Summary: Nurse Training School - The London Hospital
Disclaimer: Call The Midwife belongs to the BBC and others - I am simply borrowing their wonderful characters.
Author's Notes: As always, massive thanks to Sittingonthis for the sense check and to Jlynsca for her editing skills.
Thank you too for your lovely reviews; particularly my regular contributors. I appreciate every single one. This particular update covers some quite difficult subject matter, so I decided to break it up a little in order to make it a little less hard to read. Even so, this bit is a little longer than usual, so make yourself comfy before you settle down to read.
Delia sighed as she adjusted her cap in the mirror and ensured that her hair was neat. She had no intention of receiving a dressing down simply due to how she presented herself at work. The Welsh nurse supposed that it was only a matter of time before her luck with placements ran out. She had enjoyed the challenge of Coronary Care, even if she'd missed two weeks because of her bout of meningitis. Paediatrics had been so good, she was firmly considering extending her training and specialise within the department.
Psychiatrics however, was turning out to be every bit as challenging as it had been for Patsy. Delia had been under no illusion that it would be easy; not after seeing Patsy almost come apart at the start of her placement. However, Patsy had found a way to cope. Not just with the patients, whose stories were heartbreaking enough, but also with the department's treatment of the patients.
She had been warned not to get too close to the patients. Nor should she give them any personal details about herself. Their mental state made them manipulative and cunning. Matron had told her quite clearly that treatment for the patients came in the form of medication and therapeutic procedures. The patients weren't rational. After all, that was why they were here. Trying to be rational with them could prove counterproductive and Delia needed to maintain a professional distance from them.
Delia was extremely uncomfortable with some of the methods of treatment, but knew she shouldn't simply dismiss them, just because they sounded barbaric. Instead, she spent every spare moment in the Hospital library, reading all the material she could gather about different therapies and drugs. She mulled over all the information she absorbed during her studies, but wasn't sure she felt any more comfortable with it.
Steeling herself, Delia stepped back onto the ward and proceeded towards the recreation room. Most patients were there for afternoon tea. She would need to ensure that they had been catered for, and then encourage them back to their beds for the early evening where they would not be too much bother. They could receive their medication while in their beds, and ensure that they were compliant for the evening.
Delia surveyed the common room as she stepped through the double doors. She knew that other nurses would also routinely visit, although most of the others would make the most of the time when the patients were drinking tea, and take their own breaks. The women in the room seemed suitably calm, if not subdued. There was nothing untoward going on, so Delia turned to leave, deciding to remain at the nursing station. It was far enough away not to encroach on the patients' personal space, but close enough at hand if there was a problem.
She couldn't help but ask a general question to the room before she departed however. "Does anybody need anything?"
At first, none of the women even looked at her. Then, from the corner of the room, a small voice piped up. "Where are you from, Nurse?"
Delia looked at the source of the words. Angela Gold was staring at her teacup, but flicked her eyes up to glance at Delia furtively.
"I told you, Angela. I'm from Wales." With Matron's warning about information firmly in her head, Delia had only ever given the same vague answer every time Angela had asked. She noted the resigned slump of Angela's shoulders and realised that Angela had expected the non-response. The brunette glanced back out the door and realised that one senior staff nurse was currently engrossed in some paperwork at the Nurses Station, but there were no other staff within earshot.
"I'm from Pembrokeshire. It's in South West Wales."
Angela looked up from her teacup and stared at Delia for a long moment before turning away again.
Delia sighed. Perhaps Matron was right and they shouldn't be trying to engage in regular conversation. That attitude went against every principle of nursing Delia held dear. She turned to leave but stopped when she heard the scraping of a chair. When the diminutive nurse turned back around, the chair opposite Angela was now some distance from the table - an obvious invitation to sit down.
Delia looked yet again up the corridor, and still finding the area clear, made a decision and approached the young patient. Angela looked to be only a few years older than Delia. According to her notes, she had been admitted for manic depression, but other than repeatedly asking Delia where she was from, Angela had barely said 10 words in all the contacts they had shared.
"Is Pembrokeshire like how the counties are in England?" Angela asked as soon as Delia sat down.
"Yes. I couldn't tell you how it compares in size to them though," Delia answered carefully.
"So where in Pembrokeshire do you live?"
Delia wondered if the question was more a test of building trust than any real desire for a geography lesson. "Do you know Wales at all?" She decided to answer with a question of her own.
Angela snorted. "Not really," she admitted.
