Prick Clinic

Norbert

Chapter 5

Prick Clinic

My only piece of technical wizardry is a haemoglobinometer, a photo-electric colorimeter which (as the long word suggests) measures the amount of haemoglobin in the blood. This is easily explained to a non-scientific layperson.

The oxygen you breathe into your lungs diffuses into red blood cells, where it binds with iron to form haemoglobin, exactly like football hooligans handcuffing themselves to the stadium railings because the club sold their best player. The police van (haemoglobin) takes the hooligans (oxygen) to prison (the tissues) to sew mail bags (make energy). After serving a short sentence (breathing) the institutionalized good-for-nothing (carbon dioxide) is coughed back out into the community. A reduction in police vans (haemoglobin) due to trouble at the match (getting pregnant) leads to a three-match ban (iron deficiency anaemia). It is therefore essential for football hooligans (pregnant women) to lick the stadium railings (take iron supplements) to avoid getting arrested (fatigue).

A small amount of blood, taken by finger prick, is haemolysed in cyanmet solution to release the haemoglobin, which the colorimeter then measures. 

The first antenatal patient waddles in and heaves herself onto the swivel chair. She hands me a form and holds out her thumb. She knows the drill.

‘You’re Virginia Maidenhead-Spierd, date of birth 17^th of May?’ (I have given up asking ladies their year of birth. Most claim it’s a typing error.)

‘I think so,’ she answers.

Thanks to me, it is now hospital policy to confirm the patient’s name and date of birth before you bleed them, not after. The ruling came into force after an incident during one of my afternoon general clinics. I shouted “next” and a man came in from the waiting area and handed me his form. I siphoned off several tubes of blood then asked him to verify that he was indeed Mister So-and-So - So-and-So.

‘Oh no, I’m Mister So-and-So - So-and-So’s friend,’ he said. ‘Mister So-and-So - So-and-So went to the toilet and asked me to keep his place in the queue.’

‘But you’ve just let me take a litre of blood out of your arm,’ I said, incredulously.

‘I panicked,’ he answered

Ms Maidenhead-Spierd doesn’t seem at all perturbed that her gown is gaping open. She has enormous pendulous loolybells bulging out of a once white brassiere, stained grey with accumulated sweat marks. Her distended belly hangs over her pants. Lank greasy hair, pimples and rank body odour suggest she is unaccustomed to bathing. I haven’t felt so sick since the incident with the walking socks. A tit tattoo reads, “Property of Clarence”. The name is crossed out in red ink. Below it says “Wallace”, also crossed out. The third and current name is “Cedric”. How at least three different men could stick bendy bunny into someone this repugnant is beyond me. I would rather wave mine around in a bed of nettles.

I dampen a cotton wool ball with alcohol and swab her thumb. The dirt comes off, but none of the nicotine. I peel back the wrapper, remove a Sterilette and jab the point hard into her calloused skin. I take a length of narrow rubber tubing with a mouthpiece at one end and attach it to a graduated pipette. I hold this in my left hand, squeeze with my right forefinger and suck the blob of blood exactly up to the required level, a skill perfected over the years. She holds the swab on her thumb whilst I blow the blood into a test tube of cyanmet. I mix it and place the tube in the rack for the ten seconds it takes to completely haemolyse the blood. I evacuate the flow cell, tip in the test solution and read the digitally displayed haemoglobin level.

‘What is it?’ Ms Maidenhead-Spierd asks.

‘Eleven - point - eight,’ I answer, writing the result on the form and handing it back.

‘Is that normal?’

‘For someone in your condition, yes it is.’

‘What do you mean, in my condition? Am I ill?’

‘I meant pregnant.’

‘Oh yes, I forgot.’ She lumbers off the stool and waddles out.

One down, seventeen to go.

I do a quick squirt with an air freshener and call in the next patient. She pokes her head through the arch and hesitates: clearly a first visit.

‘Come in. I don’t bite.’ (In haematological circles this is an amusing vampire reference and not just something you say to a timid person.) ‘Please take a seat.’

The form says she is fifteen years old. She looks nearer to twelve.

‘Philomena Kynynicky-Smith, born on October the tenth?

She nods.

‘Is your father foreign?’

Her eyes dart nervously round the lab at the unfamiliar gadgets and humming machinery. ‘He’s that foreign I’ve never met him.’

As she is clearly frightened, I explain the procedure. ‘It’s just a little prick. Don’t be scared.’

She pouts.

‘Give me your left hand.’

She shakes her head and clasps it firmly in her lap.

‘It won’t hurt, I promise. Close your eyes and it’ll be over in a jiffy.’

She sobs, but not very convincingly.

