Quite Ugly One Morning (17 page)

Sometimes you could find yourself free-wheeling, coasting in neutral. Not dynamically going after something, no goals, not even striving to avoid a certain outcome. And it was fine for a while. Like free-wheeling, you could just let the wind blow through your hair and watch the view breeze past, relaxing, powered by the momentum of your previous efforts.

Not worrying where you were going.

She took her name back.

Dr Slaughter.

‘You can’t be Dr Slaughter. What will the patients say? And your superiors certainly won’t see the funny side. Interviewing consultants can be nervous about the slightest thing.’

The profession was noted for engendering a dark sense of humour, but the truth was that the laughter stopped if the joke was on medicine. Taking an open delight in the macabre inappropriateness of your name scored only frowns.

She had never been Dr Slaughter. She had listened to Jeremy, she had swallowed it all. The over-riding need for respectability, professional dignity. The sacrilege of flippancy. It was one thing to be born Sarah Slaughter, but to retain the name after marriage would send out bad signals. And to retain the name when the alternative was the revered and door-opening Ponsonby would be an unthinkable perversity. An ingratitude even, for this privileged opportunity.

As she was married before her first house job, she was Dr Ponsonby from the off.

Becoming Dr Slaughter had been like re-starting her career, doing it this time all for herself, on her own terms. She had the flat to herself, no more worries and no distractions, allowing her to concentrate on
her
job,
her
career, and she had the energy of someone eager to make up for lost time.

Her social life wasn’t exactly a whirl, as she soon discovered that people she had thought were her and Jeremy’s friends were really only Jeremy’s friends being polite to the good
man’s wife. So she made new friends, real friends. But mainly she hit the books. Head down, working her way through the three-part FRCA, while picking up experience and respect on the job.

So that was the career part worked out. It was the life part that would require pedal power when the free-wheeling stopped.

For too many that she knew and had seen, the career was their life. Monastically dedicated to their profession, giving it priority one now and forever. Maybe marrying an obsequious wee nursie somewhere along the line to bear a couple of baby doctors to play with and be proud of when distraction was called for.

For Sarah, there would have to be something else, she always knew. Another relationship, perhaps. What happened with Jeremy hadn’t made her forswear men or marriage completely (although medics quite definitely needed not apply); if anything it had often made her yearn for what a good relationship
could
be.

However, it had been a problem she felt she had earned the right to procrastinate over, and for a pleasant time she had. But the pleasure of free-wheeling waned with the growth of her awareness of doing so, and she had found herself unsure of what the future held, insufficiently motivated to attempt to shape it, and suspecting that her inaction was inviting the intervention of fate.

The death of Jeremy should have been an ending, of sorts, whatever questions it left unanswered.

That it should be murder certainly marked the hand of fate, and she knew she had been willing to pick up whatever cards it dealt.

But was aiding and abetting a guy like Jack Parlabane, complicity in the burglary of her employers’ offices (and the hacking of their computer system) in the pursuit of a ruthless white-collar crook and his anonymous hired assassin perhaps evidence of a life just the teensy-weensiest bit out of control?

Yes, she thought. And about time too.

She slung her jacket over the back of a chair in the anaesthetics base and sat down at one of its three computer terminals.

Proof, Jack had said that morning, was the word made flesh. However it looks, however it seems, whatever you think
you know . . . these were just your own thoughts, fleeting, subjective and insubstantial. You knew nothing until you had proved it to yourself. And unless you could prove it to someone else, knowledge was torture. Jack knew. Jack had been tortured – knowing who the bad guy was and what he had done, and watching him walk away because there was no way of proving it. Or rather no legal way of proving it. That was where the breaking in and ‘acquiring’ copies of compromising documents had come from.

Proof.

Finally, a practical advantage of the RVI’s enormously expensive digital-electronic bureaucrat. Medical records were being transferred on to the computer system, but as it would be a herculean task to input all of them, it was being done on a new-admissions basis. So if you had been admitted since about a year ago, your records would be on-line. Before that, down to the basement. The patients Sarah was interested in would probably have been admitted about the time computer technology involved reel-to-reel tapes and flashing red lights, but no matter. She didn’t have any names to call up at this stage anyway.

What the computer did have, though, was a comprehensive record of bed usage, as that was the sort of thing that Trusts liked to pay a lot of attention to. She could find out who was in any given bed, any given ward right now, but more than that, she could find out who had been in each bed before that, right back until when the system was first up and running.

