Dedication

To all the wonderful nurses in the NHS

1

I can feel the eyes of everyone on us as Dr Patel and I cross the waiting-room floor. Some of them are like meerkats, lifting their heads and tracking the movements of anyone dressed in a hospital uniform. Others are more subtle, pretending to be absorbed in the trashy magazine they’re holding or scrolling on their phones. The one thing they all have in common is a resigned air of quiet desperation. Please, you can hear them thinking, let this be the time that my name is called.

I almost want to stop and explain apologetically that the stark reality is: if you’re well enough to sit in a chair and wait in the Accident and Emergency department, you’re probably going to be there for a while. Anyone who’s blue-lighted in, or walks in with a major issue, is instantly going to jump in front of you, pushing you even further down the queue.

As a grade 7 senior sister, it’s rare for me to spend any time in the minor injuries part of A & E; most of my work takes place either in the major traumas unit, known as ‘Majors’, or the resuscitation unit, which probably doesn’t need much explanation. Minor injuries are generally dealt with by the emergency nurse practitioners, but we’ve just received a call because they’re facing an issue they’re not entirely sure what to do with.

‘Thank you so much for coming,’ Blessing, the nurse who called us, says as we step through the door. ‘The gentleman is in bay five. His name is Maurice and, well…’ She tails off, handing the notes to Dr Patel.

‘Let’s have a look then,’ Dr Patel says in that confident tone that all consultants seem to have. I wonder whether it’s something that’s specifically trained into them, or whether it just comes from the knowledge that they’re the cream of the crop. She doesn’t even open the folder, pulling back the curtain of bay five and sweeping in, leaving Blessing and me to follow in her wake. ‘Hello, Maurice,’ she says, as if addressing a naughty schoolboy. ‘I’m Dr Patel, one of the A & E consultants, and this is Tilly, one of our senior nurses. Blessing has asked us to have a look at your injury because she’d like a second opinion before we treat you. Before we go any further, can you just confirm your date of birth, please?’

‘Fifth of June 1960,’ Maurice replies, looking miserable.

‘Great. And the first line of your address?’

‘Five, the Spinney.’

‘Perfect. What seems to be the problem?’

He blushes and glances at Blessing, obviously hoping she’ll come to his aid, but she suddenly seems to find a spot on the floor absolutely fascinating.

‘It’s, umm, Maurice Minor,’ he mumbles eventually.

‘What?’ Dr Patel looks as nonplussed as I feel.

‘His penis.’ Blessing finally decides to come to his aid. ‘He refers to it as Maurice Minor.’

‘I’m a classic car enthusiast,’ Maurice explains. ‘It’s a bit of a pun.’

For a moment, Dr Patel stares at him as if he’s some kind of lunatic, before recovering her composure and continuing in her previous brisk tone.

‘What’s the matter with him… it?’

‘It’s probably best if you take a look,’ Blessing advises her. ‘It’s easier than trying to explain.’

‘Fine,’ Dr Patel sighs as she draws the curtain to give us privacy. ‘Do you mind showing me, Maurice? Ah,’ she observes once he lowers the blanket to reveal the aforementioned Maurice Minor. You know how the penis is often referred to using an aubergine emoji on social media? Maurice’s penis looks like it’s been auditioning for the part. It’s horrifically swollen and a hideous dark purple colour. It only takes a moment to locate the cause.

‘Is that… a washer?’ I ask, pointing at the metal ring encircling Maurice Minor’s base. It’s a little like the kind of thing you’d put under a bolt when you’re assembling furniture, except much larger.

Maurice nods, wearing an expression of pure misery.

‘How—’ I begin, but before he can launch into what I suspect will be the IKEA-furniture version of the ‘I was vacuuming in the nude and fell on the Hoover nozzle’ lie, Dr Patel cuts me off.

‘We need to get that off, and fast,’ she states. ‘How long has it been there?’

‘Since eight o’clock last night,’ Maurice mumbles.

‘You mean you’ve had that thing on your penis for over twelve hours?’ Dr Patel demands, outraged. ‘Why did you leave it so long to come in?’

‘I kind of hoped everything would go down and I’d be able to get it off,’ Maurice tells her.

‘I see. And presumably you’ve been yanking and tugging at it, which would only have made the swelling worse.’ She snaps on a pair of surgical gloves and lifts the penis to inspect underneath, making Maurice wince. ‘The skin is broken under here,’ she observes. ‘We’ll need to treat that to make sure it doesn’t get infected. I take it the washer wasn’t sterilised?’

Maurice looks like he’d quite like the earth to open up and swallow him as he shakes his head. Dr Patel is making no effort to conceal her disdain, so I don’t entirely blame him. Poor Blessing is desperately trying to look anywhere other than at Maurice Minor, but I have to confess a slight ghoulish fascination. This was obviously some sort of sexual misadventure, but what on earth was he trying to achieve?