Delia smiled. "Well, I come from a tiny village that I can guarantee you've never heard of, but the nearest place you might have heard of is Tenby," she explained.
Angela frowned. "That seaside resort?" She asked finally.
Delia nodded, encouraged that she was striking up what appeared to be a structured, meaningful conversation. "That's right. It really is beautiful."
"I'm sure. So why leave there and come here?" Angela continued with the questioning.
"I came to London to train." Delia shrugged nonchalantly. "The best teaching hospitals are in London. It made sense to come here."
"But what about everyone you left behind? Don't you miss them?"
"Of course I do. But I write regularly, and I visit when I can. Instead of seeing them all the time and taking them for granted, I make the most of visits home. It can't be helped. I need to be here." Delia realised that she was probably saying too much and snapped her mouth shut in an attempt to stem the flow.
"You're the first person here that talks to me like a human being," Angela commented bluntly.
Delia frowned, unsure how to answer but found that she didn't need to as the other woman continued to speak.
"I am a human being," the woman stated, emphasising the last words with an intensity that worried Delia.
"Are you from London?" She asked neutrally. Delia's ear was not trained to differentiate the nuances of different London accents, so she decided not to take it for granted.
Angela looked at her in surprise. "No," she stated softly. "No, I'm not," she whispered. She looked suddenly unsure and vulnerable.
"You don't need to tell me anything about yourself, Angela," Delia reassured hurriedly. "I'm sorry for prying."
Angela gave a tight-lipped smile. "I'm not from round here," she confided. She stared at the door of the common room for a long moment before looking back at Delia. "My name isn't Angela Gold either."
Delia frowned. "Then who are you?" The conversation had taken an unexpected turn, and she did her best to damp down her alarm.
"My name is Angela Goldberg."
Delia narrowed her eyes when the woman sat opposite looked challengingly at her. "So you're telling me you're Jewish." She shrugged. "So what?" Delia really had no interest in other people's religious beliefs. It was how a person behaved that mattered to her.
"I came here as a refugee," Angela continued, her voice barely above a whisper. "A distant relative in Aldgate gave me shelter."
"You escaped Nazi Germany?" Delia guessed. "You must have been very young."
"I left Germany in 1945," Angela corrected, her voice hoarse.
Delia's eyes widened in shock. "You were held captive?" She asked delicately, not knowing if it was even appropriate to mention any ordeal Angela may have suffered during the War.
Angela looked grim. "Do not shy away from it, Nurse. It's something no one should forget. I was in Birkenau. I left alive." Her voice became brittle again. "My twin did not."
Delia closed her eyes as she attempted to mute her reaction. She had seen the newsreels and read the reports about the Holocaust. Mengele's experiments on children and identical twins in particular, had become infamous. When she opened her eyes again, she noted that Angela was studying her carefully. Delia realised that she was waiting for a reaction, and how she responded was important to her. Instead of simply offering an apology for something she couldn't possibly understand, Delia chose a different route. "Why did you change your name?"
Angela blinked in surprise. It was not the reaction she had been expecting. "My adopted family did it on my behalf. They said that it was important that I move on, and not be asked endless, ghoulish questions that would only remind me of the horror." She barked out a short laugh. "As if I could ever forget."
"I take it no one spoke about it," Delia surmised.
Angela shook her head bitterly. "I survived hell and the rest of my family did not. I was shipped to a foreign country at the age of 14. I was too emaciated to go through puberty, couldn't speak English and was told not to tell anyone I'm Jewish." She canted her head slightly. "Is it any wonder I'm in here?"
"Nurse Busby!"
Delia jumped and turned to see Matron standing in the doorway, a disapproving look on her face. She turned back and smiled apologetically at Angela. "I have to go."
"Thank you, Nurse," Angela stated as Delia rose.
Delia's brow furrowed again. "For what?" She enquired softly. She could feel Matron's eyes boring into her, but felt that this was important.
Angela smiled wanly before picking up her cup of tea. "I am a human being," she repeated, no longer looking at the dark-haired nurse.
A few days later, Delia sat on a bench situated in the patio area that was ironically called the garden at The London Hospital. Simply adding some pots and tubs hadn't really done much to make it feel more pastoral, but it was better than being stuck inside. Delia needed to blow out the cobwebs and shake off her mood. She breathed in deeply and closed her eyes, wishing that the aroma was more reminiscent of rural Wales.
"Don't tell me you've started smoking," Patsy commented as she sat down next to the other woman. The garden was a favourite haunt for smokers who wanted to go outside.
