Same Disclaimer as before
This Chapter is dedicated to all ROGs and POGs who
work in the healthcare industry – you folks are amazing
Chapter 4 Nurse Rachel
When Ruth reached the hospital, the reception desk redirected her to the surgical floor. The sister on duty on the surgical floor said that she could only discuss details relating to patients with their immediate family. Without hesitation, Ruth told her that she was Harry Pearce's wife and gave her name as Rachel Everington. It would not be the first time that she had told this lie. Then again, in the world of espionage, this did not really qualify as a lie, just a cover story used to gain more information. The sister then informed Ruth that her husband was in surgery. She could wait in one of the waiting rooms down the hall from the operating theatres.
"Rachel Everington" was one of the last legends which Ruth was working on before she left the Grid all those years ago. She used it even though she did not know whether any one had bothered to pad out the legend after she left, or whether any one had in fact used it and discarded it. It was a dangerous thing to have done, but she did not have a choice. She would have to tell Malcolm about it later.
Ruth sat down to wait. She noticed that the clock said it was 3 pm. After an hour, she started to pace. When she became tired of doing that, she sat down again. She was out of her mind with worry. From the waiting room, it was not possible to watch the entrance to the operating theatres, so every 15 minutes or so, Ruth would get up to check the entrance. Once or twice, they brought out some other patient who had been through surgery. Ruth was a little relieved each time when she saw that it was not Harry.
Ruth did not feel like flipping through the gossip magazines that were available in the waiting room. Those were not her usual reading material. She wished she had something to do. Having access to a computer would certainly help.
She was grateful when Adam, Malcolm and Connie turned up at 9 pm. By then Harry had been in surgery for over six hours. Ruth took some comfort in thinking that if the doctors were still working on him, there was a slim chance that he might pull through.
Malcolm brought her a department issue laptop and mobile phone. There was wi-fi in the hospital so at least she could try and hack into a couple of databases to find out what happened this afternoon. Hospitals generally discouraged the use of computers and mobile phones but at least in the waiting room section of this floor, the wi-fi signal was fairly strong and stable.
When Ruth told the three visitors that she had used the legend of "Rachel Everington", Malcolm agreed that it was probably a good idea that she did not use her real name. He did not think that that legend had ever been used. Adam debated whether he should tell Ruth that the assassination was precipitated by her return from the dead, but Ruth beat him to it.
"Adam, you don't think that the hit had anything to do with my coming back?"
Ruth expected a "no, no, Ruth, don't be silly" type response from Adam. But the look which Adam gave her said it all. Her deduction was spot on, as usual. Adam decided that Ruth must be told so that she could take greater care for her own safety.
"There is some concern that the assassins might make another attempt to finish the job. Its less clear, at this stage, whether they are also out to get you. We have arranged for a security detail for both you and Harry here, at the hospital, so you should be safe for the time being. Its probably a good idea for you to hide behind a legend for the time being so as to throw the scent off, if any of the assassins was looking for you." Ruth now wished she had never come back.
It took a woman to understand another woman. Connie knew what was going through Ruth's mind. In particular, she knew that no matter how hard they all tried, Ruth was not going to leave that waiting room until they wheeled Harry out, and if Harry lived, she was not going to leave the hospital. So Connie took the liberty of packing a small overnight bag for Ruth, complete with toiletry items and a change of clothing. The three of them left after sitting with Ruth for an hour. Ruth insisted they should all go home and have some rest.
Harry was finally wheeled out of the operating theatre at 11:30 pm. He had been in surgery for over 8 hours. They took him immediately to the intensive care unit. One of the surgeons stopped to give Ruth a report of what they had been doing for the past eight hours.
"Mr. Pearce suffered gun shot wounds both to his chest and his head. The bullet that went into his chest nicked his heart. If it had gone one centimeter to the left, he would not have survived. We spent a lot of time trying to repair the damage to his heart. He lost a lot of blood and it was touch and go at one stage. We lost his heartbeat more than once during these procedures." Ruth was glad that she did not have anything to eat all day; if she did, she might be throwing up violently by now.
"To complicate matters, another bullet also scraped past his head and caused damage to the left side of his skull. Two teams of surgeons worked on him at the same time. This is why it took so long. We managed to repair the damage to both his heart and head but we cannot be sure if there has been any brain damage, and if so, whether such damage is permanent or not." The doctor gave Ruth a moment to digest this information. He thought that this woman was going to collapse on him.