‘Blessing,’ Dr Patel practically barks. ‘We need to get this thing off. What were your thoughts?’

‘We were planning to cut it off,’ Blessing tells her meekly. ‘But there’s so much swelling around the washer that we couldn’t see how to get the cutters in there without doing more damage. That’s why we called you.’

‘Good observation,’ Dr Patel tells her as if praising a dog. ‘We need to drain the blood out of the penis first. Treat it like a case of priapism.’ She turns to me. ‘Are you comfortable with treating priapism, Tilly?’

‘Comfortable enough,’ I assure her. ‘It’s not something we treat regularly, but I’d numb the area with local anaesthetic and then drain from as many sites as required using a needle.’

Maurice obviously doesn’t like the sound of this at all, as his face turns ashen.

‘You mean you’re planning to stick needles in Maurice Minor?’ he asks, horrified.

‘It’s that or risk having to amputate,’ Dr Patel tells him matter-of-factly. ‘The longer we let this go on, the more danger there is of permanent damage to your penis. It may already be too late, but we won’t know that until we deal with the current situation. Are you happy to sign a consent form for us to proceed?’

The threat of amputation has obviously had the desired effect, as Maurice nods mutely and Blessing disappears off to sort out the paperwork. I take this as my cue to go and fetch the relevant equipment for the procedure.

‘Right,’ Dr Patel announces when I return with a trolley and Maurice has signed the form. ‘I’m going to give you an injection to numb the area, and then Tilly here will start draining the excess blood from your penis. Hopefully, once that’s done, we’ll be able to see what we’re doing to get the washer off. Any questions?’

Maurice shakes his head and closes his eyes as Dr Patel inserts the small needle and delivers the anaesthetic. After a minute or so, she flicks Maurice’s penis lazily with her fingers.

‘Can you feel that?’ she asks.

‘No.’

‘Good. Off you go then, Tilly.’

‘Please be very careful,’ Maurice begs.

‘I’m always careful,’ I assure him as I insert the needle and begin to draw off the blood. After a while, Maurice Minor is still far from pretty, but it’s a lot less swollen and we’ve got a much better view of the washer. Dr Patel hands me what, to all intents and purposes, is a miniature pair of bolt cutters. At the sight of them, Maurice looks like he might faint.

‘Be particularly careful with these,’ Dr Patel warns me. ‘We just want the washer, nothing else.’

‘Dear God,’ Maurice groans, and I swear I spot the faintest trace of a smile playing on Dr Patel’s lips. She’s enjoying herself, the sadist. To be fair, I’ve worked with her for a number of years and, while she’s held in very high esteem for her encyclopaedic knowledge of the human body and her ability to stay calm under pressure, she’s also known for having zero tolerance for fools. It’s no wonder she’s not impressed by Maurice.

I’m concentrating hard as I ease the bolt cutters into place but, despite our efforts, Maurice’s penis is still a little too swollen for me to get reliable purchase on the washer without risking catching his flesh in the jaws at the same time.

‘Blessing?’ I ask. ‘Can you stretch the skin a bit to give me a better view, please?’

‘Sure.’ She carefully grasps Maurice Minor and pulls the skin on either side away from the washer. Maurice sighs heavily.

‘Is everything OK?’ I ask him.

‘Yes,’ he replies. ‘I was just thinking about the irony of two beautiful young women handling Maurice Minor and him being totally unable to enjoy the moment.’

‘Are you for real?’ Blessing asks him, outraged.

‘Sorry. An attempt to lighten the mood.’

‘I would suggest that you keep your humour for a time when there isn’t someone about to attack your nether regions with a bolt cutter,’ I tell him blandly. ‘Ready?’

He closes his eyes tight shut as I manoeuvre the cutter onto the washer and carefully close the jaws. Annoyingly, the cut doesn’t go right through the metal so, after checking that I definitely don’t have anything in the path of the jaws that oughtn’t to be there, I take a second cut. This thankfully does the trick.

‘Very good, Tilly,’ Dr Patel observes. ‘What now? Prise the metal apart or make a second cut?’

We study the washer together for a moment. Although we might just be able to prise the metal apart far enough to get it off, it’s quite thick.

‘I think, on balance, I’d go for a second cut,’ I tell her.

‘Me too,’ she agrees. ‘Blessing, can you lift the penis so Tilly can get to the underside?’

As I close in with the cutters again, I can see what Dr Patel meant about broken skin. Maurice obviously tried very hard to remove the ring himself, as it’s practically raw under here. Very carefully, I manoeuvre the cutters into place and, when I close the jaws, I’m rewarded by a satisfying ‘ping’ as the washer splits in half and flies off.

