Therapeutic Window

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Therapeutic Window Page 18

by Steve Low

The day of my exam, I woke early, long before the alarm. Beside me in the darkness, I could hear the respirations of my wife. My eyes were captive to a boring sensation and my mind was engulfed by medical jargon – the management of asthma, the differential diagnosis of post-operative jaundice, the laboratory characterisation of acute tubular necrosis. Inside my abdomen, my colon writhed python like. I had to dash down the hall. In the bathroom, I scrambled for the pan. My insides exploded. Wretched, I almost lost it at the top end as well. I hung over the basin, clutching the white porcelain. Slowly the spasm ebbed away. I straightened. I scuffed through to the kitchen. Outside the window, I could see a vivid illumination permeating the skyline. I stared at the horizon and felt an intense desire to escape. If only I could be over that hill, with my foot on the accelerator – window down – a cool breeze brushing my neck.

  Across the table my books and papers lay, their utility almost completed. I picked up a folder and gazed at it in a dazed fashion. I recognised the information, but felt I had no hope of recalling it. I threw it back down onto the table. It was too late now. My study effort had been well short of the mark. I would know as soon as I saw the questions. There were certain areas where I was deficient. If one of those topics came up . . . The prospect of defeat brought a lump to my throat. I swallowed - an uncomfortable manoeuvre in my desiccated mouth.

  I thought of Remington, like myself, facing written questions that day. My friend had been far more focused. He was confident. His study program had been fulfilled. Soon, maybe, he would be crowned a radiologist. The bastard! The cocky prick. I didn’t have any confidence. Nil. Zero. Zip. I snapped the electric jug on. Half a cup of coffee – that would be all I could manage. I would never absorb any food. The previous night’s meal was still repeating. God I felt awful – just plain very bad.

  Nine o’clock loomed like the hangman’s noose. Soon they would kick away the stage and I would swing. I stopped on the footbridge over the Leith Stream and stared for a few moments at the beer coloured water slipping by. It was quite warm for May. I unzipped my jacket, to forestall a glandular eruption. The cold air soothed. I continued on, across emerald grass, toward the clock tower. Underneath it, I could see my associates Boy Wonder and the Handwringer. I almost laughed out loud, thinking of the contrasts between the three of us. Boy Wonder, although claiming to be under prepared, would be brimming with confidence. The Handwringer would be wringing his hands. What else! His face would be a picture of agony. I could sense my own features to be set like stone. My jaw was rigid and my teeth hurt.

  We entered the building. Before the grand staircase was the ablution room. There were rows of columnar urinals. We stood foolishly, our streams arching down in parallel. Then the Handwringer had to dash in behind a swing door. Like a machine gun, the Canadian gut exhausted, while Boy Wonder and I hurriedly washed our hands.

  At ten to nine, we were let in to the examination room. It was a conference room, with a huge round table in the centre. The supervisor lady sat us down, well apart. She had thick glasses, a fur coat and pinned up grey hair.

  “I will hand out the question papers now,” she fluted. “You may start to read the questions, but you must not write anything down, until I say so.”

  I felt a little calmer. There was a job to do, that was all. Maybe the questions would be good?

  They weren’t. The python reawakened inside. My vision became unfocused. I looked at the paper again. Question one. Forty five minutes on the liver. I hated the liver. All those hepatocytes and kuppfer cells – sieving the blood – cleaning it up like a bleech. It smelled bad as well. At postmortem, it slid its way across a silver tray like a giant green amoeba. Nauseating. A glucostat. A hemostat. The producer of a green slime.Bile. Child’s Classification of liver diseases came to mind. Sure, I knew some things, but not enough.

  Question two. Planning a new intensive care unit. No, no, no. God please – it cannot be so. I had done no preparation for that at all. Defeat loomed in my shimmering vision.

  Question three: Forty five minutes on the utility of pulse oximetry in the intensive care unit. I was half prepared for that. I would start on it first. Get a little confidence going. That might help with the other questions.

  I looked up. To the left, the Handwringer – his eyes screwed tightly shut. The small dark mouth spoke silently, like a feeding goldfish. Opposite, the Boy Wonder was well underway. Head down, eyelids halfway closed, he spewed forth. His pen scratched furiously. He was soon asking for another answer book. He was smiling and nodding, as if he had already won the gold medal. In comparison, I was off the pace. I had only filled a third of my first answer book.