"Although the surgery is a success on the whole, Mr. Pearce is now in a coma, and it would be difficult to say when or whether he will come out of it. We just have to be patient and wait and see. He will need to stay in the ICU for at least two to three weeks, assuming that he makes any progress. We have done everything we can to repair his wounds. It is now up to him to get on the road to recovery."
Ruth thanked the doctor and went into Harry's room in the ICU. When she saw Harry, she could not stop the tears any more and started to sob quietly.
There was Harry lying in bed, with tubes coming out of every orifice. In order to repair the head wound, they had to shave his head and now he was wrapped in some sort of bandage turban. To ensure that Harry's airways were protected, he had been intubated with some contraption through his mouth. There was the obligatory IV drip attached to his arm, the better to give Harry his medicine and sustenance. Since he was comatose, they also had to put in a foley catheter tube to siphon away urine. There were also some other tubes and cables which were attached to Harry's chest at one end, and at the other end to a variety of machines which reported Harry's vital signs.
He looked so weak and defenseless. Ruth could not bear the sight of her Harry being reduced to this. At least his heart rate monitor showed that he was still clinging onto life. Since leaving Harry, Ruth often dreamed of the time when she might see him again. Never in her wildest dreams, or nightmares, did she think that she would see Harry looking like this.
Hospital rules were such that even family members were not allowed to stay in the ICU rooms indefinitely. Fortunately for Ruth, Connie had the foresight to make special arrangements with the hospital for Ruth to stay in one of the crash rooms used by doctors and nurses between shifts. This was not normal arrangements, but then again, Harry Pearce was not your normal patient. Ruth could not remember whether she slept at all, but at least she was still close to Harry. The sister on the ICU floor promised to wake her if Harry took a turn for the worse.
The next morning, Ruth woke early and as soon as she showered and dressed, she rushed to Harry's room in the ICU. She saw an agent positioned discretely at either end of this floor of the hospital. She arrived just as a nurse was injecting something into Harry's IV drip. Apparently the doctors had prescribed some penicillin to help with Harry's recovery. After she finished, the nurse took her tray of medicine and carried on with her duties with other ICU patients.
Shortly after the nurse left, Ruth noticed that Harry's life support machines started to blink and beep all over the place. Harry himself started to go blue in the face as if he had trouble breathing. Ruth might not have understood what was happening, but it was clear that whatever medicine they just injected into Harry was doing crazy things to his system, bad crazy things. Ruth immediately pressed the panic button.
The nurses rushed into Harry's room and quickly decided that Harry must be allergic to this particular brand of penicillin. By now one of the doctors also arrived and he immediately injected something to reverse the effects. They then noted on Harry's chart his new found allergy so that the mistake would not be repeated in future.
No one could have known that Harry would be allergic to this brand of penicillin. It was not noted in his medical history. He probably never had this brand of penicillin injected into him before. If Ruth had not been there and alerted the doctors and nurses in time, they might have lost Harry, or Harry might have suffered more damage to his organs. For the first time in a long time, Ruth felt that she had done something useful. She held Harry's hand and rubbed it gently, whispering to him, "its alright, you're back now, its OK."
When Adam and Malcolm came for a visit later that day, Ruth decided to discuss with them the morning incident.
"Harry's allergic reaction to penicillin was not something we could have anticipated. But it shows how easy it would be for one of the health care professionals to be coerced into giving Harry a fatal dose of something which might be untraceable. If, as you say, it remains a possibility that another attempt could be made on Harry's life, then I think that Harry needs more attentive care than just a couple of minders stationed outside his room. When Harry came into the ICU last night, he was the only patient in this ward. This morning, they received three other ICU patients. The nurses are now a little overstretched. What happened this morning was not the nurses' fault, of course, but it would be so much better if we can get a private nurse for Harry."
"Perhaps you ought to be his private nurse, Ruth." Malcolm was only half joking when he said that, but as soon as the words left his lips, he saw the sparkle in Ruth's eyes and he knew that that was not one of his better ideas. He could almost see the imaginary light bulb light up above Ruth's head, the way it is always depicted in a cartoon. Oh no, Malcolm thought, what have you done now, you silly old fool.
"Yes, you're right Malcolm. I am here at the hospital all day anyway. If the nurses can teach me all the basics, I am a fast learner, I can be Harry's private nurse. Its not as if the Grid wants me back straight away." Ruth brightened at this possibility.
Adam and Malcolm knew better than to waste time trying to talk Ruth out of this ludicrous idea. As long as they have not sorted out who ordered the hit on Harry, perhaps it was for the best that Ruth should be confined to the hospital. Adam and Malcolm were unsure whether the hospital would go for this idea of having Ruth take up nursing duties. They decided that Connie should be in charge of discussing the subject with the hospital administrator. Both men had things to do back on the Grid. Connie was the logical choice. She had already twisted the hospital's arm once before, when she arranged for Ruth to spend a night in one of the crash rooms. Connie could be most persuasive when she put her mind to it.
