Tag Archives: hospital

Autumn notes: Man on a Tram

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Peak hour, crowded tram. Deep in my book, head down in a forest of winter clothing, I sense rather than see the form that moves in my direction. The form sits down at my side. The face that I glimpse is dark, a face of bones and wrinkles like ravines. The hair, a crown of silver curls, strewn or scattered, falls in accord with the whim of wind or gravity or inertia.

The man is short and narrow. His slim haunches scarcely fill half of the empty half seat at my side. He looks about my age, but, reckoning with an educated eye I decide he’s two decades younger. Ragged black clothing speaks of neglect. The silver hair smells of cigarette smoke. A whiff of breath speaks of last night’s grog. Surrounding him, standing or seated, commuters armed and painted for the day in the City, all in their groomed elegance, escape into screens and music. The forest towers above and about him. The man lacks all accoutrement and adornment. He sits with his stillness, the smallest adult.

The man sits with his back to me. I return to my book which absorbs me for a mile or two. A rattle of a flat voice at my side brings me back to the tram. The voice speaks a question: Alfred Hospital? Before I can compose a response the slim young woman facing the black man speaks, It’s close, I think. I’ll look it up. The young woman interrogates her phone with quick little fingers. Her hair is light brown, her face nearly pink, her glasses, large and round, giving her the look of an undergraduate continually astonished by the adult world. Her eyes are small, shiny, slanted.

Yes, she says, it’s the stop after the next one.

The man’s voice rattles: Medical appointment.

The young woman leans, points further down the track, over her shoulder: Commercial Road. The man sits as we all do, in the young woman’s face, in uninvited intimacy. Her voice is kind, her gaze at the man, steady, frank, unafraid.

The rattle again: Dunno what the doctors will tell me.

I hope you’ll be alright.

 

 

The thin man rises just as the tram lurches to a stop. He glides toward the door, correcting for the lurching with a deft swing of hip and thigh that is effortless and graceful. He dismounts and disappears.

 

The Night Away from my Wife

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At breakfast yesterday morning I said to my wife: ‘I won’t be coming home tonight.’

My wife was reading the paper. She said, ‘Le Pen looks ominous.’

I said: ‘I won’t be coming home tonight. I’ll be sleeping out.’

‘That’s nice, darling.’

I said, ‘I’ll be sleeping with a stranger. For money.’

‘That’s nice darling.’

I kissed my wife goodbye. She said, ‘Have a good one.’

I went to work.

 

After work I went to the place that offers the services I desired. Discreet premises, modest, not flamboyant at all. I knocked on the door. The person who opened the door was a man. He asked my name. I said, ‘Howard.’

‘Goldenberg?’ – he smiled. A nice smile. ‘I’ll be looking after you first’, he said. ‘Then my colleague will take over. I’ll just measure you now – as a preliminary. So my colleague will have an idea of your…dimensions.’

The pleasant man measured me here and there and wrote in a file. ‘Come this way, ‘he said, you can take your clothes off and shower first. Then you can change into something, ah, a little less formal.’

He showed me down the corridor past a series of doorways to a small room in which I found a small table and a chair, a TV and a bed. The bed was larger than a single, cosy for two. Three, I reckoned, would be a crowd.

 

The pleasant man turned to go. ‘What about payment?’ – I asked. ‘I don’t deal with the money. You pay your particular worker for their services.’

I felt unhappy about this – not the matter of emolument but the grammar. ‘Their services’ sat poorly with me for one worker. Or – a late thought – would I be spending the night with more workers than one? This might be expensive.

 

I took a shower. It was not until the hot water was running over my grateful shoulders that I realised I’d brought no soap. I looked around and saw a liquid soap dispenser above the sink at the opposite side of the bathroom. I turned off the shower, emerged, dried myself, pumped a palmful of semen-coloured liquid, (which, upon sniffing, I found to be some innocent hydrocarbon derivative) and returned to the shower recess, where I employed a busy free hand to turn on the water, to adjust the temperature and to dip into the reservoir-palm for moieties of soap, which I then deployed to those portions of my body I judged strategic for the encounter ahead. 

I dried myself and wrapped my glowing body in something a little more comfortable. The time was seven fifty. The room was booked to me until seven the next morning. When I booked no-one actually told me when my worker/s would commence work. I sat on the bed and crossed my legs. I moved to the chair and sat. And waited. Nothing happened, no-one arrived at my door. I listened and I heard voices, other doors than mine opening, doors closing, then silence.

What to do? Perhaps I should read. I went to my daypack and found a book. Edited by the former Chief Rabbi Jonathan Sacks, the book was my siddur, the book of Jewish Prayer. I opened the book and I prayed for strength and guidance. There came a knock at the door. Engaged in my devotions, I did not answer. Another knock. More silent prayer. Another knock, and a voice that said, ‘Knock, knock. Anyone there?’ That, I reflected, is precisely what the worshipper is asking at prayerful moments. The door opened behind me. A voice, a pleasant voice, said, ‘Good evening, I’m your…’ – then choked: ‘Oh! I’m sorry. I’m so sorry.’ I heard the door close behind me.