  The supervisor irritated – always clearing her throat. Then she began to suck a sweet. I couldn’t believe it. Couldn’t she wait until it was over? No, slowly she unwound the paper. It crinkled and cracked agonisingly. Only I seemed to notice. The other two were totally focused. Stuff her. Where did they get these women? Oh Christ, don’t waste precious time, get back to the liver.

  “You have fifteen minutes left,” she announced. I would have loved to be sprinting – gunning for the finish. Instead I was nearly spent. I jotted down random bits of information – thoughts that begrudgingly came to the surface of my under-achieving brain. It had become hit and hope. Great chunks of time had passed, where I was vacant. The Boy though, was flying - with a capital F. The lady literally had to grapple with his pen at the finish, to stop him writing. She was very snooty about that. Indignant. Time was up. Tie up your papers and get out.

  It was a long climb up to Highgate, past the psychologists, the dentists and the lawyers in their offices made from converted houses. Further on up the road, partly concealed mansions perched on sunny promontories, alternated with run down wooden shacks in shady gullies. The day weighed heavily. Surely I was already out of the exam race. Boy Wonder, and a slightly reluctant Handwringer, were in a bar celebrating. I had no desire to indulge in a post exam analysis. The Boy would be unctuous, the Wringer quietly knowledgeable. Question two would have been a gift. And just as well they had read the article in the Lancet, related to question one. Trouble was, there hadn’t been enough time to get it all down. If only that fox-fur lady hadn’t come and pinched his pen. Surely the Wonder-boy could have written into the next century.

  I carried on through the exhaust fumes, up the gun metal sidewalk. Eventually the cream weatherboard bungalow, was before me. I stopped momentarily. If Melanie was already there, could I face her? I felt close to breaking. I really didn’t want sympathy. I swallowed a dry lump in my throat and went in. Sade pulsed in the background. On the floor below me, a contorted body lay, limbs skewed, left foot above the right ear, muscles contracted beneath a glittering bodysuit.

  “Oh God, it’s you,” Beth screeched. “How embarrassing,” she laughed, not looking at all abashed. “Help I almost forgot,” she said touching me on the upper arm. “How was your exam?”

  I shook his head, unable to hide my despondency. She came forward and put an arm around sagging shoulder.

  “No good huh?” she said. Her eyes, hazelnut and translucent, looked up beneath a worried brow.

  “I’ve burned my boats, I think,” I said. I laughed mirthlessly, but it helped relieve the tension. She suggested a drink and I needed no further enticing.

  “It’s no wonder really, when you consider all that’s been going on,” she said, pouring wine into spotless glasses. “How could you concentrate? There’s just no way.” She led me away from the kitchen bench to the open plan living area. “Come with me onto the couch. I’ll cheer you up.” She guided him back to the recent past. It was therapeutic talking about Melanie and the tumultuous force that had overtaken them. “She’s a beautiful lady,” Beth said. “It’s great she’s been romanticised. Rikki is a nice guy, but he’s a man’s man really. He’s always out drinking with the boys. He doesn’t understand women. Larry was much the same to be honest.” She looked down at her splayed fingers. “It’s been on again, off again wi
th him. That’s the way he lives. He’s one hundred percent enthusiasm, followed by a period of intense introspection –when something doesn’t go right. He’s been married before you know. He’s got a child. A boy called Sam. Lovely kid. He dotes on the boy. He spends half his time around there, with the ex. She’s got a new man, the ex. But they all seem to get on together, like a house on fire.” She jumped to her feet, put her hands on her head and began to stretch her lateral thigh muscles. I admired the firmness and volume of her thighs. As each side came under tension, the lateral muscle groups stood out in anatomic definition.

  I sought the bottle, and she flipped the cassette over and activated the play button. ‘Smooth Operator’ filled the room with its syncopated sound. She turned it way up, as coincidently, Melanie entered the room. The two of them got into a dance groove, not bothering with any ‘hello’s or ‘how are you’s. I came over with a wine glass and joined in, happy to try and forget about the exam.

  A few days later I was summoned to Boatwood’s office. He scarcely looked up as I let myself in. He was studying a document laid before him on the huge oak desk. His high backed chair was grooved with the faculty coat of arms. On the wall behind him hung an oil painting of Mount Cook. The brush strokes were heavy, chunky, multi-layered. On the floor was a carpet of royal-blue. A window in the south wall, gave a vantage point to see the adjacent city centre. Through the glass, I could sense the throb of the C.B.D. Life went on, despite my troubles.

