The Appendix.

Sister Rena sat down and started her breakfast. Breakfast was her favourite meal. She was always much too busy to have lunch and by tea-time she was usually so tired that she did not fancy anything to eat.
“We’ve got a student this week,” Sister Romily said, casually.
Sister Rena paused, staring at Sister Romily. There was a look of dismay on her face.
“A student?”
“Yes, a medical student.”
Sister Rena put down her toast. She felt slightly sick.
“A medical student!”
Rena and Romily despised medical students. Medical students were enthusiastic and inquisitive. They were forever asking questions. They wanted to see everything. There would have to be a tour of Casualty, a tour of the ward and a tour of the operating theatres.
You would be trying to get on with your work and a medical student would be peering over your shoulder. Give an injection: the student had to see that. Put in stitches, set a broken bone, dress a burn: the student had to see them all.
Bill Button, their last student, had a special interest in heart conditions. He was extremely bright and seemed to know everything about the heart. Even the consultants had asked him for help. He had been unbearable!
Sister Romily cleared her throat. “ The student’s name is Peter Perkin. Today is his first day in a Casualty department, his first day in a hospital and the first day of his medical course.”
Sister Rena groaned. It couldn’t be worse. There was nothing more enthusiastic than a brand new medical student. Nobody would be nicer or more polite to patients. He would help them get undressed. He would make sure that they did not fall over. He would help them get into bed. He would ask them a hundred times if they were alright. He would offer them a glass of water or a cup of tea. If they had to stay in hospital, the medical student would visit them every day. Sister Rena wanted to scream.

Sister Rena looked down at her breakfast, a grim expression on her face. She stood up and pushed her plate away.

“Let’s go. I’m not hungry.”
Sister Romily nodded in agreement and followed her friend.
Rena and Romily were two of the new breed of nurses that were gradually taking over the National Health Service. They worked in the Casualty department of Halloween Hospital, where they did almost everything themselves. They had little or no need for the help of doctors and did not think much of them.
Rena and Romily would see patients, examine them, arrange investigations and start treatment. They would take blood, book x-ray photographs and apply plaster of paris.
Rena might be removing a huge chunk of metal from someone’s eye, while Romily treated a man who could not have a wee. When Romily gave an injection to an epileptic, Rena might be examining a small child with tonsillitis. On Saturday 27th of March they both treated twin brothers with boils on their bottoms. If Rena was attending to an asthma attack, Romily could be performing a lumbar puncture, stopping a nosebleed or fishing a peanut out of someone’s ear. They even did small operations; removing children’s toenails (their favourite), burning warts, bursting boils (their second favourite), pulling rotten teeth, pinning broken bones back together and sometimes, when the doctors could not be found, removing tonsils, adenoids or appendixes.

When Rena and Romily arrived on that Monday morning, Peter Perkin, the medical student, was already hard at work. He had seen two patients. He had arranged blood tests for the first and sent the second for an x-ray. He looked very pleased with himself. He said he was more than happy to see the third patient, the only one left, if Sister Rena would make him a cup of tea. Sister Rena bit her bottom lip so hard it bled. It was the only way she could stop herself strangling Master Perkin with the crepe bandage she kept in her pocket.

Peter went and sat at Sister Romily’s desk in the nurse’s station to write up the last patient’s records. Rena and Romily watched him carefully. They were looking at him, not as a pupil or apprentice, but with the professional interest of expert diagnosticians.
“Peter doesn’t look well.” Rena sounded concerned.
“No,” agreed Romily, “he doesn’t. He looks quite pale.”
“Yes, he is pale,” Rena continued. “Look! He’s sweating a little.”
Romily nodded. “Are you alright Peter?”
“Yes, I’m fine,” answered Peter, but he was beginning to feel slightly uneasy.