 

 After a time I finished, replaced my siddur in my pack and went in search of my visitor. I found the owner of the pleasant voice, a woman, younger than I, perhaps half my age. She looked Samoan. Her voice spoke a volley of apologies, my voice answered with assurances and then she said, ‘My name is Hortense. And you’re…’ she was studying my folder in which her male colleague had recorded my dimensions… ‘You’re Howard. Let’s go to your room Howard.’ I did as I was bid.

 

‘Would you like to sit on the bed, Howard?’ It didn’t seem like Hortense expected any verbal reply. I sat. She stood facing me, looking down at the top of my head. ‘How do you keep those on? Do you wear it everywhere? I mean, all the time? Like in bed?’ I explained. Then I had questions of my own: ’Hortense, will anyone else be joining us tonight?’ ‘No, just me, Howard. I think I’ll manage alright. I’ve done this before. You’re not nervous are you? You don’t need to feel nervous.’ I reassured Hortense I was not nervous. I too had done it before. 

 

‘First I’m going to tie you up,’ said Hortense, indicating the forest of leather straps and wires festooning a rail on the far wall. As Hortense leaned generously forward, ‘tying me up’, her crucifix dangled just above my nose, pendulating and tickling me as she moved. It was a not-unpleasant preliminary.

Hortense returned to her folder. ‘Oh, you’re a doctor!’ There was delight in her voice. She looked again at my yarmulke. ‘Well Doctor, I suppose you do circumcisions?’

‘I used to. Hundreds of them, not anymore.’

‘It’s so much better, isn’t it.’

‘Isn’t what?’

‘Much nicer. Don’t you think?’

I could not fashion a suitable response.

‘Well, look at me’, said my companion for the night, ‘I’ve been dating for a long time now, quite a number of partners. It does look much nicer, doesn’t it. Cleaner too, you know, once they’re done?’ I couldn’t really say, so I didn’t say anything. Hortense took my silence as affirmation.

 

I had a pleasant enough night with Hortense. She said, ‘I suggest you take a shower before you go home to your wife.’ I did so, paid my money, jumped onto my bike and rode home through the rain, accumulating grit and road grime as I rode. As her drowned rat of a husband came sweating through the door, my wife was breakfasting: ‘Le Pen did badly,’ she said.

 

Melbourne’s Daughter

By Posted in Childhood, Life, Medical, Opinion Tagged , , , , , Leave a comment

Deep with the first dead lies London’s daughter

(Dylan Thomas)
The newspaper article was short, buried at the bottom of an inner page: Man Sought in Child Death was the headline. Ambulance officers were called to attend an infant who was not breathing. They found injuries described as Non Accidental. They detected a feathery heartbeat and commenced resuscitation and brought the baby to hospital.
Following further treatment the baby underwent scans of the brain. These demonstrated Injury Incompatible with Life. Police wished to interview a man in connection with the matter. 
Nearly forty years ago I became intimately familiar with that hospital. At the age of fifteen months our youngest child was treated there for Aplastic Anaemia. I had learned enough of this invariably fatal disease at medical school to dread it. Over three miraculous days and three intense nights nurses and doctors worked on our infant as if she were their own. Three days following her admission our baby was home again, her condition in spontaneous remission. It never recurred.
I witnessed at that time what a friend describes as the operation of ‘an edge’. He says a hospital like that is a line where the worst and the best meet and rub up against each other. The worst, he suggests, is the suffering or death or loss of a child; the best is the application of skill and care and discipline in opposing the worst. The line where the best strains against the worst is a hospital like this one. My friend describes this as ‘OUR best’. By extension the loss or suffering of the child is OUR worst. I mean we are all implicated.

 
What must we learn from those pregnant expressions: ‘Non Accidental Injury’ and ‘Injury Incompatible with Life’? Horribly intrigued I sought more news in the next day’s paper. I found nothing. For the first time in my life I went to the news on-line. I googled ‘non-accidental injury to baby’. Straight away I was sorry I had done so. Case after case, headline after headline, BABY AFTER BABY, the web told of the slaughter of our very young in Australia. RecoiIing, I quickly ungoogled. A phrase from the biblical book of Numbers came to me – ‘a land that devours its children.’
Another friend is a senior doctor at that same hospital. He is the person with whom the buck stops, it is he who has to confront the adults in whose watch a non-accidental injury has taken place. Too often the x-rays show the many non-accidental fractures that have healed or half-healed or never healed in a baby’s short tenure. He sees the scans that show the brain bruised and bleeding from multiple sites. Calmly, civilly, he must direct questions to the adults. He says, ‘Your baby has been injured in ways that cannot occur by accident. Can you explain the injury to me?’ The adult partnership fissures along one of many fault lines, the truth emerges. And the truth is braided of many rotten strands. The perpetrator – sometimes more than one perpetrator – is almost never the simple monster we like to imagine. The perpetrator too often had himself been monstered – his life fractured, his brain contused by one evil or by another or by many.
I read, over the days that followed, a scattering of further details, most of them horrible beyond my imagining. And finally, this: the injuries being incompatible with life, the parent of the child had agreed the doctors should turn off the machines. But before that, she donated the baby’s organs. Injuries incompatible abruptly became compatible with saving half a dozen young lives.

