In the Midst of Life

They took samples of blood for path lab reports onhaemoglobin levels and white cell counts; took more blood to measure the electrolyte balance; ordered sputum and urinary analysis; probed orifices; and discussed erythrocyte sedimentation rates.
    They came and went, and, as the weeks passed, they came less and went more quickly. In my experience, consultants, and particularly surgeons, kept an invisible barrier between themselves and their patients. Before and during the operation their professionalism could not be faulted. But once the post-operative stage was reached they became more remote. The house surgeon, the most junior of the doctors, was the only one who spent any time with our patient.
    But, in fairness, there was nothing more that they could have done. They had twice, by emergency operation, rescued Mrs Ratski from certain death. After that, it was up to the nursing staff to help maintain life. And this is what we did, day by day, hour by hour.
    One of the most distressing things to witness was her fear of us. Nurses do not usually inspire fear. We asked Slavek if he knew why she was afraid, and he told us that she thought she was in a prison camp where the Nazi doctors carried out forcible experiments on human beings. He tried to reassure her that she was in an English hospital because she had become very ill, and that we were making her better, but it made no difference. She was convinced that we were conducting experiments on her and pointed to her stomach.
    ‘Look what they have done to me. They have cut me up and pulled my insides out (she pointed to her colostomy). They have interfered with my private parts; it is too terrible to say what they have done. You wouldn’t believe it if I told you. They cut my throat – you saw it. No, my son, this is a medical experiment, the work of the devil. They have no heart, no pity, no soul. They are machines doing the work of the devil.’
    Mrs Ratski was tough, both physically and morally. She had lost almost all her menfolk in wars and insurrections. Political conflict had been her only experience of life, and she had kept going through it all to keep the nucleus of her family alive. During the Second World War she had been in one of the many prison camps,where she must have endured cold, starvation and cruelty. She had been surrounded by death, but somehow survived.
    In hospital, she lived through two operations and began to recover; but with increased strength she became more resistant to our efforts to nurse her. She fought us whenever we came near her, even for benign things like bed making. We tried to give her drugs by mouth, but she hit us and spat at us and knocked them to the floor, so the doctors ordered that drugs be given by injection. This required three nurses – two to hold her down, one to inject. She screamed and shouted what was probably abuse at us, then hit us as soon as she could. She tore off her abdominal dressing, and the colostomy bag; she even managed to pull out the self-retaining catheter. We were at our wits end to know what to do, so paraldehyde was ordered. This was a colourless fluid with a distinctive and revolting smell, which emanated from the patient, and could be smelled for a wide area around. We nurses hated having to inject it, because such a large quantity had to be given with a wide bore needle, thrust deep into the muscle. It certainly sedated the patient, but seemed to have peculiar properties, and I wondered if it was hallucinogenic. When the effect of the drug wore off, after about six hours, patients were often wildly excitable and disorientated.
    Mrs Ratski had been in hospital for five weeks, and during that time I became increasingly troubled. When the paraldehyde started, I could not contain myself any longer. I blurted out to the staff nurse, ‘Why are we giving her this stuff?’
    ‘Because we have to be able to control her.’
    ‘But it’s mind-bending! People aren’t the same after they have had it.’
    ‘I know, but we have to give it.’
    ‘Why?’
    ‘You are not here to ask questions, Nurse. You had better speak to Sister, if you are worried.’
    ‘I
am
worried, and it’s not just the paraldehyde that is worrying me. It’s everything.’
    It took a lot of courage to speak to Sister. The nursing hierarchyin those days was such that a junior student nurse couldn’t speak to a ward sister unless spoken to first, so I asked Staff if she would intercede for me.
    A couple of days later, as I