Sister Rena continued to look intently at him. “You look uncomfortable, Peter.”
“Yes, he does,” said Romily. “I think it’s his tummy.”
“Yes, that’s it,” agreed Rena excitedly. “He’s got tummy ache. I knew there was something wrong.”
“You should have told us, Peter.” The two nurses looked sternly at him. “We better examine you.”
Peter did feel a little sickly. He thought that it was because he had been up so early and not had breakfast. Now that they mentioned it, he could feel a very small pain in the bottom of his tummy.
“I do feel a bit sick,” he said.
“I thought so,” said Romily. “Come on. Come with us. We’ll have a look at you. We’ll have you right in no time.” The nurses helped him up and took him to one of the patients’ cubicles.
“You better get undressed and put this gown on.” Rena gave him a clean, white hospital gown. “We’ll go and get you a wrist band while you’re getting changed.”
By the time the nurses came back Peter was lying comfortably on the examination couch in his hospital gown. Sister Rena checked his pulse while Romily measured his temperature. He was asked to stick his tongue out and they both looked thoughtfully at it.
“I’ll check your tummy, Peter.” Sister Rena spoke quietly and reassuringly.
Sister Rena examined Peter’s abdomen very carefully, pressing gently at first and, then, more firmly. In the bottom right hand corner, where the appendix is, she seemed to press down very hard and Peter winced.
“Mmmm . . .” she said, glancing up at Sister Romily. “You better check this yourself.”
Sister Romily repeated the examination just as carefully as her colleague. She also seemed to press down very hard over Peter’s appendix and, again, he winced.
The two nurses stood and looked down at him, their arms emphatically folded across their chests.
“I am afraid it’s your appendix, Peter.” Rena spoke while Romily nodded in agreement. “It will have to be operated on.”
“We would do it ourselves, of course,” continued Romily, “but it is very busy here, today. We will ask Miss Preece to operate. She is an excellent surgeon.”
Rena glanced at Sister Romily. “The poor boy probably doesn’t know what his appendix is. After all, it is his first day!” They looked inquiringly at Peter.

“No, I am not exactly certain,” he admitted.
“Well,” explained Sister Rena. “The appendix is in here,” she pointed to the bottom, right hand corner of his tummy. “It is about the same size and shape as your little finger.” She held her little finger up to demonstrate. “It is usually a nice, pink colour. It can be perfectly straight or curly, like a pig’s tail.”
“When you get appendicitis,’ Sister Romily added, ‘the appendix goes bad. It gets hot, red and swollen. If nothing was done, it could burst. That would make you very ill. It’s called peritonitis.”
“Nobody knows what the appendix is for. It doesn’t seem to do anything, except go bad and that often happens at the most inconvenient time.” Sister Rena raised her eyebrows as she explained this.

The two nurses smiled sympathetically at Peter. He thought that they seemed a little more cheerful than when they first arrived at work. Sister Rena squeezed his hand.

“We will let your parents know, Peter. They will want to come and see you, after the operation, of course. We must get you to the operating theatre as soon as possible. We don’t want that appendix of yours to burst.”
“No we don’t,” agreed Romily. “We would never forgive ourselves.”
The thought of a burst appendix gave Peter quite a sharp pain.

As soon as the hospital porter arrived to take Peter to the operating theatre, Rena and Romily went back to work.

Peter was a brand new medical student. It was his first day in Casualty, his first day in hospital and the first day of his medical course. It was, thought both Rena and Romily, a wonderful opportunity for him to be involved in an operation at the very beginning of his career.

* * *

When Peter’s parents arrived at the hospital about two hours later, Rena and Romily were waiting in reception to meet them.

“We will take you straight to see him,” said Rena as she led them down the main corridor.

“I am afraid that things did not go exactly as planned,” she explained. “We were all mistaken. It wasn’t his appendix after all.”
“It seemed to be a classic case,” added Romily, “straight out of the text-books. Miss Preece, who is one of the best appendicectomists in the country, was very surprised. To be honest, she still can’t believe it.”
They stopped in front of a frosted glass door. Peter’s name was on the door.
Sister Rena smiled consolingly at Mr and Mrs Perkin. “I have to say that it turned out to be much more serious than we thought,” she explained.
Rena opened the door and showed them into the room. Peter’s bed was neatly made and appeared to be empty.
“His appendix was fine,” she continued. “It was completely healthy. In fact, it was the rest of him that was bad. We had to remove everything.”
Sister Rena pulled back the bedclothes. There in the middle of the bed was a small, pink object. It was about the same size and shape as your little finger. It was perfectly straight.
It was Peter Perkin’s appendix and it looked completely healthy.

“I am very sorry to say that that’s all that’s left of him,” said Sister Rena.

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