She accessed the bed usage files and selected the GRH. The screen offered her the geriatric hospital’s six wards: Abercorn, Boswell, Currie, Dundas, Esk and Fettes.

Start at the beginning, Sarah thought, and hit A.

List by Bed no. or Alphabetical by patient?

She hit B and watched the information scroll down the screen, listing the bed number (GRH.Abe.1), the patient’s name, date of birth, the reason for admission and the date of admission. She scanned the right-hand side of the list, looking at the dates. One woman had been admitted three months ago, but most had arrived over the past four weeks.

Sarah selected the first bed on the list, occupied by Theresa Sullivan, 3/5/17, since about a fortnight ago. She pulled down one of the menu bars at the top of the screen, requesting a list of all the bed’s previous occupants.

The turnover was very healthy, from the Trust’s point of view. Plenty of names, longest stay about six weeks before death or discharge. But it was the first occupants of each bed that she was interested in, the long-stay crumbles whose ten-year-plus tenures Jeremy had truncated to free up the beds. She needed names, then she could get their records and investigate the nature of their discharges – and what happened next.

The first bed was a non-starter. Its first occupant was admitted only a month before being discharged, probably pitching up not long before the computer system was rolling. GRH.Abe.2 looked hopeful for the second or so it took her to see a recorded admission date of 2/8/84 and then notice that the patient had died rather than been discharged.

GRH.Abe.3 provided an irritating coincidence, its first recorded occupant also having snuffed it.

GRH.Abe.4’s first patient
had
been discharged, but again only a couple of months after being admitted.

GRH.Abe.5 reverted infuriatingly to the pattern of 2 and 3, and for a moment Sarah thought she and Parlabane might be enormously mistaken, and she felt an odd, fleeting feeling of relief at the idea of her ex-husband not being guilty of what she was posthumously accusing him of.

She decided to skip down to the three closed beds listed at the bottom of the main screen. GRH.Abe.20 (DISCONT) had been DISCONTed as soon as its one and only listed occupant curled up her toes back in October. GRH.Abe.21 (DISCONT) likewise, this time November. GRH.Abe.22 (DISCONT) January.

Bollocks.

Sarah looked again at the admission date of that last bed: 24/2/82. Then she recalled the two other DISCONTed beds: 13/6/87 and 6/7/78.

And a frightening thought began to whisper in her mind.

She rattled at the keyboard and called up Boswell ward, selecting GRH.Bos.17 (DISCONT) and GRH.Bos.18 (DISCONT). Both listed only one occupant prior to closure, both listed admission dates of several years back and both listed their patients as having died on the ward.

And the whisper became a voice.

GRH.Cur.22 (DISCONT). Last occupant: McGarrity, Agnes Jean, 3/3/02. Admitted: 26/11/83. Deceased . . .

And the voice became a shout.

GRH.Dun.24 (DISCONT). Last occupant: Meikle, Dennis Graeme, 19/8/09. Admitted: 14/1/86. Deceased . . .

And the shout became a scream.

Sarah closed her eyes and took a deep breath, then picked up a pen and with her other hand returned the screen to the Abercorn ward list. Then patiently, systematically, she went through every bed in the hospital and jotted down the names of all the first occupants who were both long-stay and deceased.

There were nearly fifty.

The thought, the answer, the logic was in her mind, but she refused to listen, refused to complete the equation until she had seen the records, though she already knew what she was expecting to find when she got down to the basement.

Stroke, pneumonia and various viral infections accounted for about a dozen, but every other file she picked up told the same story, the words clanging discordantly and relentlessly like a cracked bell chimed by a cracked bell-ringer.

They were all ancient dements. Shrieking crumbles, their minds long gone and their bodies following behind at an excruciatingly slow pace. Incurable. Unturfable.

‘Called to see Mrs McGarrity at 07.30a.m. Pupils fixed and dilated. No palpable carotid pulsations. No heart or breath sounds. No response to painful stimuli. Patient confirmed dead at 07.34a.m. Suspect Myocardial Infarction. Charlotte Mooney.’

‘Called to inspect Miss Murphy at 07.55a.m. Pupils were fixed and dilated. Patient had no visible pulse and no heart sounds. Patient failed to respond to pain. Declared patient dead at 08.02a.m. Suspect MI. Howard Willis.’

‘ . . . Suspect MI. Dusan Krivocapic.’