Malcolm would pad out Rachel's life as soon as he got back to the Grid, just in case the hospital, or any one else, was minded to check up on her. He would then send a package through to Ruth with all the necessary identification papers and supporting documents in the morning.
Malcolm also agreed to make arrangements with the small bed and breakfast place which was right next door to the hospital so that Ruth would not have to sleep in the crash rooms or commute between Connie's flat and the hospital. Malcolm wondered how many hours Ruth would actually spend at that B&B place. He had no doubt that Ruth was prepared to keep a constant vigil by Harry's bedside. Malcolm reminded himself to tell Ruth's security detail that this woman did not need eight hours' of sleep.
The next day, Connie James made an appointment to see the hospital administrator, Terry Jones.
"Mr. Jones, good morning. I am Connie James, one of Sir Harry Pearce's colleagues. We spoke the other day about using one of your crash rooms the night Sir Harry was brought in. On behalf of our department, I want to thank you and your staff for what you have done for Sir Harry. This is a dreadful business, isn't it."
"Yes, Ms James, it is. As if it is not enough for the criminal gangs to run around London shooting each other and then clogging up our wards so that we can take care of their gunshot wounds and overdoses, they are now shooting at government officers. At this rate, the hospitals will not be able to cope. Law abiding citizens with genuine illnesses are made to suffer when we cannot attend to them as quickly as we should."
Terry Jones had signed the Official Secrets Act and knew that his hospital was regularly used by various branches of the Government to treat their sick or wounded officers. He also knew that Harry Pearce must be someone important, otherwise, he would not be talking to this woman twice in three days. He was aware that two agents had been posted on the ICU floor. However, he was not inclined to ask too many questions. He figured that the less he knew the better. After all, the hospital was only responsible for providing health care, and what with the Hippocratic oath and all, their's is not to reason why. The sooner they could patch up patients, the sooner they could tend to others; maintaining a high patient turnover rate would ensure high cashflow, and that was the hospital administrator's main concern.
"Ah yes, Mr. Jones, I'm glad you brought up the subject of the hospital's resources being stretched to the limits."
Jones was confused. What was this woman talking about? That's not exactly what I just said. Why was she twisting my words? Was she suggesting that somehow we have been incompetent in looking after this Pearce fellow?
"You see, Mr. Jones, Sir Harry, is a very important senior civil servant. Given the circumstances under which he sustained his injuries, the Government is keen to ensure that he is given the best and most efficient care, to have him back on his feet as quickly as possible, so to speak. We need to show the folks who carried out this awful deed that we are made of sterner stuff."
Connie decided not to bring up the allergy incident. She would save it for later, if Terry Jones put up too much of a fight.
"We are giving Sir Harry the best care available and …"
"No doubt you are, Mr. Jones. I am not suggesting otherwise. Its just that we have a member of staff available who can act as Sir Harry's private nurse. If she can become involved in his care, that might free up some of your nursing staff to attend to other patients. She may not have had a lot of training as a health care professional, but she is very bright and is a quick learner. I'm sure that if one of your sisters can take her through the various procedures, teach her how to change dressings etc., she could help ease the pressure on your nursing staff."
Terry Jones was not happy with this suggestion at all. Alarm bells were already ringing. Think of the negligence suits I would have to field if this person without proper training were to cock up and give the patient the wrong pill, or wrong dosage. It would not be the first time that this sort of mistake has taken place, but at least in these other cases, the culprit was a proper member of staff and would be covered by the hospital's insurance policy. To bring in some outsider, without proper training, to look after a coma patient currently in the ICU. This must be the worst suggestion he has heard in his entire life. If he were to go along with this outrageous suggestion, how would he even begin to ask the Government to absolve the hospital from all liabilities if something should go wrong?
"Look Mr. Jones, I can well appreciate that this is not a simple or straightforward suggestion. Why don't you discuss this with your ICU staff and get back to me, say, by 4 pm today? I'm sure we can work something out over the liability issue."
Who was this woman and how could she read my mind? Terry Jones had no choice but to agree. After Connie James left his office, Terry Jones asked sister Margaret to see him in his office as soon as possible.
