21 Nov 2023
Mark Turner delves into some of the issues facing the profession in the first part of a fictional story about UK practice life.
Image © yana136 / Adobe Stock
“Hello, you must be Alison,” Margaret said quickly with the glimmer of a smile.
Ali sat up in her waiting room chair.
“Hello.”
Margaret had shoulder-length hair tied in a loose ponytail and clear brown eyes. She looked tense and tired, Ali thought.
“Well, we might as well start the tour with the waiting room. Has Sharon said hello?”
Sharon nodded cautiously from behind the reception desk.
Margaret’s accent was difficult to place – northern? But some vowels sounded flat – home counties? Then a word jumped from the west – Bristolian? Ali settled on an early childhood spent in the midlands, but the really striking thing about her voice was the lack of optimism – it made her sound like a gruff storyteller.
“And this is the big consulting room. Everyone likes to use it.”
Empty syringe wrappers were scattered across the worktop, along with a pair of half-filled blood tubes. In the corner, a large screen offered a brightly coloured diary of the day – Ali absentmindedly walked over to it. Client names were highlighted in boxes; two appointments had been blocked off for a “lunch break”. Margaret watched as Ali studied it.
“Is everything all right?” she asked casually.
“Err, y-yes. Umm.”
“Shall we continue?” They walked through another door into the pharmacy. “We try to keep stock to a minimum, but you know how vets will be.”
“Oh, err, yes, I suppose so.”
The shelves were full of boxes with familiar names – it was comforting to Ali to see these reminders of her previous job and momentarily she was back in Yorkshire. Some glass vials had fallen over like miniature bowling pins and she started rearranging them in a neat triangle.
“Oh, don’t worry about that,” Margaret said with a chuckle.
In the next room, a girl was looking at her phone. She could have been on a railway platform or in a school corridor. A radio was hanging on the wall and had a long strip of Elastoplast with the words, “DO NOT CHANGE STATION” stuck to it.
A young vet was wrestling with a white dog, pulling at its lead and dragging it slowly, silently across the floor, as if it was on wheels.
“Well done, Natalia,” Margaret added without stopping. “Come on, I’m sure the team have got everything under control.”
Ali looked around for the rest of the team, wondering if she had missed someone – perhaps a nurse busying herself with an inpatient – but the room was otherwise empty and felt strangely still, like a hotel venue after the guests have left.
Upstairs in the office, they sat down and Margaret perched some glasses on her nose before tapping away at a keyboard.
“Here we go, just bringing up your details, Alison.”
“Oh, call me Ali, all my friends do.”
Margaret’s expression suddenly froze as if hearing the name of an estranged relative, followed by, “Okay Ali,” spoken more quietly.
A tall, dark-haired man walked in and started searching for something. “You okay?” he asked, instantly recognising Margaret’s mood. “I, I think that emergency has just arrived.”
“All right. Is anyone free?”
“Ah, there it is. Vicky is in with someone, and Natalia is still getting the blood,” the man replied, brandishing a scruffy piece of paper.
Margaret’s face twitched. “Okay Alison. I know we had you down for an induction today, but how do you feel about seeing a quick appointment? Socks Saunders has diabetes, so I’m sure it’s nothing too complicated. It can only be a question of blood sugar too high or too low, right?”
Ali couldn’t help but marvel at how Margaret had successfully condensed nearly a term’s worth of undergraduate lectures into one short phrase. She stifled a sort of gasp at the thought.
“Err, yes, sure. Anything to help.”
Ali walked down to the waiting room again. Once there, she could see a man in the car park struggling with a large cat carrier, his breath curling upward in the still autumn air. She tenderly opened the clinic door for him.
“Mr Saunders?”
“Yes, that’s me. Are you one of the new nurses Sharon’s been telling me about?”
“Err, no, my name’s Alison, I’m the vet. Is that Socks you have there?”
“Yes, hope you’ve read up about him then. Abi was so good. I’m not particularly happy having to start all over again.”