‘ . . . Suspect Myocardial Infarction. Charlotte Mooney.’

‘ . . . Suspect MI. Gwyneth Peters.’

And so on.

Glazed-eyed, and with a growing feeling of both emptiness and nausea, she made her way downstairs to Switchboard, where she got a copy of the current six-month rota for Jeremy’s firm, and where a quick root through a cupboard produced a dog-eared copy of the sheet for the six months before.

Sarah wandered back to the anaesthetics base and sat
down with the rotas, her diary, last year’s calendar and her list of dead patients. A few minutes’ work confirmed it. Jeremy had been on-call the night before all but six of the deaths, and ethical arguments notwithstanding, it appeared that her ex-husband was the most prolific serial killer in British history.

Parlabane held Sarah close to him with both arms, his hands pressed against the warmth of her shoulderblades, his face in her hair, breathing in the mingling sweet scents of perfume and shampoo. She had one arm around his waist, the other around his shoulders, and her face was buried in his neck.

Fortunately the recent introduction of the subject of mass murder proved most efficacious in repressing Parlabane’s emotions and impulses as Sarah sobbed heavingly against him in his kitchen.

‘I don’t even know why I’m crying,’ she sniffed. ‘I didn’t even like the bastard. It’s just hard to accept that the person you were once married to has outstripped Fred West and Bev Allitt in the murder prolificity stakes. It could be as many as thirty. That would make him the British all-time number one.’

‘No, no,’ said Parlabane in a gentle whisper. Don’t torture yourself. Think of the money you’ll make flogging his sexual secrets to the tabloids. Besides, he’d only be number two, behind Margaret Thatcher, unless I’m the only one who thought that winning an election was not ample mitigation for the slaughter of thousands of young Brits and Argentinians.’

‘This is not helping,’ she said sternly, pulling her blotchy and tearful face up. ‘Oh, I need a seat, Jack. Haven’t you got any bloody furniture in this place yet?’

‘Just the bed, I’m afraid.’

‘Good enough,’ she muttered, and pulled away, walking trance-like towards the door.

‘Do you want a cuppa?’

‘Got anything stronger?’

‘Just whisky.’

‘Serve it up.’

‘We need to get this straight,’ Parlabane said. ‘At this stage I understand just a little more than bugger all. We’ll start with the basics. First of all, how?’

Sarah sat with her back against the headboard, sipping
steadily at the medicinally large measure of aqua vitae Parlabane had poured her. She stared dazedly at the wall in front, then closed her stingingly bloodshot eyes for a second and looked more focusedly at her questioner, who was leaning against the casement window.

‘It’s that ole devil called potassium chloride again,’ she said croakily. ‘A little injection, myocardial infarction, dead crumble, no traces. Except that no one even goes looking for traces because an old crumble dying of a heart attack is not exactly suspicious.’

‘Wouldn’t someone – a nurse, say – notice he had been injecting the patient shortly beforehand? How long does this stuff take to work?’

Sarah gave a wry but sad grin. ‘About a minute, maybe less. But there would be nothing for the nurses to notice. Jeremy was a clever boy, remember. All but two of the records report the patient being found dead first thing in the morning.’

‘So is there no one around then or what?’

‘Yes, of course there is. But that’s not when he did it. They were
found
dead in the morning, but the poor old duffers would have been lying there all night. Jeremy was on-call for the GRH but as a registrar he wouldn’t have been there a hell of a lot. He’d wait till he was asked to come in by the SHO to check out some other patient, or maybe popped in late at night, again, ostensibly to check up on some
other
patient. At that time, the few nurses that are around are having a cup of tea or catching up on the ever-increasing volume of paperwork. No one on the ward, certainly no one in the little side rooms. Jeremy nips in, quick jag to the old soul that’s overstayed their welcome, and off again.’

Parlabane retained a look of incomprehension.

‘But wouldn’t someone notice that a patient was having a heart attack?’

‘It’s not so spectacular when it’s some oldster lying down in their bed, probably asleep. Nothing to see. Trust me, Jack, the first anyone would know there was something wrong would be the next day when the poor soul’s cup of morning tea was found going cold. SHO gets called to examine, declares death, times it then and there. And in the one-in-a-million chance of anyone thinking something’s suspicious, Jeremy isn’t in the equation at all because it was a completely different patient that he was dealing with.’