‘Great job,’ Dr Patel says. ‘Right. I think our work here is done. Are you happy to take over now, Blessing?’

‘Yes, thank you for coming over.’

‘No problem.’ She turns to the patient. ‘Maurice, I wish you all the best with your recovery. Whatever happens, don’t have sex or attempt sex for at least four weeks. That includes masturbation, do you understand? And if you have the urge to experiment with cock rings again, do us all a favour and buy one that’s designed for the job from a shop, will you?’

‘Yes, thank you,’ he replies meekly, but she’s through the curtain and heading back towards Majors before he even stops speaking.

‘Total waste of my fucking time,’ she hisses as we cross the waiting room, and I’m aware of a few ears pricking up. ‘I do this job to help genuinely sick people, not DIY perverts.’

‘I expect he’s learned a valuable lesson,’ I whisper back. ‘And it did give me an opportunity to practise some skills I haven’t used in a while.’

‘Hm. Shame you didn’t slip and chop his cock off. People like that don’t deserve to be put in charge of such a delicate organ.’

‘I’m not sure the claims department would agree with you,’ I tell her with a smile. ‘Plus, you know how much everyone loves a good sexual injury story, and that was a cracker. I’d put it up there with the woman who came in with a hen’s egg up her vagina.’

Dr Patel smiles grimly. ‘Bloody Gwyneth Paltrow has a lot to answer for. Do you remember the poor woman who tried to copy the vaginal steaming routine using her kettle? If there’s one part of the body you don’t want cooked medium to well done, it’s that. That was nice work on Maurice, by the way. Well done, Tilly.’

I smile back at her. At moments like this, I truly love my job.

2

I’ve known I wanted to be a nurse since I was a teenager, but I never expected to end up working in A & E. I always imagined myself on a ward, chatting jovially with patients as I adjusted their drips or helped them with their medication. However, we were expected to work in a variety of roles as part of the training and I found myself drawn to the cut and thrust of A & E, even though the schedule of twelve-hour day and night shifts is punishing. The other surprise is that Natasha, my younger sister, ended up following me into nursing and works in the Paediatric department of the same hospital in Tunbridge Wells. Neither of our parents have any connection to the medical world and my father is positively hospital-phobic, so they find it particularly strange that both their children are nurses.

As predicted, the Maurice Minor story made its way around the entire department by the end of my shift, and there are still a few giggles as we prepare for our briefing the following morning. Five minutes into the briefing, a man bursts in, looking rattled.

‘Ah, Dr Milne,’ Dr Patel says dryly. ‘Nice of you to join us. We start at eight, for future information.’

‘I’m so sorry I’m late,’ he tells her. ‘I couldn’t find anywhere to park.’

Uh-oh, I think to myself. One of the many things you learn quickly about Dr Patel is that she has no time for excuses.

‘That must have been very trying for you,’ she tells him, the note of sarcasm in her voice as big a warning signal as a rattlesnake shaking its tail. ‘Parking is always a challenge at any hospital, and yet we all seem to have managed it. Might I suggest you allow more time in future?’

He opens his mouth to speak, but the expression on her face evidently makes him think better of it, and he ends up nodding mutely.

‘Right,’ Dr Patel says, having made sure that the new arrival has got the message. ‘Please continue, Dr Kozlov.’

‘As I was saying,’ Dr Kozlov, the consultant from the previous night shift, says with a heavy sigh, looking pointedly at a blushing Dr Milne, ‘bay five has Mr Jones, who has complex fractures of the femur, having been involved in a road traffic accident in which his motorbike collided with a car just after midnight last night. He’s stable, and we’re keeping him comfortable until theatre are ready for him. No obvious complications, he’s a lucky man, but we’re keeping him under close observation just in case. No evidence of concussion or other head injury. He does have considerable bruising of the torso and two fractured ribs, but these are to be expected. Any questions before we move on?’

The meeting continues in much the same vein as Dr Kozlov takes us through each patient currently in Majors. Once he’s finished, he stands aside to let Dr Patel finish the briefing. Unusually, we haven’t been interrupted by any urgent new arrivals this morning.

‘Everyone, this is Dr Milne,’ she tells us at the end. ‘He’s a junior doctor and it’s his first day with us. Tilly, I’d like you to take him under your wing to begin with, please.’ She turns to Dr Milne. ‘Tilly is one of our senior nurses, so she’ll show you the ropes and get you up to speed. Remember, all medical interventions need to be agreed with me or one of the other duty consultants. I don’t know what it was like where you came from, Dr Milne, but we operate a tight ship. Any questions from anyone?’ She looks around the room. ‘Good. Why are you all still here then?’

As the others file out to begin their shift, I take a moment to study our new arrival, and I’ll admit to liking what I see very much. He’s dressed in the standard uniform for junior doctors, but I can’t help noticing his strong-looking forearms. His dark wavy hair is shiny, making me suspect there’s some kind of product in it, and his brown eyes sparkle with humour. Having him under my wing for the day is going to be very pleasant.