  “How did your writtens go?” Boatwood asked, smiling. The smile withered, as I told my morbid tale. “Oh well,” Boatwood said abruptly, “Maybe vivas are your thing.”

  They weren’t my thing. However I was disinclined to enlighten Boatwood of his pupil’s shortcomings.

  “Now to get to the point Davenport,” Boatwood said, “You’ll have to go to the Australasian Scientific Meeting in Sydney, in two weeks. I need you to present the results of our HyperPEEP study. I was going to do it myself of course, but unfortunately, this business with Mr Hart has complicated matters.”

  I had heard the rumours. An enquiry was imminent. The hospital ethic’s committee, was to be convened for an extraordinary meeting. There was a feeling about that the controversial therapy applied to Mr Hart should have had prior ethic’s committee approval before use.

  “Various people are running amuck with sharp knives,” Boatwood said, after a lengthy pause. Tugging at his beard, he launched into a monologue concerning the merits of ground-breaking scientific research in medicine. “Too often, research is merely a timid rehash of someone else’s work,” he said. “I’m sure I don’t need to convince you, that to progress, one has to venture beyond the normal constraints of the mediocre.” Boatwood’s eyes, were fixed on the wall behind my head. He wasn’t really talking to me at all, but to an invisible audience of seraphic professors, who might redeem him – set him free from earthly constraints. “Ethical matters have cloaked research in a strait-jacket in recent years. But ethics are inconsistent across time and cultures. One moment your program is acceptable, the next it is banished to the catacombs of the earth.”

  Suppliant to the examiners – a victim of love – I could hardly get excited about the Professor’s dilemma. My own plate was full. Boatwood was talking to the wrong man. In academic intensive care, I was a coaster. I was uncommitted and a slave to fanciful passions. I lacked that pragmatic drive.

  The trip to Sydney had few attractions. The prospect of speaking to the academic masses, sent a pulse of fear up my backbone. It was an order though. You didn’t turn down that sort of invitation. Boatwood appeared unconcerned by my lack of commitment to the academic cause. Probably, he was unaware of the levels of dedication amongst his underlings. He would consider them all to be unwavering workaholics. Why wouldn’t you be he’d reason. If he knew of my perilous relationship problems, then he would see that as the explanation for Davenport’s under performance. In Boatwood’s view, a bit of hard work cured everything. Engage your brain with a good research project Davenport. That will take your mind off trivial matters of the heart.

  “Sure, I’d love to go to Sydney,” I lied.

  “Good.” Boatwood stood up and I arose with him. “We’ll go over the content of your presentation, sometime before you leave.”

  Later I met Melanie in a student cafe in upper George Street, reasoning that our contemporaries would not frequent such a place. ‘The Governors’ it was called. I remembered it from my student days in the late seventies. We sat down at a square table of recycled timber and I started massaging her knee under the table.

  “I’ll come too,” she said, after I told her of my impending trip to Sydney.

  My massaging hand became still. “Eh?” I said.

  “I’ll come with you to Sydney,” she said.

  My laughter resounded around the tiny cafe. Bohemian patrons looked across, appearing bemused by these foreigners. “How will you swing it?” I finally managed.

  “I’ll say I’ve been specially selected as the speaker’s concubine,” she said, swiping my roving hand away, as I tried running it up the inside of a thigh.

  “Ah well – I must be supremely naive. What will you do? Wear a paper bag over

  your head? Gibbs or Green will probably be there too”

  “Yes, you’re right – I am just dreaming . . .

  The conversation moved away from the topic but I sensed she was a bit on edge about something. When our coffees were finished she launched an unexpected attack.

  “To be honest, I just can’t believe that you’re able to do it.”

  “Do what,” I asked

  “Stand up in Sydney and cover up the truth. I presume you’re only presenting the second successful study?”

  “Well yes. Boatwood says the first study was invalidated by not having constant supervision.”

  “Oh come on.” Melanie sat up straighter. ”What if there was no technical issue – that the animals just died from tension pneumothorax?”

  “You’re right’” I said quietly. “I’m not very comfortable with the whole thing.”

  “So why do it then?”

  “I don’t know. I like Boatwood I guess. He’s human. Green is so plastic and Gibb’s is frankly horrible.”

  “That’s not a good reason to support something so immoral. And what about the death of Mr Hart? That even further derails hyperPEEP. Everyone knows he started to improve when you took the hyperPEEP off.”

