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  He escorted her round the room, from handshake to handshake, and to each man she smiled, and where possible, made some sort of comment that showed she had done her homework well. A few of them had published papers in the medical journals, and Miss Manton had been at some pains to check on this, and to show them that she knew of their importance. She moved well, showing no awareness of their eyes following and assessing her, rather enjoying the slight nervousness deep inside her, enjoying her own performance.

  The last man to whom she was introduced was the one of whom she had been most conscious the moment she had come into the room. She had realised, with a decided lift of her spirits, that he too was very conscious of her. That was why he was the last to be introduced, why he had remained well in the background until the very last moment, and with her memories of his normal tendency to be in the van of whatever was happening, she was amused and gratified.

  ‘Dr. French,’ Mr. Heston said. ‘Our most recent addition to the Consultant Physician staff, Miss Manton——’

  ‘Well, well.’ James French smiled at her, crinkled his wide dark eyes. ‘I wondered, you know, when I heard your name, I wondered.’

  He shook her hand, and then, not letting go, closed his other hand over it. ‘It’s been a long time.’

  ‘It has indeed,’ she said, and looked at him consideringly, noticing that age had improved his looks. He had been almost pretty five years before, with his crisply curling dark hair and square jaw, but now prosperity had blurred the lines of his face a little, giving him a look of solid success that changed mere beauty into a more interesting masculinity.

  ‘You’ve met before!’ Mr. Heston looked shrewdly from face to face, and then smiled, a triumphant old womanish grin. ‘How very interesting.’

  ‘Dr. French was on the staff of a hospital where I was working some years ago, Mr. Heston. It is indeed very pleasant to meet an old friend. I hope you are well—Dr. French,’ and she gave enough emphasis to the last two words to remind French that they had been on first-name terms once.

  ‘Well, well. I must leave you to talk of old times, then. Perhaps I can bring you some coffee——’ Heston went away to fetch coffee, and French released Elizabeth’s hand, and thrust his own into his trouser pockets.

  There was a pause.

  ‘So, Elizabeth?’

  ‘So, James?’

  ‘I wondered, you know. But then I thought—no, it can’t be. Not my Elizabeth Manton. She must be married by now, with umpteen children clutching at her skirts.’

  ‘Oh, really, James! If you thought that, you must certainly have forgotten me very thoroughly.’

  He laughed fatly. ‘Oh, far from it, far from it! I remember you very well indeed. But it was certainly very possible that someone had changed your—inclinations. Women do change.’

  ‘Not me, James. I told you once before I was not the domestic type. I’m still not.’

  ‘But still a woman.’

  She reddened very slightly. ‘Still a woman. That hasn’t changed. I doubt if it will—ah, coffee. Thank you, Mr. Heston.’

  Heston took her away then, and she talked easily to various men, listening with interest to what they had to say, but never unaware of French, always conscious of his whereabouts in the room as she moved from group to group. She came back, after a decent interval, to stand beside him again.

  ‘It’s a remarkable coincidence that you should be appointed here, Elizabeth. That we should meet again after so long. I’ve been here a year now——’

  ‘I know.’

  He looked sharply at her, and then smiled slowly.

  ‘Not entirely a coincidence, then?’

  ‘Not entirely.’

  ‘I see. I trust I—er—I’m not the only reason——’

  ‘Dear me, no. I felt ready for a matronship—I’ve been ready for two years or more. It was a question of choosing where I should apply. And when I saw this post advertised, and remembered seeing your own appointment in the B.M.J., I thought it might be—pleasant—to know someone on the staff. You mustn’t flatter yourself unduly, James.’

  ‘Ouch.’ He produced a mock deprecatory smile, and they both laughed.

  ‘And how has the world treated you these last five years, James? Apart from this consultantship, that is?’

  ‘Well, let me see. I have a small private practice——’

  ‘That was inevitable!’

  ‘And why not? I like my creature comforts, and even consultants are underpaid in the N.H.S.’

  ‘It’s comparative,’ she murmured, with a sidelong glance that made him laugh again.

  ‘So I’m greedy! That hasn’t changed either!’

  ‘And what else?’

  ‘I married almost a year ago.’

