The Hartley Rule

Short short story

 

          Hartley strode into the pub outside the hospital and sat down with us, sweating. “I’ve been given a final warning,” he said.

          This was Hartley’s third final warning since he started medical school.

          “They said they’ve created a new rule in the medical school especially for me, and they’re going to call it the Hartley rule,” said Hartley when he came back a few minutes later with a pint of cheap bitter. “I think I’m in for it this time.”

          “You’re almost there,” I said. “Just keep your head down, study hard, and pass your finals; for God’s sake, you’re so close to the finish.”

          Hartley always said that the Dean of the medical school had it in for him since day one. I’m sure that wasn’t true, but he certainly didn’t have any friends left in the faculty nowadays.

          In their eyes he was a failure, simple as that. Hartley was twenty-eight years old, and ten of those years had been spent at the University Medica lSchool; he'd managed to extend his time there by five years through various repeated failures and disgraces. But he studied hard, really hard; harder than most of us. Hartley spent a lot of time revising in the library; longer than any of the other medical students, and he usually stayed until closing time. And to me, his study technique was- well, okay. He stuck to the syllabus and read around his subjects. He used ‘mind maps,’ and different coloured cards for study aids. His A3 flow diagram of the Krebs’s Cycle was beautiful.

          But then the exam results would come out, and there he would be, at the bottom of the class again.

          It took me a couple of years to figure out Hartley’s problem. It was his nerves. One time in the exam hall I looked over at Hartley’s desk and there he was, his shirt soaked under the armpits with sweat, and his hands shaking over the desk so badly he could barely pick up the pencil. No wonder he couldn’t get any marks; he barely answered the questions.

          Things got worse in the clinical years. The ward rounds were the worst, and would reduce Hartley to tears. A physician called Dr North liked to grill us, and would ask us spot questions by the patient’s bedside. This was too much for Hartley. On one occasion the questions went round and as they got closer and closer to him, his face reddened and his hands started shaking, and by the time it was his turn he was inconsolable.

          “Boy—tell me what clinical signs you can see on this patient.”

          Silence.

          “What’s wrong boy? Tell me what you see.”

          Silence. The old woman patient smiled at Hartley, but this seemed to make him worse.

          “Mitral facies,” whispered Donna in his left ear. “Just say she’s got a rash of mitral stenosis.”

          “She’s got AF on her monitor,” said Harvermeyer in his right ear.

          “Say something- anything,” I whispered.

          “She- she’s…” said Hartley.

          Dr North frowned. “She’s what, boy?”

          “She’s…wearing a wig?”

          The old woman patient started crying, and that heralded the first official complaint to the Dean’s office. Dr North wrote that ‘the boy’s nerves are so shot to pieces that his chances of ever being an effective doctor are absolutely zero.'

 

          When Hartley got up and went to the bathroom, Donna stood up and sat next to me, placing her blackcurrant and soda next to my glass of Coke.  “We can’t help him anymore,” she said, looking me directly in the eye. “We can’t cover up his mistakes. The guy is a moron; if he qualifies and ends up killing patients then we’ll have blood on our hands.”

          I snorted. “You’re being over the top. Hartley’s a nice guy, if not a little slow. I’ve heard stories of people who performed poorly as medical students but made excellent doctors.”

          Donna grabbed hold of my shoulder and pulled me closer, digging her long red fingernails into my skin.

          “No more cover-ups,” she said. I told her she resented Hartley for the second time he had said something inappropriate. He came back with another beer, and Donna flashed me a look.

 

          The second time Hartley had said something inappropriate was in a clinical lecture given by the Dean on surgical issues. It was quite boring, and I wasn’t paying attention until he started asking questions to the lecture theatre.

          “Can anyone tell me where McBurney’s point is?” said the Dean. I looked over at Hartley who was beginning to sweat again. I put my hands over my head and looked through the slits between my fingers.

          The Dean challenged one of the students on the front row, and Hartley relaxed again.

          “Now,” said the Dean pointing his stick into the audience, “who can give me an example of a fistula?”

          The end of the stick landed at Hartley’s desk.

          “I…I…” said Hartley.

          “What’s wrong boy; cat got your tongue?” said the Dean. “This girl next to you has five fistulae that I can see already,” he said, waving his stick in Donna’s direction. I could see her whispering in his ear.

