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Sick to Death

Page 3

by Douglas Clark


  ‘Vomit, I think.’

  ‘Then for Pete’s sake, light up that pipe of yours.’

  ‘What did Hook say?’

  ‘He wasn’t there. The Station Sergeant says she was last seen, he thinks, by Brian Dent about ten twenty on Saturday night.’

  ‘He thinks?’

  ‘He’s sure, but he didn’t have the facts in front of him.’

  ‘Thanks.’

  ‘What if he brought her home and came in with her?’ Green asked. ‘It’s a Chubb lock. He’d only have to pull it to behind him as he went and there’d be no sign of his having been here.’

  ‘Having done what?’

  ‘Changed the insulin. She could have left him alone long enough for all sorts of reasons. While she went for a whizz or changed her clothes, or anything.’

  ‘He was closest to her. We’ll bear him well in mind.’

  Hill joined them, saying, ‘I would say she must have missed the pan when she puked. Just a bit. Probably one splash went on the floor. There’s a rag there—on the U bend—which I think she used for wiping up. Probably didn’t rinse it very well afterwards. Feeling too ill at the time, I expect. Anyhow, it’s all dried out now and smells a bit sour.’

  ‘Could forensic do anything with it, d’you think?’ asked Masters.

  Hill grimaced. ‘Maybe. I’ll bung it off to them if you like. But I’m not all that hopeful because it has definitely been rinsed. It’s not as if there’d be a lot of work on.’

  ‘In that case, hang on to it. If we find we need to know what she ate on Saturday we ought to be able to find out locally. If not, we’ll send the rag off.’

  Brant joined them. ‘There’s not a sign of anything unusual in there, Chief. Nothing to do with diabetes or medicines. Not even an aspirin.’

  ‘Thank you. In that case, we’ll go and clock in at the Bristol.’

  2 |

  After they were installed at the Bristol, Masters felt unable to settle. It was six o’clock. Time to have a bath and a drink before dinner. The unwinding part of the day when most people like to take their ease and enjoy themselves. This evening, with a golden sun tumbling westwards and lengthening shadows, when the world outwardly seemed a good place, he felt he wanted to be up and doing. He sat in his room, smoking reflectively. He supposed the most miraculous organ of murder was playing with all stops out in the case of Sally Bowker. Right on his particular wavelength. Had she been sick? He thought he’d nosed it out. If she had, had it any bearing? To him it seemed it might well be significant. He wished to hell he knew more about the girl’s disorder. Were diabetics more prone to other illnesses than other folk? Did their bodies react more violently to stimuli that in other people would be shrugged off with little or no discomfort? Green had been right. Here, from the outset, he himself was uneasy. No bliss in ignorance for him. He had to know. With a grimace he heaved himself up out of the armchair. There was one person who could tell him. Hook had said that Dr Sisson was up to date on diabetic treatment. Masters picked up the phone.

  Dr Neville Sisson was in the middle of evening surgery. His receptionist was doubtful whether he would wish to be disturbed. Masters said, ‘Please tell the doctor that I insisted you should interrupt him. You know who I am?’

  ‘I’m afraid I don’t. You’ve said you’re a Chief Inspector Masters …’

  ‘From Scotland Yard.’ Masters was just faintly surprised and disappointed that his name carried neither recognition nor weight. ‘I’m here to investigate the death of Miss Bowker.’

  ‘Oh! That’s different. I’m sure Dr Sisson will talk to you about her.’ Masters thought he detected a note of pique in the receptionist’s tone. Immediately he wondered whether the receptionist was jealous of the attention the doctor had paid to an attractive girl. Of the concern he had shown for her. It was a subconscious suspicion. Without a pause he said, ‘In that case, would you please put me through to him.’

  ‘Sisson.’ The voice was deep. The type of immature deepness that reminded Masters of a boy whose voice has just broken and not yet completely settled down. He guessed it was a cultivated deepness, adopted to impress.

  ‘Detective Chief Inspector Masters of Scotland Yard. I should like to meet you, doctor.’

  ‘When?’

  ‘This evening if possible.’

  ‘Well, I’m free—I hope—after I’ve eaten. By about nine o’clock.’

  ‘Can I see you then?’

  ‘You can. But I’m on call, so there’s no guarantee of an uninterrupted chat.’

  ‘I’ll risk that.’

  ‘As you like. D’you know where I live?’

  ‘If it’s at the surgery I have the address.’

  ‘Fine. I’ll expect you. Now, if you’ll excuse me, I’ve got a dozen patients waiting.’

  ‘Thank you. Sorry to have interrupted you.’

