The Hospital Ward

The Hospital Ward

The Hospital Ward 1080 1350 Alan Perkins

It hadn’t rained, but the concrete was damp. It wasn’t frozen, but the air was dropping and the sky showed faint stars through the streetlights.

Late, she rushed through the neon-lit entrance to the hospital, past the spot where the snack counter used to stand. The management was still several months away from opening the chain store coffee counter, so the space was empty and the absence was obvious and gaping like a wound. She was moving at almost a jog, a slipping shuffle she often did and had no time to think of Ahmed, who had worked there for a decade, joining from a local café, preferring the sense that he was bringing a little comfort to those most in need. He had believed that the hospital needed him as much as the doctors and nurses but soon saw that his mind had been clouded and that the space he occupied was simply that; space. He was a month away from applying to work at the chain store coffee counter and ten weeks away from leaving London.

As she approached the relative sanctuary of the nurse’s room she had the familiar tingle that she felt each time she arrived, as though every day she had spent in the building, every hand she had held through trauma, death or recovery had left a small residue in her mind, like an image photocopied beyond recognition. The room layout had stayed the same over the years, save for the change of calendar and work schedules. She thought of her early days, working in a uniform that felt more like fancy dress than reality, the farewells to colleagues, and the forced friendliness of a new starter’s first day.  She had never been officially asked to be in charge of onboarding new nurses but each time she saw a newcomer, with that recognisable stare and awkward, rounded body language, she found herself making tea and telling them that it would be alright. She would find a space for them to put photos of loved ones on the wall of the nurse’s room, next to the picture of her daughter, smiling in her school portrait. She had updated her picture half a dozen times in the previous decade.

Perhaps it was because she was a migrant. Perhaps the cold feeling of isolation never truly leaves your skin and the sight of others smiling through their displacement would always hit her harder than it hit colleagues who had often trained together or come up through the local schools. Not that there was ever a divide. Being a nurse provided an infinite supply shared experiences that overrode upbringing or background. Once you had watched someone die before you, cleaned the fluids that expelled in the dying moments, washed the cadaver and sat with the relatives, you were united. Soldiers must feel like that in battle. Or plane crash survivors.

The staff room was backstage at the opera. It was the trenches. It was a safe zone set out in a war. It was an artist’s studio. It was a hotel bar, populated by people who needed each other but would soon move on. It was a changeable roster of reassuringly archetypal character types, like the changing cast of a long-running play. The conversation, because of the seriousness of the job, was rarely about anything more than drinking exploits or TV updates from the nightly shows. As the nurses worked alternating shifts, they experienced TV soap operas through a hive mind, with the off-duty staff reporting what had been missed by those on shift, who soon pictured the action as clearly as if they had watched it themselves. They had experienced this combination of reality and oral history for years and could no longer remember which episodes they had seen and which they had been told about.

If you ask any nurse, they will tell you the same thing. When a big day is on the horizon, when a miraculous or monstrous moment is coming, the day just tastes different. It is as though the oxygen in the building takes on a new quality and the lights give off a different tone as if the joyous memories have sunk a little further into the collective memory and each person feels closer to the horrors that they have witnessed. They are more alert, without noticing it. As she rushed into the room to slip off her coat, drink the last guaranteed liquid of the evening and appear on the ward, ready to face her public, her duty and her friends, she felt the skin on her hand tighten marginally. She felt a sharpness in her gut, just above the liver, like a tiny firework, pulling the organ out of place. No nurse would ever speak of this feeling. Nobody wants to curse the shift.

‘Hey love’ says Sally, handing her the changeover report. Sally had moved to the hospital after her divorce from a man who, depending on who you talked to, beat her, stole from her, or attacked her children. Sally was two years away from moving out of the city, taking her children to a quieter life in the calm of the southwest. She was hungry from skipping her last break. She had replaced a large, stocky nurse named Damon, who had believed himself to be the king of the ward and was humiliated to find he was not missed by his old team.

Something must have happened during the first two hours of the shift. And yet, if you were to ask any of the nurses what happened, not a single one could tell you what it was. The searing blister of the coming events scorched the peripheric memories from everyone.

It started, as usual, with a rumour. A slow vibration, not even a word, made its way around the A and E ward. Just a sound. Low, like the sound of startled animals in the wild. People’s body language changed and the ward became a subtle dance of controlled panic. It was too expressive. Strangers were leaning over, talking, sharing pictures on phones. Doctors moved with short, hyper-fast actions that were darkly comic, like a cartoon playing at double speed. The vibration grew and developed glottal, plosive, consonant sounds. From these sounds, the atmosphere grew tenser and the vibration took on a shape. The beginnings of the words ‘attack’ and ‘bomb’ started to form and echo around the walls of the ward, bouncing hard off the clinical, bleached whiteness. She was called to meet the head of the ward immediately. They all were. By now, the word-like sounds were being linked into sentences that grew like tentacles around the ward. There had been an explosion a few streets away, in a busy restaurant area that the nurses knew all too well. There was every chance that some of the staff, upon finishing their shift had stopped there to pick up noodles to take home to their children. Rumours immediately grew that there were dozens, then hundreds of casualties. More attacks were underway. This was a lone wolf. This was the start. This was the end.

