Valentín calls seven people to take their date away

WEDNESDAY, 16:40

He dials the last number on the sheet at twenty to five. Valentín Pedrosa has spent twenty-three years in the admissions office of the district hospital of Valdemoral and he has the habit of saving the call that will go worst for the end.

“Doña Obdulia, good afternoon. It's Valentín, from the hospital. We spoke on Friday.”

“Oh, Valentín. I've even got my bag packed.”

That is the worst of it, and it arrives at second forty.

He explains it the way he has explained it six times this morning, trying not to say “system” or “criterion” or “index”. That from tonight the knee surgery list is sorted a different way. That it used to be sorted by how long each person had been waiting and now it is sorted by how badly off each person is. That her name was among the first seven on Friday and this morning it is not. That she is not being operated on Thursday the 23rd.

“And when's my turn now?”

“I don't know, Doña Obdulia. That depends on who comes in ahead of you.”

“But on Friday you knew.”

“On Friday I knew.”

Obdulia Bragado turns seventy-nine in January. She walks with an aluminium stick they gave her at the health centre and she has a daughter in Zaragoza with a plane ticket bought for the 22nd. She says nothing. On the phone display, the call timer goes past two minutes, and Valentín does not fill it.

“And the one who takes my place, do they know already?”

“Yes. This morning.”

“Then that's all right.”

At five to five Valentín hangs up and makes the last stroke on the sheet. In the column beside it he has noted, in his own handwriting, what happened on each call: two cried, one insulted him personally, three hung up without saying goodbye, and one said that then it was all right.

WEDNESDAY, 11:15

The fourth on the sheet has his wife answer the phone, and he takes a while to come. Fermín Olmedilla has a panel-beating and paint shop with one employee, on an industrial estate twelve kilometres out, and on Friday he booked two weeks of planned sick leave.

“The lad's already hired to cover me. I signed on Friday afternoon.”

“I know. I'm sorry.”

“No, forgive me. On Friday you didn't know.” A radio and a compressor can be heard. “Can you give me something in writing?”

“I can give you a hospital letter with today's date and the whole explanation. I'll have it signed this afternoon.”

“With a stamp?”

“With a stamp and my name on it.”

“Send it to the shop, not to the house.”

And before hanging up:

“Are you doing many of these today?”

“Seven.”

“Let's see how your day ends, then.”

At half past eleven Valentín asks the unit supervisor to authorise seven letters with the same wording. She signs them in twenty minutes, and it is the fastest anything moves all week.

WEDNESDAY, 08:05

He switches on the computer before taking off his coat. The surgical waiting list for trauma has one thousand one hundred and forty names and runs to fifty-six screens. He scrolls down to where Obdulia Bragado's name was on Friday, which was position six, and it is not there. He searches by her record number and finds her at four hundred and twelve.

At the top, among the first seven, there are seven new names. The third is a woman of forty-six with an index of seventy-one out of a hundred who had spent fourteen months at position three hundred and eighty-eight.

Valentín checks whether the program has made a mistake. He opens the log of the overnight task, pulls out the two listings — yesterday's and today's — and compares them line by line for an hour and a quarter.

The program has done exactly what it was asked to do.

WEDNESDAY, 00:00

There is nobody in the building except A&E and the security guard. The scheduled task takes ninety seconds to re-sort one thousand one hundred and forty names by clinical priority index instead of by date of entry onto the list.

At midnight plus ninety seconds the task leaves a line in the log and switches itself off.

TUESDAY, 18:40

It takes him forty minutes and three transfers to get through to an actual person at the health authority. He asks one single thing: whether the seven who already have a date keep it.

The woman at the other end opens the instruction and reads through it aloud, skimming. She says there is nothing in there about that. She asks him whether any transitional arrangement is recorded, and Valentín, who has known the text by heart since ten past eight on Monday, answers that none is.

“Then no.”

“And who tells them?”

There is a short pause, the kind made by somebody looking at an organisation chart.

“Well, you do. Who gave them the date?”

Valentín hangs up, goes down to the machine, comes back with a coffee he does not drink, and makes the sheet of squared paper: the seven names, the seven phone numbers and, beside each one, the time he called them on Friday. He puts them in the same order as Friday, so that Obdulia Bragado, who was the last to get the good news, will also be the last to get the other one.

MONDAY, 12:00

“Give me the seven names from Friday and I'll call them myself.”

Amanda Quintanar, a trauma surgeon at the hospital for nine years, is standing in the doorway of the admissions office with her coat open and a folder under her arm. For two years she has been asking in writing for the list to be sorted by priority index rather than by seniority. On Friday, without knowing it yet, she won.

“No.”

“Valentín, I'm the one who asked for the change. Let me face them.”

“And I'm the one who gave out the dates. By phone, Friday midday, one by one.” He closes the screen. “Do you know how many people thank you on the telephone in twenty-three years?”

Quintanar puts the folder on the desk and does not open it.

“I know you're going to have the worst Wednesday of your life and that you're going to have it because of something I asked for.”

“I called them. That's all I'm saying.”

“Fine.” She does not move from the doorway. “But I want you to know where those seven slots come from, because I've known for two years and nobody has asked me. I have a patient of forty-six who hasn't been able to get up to her own flat since January. She has been on the list fourteen months and every time somebody with more seniority joins, she drops a place. Under the old rule she gets operated on in 2028.”

“And under the new one?”

“Thursday the 23rd.”

Valentín sits looking at the closed folder because he has nobody to name.

“Now you ask me whose seven slots I'm taking,” she says, and she says it tired, with no appetite for winning. “That's what I haven't been able to answer in two years. It's why I asked for the change.”

She tucks the folder back under her arm and goes out without closing the door.

“Seventy-one,” she says from the corridor. “In case on Thursday you want to know who goes in.”

MONDAY, 08:10

The instruction arrives at ten past eight in an email with a four-page PDF. It applies from midnight on Wednesday. The surgical waiting list will be sorted by a clinical priority index from zero to one hundred that adds up reported pain, range of movement measured in clinic and what the joint stops that person doing in their own home, and will stop being sorted by the date each patient came onto the list.

Valentín reads it twice. The second time slowly, looking for the word “transitional”.

The first thing he does, before his coffee, is open Friday's sheet.

FRIDAY, 13:50

Seven theatre slots for the following three weeks and seven names in order of time on the list. Valentín has been calling since five past nine and he is on the last one. This is the part of the job that makes the rest of it bearable: a three-minute call in which people start thanking an admissions clerk.

“Is that Doña Obdulia Bragado?”

“Speaking.”

“I'm calling from the district hospital of Valdemoral, from admissions. It's about your right knee. We have a date.”

On the other end there is the scrape of the handset against something, and a chair.

“Thursday the 23rd, admission at eight in the morning, nothing to eat or drink from midnight. The letter will reach you on Tuesday, but I'm telling you by phone because some people get the letter late.”

“Thursday the 23rd.”

“Thursday the 23rd.”

“Wait, wait. Could you say it again slowly, so I can write it on the kitchen calendar?”