 
I described babies who are killed as OUR babies. I felt, as I read Helen Garner’s, ‘This House of Grief’ that the three murdered boys were in a real sense Garner’s children, they were mine, they were all our children. And in my moments of google horror I felt the same shock of personal responsibility.

In the small South Australian town of Penola people built and tend a park to remember their babies lost.

Health is not a Human Right

By Posted in Life, Medical, Opinion Tagged , , , , , 6 Comments

I am about to make some shocking suggestions: 

Health is not a human right.

The Morrison-Turnbull budget cuts to Medicare Rebates are not completely bad.
Running in the dark this morning, I noticed the illuminated sign outside the local hospital. It read:

PRIVATE HOSPITAL.

 

I felt unhappy reading that. A hospital is a place where human beings help other human beings with their health. The meaning of a hospital cannot be realised with that label. ‘Private’ tells the reader that some humans will be admitted and others turned away. Privacy as a personal property might well have been eclipsed by the internet, but ‘private’ survives with this message, unkind to some, saying ‘keep out.’

 

If health were a right we’d need to outlaw Down’s Syndrome, premature death and disability. We would legislate and make ourselves ridiculous. The error of language here betrays an error of thinking. We cannot assert a right to health, but we can create a right to equal access.

 

I am a private doctor. I am a public doctor. The public is composed of private persons. I treat one person at a time, privately. That is, personally, confidentially; two humans together, doing what every human does in a lifetime: ordinary transactions of care.

 

Doctors generally share a number of characteristics. We are serious, careful, committed and proud. We are defensive of our liberties, self-righteous and voracious of cures. We are expensive; I mean someone, somewhere, always pays for cures. In its new budget the government has pegged Medicare rebates. This skewers doctors and patients: either the doctor loses or the patient loses. There is nothing new in this.

 

When Hayden-Whitlam introduced Medicare I bulk-billed everybody. I thought it was a wonderful thing that a person, be she rich or poor, might consult a doctor equally. I thought so then and I think so still. To assure doctors they would not lose, the Hayden-Whitlam Government set up a referee who increased the rebate in pace with the rising costs of practice. This was costly. So the government told the referee to stop indexing rebates. And I stopped bulk billing. Often patients found themselves facing a choice – see the costly doctor or feed the family. When this occurred all doctors I know abated their fees so the patient might afford both cure and food.

 

What a government does in tightening benefits is to create the need for a new force to operate in care. The force is not one of rights but of grace. The doctor and the patient gaze upon each other as we did through all history, unmediated by refunds and rebates, freer now of the obscuring presence of the insurer. Two humans in a situation of human need.

 

The words ‘Private Hospital’ jolt me. They remind me that health is not merely a matter of economics or of civil rights, but of civil opportunity.

 

Jim is Dead

By Posted in Faith, Family, friendship, Life, Love Tagged , , , , , , , , 9 Comments

December 18, 1969. A large moon rises before me in the geriatric wing of the Royal Hobart Hospital. This is unexpected as we are indoors and it is noon. The moon shines across the room in my direction. Beneath the bright disc sits a white clerical collar. Just below the disc’s equator a set of white teeth smiles widely. The smile advances, a pink fleshy hand extends and a voice says, ‘Hello. I’m Father Jim. I’m a chaplain here. Call me Jim.’ The hand is warm and kind. I am a new doctor. Today is my first day in my first job. All around me old people drool and gibber in a manner to overwhelm a new doctor.

The moonfaced Friar Tuck is delighted to meet Howard Goldenberg. He says, ‘You’re new here Howard? Welcome to the Royal. I hope you’ll be very happy here.’

Fifty metres distant stands the weatherboard shack which houses the new doctor and his new wife. The new doctor says, ‘Jim, will you join my wife and me for lunch? We’re going to eat soon. Fish…it’s an Indonesian recipe.’ Jim would love to. Thirty minutes later Jim and his new friends Annette and Howard are seated in the shack eating a luncheon of fish bones and curry. Jim fossicks for flesh among the fine bones, eats up and does not complain. And Annette and I have made the first new friend of our married lives.

April 6, 2016. My Facebook-facing daughter forwards the following:

Dear Howard, I am sorry to have to post a message like this via Facebook but I am sad to say that your good friend Jim Smith has died this week, here in London. My name is John and I am his partner, Jim & I met you in North London when you were visiting your family, I think in 2014. Jim had a stroke last year and I was caring for him at home, he had to go into hospital with a pulmonary embolus and then had complications which led to his death on Sunday. I know he always enjoyed his conversations with you, if you have any special memories you would like to send me I can include them in a JimMemory book I intend to put together. I will let you know when the funeral is, if you would like to light a candle and say a prayer for him.

PS RIP Jim! He was quite comfortable and free of pain (he had some back trouble) at the last. John

Jim is dead. Faster than tears an image flashes before me. I see a black and white photo in a family album of a moon-faced man seated outside our rustic house in a village outside Melbourne. The large face is crowned with a white handkerchief knotted at its corners. Upon the lap of the large man sits a small child, our angel Raphael, aged not many months. A perfectly ordinary image: no collar, no ecclesiasticals, no pretence; just a man nurturing a child. The image says enough. A man, a child. Poignant as a Pieta the image drives me from my screen to Annette. My voice disintegrates as I tell her the news. I ring my daughter who is tearful too.

