‘Come, wise one, let us start the ward round.’
Chapter 3
Chopsy
One and a half hours later and we were still traipsing round the wards. I was starving, and bored out of my brain. Ash, while nice to look at, was all about efficiency. Minimum time spent with each patient, protocols followed to the letter,nobanter with the ward staff. He was a machine. He was also the most blunt, literal person I had ever met.
‘You have partial occlusions of the right coronary artery and the left main stem here and here.’ His trusty diagram of the heart and its vessels was out, and he was frantically scribbling all over it to demonstrate to the middle-aged male patient we were with the extent of his cardiac disease.
The diagram was looking increasingly like a dog’s dinner and the patient’s face had lost all colour.
‘We must stent here and here, yes?’ Without waiting for an answer he got up to go, then seemed to remember something and sat back down. ‘Your BMI is too high and you have a twenty-year pack history; you must resolve these issues,’ he declared, obviously happy with his explanations and keen to move on. The patient looked at me in helpless confusion, then back at Ash.
‘What’s BMI and what’s pack history?’ he asked.
‘You are fat and you smoke. This is why you have coronary artery disease.’
The patient’s face flushed red with anger. ‘I – I … you can’t speak to me like that,’ he spluttered.
‘I speak the truth.’
‘Listen, mate, most of that I couldn’t bloody understand except the fact that my heart is completely buggered, and what I could understand was insulting.’
I quickly grabbed the diagram Ash still had clutched in his hand, and stowed it away.
‘Mr Tobin,’ I said. ‘Can we start from the beginning? There are some narrowings in the blood vessels that supply your heart; we’re going to open them up with little tubes called stents. In order for them to stay open you may need to alter your lifestyle somewhat.’ I explained how he could do this, and that Ash hadn’t meant he was fat, just that he needed a healthier diet.
‘But he is fat,’ Ash grumbled as we walked to the next ward. ‘He’shuge.’
I took a deep breath. I had to push past my timidity and be honest with him. ‘You can’t go round telling patients they’re fat, Ash,’ I said. ‘I’m sorry but you’ve got to be a bit more diplomatic. And enough of these diagrams, you’re scaring the pants off them.’
‘I like the diagrams.’ He was starting to sound like a petulant child. ‘They show the patients exactly where I will put the stents. This is good. They like this approach.’
I rolled my eyes. ‘No, Ash, they don’t. You nearly made that lady on Brecon ward wet herself.’
‘She was awed by my surgical skills,’ he said.
‘She was terrified that you’d left her heart looking like a badly drawn game of noughts and crosses. I know it must have been a difficult procedure and no doubt you are skilled to have done it, but you can’t get overexcited with the patients and leave them feeling that they are riddled with stents.’
We had come to a stop outside the next ward, and Ash was looking at his feet as they scuffed the floor.
‘Fine, no more excellent diagrams,’ he allowed, still grumpy.
Men, I have found, are a lot happier once fed, and I was starving.
‘Elevenses?’ I asked.
‘What?’ he lifted his eyes from his as-always-intense perusal of our patient list.
‘Tea, coffee, cake?’
He frowned at me. ‘Why?’
‘To relieve the boredom? So I don’t eat my own arm?’
He laughed. ‘Okay, wise one, let us eat cake and leave your arms intact.’
Cake with Ash was fun once he’d loosened up a bit. I found out that he was from Iraq and that his sisters had moved over here but his mum refused, even though his dad had died a few years ago. Despite all the unrest, she had her friends and her routine, and she sounded as stubborn as Papa. Ash missed her. He said he couldn’t visit, as it wasn’t safe. He would be considered to fetch the same ransom as a foreigner, and his mum didn’t like making the journey.