‘But couldn’t these be natural deaths? If they’re all such ancient old fragile things?’

‘Technically, medically, yes. There’s no way of proving he was responsible for any specific death, that’s why I don’t know how many he actually killed. Chances are not everyone who died of a heart attack in the middle of a night that Jeremy was on-call was injected with anything. But not everyone wasn’t, either.’

‘How can you be sure?’

That bitter, regretful smile.

‘Crumbles never die. I told you that. They last forever, unturfable, permanent fixtures. Now and again, one of them is bound to cack it eventually. But not thirty in six months, and not all from MIs, and definitely not all on the nights that the same registrar was on-call.

‘Cheers,’ she nodded, and had a large swig from the glass.

‘Well blinking flip,’ Parlabane said, sighing and running a hand perplexedly through his unruly mop. ‘That would appear to cover “how did he do it”. But I suppose my next question has to be how
could
he do it? A need for ready cash doesn’t turn you into a wilfully homicidal maniac.’

Sarah just sat there, shaking her head, staring into space again. Then tears began to form once more in her eyes, but she blinked them away and wiped her face with her sleeve and gave a sad little laugh.

‘I’d be surprised if he lost a nanosecond of sleep over any of them. You’re forgetting, Jack. Jeremy didn’t go into medicine because he had some kind of caring vocation. It was just the family business. To him, patients weren’t people. They were conditions, diseases. In this case incurable – and worse, uninteresting – ones.

‘These weren’t lovable old grannies, either. George Romero’s – full of the living dead, remember? Bewildered shells, bereft of all the things that usually let us identify with another human being. The only distinguishing characteristic of each one would be their phrase, their shriek. “Take me out, take me out, take me out.” “Come down from there, come down from there, come down from there.” “Ming-a-dring, ming-a-dring, ming-a-dring.” Most of the language is gone, just some fragment somehow remaining, and that’s what they’ll scream when they’re scared or need some attention, what they’ll shout when they’re angry or when
they’re happy, and what they’ll just mutter for no apparent reason at all.

‘Relatives – if they have any – seldom or never visit. Christ, who’s going to come in for that? “How’s it going, Uncle Bill?” “Ming-a-dring.” “Nice day for it, eh?” “Ming-a-dring.” “I see Hearts won on Saturday.” “Ming-a-dring.” Seeing the person they once knew reduced to a living corpse that doesn’t even know they’re there, and may not even know he or she’s there – who wants to put themselves through that?’

Parlabane nodded. ‘So these are people some might say were better off dead?’

‘That’s a matter of much argument and debate. Certainly, most of them would be marked down as NFR in the event of an arrest.’

‘NFR?’

‘Not for resuscitation,’ Sarah stated. ‘We don’t go in for euthanasia, but there are times when it is clinically decided to let nature take its course. And these days, with this “living will” business, people are actually requesting such non-intervention for themselves.’

‘But these ones didn’t.’

‘Hardly. The wording of these things has to be a bit less ambiguous than “ming-a-dring”. And this wasn’t non-intervention.’

‘Something a bit more “pro-active”, Mr Lime might say?’

‘Quite. But Jeremy would still have thought it a fairly logical and even humane course of action. They don’t know where they are or what’s going on. They don’t have anyone who’s going to mourn their passing – in fact you could say that in some cases it would allow the relatives to finally properly mourn the loss they’ve gradually suffered over several years. It’s quick and painless. And those beds could well be put to better use.’

She finished off her drink and handed the glass to Parlabane. He placed it on the window-sill and sat down on the edge of the bed.

‘Right,’ he said. ‘That’s method and plausibility covered. The tricky part is Lime. It’s one thing bribing a hard-up doctor to off-load a few unsuitable patients on an unsuspecting Eventide rest home, but it’s quite another to sidle up and offer him a few grand to quietly bump them all off. Unless
Lime paid Jeremy just to free the beds and Jeremy chose his own method of doing so.’

Sarah was shaking her head.

‘Lime knew,’ she said. ‘And I know this for a fact. For a start, he sent his own hitman armed with potassium chloride to kill Jeremy. They must have discussed it, or how else would someone like Lime know about its properties? Even if he did know about potassium chloride independently, it’s rather a huge coincidence that he would suggest its use to murder Jeremy, wouldn’t you agree?’

