Train Crash

Stormhill Hospital, Glasgow 1959. Sister McConochie takes over Emergency.

Glasgow December 1959

At Stormhill Hospital most of the doctors had nicknames behind their backs. Some of the better ones were:-    Penicillin - Dr. Fleming; Grating - Dr. Alexander; Slybacon - Dr. Cunningham; Casebook - Dr. Finlay; Swede - Dr. Hemming, with a clump of hair sprouting from the front of his otherwise bald head; Jerry - a positively ancient consultant (Jerry-atric!); Hypo - young Dr. Evans, constantly giving injections; and Tomcat - Dr. Singer, the ‘playboy’ of the hospital staff.

Right now Dr Singer, alias Tomcat, was explaining a patient’s treatment to Diana, while trying to peer down the front of her uniform. Diana probably knew Mrs Mackie’s current condition and treatment better than he did. She wasn’t even Tomcat’s patient. He just fancied Diana, and was using this as an excuse to chat her up. Diana was always a little shy with the doctors, and this one usually made her even more nervous than the others. She was at a loss on how to handle him. After all, he was a doctor, and she was only a student nurse. Sister McIntyre on the other hand, had no such qualms.

“Come along Doctor Singer, Nurse Futers has work to do, and I believe Mr MacCaully in Ward twenty requires your attention.”

Diana, Carol and Naomi were currently working in Ward 4, women’s surgical, which was a country mile walk from Ward 20. Quite far enough to keep Tomcat away from Sister McIntyre’s nurses for a while. If Mr MacCaully did not require Dr Singer’s attention, then maybe Sister had been misinformed! Either way she very much doubted if he would come all the way back just to register a complaint about a little misunderstanding. More likely he would encounter someone else’s nurse to explore on the way.

 “Good one Sister,” said Carol on her way past.

“Don’t be impertinent, Nurse Burns. It was rather good though, wasn’t it?”

 “Next time I’m going to set Naomi onto him,” said Carol to Diana. “Then stand back and watch the fun, as like cons like. I don’t know why he keeps picking on you in the first place. Well, that’s a lie, yes I do. You should get yourself an ugly mask for when he’s around. Then he’d be sure to click with Naomi.”

“Come along girls, stop chit-chatting, there’s work to be done. Three beds still to be made up, and Mrs Black’s physiotherapy routine in ten minutes.” Sister McIntyre marched past, her back ramrod straight. She was an exceptionally good nurse, and at twenty-six years of age, had been a Sister for only eight months. She tried to compensate for her youth by appearing prim and proper; which didn’t fool anyone for a moment. Off the ward she could be good company, and a lot of fun. She was also engaged to the most eligible bachelor doctor in Bishopbriggs. They were planning to marry on Burns’ Day. He had even referred a couple of borderline cases to the hospital, just so he could visit - or so the story went. Sister’s married name would be Scott.

After Mrs Black’s physiotherapy, it was time to do the rounds with the medicine trolley. It was Naomi’s turn to administer the medicine, while Diana checked, and entered the time and dosage. This was entered twice - once on the trolley list, and again on the patient’s record, clipped to the foot of the bed.

Diana had to hand the medicine to Naomi, stating the description and quantity. Naomi then had to confirm that what Diana said was what she actually received, before administering it to the patient. Diana filled in the forms, and Naomi checked as correctly entered. It seemed a cumbersome operation on paper, but in practice a good team could carry it out almost as quickly as they could without the checks. Naomi was quite efficient at it, which was more than could be said for some of her other duties. She was no fool, but she had no time for the things she didn’t like doing. If she put her heart into everything, she could be a good nurse, because she had the necessary intelligence.

Unfortunately there was not much chance of that happening. She was man mad, and saw nursing as a stepping-stone to a better and easier life. She was determined to make a good ‘catch’ and live Easily Ever After. The trouble was most of the men she zeroed in on suspected her motives. She was too brazen and forward, even though she was basically an attractive young woman. If she could tone things down a little she might have more success. No doubt continued practice would hone her skills.

Already she was just starting to wise up to the facts. Her latest outfit was almost demure - by Naomi’s standards, not Diana’s or Carol’s. But it was a start in the right direction. Sooner or later she would hook her big fish, and sail off over the horizon. She thought Tomcat might be good fun, and she just might accidentally brush up against him next time he appeared. Why did he always have to pay so much attention to Diana? She was so small and fragile, a big man like him might break her.