Delia wrinkled her nose in disgust. "Not on your life. I have no intention of getting hooked on anything," she declared determinedly.
"Anything?" Patsy rejoined innocently, lighting a cigarette with unconscious ease.
Delia blushed at the insinuation and scanned the garden quickly, already knowing that it must be empty for Patsy to make such a comment.
"Anything that makes me sick as a dog," she amended with a rueful grin.
"So you have tried then?" Patsy was intrigued. She had offered Delia a cigarette once but had never pushed or enquired further when the brunette politely stated that she didn't partake.
"Have I not told you that story?" Delia was incredulous.
"No. Come on. How bad was it?" Patsy was already teasing, but her smile took any edge from it.
"Awful," Delia replied firmly. She grinned as she shook her head at the memory. "We were behind the bike sheds at school. Mavis had managed to pinch some cigarettes from her dad. Players, if I remember correctly. She and Sally lit up and smoked like they were film stars. Mavis offered me one, so of course I said yes."
"Why of course?" Patsy asked.
Delia rolled her eyes. "At the time, I would have told you that I simply thought Mavis was brilliant and I wanted to be just like her. Now of course, I'd be honest and say that I fancied her like rotten."
Patsy snorted. She took another drag and encouraged Delia to continue.
"Obviously, I had never smoked before, but I'd been watching them, and I'd seen it at the pictures, so I lit up and took a great lungful. And immediately started coughing like mad. Then, even as I was coughing, I realised I was feeling sick but before I could warn anyone, I threw up all over my shoes. I think I splashed sick on Mavis too."
She gave Patsy a resigned look. "That put paid to any friendship we'd ever had. Before I realised what was going on, Mavis and Sally scarpered, leaving me to throw up by myself. I was most put out and feeling very sorry for myself until I realised why they had so cruelly left me." Delia was quite enjoying regaling Patsy with the events of her past.
The blonde nurse nodded and gestured with her free hand. "Well, go on. Do tell. Why had they abandoned you?"
"Because Miss Jennings, our Head of Year was out on patrol. She must have seen us as she came straight over. I was too busy being sick to spot her coming but the others hadn't." Delia shook her head. "Goodness me, she let rip. It was half in English, half in Welsh. I could barely follow what she was saying. She only stopped when she realised that I was more interested in throwing up than listening to whatever it was she was saying. She took me to the nurse's room and then sat with me and made me drink two glasses of water. She sat with me, rubbing my back, until I recovered enough to stop heaving."
Delia paused for a moment and smiled wistfully before looking at Patsy fondly. "I'll never forget her, Pats. She just completely calmed down and then spoke to me really quietly. She said that her father had miner's lung and could barely get out of his chair without getting out of breath. She asked me why anyone would choose to put smoke in their lungs when they were surrounded by the glorious fresh air of Pembrokeshire and then she asked me to promise her never to smoke again." Delia halted again as she recalled the memory in her mind's eye. "She was so sincere, and so urgent about it. I couldn't help but promise her." She looked at the blonde nurse and grinned. "If I'm honest, I definitely had a crush on her."
Patsy laughed with the younger woman but she could see that such a seemingly innocuous contact had had a profound effect on her. "So you kept your promise?"
Delia nodded unashamedly. "Yes. It was really important for her, so it became important to me. It certainly helped that I had no desire to feel that ill again so it wasn't exactly a hardship for me. It's never even crossed my mind to break the promise. I suppose once I said no enough times to realise that it was just as easy as saying yes then it wasn't an issue anymore."
"You didn't feel you needed to join in and be part of the crowd?" Patsy asked lightly, knowing that smoking at boarding school actually afforded one a little anonymity given that practically all the girls lit up.
"Being part of the crowd is overrated," Delia decided. She sighed and sat up slightly. "So was it simply the urge for a cigarette that brought you out into the fresh air, Nurse Mount?"
"Well I was heading for the staffroom," Patsy admitted candidly. "But I caught sight of you as I was walking down the corridor and found myself diverting here before I even thought about it." It really had been as simple as that. Patsy had become more and more worried as Delia withdrew into herself during the placement. She tried encouraging her to talk about the patients or her experiences. Delia would give her a sketchy overview of her day, but Patsy was sure she was holding back on how she was coping. Patsy valued just how important Delia had been to her during her tough times. It was only right that she do the same for her. She just hoped that Delia would reach out when she needed to, and not try to go through the experience alone.
Spotting Delia in the courtyard on a break was reason enough to alter her destination. Seeing the forlorn and dejected look on her face simply made Patsy hurry to reach her.