Father Jim Smith married hundreds of heathen nurses to hundreds of pagan doctors in his days at the Royal. All those unbelievers flocked to this man who seemed to personify something missing from the lives of those science-infested people. But around 1990 Jim quit marrying. He said, ‘I marry them, they make vows, then they divorce.’ He felt the losses, each by each, personally. ‘It’s as if their marriage meant more to me than to them’, he said.

Father Jim introduced us to his partner in goodness, Jim Turley. Now we had two Father Jim friends. The two – together with a non-priest – created what might have been Australia’s first refuge. They called it St Michael’s Priory and to it flocked beaten wives, beaten children, lonely people, people mad and broken. All were taken in, housed and fed, and where possible, repaired.

The Priory rested upon the slender incomes of the three and upon donations from parishioners, who brought laying hens, a milch cow, produce – and a pair of Nubian goats. The Jims took us down to shed and showed us two sleekly beautiful creatures. Their coats of Nugget Dark Tan shone on the backs of their aristocratic bodies. Shy, their slender faces darting, their small ears rising and turning to sound, they looked like deer. ‘Meet the Goldenbergs’, said Jim Smith. He was addressing Annette and me, not the goats: ‘This one is Ruth and this is Naomi. They’re pedigreed. We were told we should register them. You could register them by name, so we chose from the Bible. Then Jim and I said, “Ruth and Naomi are Jewish names. Let’s give them Jewish surnames”. So we called them Goldenberg, after our Jewish friends.’

Years later Annette and I gave our third child a Biblical name. She became Naomi Goldenberg, named after a relative at St Michael’s Priory in Hobart.

The Jims used to come to our shack in Gore Street, for Shabbat dinner on Friday nights. They’d stand silently in their yarmulkes while I’d recite Kiddush. Afterwards they’d make a fair fist of translating odd phrases from the Hebrew, to which they’d been introduced during their studies in Divinity. One Shabbat eve one of the Jims – I don’t remember who – challenged the second: ‘Jim, I don’t sense you are making any effort at all to convert the Goldenbergs.’ The other Jim confessed: ‘That’s true.’ And the second Jim nodded and admitted he too was remiss. And one said: ‘I don’t feel any call to change the Goldenbergs.’ That moment love shimmered before us at our Shabbat table: two men of God had each found grace sufficient to deny abstract vocation in favour of human feeling.

Eventually Jim Smith left the Royal, left Hobart, said goodbye to the Priory and to his celibate brethren. It might, for all we knew, have felt like dereliction. Today I picture it as burnout, as an escape from accumulating vicarious trauma.

Jim took a job in Melbourne as chaplain at Pentridge. There his parishioners were prisoners and warders. He sat and he listened to their confessions and to their unconfessions, their lies and their rationalisations. One godless murderer habitually visited Jim on the pretext of spiritual need where he simply craved intelligent conversation. That man had forced his way into a hairdressing salon where he splashed lighter fluid over his rejecting girlfriend before igniting it. The woman survived her horrible burns. Her hairdresser did not.

An equally godless, notoriously brutal warder used to seek Jim out in the Officers’ Mess. He’d ask Jim, ‘Do you mind if I join you?’ Jim decidedly did mind but avowed the reverse. The man, loathsome and unctuous, habitually chose Jim as his companion. Jim couldn’t say which of the two – the murderer or the officer – he liked less.

On one occasion the murderer made a singular confession: boastfully he declared, ‘When we want to punish a warder, we do. We have our ways.’ Jim, genuinely curious, asked –‘How?’ He regretted the question instantly. The prisoner said, ‘We piss in their tea.’

Some time later Jim went to the Officers’ Mess for lunch, took his seat at an isolated table and said, ‘Yes, of course’ when the warder asked to join him. Shortly a prisoner arrived to take their meal orders. Jim ordered his lunch, the warder ordered, the prisoner noted their requests, then asked, ‘Beverages, gentlemen?’ Jim requested tea, the warder said, ‘Same for me.’

Jim sat and enjoyed the warder’s conversation until a second prisoner arrived bearing their food and drink. This prisoner was none other than the murderer. He handed Jim his food, passed the officer his, then said, ‘Here’s your tea, Father.’ He walked around the table and, standing a little to the side and behind the warder, passed him a second mug. Winking hugely at Jim he said, ‘And this is yours, sir.’ Jim sat and watched and kept his peace.

Once again Jim and we were living in the same city. Often he’d would join us at our Shabbat table and at Passover Seder and he’d report on what he called, ‘my time in gaol.’

Later, with his usual genius for vocation among the desperate, among those who were losing and those who were lost, Jim became chaplain to Intensive Care at a major Melbourne hospital. In ICU something like one patient dies of every four who enter. The rates of loss are higher than in a theatre of war.

Eventually Jim retired. Amazing us all, since he’d been resolutely republican and a pronounced proletarian, Jim settled in Britain. Here he found love, a partner in John, and diabetes – the lot of many Friar Tucks.

