatic blackouts and the kind of heart-rate I normally only achieve with a monstrous excess of class As, or mortal dread, or getting caught. I told you my heart was broken.