It was the first time Ali had heard this name. She pondered it for a moment and then glanced for a second time at Socks.
“Shall we go straight through? He doesn’t look that well, does he?”
Socks’ owner placed him with a thump on the consulting room table and stood back. Ali tugged at the brown string that held the basket together until it released with a puff of dust.
“All right, let’s get you out of there.”
She heaved at the cat and placed him on the table, desperately hoping that he would stand or display some other sign of good health, but Socks sank on to his elbows, looking nauseous after the journey. Ali inspected his gums and listened to his muffled heart – the rhythm was normal, but was there also an unsentimental knowledge of its own future in the way it thumped delicately, like a ship making its way out to sea.
She pulled the stethoscope from her ears and looked up. “I think we should keep him in and run some tests, is that okay?”
“Yes, I suppose so. I thought you might say that.”
He shuffled slowly to the reception desk. “How are you, Sharon, anyway?”
“I’m okay Mr Saunders, thank you for asking. We just need a signature on this form – is that estimate all right for you? Diabetes can be an expensive condition to treat.”
“Oh, I have given up worrying. The bills just keep coming from this place. I know it’s not your fault,” he said, letting the phrase slip through the door that Ali had left ajar.
Ali wandered into prep and put Socks in his cage, on the floor. There was no one around, so she walked further, past the stairs that led to the office and into a narrow corridor. The ceiling was lower in this part of the building and made her feel claustrophobic, as if she were going into a network of underground caves.
She entered a utility area. A washing machine was on and through the window, she could see the familiar green of surgical drapes. Fluorescent strip lights blinked, while the autoclave machine clicked and hissed – the sound always made Ali nervous, as if at any moment it was going to explode into a million pieces.
“H-hello?” she called.
She pushed at another swing door and entered a ward. The blood-sample dog was here wearing a small bandage and Ali was relieved to see that he seemed more relaxed.
“Do you know where everyone is?” she asked him.
He wagged his tail and panted in reply, meeting her gaze.
“No, I don’t either.”
At the back of this room, a beach towel with the Polish national flag printed across it was hung from two builder’s joists and partially hid a large gap in the wall.
“Hello?” Ali pulled the makeshift curtain up and, stepping over bricks and cement dust, walked on to an old-fashioned red tile floor. A slim woman in scrubs was hanging washing up with an assortment of coloured pegs.
“Oh, hi, you must be Alison. I’m Lou, one of the nurses. Sorry, we’re a bit short-staffed this week. Normally, this would all be done by now.” Louise gestured toward the two bin bags full of washing.
Alison looked around and back towards the gap in the wall.
“Oh my god, it’s so embarrassing, isn’t it? The whole place has recently been done up, but then these large cracks started appearing in ward. Apparently, the builders made some sort of massive cock-up and now they’ve got to come back and stop the whole place from falling down. They haven’t admitted to doing anything wrong, of course. Just don’t cough too loudly, L-O-L!”
“Oh, really? That doesn’t sound good. Yes, I heard about the refurb in the job advert.”
“Anyway, do you need a hand with something?” Louise asked.
They walked back into the prep area and found Margaret placing a catheter in Socks’ front leg. The girl from earlier was holding the cat in a disinterested way.
“Ah, there you are, Alison.”
Ali suddenly felt awkward. She sensed that she was meant to be doing this.
“I-I was just coming to do it, but…”
“I saw the poor thing sitting here and thought fluids might be in order. We don’t like to leave cats unattended, Alison.”
“Y-yes, of course. It’s just that I couldn’t find any…”
Margaret walked past with Socks in her arms and the girl scurried behind, carrying the bag of saline as if she were holding a long elaborate wedding veil.
“Can you write up the hospital sheet and make a plan? Glucose too high…” Margaret called back as she disappeared.
Ali looked to Louise. “I was just coming to do that – I-I just couldn’t find anyone to help me.”
“Oh, please don’t worry. Listen, why don’t we go for a drink one evening after work? There’s a few things you should know about this place – I can fill you in…”