Now, me he wouldn’t break, though I might let him crack me a bit. Just a little surface crazing maybe. As for Diana, she’s suffering more than surface crazing. She can have just about anyone she wants, and she’s dating a BUS CONDUCTOR!? An obvious case of terminal crazy if ever I saw one.

Dr Finlay (Casebook) was nothing like his fictional namesake. He was short, with ginger hair, and his nose was only just large enough to serve as a pushbutton, never mind as rudder for a battleship. But he was a very good clinical doctor and diagnostician, one of the best Stormhill had ever had. Not yet forty, he had eleven children living in a large country house with their worn-out mother. The Asians would not inherit the earth through his default. He was currently in the Outpatients Department, where he spent most of his time. He had a problem in the shape of a young Mr Harper sitting opposite him. Harper was one of the last of the army National Servicemen, and had just been discharged after flying home from Malaya. According to Casebook’s diagnosis, Mr Harper also had cholera. Damnation he thought, how could the army have let this happen? They were supposed to be very good at this sort of thing. They were in fact the experts on tropical diseases.

“Could you wait here for a few minutes Mr Harper, I’ll be back shortly.”

He strolled over to Sister Barnes, and said softly “Cholera, lock the door, nobody in or out until I know who he has contacted since coming in. Then a couple of nurses here from Isolation to take him over there. Get your staff nurse to bring the staff’s medical records to me.”

“Straightaway Doctor,” said Sister Barnes, who had complete faith in Casebook’s diagnostic ability. Outpatients also doubled as Emergency, a situation about which Dr Finlay had frequently complained to no avail. He was adamant that the two should be separated, with Emergency in Ward 4, Women’s Surgical. Or even half of Ward 4, since it was rarely more than half full. It was the closest ward to the main operating theatres, and the sensible place for Emergency to be situated.

Now he checked his own medical file. Damn, he was due for his booster shot this week. No danger of him coming down with cholera, so long as he took the shot. But it might be a while before he saw the wife and kids. Better get a bed picked out, where he could grab some sleep, as and when possible.

“Mr Harper, I’m afraid you have cholera. Don’t worry too much, we can treat it, and you will be okay. But meanwhile we have to put you in the Isolation ward. I’m sure you wouldn’t like to spread the disease - it’s quite contagious.” Harper shrugged.

“Okay, let’s go, I’ve got no pressing appointments right at this moment. As a matter of fact, I’ve got no job yet either. A free bed and food for a while could be just what the doctor ordered - Doctor!”

Funny how we all have our own different perspectives on life’s little problems, thought Casebook, with a smile for Harper’s benefit. The latter was taking things remarkably well, considering he didn’t feel particularly well - which was why he was here in the first place. The Isolation nurses arrived and took Harper under their wing. Dr Finlay started on a long list of telephone calls, while thumbing through the staff’s medical records. Reinforcements began arriving from the wards, having first been vetted for cholera immunity. They would segregate and interview the people already in Outpatients, most of whom were by now starting to ask questions of their own. It would be quite safe to send most of them home soon, so long as they didn’t miss any who had come in contact with Mr Harper. Those without current cholera protection would be given a booster shot. Casebook was thankful for the nationwide vaccination program of recent years, which made things relatively simpler. His biggest worry was whether either of the two young babies in Outpatients right now had contracted the disease.

He very soon had an even bigger worry. The phone lines began to run hot. An express passenger train from England had been derailed at speed just outside Glasgow. Emergency vehicles were on their way to the scene of the accident now. Stormhill would have to act as clearing house for the injured. First reports were to the effect that it was a serious accident, and there would be many casualties.    Damn it, damn it, damn it!

Dr Finlay’s worst nightmare had suddenly become a reality. He rang Sister McIntyre and asked her to begin clearing as large an area as she could at the end of Ward 4 nearest the operating theatres. Then he called Matron, to fill her in on the situation. But Matron kept her ear to the ground, and was already in action, rearranging nurses, beds, bedding, surgical instruments, sterile towels and bandages etc.

“You just concentrate on contacting the doctors, I’ll handle the rest,” said Matron. “Unfortunately our Registrar is elsewhere right now. I’ll let you know when he’s back on deck. Ward 4 will be cleared, and its patients shared between 5 and 6.”