‘Welcome to the department, Dr Milne,’ I tell him, holding out my hand. ‘I’m Tilly.’

‘Delighted to meet you, Tilly,’ he replies, gripping my hand with just the right amount of strength. ‘Please call me Luke.’

I smile. ‘I can call you Luke in here, but Dr Patel will haul me over the coals if she hears anything so informal in front of the patients.’

‘Is she always that terrifying?’

‘I wouldn’t call her terrifying, exactly. If you do everything she says and don’t upset her, she’s a pussycat.’

‘Hmm. I’ll take your word for it.’

‘Shall we go and see some patients then?’

* * *

One of the things that I love about my job is that you never find yourself clock-watching. From the moment the shift starts, you’re fully immersed and you never know what’s going to come through the door next. Peak adrenaline is when the red phone rings with a trauma call. This is how the paramedics alert us to an incoming case so serious that the trauma team needs to assemble. If you’ve ever seen one of the hundreds of hospital dramas on TV, you’ll have seen people running alongside stretchers as they try to hook up drips and yell medical terms such as ‘intubate’ at each other. Thankfully, the reality is a little less dramatic. Everybody is in position before the ambulance arrives, and we work quickly and quietly to try to stabilise the patient as swiftly as we can. Of course, we don’t always succeed, and that’s tough, particularly when the patient is young, but you don’t generally get time to dwell on it because the next emergency is usually just around the corner.

Today is no different. No sooner has the motorcycle accident victim gone down to surgery than his place is taken by an elderly woman who has fractured her hip as a result of a fall at home. She looks pale and frightened, and seems confused about where she is and what’s happening to her.

‘I don’t rate her chances,’ Luke mutters to me conspiratorially as I do her observations.

‘One thing I’ve learned from my time here is that you can never predict a patient’s journey,’ I tell him equally quietly.

‘Yeah, but hip fractures are usually the beginning of the end for old people, aren’t they?’

‘What area were you working in before?’ I ask as I study the screen. The woman’s blood oxygen levels are lower than they ought to be. ‘Mrs Corrigan?’ I raise my voice and two cloudy blue eyes lock on to mine. ‘Can you take some deep breaths for me, please?’

‘I was in geriatric care,’ Luke whispers as I watch Mrs Corrigan’s fragile chest rising and falling. ‘Hip fractures and pneumonia were the two biggest signs that a patient was starting their final decline.’

‘That’s looking much better,’ I tell Mrs Corrigan brightly as the oxygen levels on the screen come up to normal levels. ‘Make sure you breathe deeply every so often, OK?’

‘That’s all lovely,’ I tell Luke quietly, so Mrs Corrigan can’t hear, ‘but irrelevant in this role. For all I know, Mrs Corrigan might make a full recovery and spend many years waltzing round a ballroom with her surprisingly ardent lover. Our job is to assess her and, in conjunction with the consultants, decide what treatment path is going to be best for her. Whatever happens, she won’t be staying here. So, what are your thoughts, doctor?’

He stares intently into my eyes, and I can feel my skin prickling under his gaze. The last time someone looked at me with that level of intensity, it was my last boyfriend, I was naked and underneath him. To my horror, my mind starts to imagine Dr Luke Milne in that position. Thankfully, he breaks the spell by speaking.

‘It’s unlikely that anything could be done for her surgically,’ he murmurs. ‘But she can’t be discharged without an appropriate care package in place, so I guess I’d admit her on to a ward and keep her under observation while social services sort out the relevant bits and pieces.’

I smile at him. ‘Good plan. Given that she’s broadly stable, shall we go and see if Dr Patel agrees with you?’ I raise my voice again as I carefully remove the blood pressure cuff from her arm and ease her finger out of the oxygen monitor. ‘Mrs Corrigan, are you in any pain at the moment?’ I ask.

‘No, dear,’ she replies in a wavering voice. ‘If you’re finished, I’ll be on my way.’ She starts to try to sit up and winces.

‘Try not to move, Mrs Corrigan,’ I tell her firmly. ‘You’ve broken your pelvis, so you need to stay in bed for now, OK?’

‘I can’t stay in bed, dear,’ she says, her eyes filling with tears as she sinks back onto the pillow in defeat. ‘I’ve got to feed my cat.’

‘We need to keep you here for a while. Is there someone we can call to feed your cat? What’s his name?’

The Story Continues on BooksBarbecue!

Enjoyed this preview? ❤️ Do not stop here!

Read the complete book free online → 🔗

Continue reading now on BooksBarbecue and discover every page!

Love reading? Bookmark BooksBarbecue.com for more amazing books!

Happy Reading!