  ‘I’m delighted to hear it. A man needs a wife, especially an ambitious man.’

  ‘Oh, lord! Was I that transparent when I knew you?’

  ‘Oh yes,’ she said calmly. ‘You were. I assumed you would marry. You were always a practical man. I hope you’re happy.’

  ‘Oh, very. Jennifer is a delightful person, delightful. You must meet her soon.’

  ‘I’d like to. Is it tactful to ask if you have a child yet?’

  ‘Oh, certainly you may ask. I haven’t. I have no particular urge to perpetuate the species, and Jennifer——’ he smiled. ‘Jennifer is happy to spend her entire effort caring for me.’

  ‘Comfortable.’

  ‘Extremely comfortable. I find my life pleasantly free of unnecessary complication.’

  ‘Some complications may be comfortable. Sometimes.’

  He took her empty coffee cup from her, and looked at her consideringly. ‘You may be right. It depends on—circumstances.’

  Sir Peter came hobbling across the room, Heston in his wake, and shook her hand with a flaccid grip.

  ‘Well, Matron, must go, must go. Not so young as I was, y’know. Got to keep to a routine, my age, and I want my lunch. Glad to have you here, glad to have you. Good morning, Miss Biggs, good morning,’ and he turned and went, leaving Heston, embarrassed for once, to apologise for his lapse of memory.

  ‘The old boy forgets the years sometimes, Miss Manton. You must forgive him——’

  When Heston too had gone, and one or two of the other men had departed for their ward rounds, Jamieson and Sisson, a physician senior in appointment to James, joined Elizabeth and French, and the talk turned to hospital matters.

  Elizabeth listened carefully, watching the three men as they talked at each other through her, offering no comments of her own.

  ‘You have great scope here, Miss Manton,’ Jamieson was saying. ‘With all due respects to your predecessor, this place is long overdue for a shake-up.’

  Sisson, a big man in a shabby brown suit, scowled. ‘Not too much of a shake-up, I hope, Miss Manton. I’m a great one for letting workable methods go on working. No need to make changes just for the sake of it, hey?’

  ‘It isn’t always possible to realise methods work less well than they might until you change them,’ French said, his eyes on Jamieson. ‘New ideas are worth trying for their own sake, wouldn’t you think, Sisson?’

  ‘I would not! There’s enough work to be done with what we know. No need to go digging for a lot of stuff it’s unlikely you can do anything with.’

  ‘Research can uncover a good deal one can do something with,’ French said mildly.

  ‘Depends on the research,’ Jamieson said sharply.

  ‘And what else is needed,’ Sisson grunted. ‘Remember that. Treat the ill you can treat, and with what you’ve got left, you can have a go at the others—the ones who might be ill, but don’t know it. Wouldn’t you agree there, Miss Manton?’

  ‘Of course we must always treat the frankly ill,’ Elizabeth said carefully. ‘But I hope that a hospital will always find the energy to work towards preventing future illness. If that is what you mean.’

  ‘Something like that,’ French said. ‘Something like that. My own feeling is t
hat if one can find some of the causes of illness, one may not at this moment be able to treat the existing illness—recognised by the sufferer or not—but perhaps have a later basis of preventive work.’

  ‘That again, French?’ Jamieson sounded scornful. ‘If you’ll forgive me, I can’t see that a research project involving psychoneurotics, or whatever it is you’ve got in mind, can ever be deemed a piece of preventive medicine.’

  ‘At this stage, I can’t pretend that I do either,’ French said easily. ‘But it might. That’s my point. Make your research, and then apply it. It’s a question of one’s approach.’

  Sisson grunted. ‘Expensive and bed cluttering research is all very well if you’ve got the beds and the money. We haven’t. Miss Manton’ll bear me out on that, I’m sure, once she’s had a chance to look about the place a bit.’

  James smiled at her then. ‘We’re boring Miss Manton. It’s hardly fair to bombard her with our private argument on her very first day. She will think we are trying to enlist her aid on one side or the other—and since she has no knowledge of the argument or its protagonists, we mustn’t alarm her with our discussion!’

  Elizabeth smiled. ‘I must confess I am rather in the dark about your discussion—but I had realised it wasn’t an entirely abstract one.’

