I married a patient of mine two days before she died and her sister handed me a box in a car park. There was a form in it that a nurse had already filled in.
PART 1 — ST. OSNEY'S
I am forty now. I was thirty then and this is ten years ago.
People always go for her age first. She was nineteen, I was thirty, and that is the bit that gets said in a certain voice.
Her age is not the problem and it never was.
The problem is that Rosalie Voss was my patient and I was her doctor, and there is no version of the following in which that is not the entire point. I am going to say that now, at the top, so that nobody has to wait for me to get there.
She came onto the ward at St. Osney's in the January of 2015 and she was there, on and off, for nine months.
She was the funniest person in that building. That is not a thing people say about patients to be kind; she was genuinely, professionally funny, and she ran that ward.
She had the nurses doing bits. She had a running commentary on the consultant's shoes.
And she went at me constantly, because I was thirty and serious and working six days and I had a face on.
Dr. Marrant. You know smiling's free.
I would do the eye roll. She would laugh. That was the routine for about nine months and it was the best part of my week and that in itself should have told me something.
In the September we stopped treating to cure and started treating for comfort, and there was a conversation in a side room with her sister in it, and after that there was not very much time.
I should put down what the nine months actually were, because the version that goes round has us falling in love, and that is not what it was and it is worse.
I was on that ward six days a week for most of 2015. I was thirty, I was two years out of my foundation years, I had about eleven thousand pounds of debt that was not student debt, and I had been doing agency shifts at a different hospital on Sundays since the February.
I had no friends in that city. I had moved for the post.
And there was one room on that ward where somebody was pleased to see me.
That is the whole mechanism and it is not romantic. A lonely, knackered doctor had a patient who made him laugh, and he started doing her obs himself when he did not need to, and nobody said anything, and it went on for nine months.
By about the June I was going in on my day off. I have had to write that sentence in a statement.
And about eleven days after the September conversation she said: "Right. I've got one last thing."
I said go on.
And Rosie said: "I want to marry you."
I laughed. I thought it was a bit.
And she said, with no particular weight on it: "Come on. I'm not turning up in heaven unmarried, am I."
I said yes.
I want to put down how long that took, because I have been asked it formally, under oath, by a panel, and I could not answer it then either.
It was not a decision. There is no moment in my memory where I weighed anything. There is her saying it and there is me saying yes, and there is nothing in between, and I have spent ten years looking for the gap.
We did it the next afternoon on the ward.
About twenty-five people. Four of her family, her sister Magda, two of her mates, and the rest of them staff who came off their break.
I wore a tie instead of the stethoscope. A nurse plaited two rings out of clean bandage, which took her about four minutes and which I still have.
Rosie had a white scarf over her head because she had no hair, and she wore it like a veil and she knew exactly what she was doing with it.
Magda brought flowers from the shop downstairs.
She smiled the whole way through it. She did a joke in the middle of it. She got about nine of those people to cry.
Two days later she died, at about four in the morning, and I was not there because I had been sent home.
After the funeral I stood by my car in the car park at Hallam Vale for about twenty minutes because I could not work out how to get into it.
And Magda came across that car park with a small box.
She said: "She told me not to give you it till after."
My name was on the lid in Rosie's handwriting.
I opened it there, standing up, next to a Vauxhall, and the first thing in it stopped me completely.
PART 2 — THE BOX
It was a photocopy of an incident form.
Not a letter. Not a ring. Not a photograph.
A trust incident form, two sides, filled in by hand, dated the tenth of September 2015 — which is the day before the wedding — and signed at the bottom by Ivy Rennard, staff nurse, band six.
And underneath it in that box there was a second copy of the same form, completed in Rosie's own handwriting, in her own words, naming herself as the person raising it.
And a letter, which is three pages.
I am going to do the letter in a minute. The form first, because the form is what took my legs.
Ivy had filled hers in on the Thursday afternoon. Before any of it happened.
She had written down what she had observed over nine months and what she had been told was going to happen on the Friday, and she had set out her concern in four lines in the box they give you, and she had signed it.
And she had brought it to me in a corridor on the Friday, five minutes before, to give me the chance to know.
I will come to what I did with that, because that is Part Four and Part Five and it is the whole reason I am writing any of this down.
Rosie's copy is the one that undoes me.