Every Passover and every Jewish New Year a letter would arrive addressed and written in the child’s block lettering that was the Jim Smith calligraphy. The letters told us of the Jewish roots of Jim’s belief. They’d include clippings from the newspaper columns of ‘my favourite religious writer, Rabbi Jonathan Sacks’, soon to become Chief Rabbi of the British Commonwealth. In his long London epoch Jim read widely and deepened his sense of following a Jewish Jesus. His pleasure in our friendship grew deeper and eventually he crossed the world to attend our eldest daughter’s wedding in Melbourne.

Jim lived with John, sharing travel with him as well as musical theatre, which he loved. A man great in his levity, Jim radiated a softness that healed, attaching him to old friend and to new. When I visited my daughter Naomi (the goat’s child) and her husband and children during their domicile in London, Jim, frailer now, crossed the great city with John for a visit. It was Shabbat and space and time had shrunk. Here was Jim, here were his old friends, here were our tender little ones. Jim was still Jim. The spark of joy still shone. But I wondered if we’d meet again. The moments passed.

And now Jim is dead.

  

Toby’s Fingers Stuck in the Bath Hole

By Posted in Family, Life, Medical Tagged , , , , , , , , , , , 11 Comments

My wife Annette and I are having an early dinner when my phone rings. It is Rachel, our elder daughter: “No-one is hurt, everyone is OK, but I’ve called an ambulance: Toby’s fingers are stuck in the bath hole.”

I reckon I’m equal to this little challenge: ”Darling, just soap his fingers liberally then they’ll become slippery and he can just slip them out.”
“I’ve done that, Dad, and it didn’t work. I’m attending to Toby, but I need help with the other kids. Can you come over?”
“We’re on our way. We’ll be 15 minutes.”

In the car, Annette looks at her watch and calculates that Rachel’s brother, Raphael, will be driving home about now. He might get to Rachel’s before we do. She calls Raph and indeed he is only a minute away from Rachel’s house. He isn’t driving; he’s on his bike.

We drive into Rachel’s street which is blocked by two large fire trucks, a smaller fire car, two ambulances and a police car. There is no smoke and there are no signs of a motor accident.
We park at a distance and make our way on foot to Rachel’s house. Flung to one side on the grass is Raphael’s bicycle. Ahead of us the large torso and bum of a fire officer protrude from the bathroom window. The head and shoulders are out of view, presumably inside.
We make our way to the interior. A large man walks purposefully ahead of us, lugging a heavy timber box of plumber’s tools. From the narrow hallway an ambulance officer carries a plastic drink bottle into the bathroom. The bathroom itself is small. What with the toilet, the shower recess and the old-fashioned claw-foot bath, two is a crowd here. This evening the crowd is larger: the ambulance officer, a young lady, is leaning forward, passing the drink bottle to a male colleague who sits on the edge of the bath. The missing fireman’s face and shoulders are framed in the window, as he leans inward, observing and giving advice and instructions to another fire officer lying on the floor. This is another partial fireman, his face and arms invisible beneath the curve of the steel bathtub.
What he lacks in extremities and face he makes up for in length: this is a very tall fireman.
In the tub, drained of its bathwater, sits Rachel, her back to the door. On her lap is the skinny white body of Toby, aged five, a runt, a set of bones with a piping voice. One of his arms extends to the bath hole. His fingers are not seen.
The mother is reading a story to her child.

From the family room, children’s voices are calling: Toby’s twin, Miles, and their older brother, Jesse, have sighted us: “Saba! Savta! Toby is stuck. His fingers are stuck in the bath!
Look! Lollies! Raph is giving us a special treat.
The boys peel themselves from the arms of their uncle Raphael, who stands with his bare chest, wet with the sweat of his bike ride on this hot evening of 30 plus degrees.
Miles and Jesse pull at our clothing, dragging us to the bathroom, to see Toby and his missing fingers. They squeeze past the ambos, step onto the prostrate fireman and clamber into the bath. We follow them, secreting ourselves along the far wall and we greet Rachel. Raph stands behind us in the doorway.
Rachel smiles the smile that we’ve seen before, the smile that welcomes mere chaos that unseats tragedy.
Pasted over her fear, and threat and alarm, Rachel’s smile invites us to see and share the joke.
It is hot in the bathroom. Toby’s free hand wields a lollypop that disappears and reappears in and out of the recesses of his mouth. He cries out his greetings, his words emerging through a slop of saliva and lolly juice. He is having a pretty good time.

Rachel gives us a synopsis: “I called the ambulance and told them that Toby’s finger was stuck. These guys came and called the fire brigade. While I was on the phone, Toby’s free fingers were curled up and cramped, so he made them more comfortable by poking another couple into the plughole. Now there are three fingers that are stuck.
“The fire guys have all the right tools and equipment. They get fingers out of plug holes all the time. I didn’t know that bathplugs are a fireman’s specialty.”
The fire chief in the window frame elaborates: “Normally, a plughole is a ten-minute job. They’re all plastic nowadays. But this bath is a genuine antique, made of genuine steel. The plughole itself is probably made of toughened steel: it’s usually a disc about half an inch thick, with half a dozen circular holes, all of them just about the width of a toddler’s finger.
“The plan is to cut away the drain pipe. This will allow us to raise the bath from the floor, so that Steve can get right underneath and free Toby’s fingers from below. He’ll push up on Toby’s fingertips with his own finger.
If that fails, we’ll have to saw away the steel drain and free Toby from the tub, and then tackle the fingers.