  “Boatwood reckons he can defend that. He said it could equally be the volume and adrenaline resuscitation that promoted the recovery in BP. Blood tests showed Hart had a heart attack. So who knows whether that was caused by the hyperPEEP effect on the circulation or whether it was happening anyway because of the ARDS illness.”

  Melanie wriggled free and stood up. “No Gerry. That’s all just a smoke screen. I’ve got to get home now. But I’m going to be pissed off if you go and do that presentation. It’s just not right.”

  Astonished by the attack, I watched as Melissa strode out of the café. The door swung shut and she was gone from sight, striking out down George Street.

  I looked around. The windows were festooned with colourful notices. Amnesty International, Greenpeace, Woman’s Refuge –that sort of thing. The lighting was subdued, in concert with the leaden atmosphere outside. The bohemians were wrapped in woollen scarves and cloth-caps. Gothic pale rakes, dressed entirely in black, sat hunched over novels. Another, with hair like a birds-nest, stared vacantly out the window, as if in a drug induced catatonia.

  Seeing Melanie leave, the neotrotskyite behind the counter, emerged silently with the bill. I took the account with a murmur. My mind was working overtime – unused as it was to the fiery display from Melanie. Here I was, recklessly sitting together with her in a public café and we were having a row. I accepted the risk, because I accepted the consequences. The demise of my own marriage seemed inevitable. However, I wasn’t about to broach the subject with Eleanor. It was easier to allow fate to pre
cipitate disaster, than to be the catalyst yourself. But the spat with Melanie was a surprise. I’d never considered there could be any anger between us.

  Outside, under the autumnal sky, amongst the two o’clock exhaust, I felt myself sinking down. I felt her detachment all the more. I thought upon her physical perfection and it cut me to the quick. I looked up and there was Drummond, standing at the door of a Chinese restaurant, Leaning against the door frame. The technician was grinning broadly. He was looking straight at me. Faltering in my step, I looked across the road, to see if Melanie was out of sight. But there she was, stopped in front of Knox Church talking with another nurse. I turned back to Drummond. The technician had followed my gaze over to Melanie. His eyes flicked back to me and his smile broadened. Disturbed, I had no option but to walk right past him.

  “Good company?” Drummond asked, still smiling.

  “What’s that you say?” I said. I didn’t stop. I looked away and strode on by and slid around the corner. It wasn’t where I had intended to go. But I needed to get out of sight. My heart thumped in my chest. I had sensed immediately, that the exposure was significant. There was something about Drummond’s expression. ‘Got ya,’ it said. Why? What was he after? Why did it benefit him to have that kind of knowledge? I felt distinctly uneasy. Not that Drummond would have seen much. But one slight show of affection between himself and Melanie, would have spoken a thousand words. I wandered absently into the hospital foyer. Green was coming the other way. My immediate thought, was to dive off into the adjacent washroom. Too late.

  “Gerry, how are you?” Green announced, his face softening with a benevolent smile. He feels sorry for me, I thought. Green was interested in discussing ethical matters. Boatwood’s ethics specifically – or lack of them, I, he said, was a key functionary in the case. “You’ll be interviewed by the Ethics committee soon,” he said. He placed a hand down on my nearest shoulder. “You’re the main man, boy-o. You’d better be prepared for a grilling. It’s that jump from early animal study to human application that has annoyed people. There should have been quite a few steps in between,” Green said.

  “Like what?”

  Green folded his arms. “Like verification of efficacy in other animal species. Like accrual of a significant population base, over several studies. Like a stepped approach to PEEP application in humans, rather than going straight to seventy. Like getting informed consent from relatives, before applying an innovative therapy. Like getting ethic’s committee approval, prior to using the therapy.”

  “Yes, put like that, it sounds bad. But on the other hand, the patient was on his last legs. Maybe it was better to do something, than do nothing.”

  Green’s face showed his disapproval. “That’s the heroic view is it?” However we’re not living in 1914. There’s no place for shotgun remedies nowadays. Every treatment should have a scientific basis. It’s got to be evidenced based medicine nowadays. Imagine if it was one of your relatives, your wife for example. What if Boatwood was applying an unsubstantiated treatment to her?”

  I considered this. Green had a point. But then if it was the last resort? It wasn’t a simple issue

  That night at home there was a telephone call from Alana. “I need to see you ASAP,” she said.

  “Why, what’s up? I asked. I felt nervous about more trouble. Had Alana cottoned on about Melanie?

  “It’s to do with Isobel, and it’s bad. I need to see you tonight if possible.” I agreed immediately to meet at the Kasbah in Kaikorai Valley.