‘Ok’ said the head of the ward ‘this is what we have trained for. We don’t know how many casualties at this point but it sounds heavy. All doctors have been contacted and are on their way here. You all know what to do. Let’s do it correctly and do what we can’.

The nurse, remembering stories of the attacks that drove her parents from their homeland, ran on legs that seemed not to be hers. Her grandparents had been killed by rebels, who came to the village with homemade explosives and machetes. Her parents risked everything to bring her to London. They had done it to protect her from this. She couldn’t help but feel that all this was following her, that she was the centre of it. She shook her head fight the thought away.

Stretchers. Stretchers everywhere. The blood bags and the people arriving to donate. The screaming of children, teenagers with limbs hanging in grotesque shapes. Adults, shrunken by the attack into fragile dolls. The squeal of wheels. Doors clattering like autumn branches in a bruising storm. Hell unleashed. The terror on the faces of people who would not survive the hour. The agony of the faces of those who would. Morphine and anesthetic. Antiseptic dressing and attempts at comforting words. Cheeks with burns like glowing embers. Chests with cavities like open sacks. A foot in a plastic bag.

The hypnotic, hallucinatory time that the nurse spent working on torn flesh and burnt limbs could have been an hour, a second or a day. There are stories of nurses in battle working for many days straight, knowing that when they stop, life will stop. At some point, she is grabbed by the head of the ward and taken over to where armed police stand. Have there always been police? Have they been there all along? Or were the machine guns a new horror, recently added to the scene.

‘You need to help over here’ said the head of the ward ‘you need to go beyond the police’.

The nurse did as she was asked. She always had. She had since her dad sat her down and forced her to put down her toys and work hard on her school book, knowing that education was her only way forward. He had encouraged her when she said she wanted to study nursing and beamed with pride when she qualified. He told her that now she could give back to the city that had saved them.

The police officers with machine guns walked with her, through the chaos and noise and lead her to a room, a side room, away from the main ward. As they led her through the double doors, the noise cut away immediately. The silence of the room left her ears with a trailing echo of the clatter just a few meters away. The room was dimly lit, but she could make out four more armed police officers, standing in each corner of the room. ‘Six in total’ she said to herself. She recognised two of the doctors who were leaning over a horizontal figure in the centre of the room. The quiet and the dark sank into her mind and in the calm, she realised who the patient was.

The doctor asked her to dress one of the wounds, explaining that there were many. The oxygen mask covered most of his face, but she could see he was unconscious. Badly injured. Probably wouldn’t survive. As she approached the lump of bones, tissue and organs on the table, the doctor made eye contact with her, smiled and nodded slowly. He looked like he could vomit. The nurse imagined that she must look the same. She approached the bed and her training kicked in. Muscle memory. Thousands of hours of changing bandages, replacing catheters and injecting solutions had given her the ability to float above her duties. She watched herself working as the doctors attempted to save the life that lay in the centre of the room.

She felt how criminals must feel when they are finally sentenced to jail: a kind of sickening inevitability. She had done what needed to be done and now must live with it. A policeman let her out without a word and accidentally brushed her with the tip of their gun.

‘Take a minute’ the head of the ward says. The nurse returns to the staff room. It must be many hours later. The hospital has taken in all that is coming. Each patient is being given the care and the chance that their condition allows. Each staff member is in the hospital. All leave is cancelled. They have enough doctors and nurses to cope. A strange calm descends her as she enters the room. As she sat in the corner, her head swinging down to her chest, Sally came and put her arm around her. They sit in silence for a while. The silence is a security blanket. After more uncountable minutes, Sally says that Facebook has an option for people to check in as ‘safe’. Sally has looked through her rollcall of loved ones and suggests the nurse does the same for her daughter. An electric bolt hits the nurse’s spine. She cannot explain in the coming years how she lived these hours without thinking of her daughter. Maybe it was the adrenaline. The shock. The desire to help people going through what her parents had been through. The years of being told that she was in a safe place that had overridden the horrors she had seen. But she checked Facebook and saw nothing. She scrolled through again and again, but still saw nothing. Opening the phone book, she pulled up the number for her daughter. She didn’t need to hear anything. As she pressed dial, she already knew what had happened.

Header photography © Hanna Komar.

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