“You and your family won’t be taking baths for a while, Rachel. This bath will be in pieces once we’ve finished here.”
I take a look at my watch. 7.45 pm. Toby has been in the bath for an hour and a half.
While we’ve been talking, the home phone has rung and rung out. My own mobile has rung unattended. Now Annette’s phone rings and it is Toby’s Aunty Naomi, calling from Sydney. She had called earlier, just when Rachel was racing between the stuck child and the other children and her urgent phone calls for help. Since that time, Naomi has learned sufficient to frighten, and nothing to comfort an aunt who has visions of fingers lost by strangulation or by nightmare surgery. Naomi has no children of her own yet and she loves her Melbourne nephews and niece with an intensity which increases with the distance.

Naomi asks to speak to Toby. “Toby, would you like me to sing Rainbow?”
Toby nods, his mouth occupied by his lollypop.
Rachel switches the phone to Speaker and says:
” Toby is busy with a lolly. He does want you to sing.”
Naomi’s voice floats into the bathroom.
“Somewhere, over the rainbow,
Way up high…”
The phrases float, spacious, into the bathroom, the words a familiar caress for the boys at their bedtime. Naomi’s singing voice is a sweet soprano, usually crystalline. Tonight the voice is thickened with an unfamiliar tremolo.
“ there’s a land that I heard of
Once, in a lullaby…”
Toby is transfixed. His brothers are still. Three lollypops are held, suspended, while Naomi sings.
All conversations stops. The lengthy plumber pulls his face out from under the steel belly of the tub. His face is wet with sweat. Bathroom lint clings to his chin and brow. He lifts his head and listens. The ambos and the fire chief stand, arrested. The voice rises, crests a high note and falls. The singing undoes us, soft family and hardy professionals alike.

A skinny woman appears. She is Laura, Rachel’s best friend. Alarmed by the emergency vehicles congregating outside, she races in: “What’s wrong? Is everyone alright? Can I bring food?”
She listens, looks, offers cuddles, kisses the air with her famous loud smacking sounds and leaves, disappointed not to be catering. Laura makes me laugh, always has.

The tall man pulls his head in again. The Chief hands us a hacksaw. We pass it to the tall man. We hear sounds of sawing, long metal screams.
Alarmed, Rachel wonders aloud about Toby’s fingers: are they safely out of the way of the singing blade? The Chief says: “Don’t worry. Steve knows just where to cut. He leaves a margin of pipe just shorter than his own index finger.”

At length the drainpipe is sawn through. Everyone gets out of the bath excepting for Toby and Rachel. Annette, Raphael and I make room so the bath can be lifted. Eight adult hands hoist the tub aloft. Toby squeals with delight as he levitates.
Steve’s voice comes from the floor: “Toby, can you wriggle your fingers?”
Rachel and the ambos relay the request. Toby says, explaining the obvious to the unintelligent, “I can’t. They are stuck.”
The voice from the floor warns Rachel that he is about to push Toby’s fingertips upwards from below. Steve pushes, Toby says “Ow! You are hurting me!”
Apologising, Steve has another try and Toby cries:”Stop it, you bumhead!”
Steve stops.
The Chief retires to the fire truck, returning with some new cutting equipment which he passes to Steve. Steve now sets about cutting free the metal disc with its six perforations and its three child fingers.
The Chief invites Jesse and Miles to come and inspect the fire truck. He shows them the hoses and the heavy brass fittings, then hoists them high into the cabin and places them onto the driver’s seat, beneath the steering wheel. In the massive truck they are very small.
The Chief points out the siren, the two-way radio, the switches that elevate the ladders and all the usual automotive controls. Two boys are in paradise. I remove them before they drive off in search of a fire.

Back in the bathroom, Toby is pacific once more. He sits in the tub in his mother’s arms watching a DVD. The ambos take turns holding the portable screen at the right distance for Toby’s comfort. The DVD is in a language foreign to the ambos and fire crew. It is “Bob Esponja”, Sponge Bob in Spanish.
Now his brothers clamour to watch too. Raphael and I take them outside and hoist them onto the window sill recently vacated by the fire chief.
All of this takes place well past the bedtime of such small boys as maintain a normal, detached relationship with their bathtubs.
The boys watch and translate for the ambulance man and lady, Ross and Joelle (‘call me Jodie’) respectively. It is a cultural treat for Ross and Joelle, who have only previously enjoyed Sponge Bob in English with respective nephews.

It is about 9.00PM when the plughole with its nubbin of pipe and its heavy perforate disc is freed from the tub. Sponge Bob has finished. Toby looks at his naked self and the empty tub. He says mildly: “I am ready to get out now.”
Rachel rises, her bum and thighs numb after three hours, cradling Toby and his massive steel bracelet as she does so.
Escorted by Joelle and Ross, they make their way to the kitchen. Here Annette has covered the kitchen table with towels and a pillow for Toby’s head.
Annette takes Miles and Jesse to their bedrooms. Their protests are audible from the kitchen.
Jesse appears in the kitchen. He says,”I can’t sleep. I’m too worried.”
Somehow Annette persuades him to come back to his room. She lies down alongside him and tries to help him relax.