  In the bar Alana unveiled her story. She’d noticed in recent weeks that Isobel seemed to be going in and out of operating rooms at unusual times of the day – at times when you would expect her to be ensconced in one theatre, or down in the tea room, or chatting in a corridor – anything but going from theatre to theatre. As well as that, she had seen Isobel emerging from the bathrooms quite frequently – more than would be expected. That day she’d spotted Isobel hanging around a back corridor behind three of the theatres that fronted the west corridor. Alana trailed her and saw her go into the anaesthetic room of theatre 2. A case had been under way in the theatre there for about half an hour. Alana burst into the anaesthetic room and there was Isobel, sucking fentanyl out of a left over ampoule from the anaesthetic induction, into a syringe. Alana realized her suspicions immediately about what had been going on. The fentanyl, a powerful opiate, was likely being drawn up for personal use – in the toilet block presumably. Why else go into someone else’s theatre and draw up opiates. “She tried to deny it, “Alana said. “But I said ‘don’t be ridiculous – I wasn’t born yesterday.’ She continued with the denial for a while but then I made her show me her arms and she tried to kind of push me away but we fought a little and I managed to see needle marks in an antecubital fossa.”

  The f word was all I could think to say.

  “Exactly,” Alana agreed. “But what’s happened is she’s sworn me to silence. She’s promised she’ll stop doing it forever more.” She took a long pull on her beer.

  I sat back in my chair, blowing out a long expiration. “Mmm . . . I wonder how long she’s been doing it. If it’s only a short while then maybe there will be no withdrawal issues,” I said. “I’d better go talk with her.”

  Alana’s eyes bore into me in an unfocused way. “She didn’t want you to know.”

  “Well you told me anyway,” I said, standing up. “It’s my problem I guess. She’s my sister. I’ll have to deal with it.”

  “I guess.” Alana looked uncomfortable. “What do you want me to do?”

  “Well . . . Leave it with me. I’ll keep in touch.”

  I didn’t go to confront Isobel – nor did I go home. I couldn’t discuss it with Eleanor because she loathed anything to do with drug use. Her relationship with Isobel was cordial at best. I sat in my car in the floodlit hotel car park stewing. Maybe Isobel could come off the opiates without going into withdrawal. Maybe she was only injecting sporadically. That’s what she’d say anyway – so how could I be sure. If I took it to management and the nursing hierarchy, she’d be fired for sure. They’d help her get treatment – but nevertheless she’d be fired. What she was doing was very, very illegal. I wanted to talk it over with Melanie, even though earlier in the day she’d gotten angry with me over another ethical issue at the café. She had since contacted me and apologized – agreed to disagree. She was on the afternoon shift so I’d have to speak to her at work. A problem I had was that I was on a day off. I wouldn’t be expected to be seen up in the Barn. I’d have to ring from inside the hospital somewhere – put on one of those accents again. At least Charge Nurse Nancy wasn’t be there so I could use the American one – I found that the easiest.

  I rang from an anaesthetic department phone and managed to get past the border guards with my patter and asked Melanie if she could get out for 15 minutes or so. I stressed the urgency. She said she’d see what she could do.

  “’I’ll come out to your car. There’s no where I can think of in the hospital that’s safe. Boy Wonder’s in the registrar room.”

  I went out onto Great King Street, jumped into the car and waited. I watched the main entrance in the rear vision mirror. Soon I saw her coming, her white uniform partly covered by a mauve cape. Our embrace was guarded, the hangover from the morning disagreement only partly assuaged. Immediately I spilled out my story, outlining the dilemma I faced, watching warily as each set of car headlights drifted by up and down the street.

  Melanie was staring out the windscreen too, and as the story progressed her eyebrows came together with consternation. “Fuck Gerry, there’s no dilemma. What’s got into you lately?” It seemed her left over anger from the morning was millimeters from the surface. “Isobel has to be removed. She’s a danger to patients. They have to know.”

  “Who has to know?”

  “The authorities, the managers, the Nursing Council, rehab . . . “

  It wasn’t what I wanted to hear. I was hoping Melanie would come up with
something else. I wanted an escape route for Isobel – a solution that I hadn’t been able to conjure up. “Why are you so high principled today? ”I said. “First it was medical ethics this morning and now this. The letter of the law isn’t always the right thing to do.”

  Melanie withdrew back across her chair, her head backed up against the side door window. “Ït’s not tiddlywinks that’s being played here . . . and I know right from wrong.”

