Chapter 7 The Lornwick Wing

The Lornwick Wing was opened in the spring of 1921 with a brass plate and a short speech, and within a year Dr. Ardle Fenmore had come to think of it as the most honest building in Vessock, because it was the only one that told the truth about what the city was willing to pay for. The wing had a theatre with a skylight and an electric lamp, a sterilizing room, an apparatus that could photograph a bone without cutting the flesh, and two wards of eight beds each, one for men and one for women, and a small anaesthetic room where the patients were put to sleep before they were carried through. It had cost eleven thousand pounds, subscribed by the trades of the city after the war, and it had been given to the infirmary on one condition: that the governors would find the money to run it. The governors found the money to open it, which is not the same thing. They found it for a brass plate and a ceremony and a paragraph in the newspaper, and when Fenmore sent them a memorandum in the first week asking for two more sisters and four more nurses, they replied that the wing was a great advance and that the staff must for the present be drawn from the existing establishment. So the existing establishment ran the wing out of its own substance. A nurse was taken from Letham, and Letham went short. The probationer who had been promised to the surgical work was set to the anaesthetic room because there was no one else to put to sleep the patients, and she learned the work by watching and by doing it, which is how most of the work in the building had always been learned. Mr. Peveril, the visiting surgeon, was a small quick man of fifty who operated three mornings a week and did his rounds in a black coat that smelled of carbolic, and he had a reputation in the city for a knife that did not waste a movement. Fenmore liked him and did not entirely trust him, because a man whose hands are quick may be quick for the reason that he does not like to look too long, and looking too long is nine parts of medicine. In the second winter of the wing a man died on the table. His name was Sivard, and he was a labourer of thirty-four from Craddon, and he had been brought in with a perforated ulcer that had been going wrong for two days, and Peveril opened him and found a belly full of the poison and did what could be done, and the man died under the anaesthetic before the wound was closed. The probationer at the head of the table had put him under with chloroform, drop by drop, as she had been taught, and had watched the breathing and the colour and had called the surgeon when the breathing changed, and the surgeon had said to hold on a minute, and the minute had been enough. There was an inquiry, because there was always an inquiry when a man died under the knife in a public institution with a board and a ratepayer and a newspaper, and the board met in the room with the long table and heard the surgeon and the matron and the doctor, and then it heard the probationer, who stood with her hands at her sides and told it, in a level voice, exactly how many times she had put a patient to sleep in her life, which was seven, and how many times she had been at the head of the table alone, which was five. Fenmore had known the numbers before she said them. He had written the memorandum that would have prevented them, and the memorandum was in the file, and he could have read it aloud to the board and made the whole room look at the two years of letters in which he had asked for a second anaesthetist and been told to manage. He did not read it. He sat with his hands on the table and gave his evidence as the medical superintendent, which was that the anaesthetic had been administered according to the practice of the hospital, and that the death was the death of a man who had come too late, which was true, and was not the whole truth. The board found that no one was to blame, and thanked the surgeon for his attendance, and resolved to consider the question of surgical staffing at a future meeting. The probationer left the building a month later, not dismissed but unable to stay, and Fenmore wrote her a reference that was better than anything he had written before or afterward, and when he gave it to her at the gate he said the only true thing he had said all winter, which was that she had done nothing wrong and that the building had, and that the building would never be made to carry it, and that she must carry it for a while and then, if she was wise, put it down. He went back up the slope past the new wing, whose brass plate gleamed in the rain, and it seemed to him that the plate was the honest part and that the rest of the building was a set of arrangements for making the plate true without paying the price of it. He understood, that winter, that his job was not to cure the poor of Vessock, which was beyond any man, and not even to run the infirmary, which was merely difficult. His job was to be the wrong that was made at the top of the slope, and to stand at the foot of it and take the weight when it came down, and to do it for as long as his body allowed, and he was forty-eight years old and had begun, in the mornings, to feel his own weight in a way he did not care to examine. He had begun that same year to keep a private account of the beds. Not in the admission book, which was the public record, but in the back of his diary: the number of patients who had waited more than a fortnight for a bed, and the number who had died waiting, and the number of letters he had written to the board, and the number of those that had been answered. He had started the account as he had started everything, because a doctor who does not count cannot argue and a doctor who cannot argue is not a doctor but an apology. By the end of the year the first column ran to three hundred and forty names and the second to eleven, and he read it over sometimes at night in the flat he kept off Marrowden, and it told him exactly how much of the city the building turned away, which was a figure no annual report would ever carry, because an annual report counts the patients who were treated and never the ones who were sent on to the workhouse with a shilling for the tram.