  French threw back his head, and laughed very loudly.

  ‘Miss Manton, you must forgive us. I had forgotten that we were talking with an intelligent woman. As Jamieson said, no disrespect to your predecessor, but she—well, she was not a woman to appreciate the importance of personalities in apparently abstract discussion. But we mustn’t overload you with all this on your first day. You will have plenty of time to hear all about it. Plenty of time.’

  ‘A week, to be precise,’ Sisson sounded surly. ‘The committee meeting will be next Monday afternoon.’

  ‘Which committee is this?’ Elizabeth asked.

  ‘Oh, general medical and nursing purposes. It deals with all the day-to-day things,’ French said easily.

  ‘And a few others,’ Sisson said. ‘Bed allocations.’

  ‘Yes, a few others,’ French was smooth. ‘You’ll discover how it works, Miss Manton, next Monday. As Matron, you’re an ex-officio member.’

  ‘I shall look forward to it.’ Elizabeth began to move towards the door, and they followed her: ‘And I must now return to my office, if you’ll forgive me. I have a good deal to do before I meet my sisters after lunch. It has been most pleasant meeting you all. I am sure we will work very happily together. And may I assure you of all the help it is in my power to offer you? If there are any nursing matters you wish to discuss, please don’t hesitate to see me at any time——’

  And she shook their hands and with those men she passed as she went, leaving behind considerable satisfaction. In the consultants’ eyes, the new matron had definite possibilities.

  They were ruffled. Elizabeth could feel their annoyance as she leaned back in her chair listening to Gladys McLeod, the Home Sister, murmuring about the need for a new bathroom in the P.T.S. annexe. Gladys was the last to give her report, and her red face and stumbling phrases as she talked reflected the feelings of the other sisters.

  Elizabeth had thought very carefully about this reporting session, and to Miss Baker’s surprise, had had her office filled with chairs ready for it.

  When the sisters had arrived, and begun to form their usual queue outside the office door, Miss Baker had told them that ‘Matron would like you all to go straight in, please Sisters—yes, that’s right, Sister East, all of you together. No, I can’t say why, Sister. She just asked me to bring you all right in.’

  They had settled themselves awkwardly on their chairs, unwilling to talk while Miss Baker bustled about and when Elizabeth had come in last of all to take her place at her desk, had stood up together, their starched aprons rustling as they moved. Only Dolly, her head down over her report book, had remained seated, ostensibly too absorbed to notice Miss Manton.

  Elizabeth had made no sign she noticed this lapse from protocol, and said charmingly, ‘Please—don’t stand up. There is no need for you ever to do so. I don’t particularly value these—forms of respect. I prefer to earn them for myself.’

  They had sat down again, looking at her covertly, noticing the make-up, the way her hair was arranged, the well-cut dark green uniform so much more attractive than Miss Biggs’ voluminous navy blue had been, and moved a little uncomfortably in their chairs.

  Miss Manton had leaned forward, her arms folded on her desk, and said carefully, ‘I hope you will forgive me for asking you all to come in and report en masse like this. I have a reason for it. Apart from wanting to know about your individual wards and departments,. I want to know all of you, too, and I thought you might prefer to sit in here comfortably while you all give me your reports, and then we can go on to discuss one or two other things.’

  So they had, one by one telling her of their bed states, their admissions and discharges, ill patients and operative cases, all very conscious of each others’ presence, and disliking the whole business. Even Daphne, who had a very small report to offer, merely statistics about the number of operations performed, was disturbed, feeling, as they all did, that Miss Manton had no right to make them display themselves in this way.

  At last, McLeod shut her report book, and put it on the desk. They sat in silence, looking at Miss Manton as she put the Home report book on the pile beside her, and then turned and smile at them all.

  ‘Thank you for being so brief. I know you all want to get back to your wards, and I don’t want to waste your valuable time. But there are one or two things I must say, and I think it is worth using time on them.’ She paused, and then looked down at her hands on the desk.

  ‘I realise quite well that you all expect me to make a good many changes in the Royal. New matrons are always likely to do that, are they not?’ She looked up and caught Mary Cotton’s eye, and Mary blushed because she always blushed when people looked at her directly, and smiled back.