There was a list of local doctors and surgeons, compiled and kept up to date, for just such an emergency as this. Casebook began phoning the names on the list, including Sister McIntyre’s fiance Dr Scott. In fact he was one of the first on the list. Casebook knew him to be an excellent surgeon, though he preferred General Practice. Nevertheless, he carried out operations on his own patients to keep his hand in. Now he should be getting plenty of practice in the next twenty-four hours.  Matron phoned Sister McConochie at the nurses’ home.

“Sheena, we have an emergency. Train crash, lots of injured on their way soon. Outpatients just confirmed a case of cholera, so Ward 4 will have to become Emergency. I know it’s a while since you’ve done such things, but it’s really your kind of situation, and I need your experience. Sister McIntyre is a very good nurse, but she would be the first to admit her inexperience in this situation. And anyway, she’ll be of more use in the operating theatre. Can you handle it?”

“I’m on my way Heather, just try to keep me an open line in Ward 4 office please.”

“Thankyou Sheena, I knew we could count on you.”

Sheena knew there were at least eight off-duty second and third year student nurses in the home right now. She strode to room twelve, knocked, and opened the door.

“Anne,” she said to the girl reading a textbook “Go and round up the other second and third year girls. There’s been a very serious train crash just outside Glasgow. Tell them to be on duty with me in Ward 4 as soon as possible. We will need everyone we can get.”  Sheena walked briskly to the ward.

The story spread around the hospital like wildfire. Sister McConochie from the nurses’ home had been appointed Deputy Matron. She was setting up Ward 4 as the Emergency ward, and was going to run it.

“Sister McIntyre,” said Sheena “I would like you to take charge of the operating theatre nursing personnel. Get your experienced and qualified nurses together, and organise the theatre equipment now. The staff nurse from Ward 3 is on her way. We and the student nurses will handle reception, classification, and preparation, as well as first aid. Are any doctors here yet?”

“No, not yet Sister, but I believe Dr Scott is on his way now to lend a hand.” Sister McIntyre blushed.

“Yes, I thought he might be. I think you’ll make an excellent team, and I’m sure we can count on everyone doing their utmost - isn’t that right ladies?” She smiled at the small group of student nurses, including Carol, Diana and Naomi.

“Yes, Sister,” they answered in unison. Then she set about organising them, and everything else. For half an hour she seemed to be everywhere at once. Whenever one of the nurses had a problem, Sister McConochie would suddenly be there, giving advice. And it was kindly given advice, not orders. As the extra nurses from the home arrived, she allocated tasks to them, without a moment’s hesitation, or wasted time or effort. Everything was fitting into place with a maximum of efficiency, and minimum of fuss. Much to the amazement of most of the younger nurses. Not only that, they became confident they could do whatever was necessary, as Sister moved among them, constantly explaining and encouraging; raising their morale, and calming any fears they might have of inadequacy.

By the time the first casualties began to arrive, they all knew they could do whatever was needed, and not one of them was going to let Sister McConochie down. She was a different person to the one in the nurses’ home. Here she’s....she’s...a leader, that’s what she is, thought Carol. Under all that camouflage Sister McConochie was a born leader. Carol had heard rumours about Sister’s past career, but nobody discussed it much. One sure thing, she didn’t get an MBE for picking daisies! Now they were starting to see for themselves why she did.

Three doctors, including Dr Scott, were there when the first ambulance arrived.

One of the biggest revelations of that long night was Dr Singer. No longer was he Tomcat the playboy. As the casualties mounted, he became all business. He moved quickly and efficiently from stretcher to stretcher, cool, impersonal, and precise with his instructions. Sister followed him round, translating his instructions into action, delegating, encouraging and comforting. At one stage Dr Singer was passing Naomi as she hesitated with a saline drip.

“Let me show you my dear,” he said, leaning over her. “Okay, press here with your left hand, now see the veins, that one, pop it in, that’s it, you knew you could do it, didn’t you?”

Naomi turned to flutter her eyelids at him, but he was gone, checking the next patient. She watched him for a few moments, and felt warm inside.

Oh no, not that. I can’t afford to fall in love, it’ll ruin my plans. What plans? This IS your plan, Dummy. Wake up and enjoy it.

Naomi began to hum at her work, and Dr Singer glanced at her.  How come I never noticed before how attractive that one is? What’s her name? Naomi?