Now the Chief produces a narrow strip of steel blade, about a foot long and an eighth of an inch wide. Its surface is roughened and irregular; it looks like steel with acne. The Chief explains: “Diamond saw. It’s the only thing that will cut through that steel.”

The Chief threads the stiff blade between Toby’s index finger and the inner edge of the steel annulus. The sharp edge of the blade is applied to the steel and moved up and down. It seeks a niche or crack to bite at hard, but the steel is obdurate and the blade bounces off it. The Chief tries again and again. He is relentless. Steel against steel, the Chief versus the disc.
An exquisite Argentine proverb of Toby’s father, Pablo, runs: con paciencia y con saliva, el elefante se cogio a la hormiga.*
Over the next long time, the Chief will need all the patience and saliva he can muster. He sneaks the blade between the hard steel and the soft boy. The blade makes glancing contact with the disc, leaving a fine scratch in the steel. Now the blade comes again, finds the line of scratching and attacks. The linear scratch deepens minutely. It is nothing like a fissure. Many more passes of blade, many minutes in which Rachel braces Toby’s hand against movement. Rachel searches the face of the Chief. Is he discouraged? He is not. He is the elephant seducing the ant. He presses on.
The room heats up, the disc heats up and Toby protests. Now Jodie produces a green gadget and shows Toby. It looks like a fat whistle. “You put this in your mouth, Toby, and you breathe in. Then your hand will feel good again.”
Toby takes the toy, breathes in and out, relaxes and smiles. He likes his inhaled narcotic.
More laborious sawing, more minutes pass, many single tedious minutes, dragging themselves into hours. The disc is hot, the Chief is resolute, the ambos take turns positioning Toby’s wrist and the Toby rescue industry hums on. Eventually – it is around 10.00pm – Toby becomes fractious. He addresses Jody, the wrist-bearer of the moment. “Put my hand down.”
Jody explains: ”We have to hold it up high to get your fingers out, Toby. It won’t take long.”
Toby is not placated: “Stop it, bumhead!”
Bumhead’s offsider, Ross, gives Toby another suck of narcotic and he subsides.

A further half an hour passes, half an hour of sawing, story reading, perspiring and concentrating. The cluster around Toby and his still buoyant mother falls eventually into speechless reverie. Each person in her own thoughts, each concentrating on three thin fingers that remain pink and on a small boy’s face, pale now with medication and fatigue.

There is a bloke at the front gate who wants to talk to any member of the family. I am greeted by a shortish man with a warm smile and a huge camera. He’s from one of the TV stations. He apologises for his intrusion, he hopes he is not causing distress, would any member of the family be prepared to describe what is happening? I answer, “No.” The man accepts this gracefully and walks away.
I retrieve a phone call. It is Pablo, Toby’s aphoristic father. “Howardo, what’s happening? Is Toby OK? Should I come home?”
Pablo is up country, the indispensable leader of his team’s annual residential seminar. He is out of town but painfully in touch. It tears him in two.
“No, Pablo, Toby is safe and cheerful, his mum is cheerful and the house is full of fire people, ambulance people, family, friends and kibitzers. There’s no physical space for a mere father. OK?”
Pablo is OK, just. I am to ring back later with more news.
Back inside, Toby stirs, complains: “My hand feels uncomterful.” Jody confers with Ross, then turns to Rachel: ”We can’t give Toby any more of the painkiller in case it depresses his breathing. Any further doses need to be given in the Children’s Hospital, with anaesthetic and operating facilities.”

Rachel flows into action. She kisses her other boys goodnight, tells them that Toby will go to the hospital to get his fingers out and he’ll come home soon. She grabs Toby’s teddy bear, a couple of books and another DVD.
Toby says a warm goodnight to all the emergency people, not excluding bumheads.
Rachel wraps Toby in a rug, marches from the house into the open ambulance, concealing her son from the TV camera, and in a moment they are away.

I follow in my car. I work odd night shifts in the Emergency Department of that hospital. I might be useful in some way; I know people there.
By the time I arrive in Triage, Rachel and Toby are nowhere to be seen. The nurse in Triage seems to expect me. “Go into the Minor Procedures Room, Howard. They’re all in there.”

Indeed they “all” are. There are Jodie and Ross and a new fire team. Steve and the Chief and our previous team only do outpatients, it seems. The new bunch comes from another fire station and they do the inpatient jobs. There is a firelady and a fireman, both selected, surely, for their tenderness towards children. The fireman is as tall as Toby is minute. He looks at me, I look at him, Rachel looks at him. He says, “Hello Doctor Goldenberg. We met at your clinic. I married your patient, Robyn. Do you remember?” Indeed I do remember. He is Nick. Rachel is looking at him hard and long because he is so good looking.

