The Fishwhacker Swindle?

In the mid-1990s I spent six months working in the Accident and Emergency department of a district general hospital in a certain Hampshire town while I tried to decide on a career path. For legal reasons the town must remain anonymous; but I have to give it a name for the purposes of this story, so let’s call it Shipmanville. Unlike most medics, A&E doctors work a strict shift system, and one Friday night I was on duty with two other Casualty officers, Amy and Dick. (His name was Richard but we all called him Dick to annoy him, and because he was one. Doctors’ humour is at the level of sophistication of your average nine-year-old's.) Amy was Chinese, endearingly modest and an obvious future star in the medical firmament. I’ve lost contact with her over the years but I imagine she’s a professor at Harvard or something by now. Dick on the other hand liked to think of himself as a potential Nobel laureate, which he clearly wasn’t even to my untutored eye in those days. He must have been no more than twenty-seven or -eight but seemed older, not least because his hair was already thinning and he had the beginnings of a comb-over. To mask his fundamental insecurity he had adopted a rather pompous manner, with his head pulled back tightly on his neck and his chin tucked in, his eyebrows faintly raised at their inner ends and his lips pursed. He didn’t bother to conceal his frustration at being stuck in a provincial backwater like Shipmanville when what he thought he deserved was a plum job on one of the London university training schemes. It wasn’t that he was a bad doctor, merely that he was an average one who thought he was the bollocks.

The night in question had been a quiet one by Friday standards, and by midnight the three of us had cleared the backlog generously bequeathed to us by the afternoon shift and were having a coffee break with some of the nurses. Amy was entertaining us all with a hilariously filthy story about a Chinese sex practice when Dick, who had been sitting in a corner sulking because he wasn’t the centre of attention, got up to make a phone call in another room. A minute later the intercom crackled alive and announced the imminent arrival of a Blue Light. This signalled an emergency. I didn’t bother trying to decipher the story the paramedic was telling as his voice was distorted beyond intelligibility over the radio system. Normally we attended to Blue Lights on a rotating basis, and it was Dick’s turn, but as he was elsewhere making his phone call and Amy had dealt with the last one (a sad case of an elderly man who had been found unconscious and alone in his flat and had died within minutes of reaching hospital, despite Amy’s best efforts) I stood up and went to the ambulance bay to await the new arrival. It would piss Dick off since he liked to show off his middling medical skills wherever possible, and I found myself whistling as I watched the ambulance skid to a stop with an unnecessary but impressive screech of its tyres.

The two paramedics sprang down like marines and rolled the stretcher out of the back, and I held the doors open and strolled after them as they pushed it down the corridor. One gave me a running history over his shoulder.

‘A1, 44, NFA, ethanol NFS, PFO, blunt trauma to abdo, LOC negative, GCS 13/15, two litres DS IV and third running.’

Translated, this was: a forty-four-year-old white male of no fixed address, whose alcohol intake was Normal For Shipmanville (i.e. approximately eight cans of strong lager a day), was pissed and fell over (PFO) and sustained some sort of non-penetrating injury to his abdomen (it later transpired that one of his friends had kicked him in the stomach); he was conscious but inebriated and had had an intravenous infusion of two litres of a dextrose and saline mix. This suggested blood loss from somewhere, probably inside his abdomen.

We got him into one of the two resuscitation rooms and set to work, myself and two nurses called Debbie and June. His name was Dave, according to the paramedics who had obtained this information from the friend who had kicked him just before the police had carted him off. I glanced at his face but he wasn’t one of our weekend regulars. He was able to respond to simple commands and was compos mentis enough to shout fuck off at me whenever I touched his abdomen, and I quickly established from this that there was no significant head injury. From the state of his abdo, though, it appeared that the kick to his belly had ruptured his spleen. Together we stabilised him haemodynamically and eased his pain, and I asked June to contact the surgeons as he needed an exploratory operation and probably a splenectomy.

June came back and told me that Dick had heard I had stolen his Blue Light case and was on the warpath, her hand making wanking motions as she spoke. I shrugged, and wrote up my notes while I waited for the surgical team to arrive.

They took their time, and after a while I wandered out into the corridor to see what was happening. Further down on the left was the second resuscitation room, and issuing from it were strident Ulster tones I recognised. I put my head round the door. There, on either side of the bed on which lay the body of the elderly man Amy had tried to revive earlier, were Dick and O’Connor, the surgical registrar. O’Connor was a snarling Celt from Belfast who always seemed to be fighting down a raging wind of fury within himself when he wasn’t fighting with someone else, which he was much of the time.

‘Why d’ya waste my focking time like this?’ he shouted. ‘Yer man is focken dead.’

Dick stood hapless, his pomposity turned to bewilderment, peering down at the dead man’s medical notes through his goggle spectacles.

‘And he’s never forty-four, ya blind twat,’ O’Connor continued, spittle flying. ‘He’s eighty if he’s a day. Christ sakes, you Caz officers, yer a shower of focken shite.’

With that he stormed out, glaring maniacally at me as I stepped aside to let him pass. Dick frowned down at the corpse on the bed, then took off his glasses and rubbed his eyes. I have never seen a man so crushed.

It turned out that Dick, enraged by missing out on the Blue Light while he was on the phone, had misread which resuscitation room Dave the drunk was in and had instead gone into the room with the old dead man, who was peacefully waiting for the porters to come and transport him to the mortuary. Shortly afterwards O’Connor had come down, seen that Dave the potential splenectomy had been allocated to Dick on the board (Dave had, rightfully, been Dick’s, and the roster on the board had dutifully reflected this), and had accordingly sought out Dick and found him, not with a middle-aged live trauma victim but with a cooling stiff.

I felt sorry for Dick that day, and we all went easier on him after that. Well, after several weeks of supreme mirth at his expense, anyway. I've lost contact with him too, and for all I know he's achieved his dream and is a jet-setting Oxbridge luminary with publications in journals like Science and Nature (though if so, he must be using a pseudonym as his real surname hasn't registered on the radar yet). I hope he's content, wherever he is. Bless you, Dick; you made my six months' penance a little more bearable, even if you are a shower of focken shite.