She had got hold of a blank form. I have never found out how and Magda will not tell me and I have stopped asking.
And she had filled it in about herself.
Name of person raising concern: hers. Relationship to patient: self.
And in the box where you set out what happened, in handwriting that had got bad by then, she had written about nine lines in which she says that she asked, that she kept asking, that she knew what she was asking a doctor to do, and that he should not have said yes and that she pushed until he did.
Dated the eleventh of September. The morning of the wedding.
A nineteen-year-old spent one of her last four mornings filling in an NHS incident form against herself.
The handwriting goes. That is the thing about that document that I cannot look at for long.
The first three lines are hers. By about halfway down it has started to drift and the letters have got bigger, and the last two lines are nearly a child's.
She did not abandon it and she did not get somebody to finish it. She wrote the whole thing herself and then signed it, and the signature is the worst bit, because you can see her take her time over it.
Magda has told me it took her about forty minutes.
There is one more thing in that box and I only found it in the November of that year, because it was taped flat inside the lid and I had not thought to look.
Two bandage rings, in a small plastic bag from the ward.
She had got Magda to take them off her and keep them.
That is a nineteen-year-old working out, in advance, that there was going to be a point where a thirty-year-old man had a pair of bandage rings in a house and nobody to explain them to.
PART 3 — THE PANEL
It came out. Obviously it came out. About twenty-five people watched me marry my own patient on a ward.
Ivy filed hers on the Monday. The Monday after the funeral.
I have had people — three of them doctors — tell me over the years that she was out of order. That she could have left it. That the girl was dead by then and what was the point.
The point is that it was true on the Thursday and it was still true on the Monday, and Ivy Rennard has been a nurse for thirty-one years and she does not do arithmetic about whether a thing is still inconvenient.
There was an investigation and then there was a longer one and then there was a hearing in the June of 2016.
I was not struck off.
I got a warning, a condition on my registration for three years, and a requirement that I never work in that specialty again, which is why I have been doing something else for ten years and why that is correct.
And the reason I was not struck off is the two sheets of paper in that box.
My own representative put them in. Not me — I had not intended to use them and I had told her so and she told me, correctly, that this was not my decision to make, because a panel is entitled to the whole picture.
A patient had written down, in her own hand, four days before she died, exactly what she had done and exactly what she had asked for.
And a staff nurse had written down, before any of it, exactly what she had tried to stop.
Between the two of them, those women gave that panel everything it needed to see what had actually happened, and one of them was dying and the other one was about to be made extremely unpopular on her own ward for eleven months.
There is a sentence in that determination that I have not been able to improve on in ten years.
It is about halfway through and it is five lines long and the middle of it says that the registrant was presented with a documented opportunity to pause and did not take it.
A documented opportunity to pause.
That is the corridor. That is Ivy with two sheets of paper at ten past two.
I have thought about that phrase in traffic, in supermarkets, at about three in the morning on the eleventh of September for ten years.
They did not find that I had fallen in love with a patient, which is what everybody outside that room assumed the finding would be and which would have been easier.
They found that somebody tried to give me a way out and I took it off her and put it in my pocket.
Neither of those women did it for me.
Ivy did it because it was the job.
And Rosie did it because of what is in the letter.
PART 4 — THE LETTER
Three pages. I am not going to reproduce most of it, because it is mine and because about half of it is jokes.
She knew she was going to ruin something.
She says it on the second page, and she says it without any drama at all, which is how she said everything.
She says she noticed in the April that I had the same shoes I had had in the January and that they were going. She says she noticed I did a Saturday night somewhere because she asked a nurse.
She had worked out, from a chair on an oncology ward, that her doctor was thirty and broke and lonely and not coping.
And then she says the line that I have had on my phone for ten years.
I knew what I was asking you for and I asked you anyway. That's mine. Don't let anybody give it to you.
That is a nineteen-year-old writing her own confession so that the man she had put in an impossible position would have a document.
And then at the end of it she does the other thing, which is the one that takes me apart.
She says: Ivy came to see me on Thursday night. She told me what she was doing and she asked me if I wanted to say anything. She's the only one in that building who asked me what I wanted instead of telling me how brave I was.
Ivy Rennard went into a dying girl's room at nine o'clock at night, the night before, and told her she was raising a concern, and asked her if she wanted to put her side.
She did not do it behind her. She did not do it over her head.