In Operating Theatre One, Dr David Scott and Sister Anne McIntyre were working superbly together. David worked swiftly and efficiently, with Dr Evans (Hypo) assisting. Anne knew seconds before David asked, just what he wanted next, and how he wanted it. He liked to feel the instrument, and know it was in his hand, while studying his next move. Anne slapped each instrument into his palm with the correct amount of pressure, right way round, and exactly where he wanted it. As soon as he finished operating, he moved straight to the next patient, leaving Dr Evans to clean and close. They had three tables in the theatre, and were rotating them as quickly and efficiently as humanly possible. Besides Dr Evans and Anne, there were two anesthetists and seven theatre nurses.

Carol and Diana were busy at the first aid station, attending to the less seriously injured, along with three second year student nurses. Carol had naturally taken control, without seeming to. The other girls followed her lead, and heeded her suggestions. Sister McConochie was keeping an eye open in all directions, and checked their work several times.

That’s my girl Carol, keep it up.  What she said was “Good work girls, I’m sorry I don’t have a spare staff nurse, but you’ll manage okay if you follow Carol’s lead. She has extra experience of this.”

What’s she talking about, thought Carol, what extra experience?  

She shrugged and carried on. Obviously she’d been nominated as leader of the group, so she would get on with it as well as she was able. It was only much later that she realised what had happened; and just how smart and capable Sister McConochie really was.

Half an hour later something troubled Sheena. She looked around, trying to figure out what it was.

Diana is missing. She’s been too long in the toilet. I’d better go and check.

When Sister entered the toilet, Diana was squatting in the corner, tears running down her face, staring blindly and silently at the far wall. She had obviously been sick, as Sheena could smell the sour odour of fresh vomit. She bent over and lifted Diana gently to her feet. Placing Diana’s head on her breast, and cradling it with her hand, she asked softly “What happened my dear? Tell me about it.”

There was a long stuttering sob before Diana cried

“She’s dead; she died; I tried; but she’s dead; Oh God, please forgive me.”

In a flash Sister McConochie remembered seeing from the corner of her eye, Dr Alexander beckoning Diana to attend to a badly smashed up elderly woman. She was dying in pain, and there was nothing they could do to save her. He had gestured for Diana to set up a whole blood drip - a purely knee-jerk reaction, that shouldn’t have happened - while he administered a large overdose of morphine. Then he had rushed off to the next arrival, leaving Diana alone with the dying patient. Sheena had been distracted at the time by a young boy screaming, with his left hand half severed.

Diana had squeezed and got no reaction. She squeezed again a little further up, but still nothing. She felt for the pulse, and there was none. She looked at the mangled legs and torso, then up to where the bone was exposed on the left side of the old lady’s face.... and she ran for the toilet as her gorge rose.

“It wasn’t your fault my dear, you mustn’t blame yourself. There was nothing Dr Alexander or anyone else could do except put an end to her suffering. That’s the down side of being a nurse. People do die in hospitals. We can’t save them all, we can only do our best to save those we can. Now, come and wash your face, then help me save a few more.”

For the next half hour Sister McConochie kept Diana by her side, as she moved around from patient to patient; checked on the supplies; applied dressings; administered drugs and other medications; checked in on the operating theatre; had an encouraging word for everyone; and generally spared herself not at all. It was a revelation to Diana how anyone could do so many things at once, and still keep all the priorities right in her head. Just how Sister could even remember everything amazed Diana, let alone all of the things she actually did.

As soon as Diana’s confidence returned, she started to anticipate Sister’s requirements. That was when Sheena unobtrusively placed her back under Carol’s wing. At the same time she made a mental note that Diana might be better suited to pediatrics. She had noticed before that children all loved Diana. Maybe partly because she was a little closer to their own size.

By five o’clock in the morning things had quietened down sufficiently for Sister McConochie to think about sending some of her girls to bed for a well-earned sleep. Some of them - like Carol and Diana - had been working for 23 hours without a break. They had done a magnificent job, all of them, and she was very proud of them. As she was about to dismiss the first batch, Matron arrived. She stood on top of the office desk, which had been dragged into the ward.

“Girls - young ladies - and not so young,” she smiled at Sheena, “I would like you all to know that I think you have done a magnificent job in this hour of crisis. You have demonstrated once more, the value and dedication of the nursing profession, thank you. And a special thanks also to my good friend Sister McConochie, who took over literally at a moment’s notice, and did so splendidly in our time of need.”

There was a cheer from every conscious person in the ward.