I don’t have time for this nonsense. ‘I have to check your haemoglobin level to make sure you’re not anaemic. If you refuse to have it done they won’t give you any iron tablets. You’ll get poorly and the baby will suffer.’

When I reach for her hand she tries to escape. A flip-flop gets caught on the foot stand and she falls. I grasp the robe one-handed (I was in the cubs. I know how to save lives). Regaining her balance, she pulls away and struggles violently. Sister appears and gasps in horror.

‘NORBERT,’ Auntie yells. ‘What the hell?’

It must look like I am trying to violently disrobe the poor child.

Apart from the tiny bump in her belly, she is a skinny little thing.

‘She fainted,’ I say, letting go. ‘I grabbed the robe to stop her from falling.’

Florence arrives and takes the girl in her arms. ‘Are you all right, sweetheart?’

‘He said exactly what my stepdad says, word for word,’ the girl sobs, much more convincingly, ‘before he does it to me.’

‘No … I … All I did was stop her from falling. Honest.’

‘Florence, take her to my office and get her cup of strong tea. I’ll be along in a minute.’

‘There’s a policeman in your office, Sister, taking statements about the break-in.’

‘Put him somewhere else.’

‘But he can kill two birds with one stone and arrest your pervert of a nephew whilst he’s here.’

‘It’s her stepfather wants arresting, not me,’ I gasp.

‘Not in front of the girl,’ Auntie hisses, signalling Florence to remove her. ‘I will see you in my office at the end of clinic. That’s two serious disciplinary offences inside half an hour. A record even for you.’

‘It isn’t what it looks like. Give me some credit.’

‘Two minutes ago I caught you masturbating in an antenatal clinic. That you do it in the privacy of your bedroom IN MY HOUSE is disgusting enough, but to practice your sordid perversions here is inexcusable. I have always had grave doubts about your suitability for this job, now all my fears have come home to roost.’ She twists my ear brutally and snarls: ‘And while we’re at it, I do not break wind in the bathroom and my sleeping arrangements are no one’s concern but mine.’ She lets go and mutters: ‘Interrogated by Security. I’ve never been so humiliated.’

I raise my hands in a calming manner. ‘Did the girl come by herself?’

‘She’s with her mother.’

‘Didn’t you hear what she said? She’s no teenage slapper. The baby is her stepfather’s. She is being repeatedly raped by a member of her own family.’

That gets her attention.

‘What you need to do, Auntie, is take that policeman on one side and tell him what has happened. With her stepfather, I mean, not in here. But be careful what you say to the mother; it’s most likely her husband is to blame.’

‘Tickle our Lord!’ Auntie blasphemes, and lurches through the archway.

This has the makings of the most gruesome case we’ve had in Brundy-cum-Inmamouth since the notorious “Goatsucker of Honeypot Farm” back in the seventies.

(Let me explain to those of you a little rusty on the geography and history of Southern England. The Macarbrough River flows southwest from the Wessex Downs to the seaside resort of the same name. The Inma is its main tributary. The confluence is six miles inland at Inmamouth, which as the name suggests was once a river in its own right, emptying into the sea. A notorious Saxon warlord called Brundy and his seamen used to come regularly Inmamouth for their summer holidays, which basically involved raping and pillaging with a little paddling on the side. When Brundy got too old for R&P he decided to retire to the coast and just paddle. He did, after all, have an awful lot of family in the area, albeit illegitimate. The good, though inbred, folk of Inmamouth were not happy about this and burned down his wattle retirement hut. Brundy therefore had to rebuild across the river and further inland. By the time he died his single hut had expanded into a village bearing his name. Over the centuries Brundy grew bigger than its neighbour, and by the end of the 19^th Century they had become conjoined. Following the local authority reshuffle of 1922, the resulting town was renamed Brundy-cum-Inmamouth. Because it is such a mouthful, everyone living here and in the area calls it Brundy. Following the A333, it is seven miles from Brundy to Macarbrough, but twice that distance on the 32 bus, which serves three other villages en route. If you look on the map or in the timetable, these are Spit, Swallow and Salty.)

Over the next hour, a steady pod of bloated whales pass through. Some hug their robes tight to their bodies; others let it hang open without shame. I see big loolybells and small, and loads more tit tattoos (butterflies are a favourite), but little in the way of sexy lingerie. Mostly it is the kind of undergarments you’re more likely to see on the washing line outside an old folk’s home. More Harvest Festival knickers (all is safely gathered within) than thongs. I flinch at hairy armpits and blue breast veins, stretch marks and Caesarean scars. The skin of some resembles a map, white hills falling into a red ocean of sunburn. Whoever compared a fat-bellied pregnant woman to a flower in bloom must have meant rafflesia. A lot of them certainly smell like putrid meat.

Not one patient mentions the missing sashes.