  I laughed, unnaturally loud in the confines of the car. The windscreen was misted over now and I wound down the driver’s door window a little. “Right and wrong,” I barked. “Right and wrong. . . That’s a joke coming from you. What on earth have we been doing for the past month. You’ve been having an affair. You can’t talk about right and wrong.”

  Melanie exploded. “That’s only affecting us. No one else knows. Isobel continuing to work is hazardous to patients. It’s different altogether . . . OK I’m no saint. My marriage is stuffed but that doesn’t make it right to have an affair. You’re right . . . But this issue with Isobel is on a different scale.”

  There was silence. I shifted uncomfortably in my seat. I looked out my window at the heavy brick of the medical school. “I’ll go and talk to her. I’ll find out the extent of it.”

  “Extent? She will minimize the extent. There’s only one solution. She has to come clean.”

  “Well . . . I don’t know. There might be a way of getting through this without wrecking her nursing career.”

  Melanie snorted. “There won’t be . . . I’m going back to work. . . . You know, you’re more in love with your sister than anyone else.” She quit the car and the slammimg door smarted in my ears. I watched in my rear vision mirror as she strutted away –head down – angry. And for the second time that day I felt the brunt of a 180 degree shift in affection. After weeks of giving and receiving love – in an almost religious like fervour – we were now at loggerheads.

  In the evening I went to Isobel and Junot’s flat. I addressed the topic and the three of us were watchful. Junot especially was guarded. The fact that Isobel was injecting opiates at work had not induced a discernable reaction. He had had a decade of association with drug use in all its forms. To him it was business as usual. His wariness was to do with wanting to avoid trouble. In Dunedin he’d gotten into a new rhythm with life. His focus was shifting towards normality and Isobel’s problem was a threat to this new life.

  “It’s vital that it doesn’t come out,” he said. “I can help her get through the withdrawal.” His eyes were fixed on me – unblinking.

  “Yeah, I can do it,” Isobel said. She didn’t look at me. Her eyes seemed fixed on some imaginary horizon. Her legs were angled underneath her on the chair in a lotus position. “Junot will know what to do – with his bag of tricks.”

  I had beads of sweat on my forehead. I played the devil’s advocate, parroting Melanie’s position. I hadn’t told them that I’d confided in Melanie of course. They didn’t know the relationship existed and I wasn’t about to own up to it.

  Junot still had me in his cross hairs. “No Gerry. Isobel will be fine. She won’t be a danger to the patients. I’ll make sure of that. It’s got to be business as usual tomorrow.”

  I had an idea - perhaps a compromise. “What about taking a few weeks off. Ring in sick. That way you can recover and go back to work clean.” I was talking to Isobel but looking at Junot. Junot appeared to be in control of Isobel.

  Junot rocked his head from side to side. “Mmm . . . yeah . . . that’s possibly a way to do it.”

  It seemed like a breakthrough solution and I felt some relief as the conversation eased in intensity. When I left, Isobel came out to the road, her arm around my waist.“ It’s gonna be cool Gerry,” she said. “ Don’t you worry about it.”

  But I was worried. As I drove away I had a nagging feeling that this compromise solution wasn’t going to suit some people.

  My solution didn’t get to see the light of day. Certainly Isobel rang in sick at 7 am on the Monday morning. But overnight Melanie had contacted Alana and between them they worked themselves up into righteous indignation. By 10 am hospital and drug clinic personnel were at Isobel’s flat while a belligerent ashen faced Junot was stalking the living room floor in agitation. Isobel’s employment by the hospital was over and there was unlikely to be a future for her in nursing – certainly there would have to be an extensive rehabilitation period.

  I took the day off work. I went straight around to the hornet’s nest.

  “How the fuck did Melanie East come to get involved in this?” Junot demanded. His lips were pinched and nostrils flared.

  “Cause I fucking needed some help that’s why.”

  “Well why her? You hardly fucking know her.”

  “I knew her through work.”

  “You’ve wrecked it for Isobel.”

  I found myself arguing the authority’s point of view – patient safety – Isobel’s own safety. How It was an easy argument to take up but it didn’t go down well with Junot.

  “You’re sounding like your father,” he said. That was the cue for me to leave. I wasn’t going to be put in the same bag as Graham.

  As I opened the ranch slider Isobel piped up. “Stop arguing guys. We can’t turn back the clock. I’ve got to face up to reality.”

  I looked back into the room. “Well that’s about right,” I said.

  Chapter 9

 

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