  ‘Well, I can assure you of this. I will make no changes in ward or departmental routines unless I absolutely must, and then only after I have been here long enough to have a really thorough understanding of the way things are.’

  Josephine moved, and then relaxed, and Ruth looked across at her and raised her eyebrows so that Josephine grimaced back in relief.

  Elizabeth missed nothing of this exchange, and went on smoothly, ‘However, there are some things about which I am concerned, and want to do something positive immediately.’

  The tension, which had relaxed momentarily, began to build up again.

  ‘It is in the area of staff relationships I want to do these positive things. In my experience, when staff relationships are really good, when people work together not because they merely happen to be colleagues, but because they have given intelligent thought to the need for harmony, and the importance of inter-dependence, then a good many excellent things happen.’

  She began to tick off her fingers.

  ‘First, senior staff are happier. That is very valuable in itself. Secondly, junior staff—and I mean students—are happier, study better, and make a better showing in examination results—which are important if the Royal is to remain a training school. As you know, the Ministry is quick to downgrade a hospital if they feel it is not a suitable training school—and they are much affected at the Ministry by examination results. Thirdly, patients are happier, get better more quickly, bed occupation shortens, turnover increases, and waiting lists shorten.’

  ‘All this happens when relationships are good?’ Dolly East’s voice cut across rather harshly, and Elizabeth looked at her and nodded.

  ‘Yes, Sister, in my experience they do.’

  ‘In your last hospital was it like that?’

  ‘It was. Most certainly.’

  ‘I see,’ Dolly said no more, sitting very straight and looking across at the younger woman with a wooden expression on her face.

  �
�And another thing that happens is this. Because student staff are happy, because morale goes up, recruitment improves. The power of talk, you know. Happy girls encourage others to join them.’

  Sylvia Swinton, the sister from Male Surgical, stirred and said, ‘I don’t quite see—I mean, we are happy here. At least I am. I thought most of us were. We wouldn’t be here if we weren’t.’

  ‘Oh, I’m sure you are happy—and as you say, if you were positively unhappy, I realise you would leave. No, I mean something rather more. I mean that I would like us here to make a concrete effort to raise hospital standards by means of improving our relationships with ourselves and our nurses.’

  Josephine wrinkled her face in puzzlement.

  ‘I’m sorry, Matron. I just don’t see what you mean. Do you mean we mustn’t tell a nurse off if she does wrong? Because it’d make her unhappy? If you let them get away with things, well, you get nothing done properly——’

  ‘Oh, I’m not for a moment suggesting we treat the students like babies! If they misbehave, or are negligent, of course, they must be dealt with! Look, let me tell you in detail what we did at my last hospital, and then perhaps you will all see what I would like to do here.’

  ‘Your last hospital—that was Colston, wasn’t it?’ Dolly said.

  ‘Yes, Sister. A mental hospital. We had a three hundred bedded unit in which physical illness was treated, however. You need not fear I am trying to make the Royal into a mental hospital community—but I would like to offer you the results of experience I gained there.’

  Elizabeth sat very straight as she said this, looking directly across at Dolly, holding her glance until it was Dolly who was forced to look away. She had been aware of the sneer in Dolly’s question as Dolly had intended her to be, could feel the cold resentment behind every word the older woman spoke.

  ‘I must say——’ Mary Cotton began breathlessly, and then reddened.

  Elizabeth looked at her encouragingly, eyebrows up. ‘Yes, Sister Cotton?’

  Mary, gratified that the new Matron remembered her name, started again.

  ‘Well, I just wanted to say, I’m all for anything that makes the nurses happier. I mean, look at my pupil midwives. I do my best, you know, I do my best, but I lost three of them only last month. I know midder isn’t easy, but all the same, I shouldn’t have lost three girls, trained and all as they are. It’s so sad when they don’t get their midder, and anyway, we need them so badly—I know being staff nurses they get fed up with all the junior work they have to do—the sluicing and all that—but even so, they ought to be happy. The babies are so sweet, aren’t they? And there’s so much they can do for the poor little mums—well, I just think anything there is that can help make them happy, I’m all for it——’