"Must be my magnetic personality," Delia mused.
"Undoubtedly," Patsy agreed unabashed. She exhaled heavily and a large plume of white smoke billowed in the cold air. "But I also wanted to check in with you. I know things have been... difficult." Patsy decided that there was no point hiding her concern.
Delia's shoulders dropped slightly. "I think I can say this hasn't been my favourite assignment."
Patsy gave her a sympathetic look but frowned when she noticed the thin red marks on Delia's forearm. "Goodness Delia. What happened?" She traced the marks faintly with her fingers.
"Angela Gold," the Welsh woman replied cryptically.
"The lady that's manic depressive?" Patsy queried, hoping she'd recalled correctly.
Delia nodded morosely. "She had been doing so well. Calm as a millpond yesterday. Something must have happened when the patients were having morning tea. She went absolutely berserk." She shrugged. "I got caught in the crossfire before she could be properly restrained."
"Are you hurt anywhere else?" Patsy's eyes studied the rest of Delia carefully, as though she could see through the material for any other wounds.
"I don't think so. Once she was secured, Matron checked me over to make sure I was alright and then told me to go and have a bit of fresh air." Delia looked at Patsy sheepishly. "I have a feeling I was looking a little peaky."
"Well I dread to think how pale you were before you came out. The cold has put a little colour in your cheeks but not much." Patsy desperately wanted to reach out and take Delia's hand in a show of comfort, but the garden was too well overlooked to be discreet.
Delia squirmed slightly under the scrutiny. "I'll be fine, Pats. I just need to toughen up a bit. Find a way of coping that works for me I suppose."
"Delia, it's not about being tough. Believe me, I know."
Delia nodded. "I know. But I've got to find a way to get through this that works for me. It's our last training ward. I am not failing at the last hurdle."
"You won't," Patsy assured her. She gave a lop-sided smile. "I won't let you," she declared firmly. Overriding her caution, she reached out and took hold of Delia's hand. "I'm here to listen to anything you need to talk about. You know that. But if you'd prefer, why don't we go to the pictures tonight? My treat. I think you could do with a couple of hours of pure escapism."
Delia gave a brief smile before glancing at her fob watch. She squeezed Patsy's hand before rising from the bench. "I'd better get back or Matron will wonder where on earth I've got to. And yes. I'd love to go to the cinema. In fact it's just what I could do with." Her smile turned into a grin. "However, I don't care if it is your treat, you are not buying Parma Violets."
Patsy looked at her in mock horror. "Would I?" She asked imperiously. Inwardly, Patsy felt a rush of relief wash over her. If Delia was able to crack jokes, then things weren't as dire as she had originally thought.
"You deliberately buy them every time we go," Delia pointed out.
"One can hardly be blamed for selecting confectionary that one at least has a chance of tasting."
Delia's mouth dropped in outrage for a second before she shook her head and grinned. "Perhaps we could get some pic-a-mix instead?" She suggested.
Patsy wrinkled her nose as she returned Delia's smile. "I think that's a very sensible compromise." She took one last puff from her cigarette before grinding the stub with her shoe. "Honestly, Deels, if you're not up for it and would rather just have a night in, I'm happy to do that, too."
Delia could see that Patsy desperately wanted to help. "Really, Pats, spending time with you is the best medicine, no matter what we do. But I like the idea of a trip to the pictures. I could do with something to look forward to today."
"Alright. I think you're due to finish before me today so I'll come to you once I've changed," Patsy decided.
"Perfect. Right. I must fly." Delia turned on her heel and hurried back to the Psychiatric wing of the hospital, feeling the heavy weight of dread press on her as she got closer.
She thought she had been making good progress with Angela Gold. Delia had spent a lot of time talking with the young woman and building up a rapport after her breakthrough with her a few days ago. The fact that Angela had trusted Delia enough to reveal her past compelled Delia to try and find out more. She reasoned that it was only natural, given how she had been with Patsy.
Delia had told Matron and the Psychiatric Consultant what she had discovered, in the hope that she could provide information that might help her treatment. Angela hadn't appeared to respond well to any of the medication that had been prescribed during her stay. The Consultant had listened attentively but stated afterward that the causes of her illness didn't really matter, he needed to find a way to treat her and keep her from harming herself, or others.
Now Angela had had another episode, Delia wondered what would happen to her.
"There you are Nurse Busby. I was just about to send out a search party," Matron commented curtly as Delia navigated the secure doors.
Delia winced. "I'm sorry Matron. I must have lost track of the time."