Nick has no hand for me to shake because his are occupied with an intriguing apparatus, whose principles he at length will explain. The principles are alarming.
Meanwhile I meet Lucy, who is operating a portable DVD player for Toby, who sits in his mother’s embrace on an operating table. Toby grips his pale blue teddy bear as he always does – with one of its arms in his mouth. Every night that bear develops a soggy upper limb. The bear keeps Toby company through his hospital stay and then disappears, forever lost. Bearnapped, we suppose.
There is a nurse who is helping a doctor administer intravenous pain killers to Toby. The doctor smiles and greets me. We know each other. A quarter of a century ago, when he was a boy, I used to be his family doctor. Then he became my medical student. Nowadays, when I work at the Royal Children’s, I operate under his direction. He is the paediatric consultant on duty tonight. His name is Dominic.

Nick explains his gadget. It is a miniature example of the famed ‘Jaws of Life’ that road emergency crews use to disimpact a crushed motor vehicle from its trapped occupant. Nick’s gadget is a menacing midget of frightening power. It looks like a pair of dark steel pincers emerging from a cylindrical contrivance connected by strong piping to a device that couches like sin on the floor of the O.R. That floor dweller is a pump that forces air under enormous pressure to the pincers, coercing them apart.
Nick introduces the fine pincers into one of the unoccupied annuluses of Toby’s steel ring. He allows the pressure to build and build. The steel of the annulus resists the steel of the jaws. All our jaws are clamped hard, as we watch in dread the application of irresistible force to an object not amenable to persuasion. I close my eyes briefly against a vision of a sudden sundering of the steel bracelet or else an explosion underfoot of the compressor. The latter would destroy the fourteen limbs standing nearby on the floor; the former could shatter my daughter and my grandson.
I adopt the business-as-usual expression that one always deploys when one’s gamble with a patient’s health hangs upon the coin that one has set spinning, spinning, as it falls to earth.
With a discrete metallic sigh the annulus cracks and gapes. Firelady Lucy hands Nick a diamond–blade saw, which he wields now with a free-swinging action well away from Toby’s flesh. As the saw makes its remorseless way through the steel disc, Dominic inserts a shield for Toby’s finger.
Millimetre by millimetre the blade divides the inviolate steel. Sixteen eyes follow the progress of the blade, a remorseless icebreaker freeing the trapped one. The saw falls still, a fraction short of the shield. Now Nick applies a wrench to the opposing shores of the bay where Toby’s finger is marooned. Another steel sigh and the disc surrenders. Toby’s finger is free. Watching Aladdin and his magic, he pays no heed to our drama.
Two more fingers to go. Pincers, saw, wrench – all are deployed in unhurried speed. Nick frees Toby’s digits, tears gather at the edges of my eyes as Rachel kisses those finger tips.

Dominic examines the fingers minutely. He is checking for tissue damage. There is the small skin indentation one sees when a ring has been a little tight. The skin is pink.
Dominic tells Toby to wriggle his fingers. Toby does so, his expression of scornful surprise registering wonder at the obtuseness of the adult world.
Dominic wants to be certain that there has been no damage to nerves and blood vessels. After x-rays he will keep Toby and Rachel here, in an annexe, until the morning, “just to be sure”.
The morning is not many hours away. I kiss my grandson and I hold my daughter’s face in my hands and squeeze her beloved flesh. Then I drive home.
On the way to the car, I phone Annette and share the news. And I forget all about phoning Pablo and Naomi.
***

In the bath a few weeks later 7 year old Jesse has an idea: “Why don’t you see if you can get your fingers into the bath hole, Toby?”.

 

* Pablo translates: With patience and with saliva, the elephant fucked the ant.

Melbourne Boy Rescued After Plug Hole Drama

Melbourne Boy Rescued After Plug Hole Drama

 

Reconsider Phillip

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The morning finds Phillip’s bed empty. No-one has discharged him, no-one has removed the intravenous bung from his arm. The plastic bottle of saline hangs from its pole, its tubing droops into air. Phillip’s just gone.

 

At mid-morning a call comes from the nearby general practice: “One of your patients turned up here with a bandaged arm; would we change his dressing? We found an IV bung. We figured he came from the hospital.”

 

Two days later a young woman wanders into the hospital. She shows the back of her right hand, swollen and deformed.

“What happened?”

A full-cheeked face, a crooked smile. A palm-upwards gesture from the opposite hand: You know how these things are. Just a swollen hand…

She offers no words.

“When did it happen?”

A shrug.

We won’t have X-ray until Monday. She turns to go, her walk crooked like her smile. A fruity aroma hangs in the air.

 

On Monday the X-ray shows a fractured metacarpal, classic fracture of the biff.  We ask again: “How did it happen?”

Her shrug, her smile convey confession and self–forgiveness.

She points in the direction of her companion, who volunteers: I made her wild.

She is so young, at least in years. Her face, even younger in its innocence, looks older in damage.

A pang of regret for that damage prompts a candid question. “Do you think your drinking is doing you harm?”

Her companion is a slim young man with a meandering black beard. He replies before she finishes the familiar smiling that she substitutes for words: It’s doing both of us harm!

That face, that beard, I know them: the man’s sobriety and his gaiety confused me. The speaker is Phillip.