She told a nineteen-year-old what she was about to do and gave her a form.
That is where Rosie's copy came from. Ivy gave it to her.
I asked Magda about that Thursday night, in a cafe at Hallam Vale, about four months after.
She was in the room. She had been sleeping in that chair for about a fortnight by then.
She says Ivy knocked. On a side room door, at nine at night, on her own ward, where she did not have to knock at all.
She says Ivy sat down on the edge of the bed, which nurses are not supposed to do, and told Rosie exactly what she was raising and why, in about four sentences, with no softening on it.
And then she said: "Do you want to put your side?"
And Magda says her sister said: "I'd love to."
Not yes. I'd love to. Because she was nineteen and she had been bored for nine months and somebody had finally handed her a job.
Magda also told me what Ivy said on the way out, from the door, which is the thing I think about most out of everything in this account.
She said: "You're not in trouble, love. You're not the one with a registration."
And then Ivy Rennard came and found me in a corridor at ten past two the next afternoon with her own form in her hand.
PART 5 — THE CORRIDOR
Five minutes before.
I was in the corridor outside bay four doing my tie, which I had not worn since about 2011 and could not do.
And Ivy came down that corridor with two sheets of paper and said my name.
She said: "Dr. Marrant. I need you to look at something."
And I said: "Ivy, not now."
And she said: "It needs to be now."
And she held it out to me.
And I took it off her.
That is the thing. I did take it. I had it in my hand.
And then I said:
"Give me that — I'll deal with it after. Not today, Ivy. She's got two days."
And then, because there were about four staff within earshot at the bay door and because I could hear twenty-five people in that room waiting:
"Go back in. Everyone's waiting."
She stood there for about three seconds.
I have never forgotten what her face did and it was not anger.
It was the thing a person's face does when they have just found out something about you that they are going to have to work with for the rest of their career.
She did not argue. She did not say Dr. Marrant, I need you to read this. She had already said it once and she was not going to say it twice in a corridor with four staff at the bay door, because she is better at her job than I was at mine.
And here is the part I have only been able to say out loud in the last two years.
I knew what it was.
I did not take a mystery document off a colleague. I am not a stupid man and I had been on that ward nine months and I knew exactly what was on two sides of A4 in a staff nurse's hand five minutes before I married a patient.
I did not need to read it. I needed not to have read it.
And then Ivy Rennard went back into that room and stood at the back and watched me marry her patient, because she was on shift and because that girl had asked her to be there.
I put her form in my jacket pocket and I did not file it and I did not read it until the Sunday.
It is in a drawer in my house. The original. I have never given it to anybody and nobody has ever asked me for it, because the copy in that box did the job without it.
She filed her own on the Monday. By the November, two people on that ward were not speaking to her and one of them had been her friend for nine years.
She retired in 2021. Thirty-one years.
And I did not speak to her for nine of the ten.
Not out of shame, which would at least be something. Out of the other thing, which is that I had decided somewhere in 2016 that she had done it to me, and I let that sit, and it was comfortable, and I did not interrogate it once.
I wrote to her in the March of this year. Four drafts, and the fourth one is one page and it does not ask her for anything.
She answered in nine days.
She did not say it was all right and she did not say she forgave me and she has not asked to meet, and I would not have either.
She did one other thing in that letter, which I was not expecting and which is the reason I have been able to write any of this down.
She asked me a question.
She wrote: Can I ask you something. Did she know she was funny, or did she just do it?
Four lines about a patient she looked after for nine months, from a woman who had every reason never to think about any of us again.
I wrote back the same day and I told her that she knew exactly how funny she was and that she practised, and that Magda had found drafts of jokes on the back of a drug chart afterwards.
And Ivy wrote once more, two lines, and the second line says: I thought so.
What she wrote in the first letter, in the middle of about a page, is this.
She said: I wasn't trying to stop the wedding, Dr. Marrant. I knew it was happening. I was trying to make sure there was a piece of paper in the world that said somebody noticed.
That is what I took out of a woman's hand in a corridor at ten past two, and put in my pocket, and told her to go back in.
A piece of paper that said somebody noticed.
Rosie wrote one anyway, on a Friday morning, four days from the end, because Ivy had gone in the night before and asked her what she wanted.
May you like
Two of them. And neither one of them was me.
THE END