‘Yes,’ he said. ‘Also, I suppose Lime would have wanted to know how Jeremy planned to go about it in case he thought it was too risky. But the problem remains: how did Lime know to approach Jeremy? He was in a position to know Jeremy was skint, but how could he know Jeremy would be amenable to administering widescale involuntary euthanasia? And harder still, how could we prove he knew?’

Sarah arched her brow. ‘I
sat in the anaesthetics base today and asked myself the same question, maybe looking for a way of proving to myself that it wasn’t true, that it couldn’t be true. How could Lime know Jeremy’s views on even voluntary euthanasia? But the answer was literally staring me in the face.’

She reached over to her bag, lying on the bed beside her, and pulled from it a yellowed and dog-eared piece of folded, glossed paper, the corner Parlabane could see dotted with small holes. She unfolded it and held it up for him to read.

‘They never clear the noticeboards, so unless someone takes it upon themself to remove something, it can sit there for years, getting stuff pinned in front of it. The bottom half of this was still showing below an ad for last year’s Christmas ceilidh.’

It was a poster advertising ‘The Great Medical Ethics Debates’, organised by Midlothian NHS Trust – ‘We’ve got a heart in the Heart’ © – and sponsored, rather unfortunately, by Diarrax, a new drug promising relief from diarrhoea, but not, presumably, of the verbal variety.

There were three scheduled debates, with formal participants listed beneath the subject titles and the promise of an open floor before final summing-ups. ‘Jehovah’s Witness to the prosecution: religious objections to medical procedures’; ‘A doctor’s right to choose: moral abstention
from terminations’; and of course, scheduled as the start-of-run opening attraction, ‘The sanctity of life or dignity in death: euthanasia and policies of non-intervention’. The name Jeremy Ponsonby MBChB MRCP was listed under this last title.

‘Don’t be confused by the dates,’ Sarah said. ‘This was donkeys ago. I didn’t actually go to any of them. They were all on nights when I was on-call. But the idea was that you had one invited big-noise on each side plus several doctors from within the Trust who particularly had a beef about that ethical question. Obviously Lime could have attended, heard some very radical ideas, and realised a possible solution to his bed-occupancy problems. However, I noticed that there’s quite a fair spread of departments and disciplines under the other two, but nearly all these names under the euthanasia title – on both sides – were either covering or would later be covering the GRH. A staggeringly convenient coincidence.’

She handed Parlabane the poster.

‘I called that oily little turd, Medway, as he obviously had a big hand in using the debates to present “an outward-looking face of the Trust”, as he put it. I told him I was trying to settle an argument, that a colleague said the “Great Ethics Debates” were Diarrax’s idea but that I maintained they had been dreamt up by the chief exec. He was delighted to tell me that yes, the whole thing
had
been Stephen Lime’s idea, and wasn’t it a shame that people didn’t always get credit for these things blah blah blah. I asked who had suggested the subjects and he told me Lime had come up with the euthanasia one “to get things off to a rollicking start” but had left it to Medway to seek suggestions from the clinical staff as to the others.

‘In enthusiastically blowing – or should that be sucking – Lime’s trumpet he told me that the great man had been so enthusiastic about making the first one “a success that would set a high standard of oratory and controversy” that he had specifically encouraged certain doctors to take part, doctors “who were likely to come up against that specific ethical dilemma”. He had been less “hands-on” after that.’

‘I can imagine,’ said Parlabane.

‘It wasn’t a debate, it was an audition,’ Sarah stated flatly. ‘Killing off the patients was Lime’s idea in the first place, and he came up with “The Great Medical Ethics” crap to see whether there were any likely contenders working at the
GRH then or who had a spell at the GRH on their rotation. The other two debates were just cover. He probably didn’t even attend them.

‘So Lime hears Jeremy and who knows, possibly some others, who sound like they fit the bill. But then he finds out – or maybe he already knows – about Jeremy’s financial problems, and suddenly he’s got a perfect candidate. And when he speaks to him about it, subtly, gently, he probably talks about how the funds going on those patients could be spent on so many more valuable things. Maybe more Intensive Care beds, or better still, funding for those name-making research projects that Jeremy and his pals are so bloody keen on.

‘And perhaps
that’s
why he killed him. Maybe Jeremy got shirty when the beds started to close but the money showed no sign of being diverted.’

Now it was Parlabane’s turn to shake his head and smile wryly.

‘More simple than that,’ he said. ‘Golden rule of assassination, Dr Slaughter.’

‘What’s that?’

‘Kill the assassin.’