          She told me later what she had whispered. “Just that it was any opening in the body. I did give him a few examples; just not the one he ended up saying.”

          “What like?” I said.

          She shrugged her shoulders. “I don’t know…nostrils? Certainly not…”

          “V…v…vagina?” said Hartley to the dean.

          The dean made Hartley re-take the year.

          We finished our drinks and put our white coats on again, ready to go back to hospital for the afternoon ward round. Hartley finished his third beer and caught up with Donna and I. “I think the beer has relaxed me,” he said. “I don’t think I’m going to be so nervous this time. Maybe alcohol is the answer.”

          “What?” I said.

          “Trust me,” said Hartley, “I know what I’m doing.”

           I remember thinking then that Donna was right; maybe we shouldn’t help Hartley anymore. I could envisage it now; first day as a junior doctor and there would be Hartley, drunk as a fart, treating and killing patients in one fell swoop, all because we felt sorry for him and tried to cover up his offensive bloopers. I squeezed Donna’s hand and she squeezed back. Today was the day.

 

          Dr North took us around the usuals; man with renal failure, man with heart failure, until we stopped at a new patient being treated for urinary obstruction. Dr North gathered us round the man who was naked from the waist down and shut the curtain, and gathered us closer for his weekly grilling. I watched him spy Hartley and his shoulders visibly tensed.

          “Boys and girls, this patient is Mr Wells and he is being treated for urinary tract disease. Can anyone tell me anything unusual about this case from looking at the patient? Can you see any clinical signs?”

          Mr Wells had a urinary catheter, was wasted and cachetic, and his hands were visibly clubbed; to me he obviously had advanced metastatic prostate cancer. I looked at Donna who was probably thinking the same thing, and she held my hand tightly. I knew what she was thinking. Don’t say a thing.

          I don’t know why I was worrying. Hartley had his hand up, confident as anything on beer and adrenaline.

          “And what have you noticed, boy?” said Dr North.

          “The gentleman has a small penis,” said Hartley.

          ‘This boy came to my ward round drunk and offended another of my patients,’ wrote Dr North. ‘I can only recommend immediate expulsion.’ So Hartley was expelled.

          I didn’t see him again until a few years later when I was down in London on a course. He informed me that he was working at a stockmarket and was earning considerably more than he would have earned as a doctor. I reminded him of his last day of medical school and he laughed.

          “Well he did have a small penis!” said Hartley.

           I told him Donna and I got engaged soon after leaving medical school and got married last year, but he seemed disinterested; his mobile phone rang and he disappeared into the London thrall. I think Donna was right when she said Hartley’s problems were more than nerves and poor exam technique; I think she was right when she said he was a f*****g a*****e.  

 

         

Author's Note

Just a quick story about my memories of medical school. All the 'bloopers' are genuine, unfortunately, though not made by me. not sure they really make a decent short story though.

Reviews

[Emel Kay]

Ok, to start, I want to point out this line:

"He stuck to the syllabus and read around his subjects. He used 'mind maps,' and different coloured cards for study aids. His A3 flow diagram of the Krebs's Cycle was beautiful."

because it is an amazing line. Nothing else. It's just my favorite.

Now onto some constructive criticism. This line:

"No more cover-ups," she said. I told her she resented Hartley for the second time he had said something inappropriate. He came back with another beer, and Donna flashed me a look.
The second time Hartley had said something inappropriate..."

uses 'said something inappropriate' twice very close together, and it made me kind of think about that phrase as I kept reading on, subtracting from the story a little. It's not a big thing, I know, but I wanted you to be aware of it. Next we have your finishing line:

"I think Donna was right when she said Hartley's problems were more than nerves and poor exam technique; I think she was right when she said he was a f*****g a*****e."

And again it's the repetition that gets me. The 'I think Donna was right when she said' and 'I think she was right when she said' again. It's just so close together, it detracts from the end a bit.

Overall, I can see why you were worried about this being a 'decent' story. But I think that you should explore this story a bit more, and it will help it out. Everyone likes to read about that one guy who just doesn't get it, or just messes up so much that you can't help but laugh. I liked it, honestly, and I think that if you allow it to expand a bit, maybe mix the actuality with your own fiction, it will become something that you are proud of as well.

As always, a pleasure to read your work.