Margaret Jameson had been in charge of the ICU for over 15 years. She loved her job and would not do anything to jeopardize it. She derived great satisfaction in seeing ICU patients recover from a variety of life threatening diseases and wounds. Not everyone made it out of the ICU, of course, and for those who did not, it was usually not the nurses' fault. The doctors have tried their best. Margaret was very strict with her junior nurses. They did not normally like to work on the ICU floor if they could possibly help it. Margaret had a fearsome reputation.
"Margaret, do you know that woman who has been camping in the ICU, next to the patient, Harry Pearce?"
"Yes, I know who you mean. She is his wife, or something."
"Well no, apparently not. She is simply someone who works in the same Government department as he does. She is now angling to become the patient's private nurse. No, no, this is not a comment on the quality of the care which you and your team have been giving Mr. Pearce, or Sir Harry, I should say. But it has been suggested to me that if this woman could receive training from you on the basic procedures, then perhaps she could take some of the pressures off your team."
Margaret thought that for Terry Jones to discuss with her the care of patients in the ICU, someone important must have leaned on him. Normally, as long as she worked within the assigned budget, Jones pretty much left her team alone. Margaret had also signed the Official Secrets Act and knew all about dealing with the Government where certain patients were concerned. Pearce was not the first high ranking civil servant who had come under her care and he would probably not be her last. Margaret had already noticed the posting of two agents on her floor. Things must be serious if it was now suggested that an outsider without proper training should be brought in as extra "help". Margaret knew all about yesterday morning's little incident involving penicillin. She did not want to bring this to Terry Jones's attention. He would just freak out as usual.
As for this woman who called herself Rachel Everington. She seemed pleasant enough, although she was very inquisitive, more so than other family members or friends in similar situations. From the outset, she had been quizzing her team about the treatment which they were giving Harry Pearce. What is this machine for, what does it do, what happens when that machine goes beeping? What medicine did you just give him? She was always very polite when she was in full inquisition mode and she had such a pleasant smile that you did not usually end up feeling offended by all these questions.
"I suppose if I kept an eye on her, Terry, she may not do any harm and might even, as you say, take some of the pressure off the rest of my team. I guess on that basis, I have no objection if she is installed as Sir Harry's private nurse."
"Splendid. I will notify the powers that be immediately. If she is still around, I suggest that you start bringing her up to speed right away. Now, I will let you get back to your duties."
When she returned to the ICU ward, sure enough, there was Rachel Everington, as always, hovering over Harry Pearce as if she was casting spells to try and make him come out of his coma.
"Hello Rachel. How are you today? Let's see. There's been no change in Sir Harry's condition overnight, so I guess that's good news."
"I suppose we should be grateful for small mercies."
"I understand that you are to become Sir Harry's private nurse. Well, we should start training you up straightaway then. I have some free time now, shall we begin?"
Ruth thought, my my, Connie was a fast worker. She had only discussed this matter with Adam and Malcolm yesterday afternoon and already the wheels were in motion. She brought a writing pad out of her bag to start taking notes.
Sister Margaret described to Rachel the functions of each machine. She taught Rachel how to take a blood pressure reading and check for urine colour and volume in the bag attached to the foley catheter. If the volume of urine collected in one of those bags dropped, or if the colour changed, that was a sign that Harry's kidneys were packing up and he should receive immediate attention. Rachel should also check for changes in Harry's blood pressure. If he was cold to the touch, then that was a sign that his blood pressure was dropping. Again, Rachel should alert one of the other nurses immediately so that they could give him another blood transfusion or iron tablets. If Harry was warm to the touch, Rachel should check his temperature immediately as he might have a fever. A fever could be a sign of infection in one or more of his internal organs.
Next sister Margaret gave detailed instructions as to what medicine to give Harry, how much and how often. She taught Rachel how to knock air bubbles out of a syringe before injecting any medicine into Harry's veins, how to set up an IV drip and how to use the stethoscope to listen to Harry's lungs. Coma patients often developed pneumonia and they must make sure that that did not happen. She then taught Rachel how to change the dressings on Harry's chest and on his head.
Lastly, she instructed Rachel on how to stretch Harry's arms and legs and give him a dry rubdown every day. Nurses have to do this for bedridden patients. It was necessary that the patient's blood circulation be given a good workout from time to time to prevent muscle atrophy. It was also essential that comatose patients are kept physically clean at all times. For one thing, this would prevent the patient from developing bedsores because they were immobile. Furthermore, patients continued to perspire even if they were in a coma, so for hygienic reasons, a regular rubdown was necessary. Some hospitals might have health care professionals other than nurses to do this sort of grunt work, but sister Margaret somehow had a feeling that Rachel would insist on doing this job herself.
This was how Ruth became Rachel Everington, private nurse to Sir Harry Pearce.
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