Matron dismissed the apology with a shake of her head. "That's not what I meant. Dr. Fairfax was looking for you."
"Me?" Delia was surprised. As a student nurse on the ward, she should have been one of the most invisible members of the team.
"Yes. Apparently, he wants to try a more invasive therapy for Angela Gold and he's requested your help. You'll find him in his office."
Armed with no more information than that, Delia approached the Consultant's office at the end of the corridor and tentatively knocked on the door.
"Ah, Nurse Busby. Are you all recovered?" Dr. Fairfax asked considerately, gesturing her arm.
"Yes sir. It's just a scratch. I was simply a little caught by surprise," Delia replied candidly.
Dr. Fairfax nodded absently as he scanned his notes again. "Yes, well I've been looking at the progress with Miss Gold." He coughed slightly. Or perhaps I should say, the lack of progress. After today's outburst it's quite clear that she is potentially a risk to herself and others," he concluded as he looked up.
"This is the first time I've seen her upset," Delia replied neutrally.
"Miss Gold has been in and out of this department for many years, Nurse Busby. Believe me, what you saw was simply the start of a prolonged mania episode." He took off his half-moon glasses and rubbed his eyes briefly. "She hasn't responded to any of the medication therapies. I really don't think we have much alternative so I am recommending a lobotomy."
"No," Delia interjected reflexively.
Dr. Fairfax looked up sharply. "I'm sorry, Nurse. I was of the understanding that you're a student, not a doctor."
Delia could feel her blood boiling and she ignored the implied warning. "Don't you think she's suffered enough?"
Dr. Fairfax grew red with anger. "I am a doctor. My job is to alleviate suffering, not inflict it. She has not responded to conventional drug therapies in order to control her outbursts." He gestured to Delia's arm. "And don't stand there and tell me that she is harmless when the evidence is quite to the contrary."
Delia moved a hand over the red marks in a useless attempt to hide them. "They're just scratches. Nothing major. Damaging her brain seems to be a drastic action."
"It may be nothing major this time, but this behaviour typically escalates. I've seen it during my many years of experience working in Psychiatry." The grey-haired doctor fixed her with a pointed look and his voice shook. He was clearly not used to being questioned. "As to your second point, I'll avoid the obvious insult to my work and instead tell you that her brain is already damaged. That is why she is here. I am attempting to repair some of that damage, or at least ensure she does no further damage to herself, or others."
Delia wasn't done. "Angela was experimented on in a Concentration Camp."
"This isn't an experiment Nurse. This is a recognised, well practiced and documented procedure. The patient has the potential to harm, be it herself or other people. I have a duty to treat that in whatever way I can." Dr. Fairfax was quite resolute.
Delia tried a different approach. "Doctor, even being prepared for the procedure is likely to frighten and upset her."
"That's why I need your help," the doctor explained. "While I have no intention of explaining the whole procedure to her, she will as you rightly point out, need to be prepared. You building a rapport with her, despite being told not to, does actually work in our favour. You should be able to approach her and keep her calm so that a sedative can be administered without fuss. The less agitated she is when that happens, the better."
Delia shook her head in disbelief. "Why does that matter? Surely the quicker she's rendered unconscious, the better?"
Dr. Fairfax grimaced. "Miss Gold will need to have some level of alertness while the procedure takes place. It's the way we can establish that the procedure has been successful."
"What?" Delia was absolutely incredulous. She had read nothing about that.
Dr. Fairfax sighed but decided to humour the young nurse. "The patient is required to recite a story or a poem or a song they know from memory. The moment the memory falters, the probe has gone in far enough. It's a reliable system of ensuring no permanent damage."
Delia shook her head rapidly. "You can't do this. And I certainly can't be part of it. She'll be terrified."
"That's exactly why I need you to be there. And quite frankly Nurse, you don't get to pick and choose what you can and can't do within the department. Miss Gold will respond better to you than anyone else on the ward and she will get the treatment required."
"Doesn't she have any say in this?" Delia asked.
"She is a mentally ill patient. One can hardly expect a rational coherent conversation from her. And I certainly don't need her agreement." He looked down at his notes again. "I've booked an operating theatre for tomorrow morning. Please see Matron and ensure you're on duty to assist." With that, Dr. Fairfax indicated that the conversation was over by nodding towards the door.
Delia watched the doctor pick up his pen and start to make additions to his notes. Furious, but feeling impotent, the brunette spun on her heel and strode from the room. She needed to talk to Matron about this.
To be continued...