  Masters felt the conversation had been far from satisfactory. Sisson had raised no objections to an interview, but he hadn’t been completely enthusiastic. There had been just a hint of unwillingness in his attitude. And when he got impressions of that sort during a murder inquiry it made Masters want to think. He chose the bath as the best place in which to ruminate. It wasn’t a really comfortable pallet. It was too small for his great size. When he lay back his knees were bent up, out of the water. But he stayed there for a quarter of an hour, apparently doing little more than gazing at the wall opposite. In fact, at one moment he found himself counting the courses of tiles.

  When they were having dinner he told Green of his conversation with Sisson and the coming interview. ‘I’d like to come with you,’ Green said. ‘I want to learn something about diabetes.’

  ‘Right. We’ll walk. Leave here about ten to nine.’

  The sergeants were discussing Double Gloucester cheese. Wondering how it got its name. They agreed on the possibility of double strength but not as to how it was arrived at. Hill said when he got back to London he’d ring the Milk Marketing Board at Thames Ditton for an explanation, because to his mind, double strength or not, the cheese was mild. Masters, unusually for him, took no part in the gastronomic discussion. He’d been paying little attention to what he ate, and still seemed preoccupied with his own thoughts. ‘We’re up the creek, aren’t we?’ asked Green.

  ‘I wouldn’t say that. Not just yet.’

  ‘Hook couldn’t suggest a suspect. How does he expect us to?’

  ‘Fresh minds. Emotionally uninvolved. Onlookers seeing more of the game. That sort of thing.’

  Green tried to wiggle a strand of meat from between two teeth with his tongue. ‘It doesn’t often work like that in our game. The locals who know the background are more in the picture. Where do we go for honey? Hook says emphatically that the lad she’s engaged to didn’t do it. What other contacts have we?’

  ‘Her partners?’

  ‘You really think two other little artist lasses would know enough about diabetes to pull this off? Or that they’d ruin what sounds like a thriving business by doing in one of the leading lights?’

  ‘If you don’t like them there’s the doctor. According to Hook he’s knowledgeable enough.’

  Green grimaced. ‘We’ll see, won’t we?’

  ‘And his receptionist. I told you I got the idea that she wasn’t one of Sally Bowker’s greatest admirers.’

  ‘That sounds more like it. When a nice bit o’ stuff gets murdered it’s usually by some rival. But we’d have to find out what or who she was rivalling.’

  Masters got to his feet. ‘I know. It could be somebody who thought she had a better right to Brian Dent’s affections. Or somebody who thought her boy friend was too taken up with Sally for the situation to be bearable. We can’t tell. But we will.’

  ‘I’m pleased you’re so confident. Are we going now?’

  They walked from the hotel to the centre crossroads with its one corner oddly embattlemented. By now there were few cars and even fewer people on foot. They could walk abreast down Eastgate to the corner of th
e side street with an arrow indicating the public library and museum. About here the buildings were of stone, pale grey and crumbling in places. Most of the older dwelling houses were now offices, devoid of any of the external touches—gardens, flowers, curtains—which must at one time have made them attractive homes.

  It took them several minutes to find their way from here. Narrow streets, backing the main shops; smaller alleys leading off. A serpentine way, past a public lavatory and a makeshift car park. At last they came to it. A double-fronted house with wooden bays painted a dingy green. Four steps up to the door. The small area in front paved over, with grass and weeds growing in the cracks. A cube biscuit tin in the porch with a stick-on label: ‘Please place urine-specimen bottles in tin’. A bronze plaque with white lettering: ‘Dr N. B. Sisson M.B. B.Ch. Physician and Surgeon’. The original surgery times had been changed. Little stuck-on squares of newer bronze gave the alterations. Under the bell it said: ‘Please Ring’. Masters, after a glance at his watch, did so.

  Neville Sisson was a big man. Nowhere near as big as Masters, but a useful scrum-size. He appeared to be loosely built, slumping into his pelvis, which gave him heavy haunches and a sloppy appearance. His black hair had been crew-cut half an inch long all over, and his side whiskers came down to his ear lobes. His eyes, like his skin, were brown, and his teeth stood out brilliant white. His tie was little more than a thin rag under a crumpled collar, and as he stood at the door he tucked the ends in behind the button of his jacket. His trousers hung low on his hips and wrinkled above fawn shoes that needed polish. Masters said, ‘I’ve brought Inspector Green with me. Do you mind?’

  ‘Not in the least. Come in.’

  There was a waiting-room notice to the right, and a surgery notice to the left. Sisson ignored them and led the way up stairs covered in linoleum. Their feet tapped out a rhythm as they went up. The first floor landing, square and spacious, was carpeted in drab haircord. Through half-open doors Masters could see a bathroom and kitchen. Sisson headed for a door leading into the front room on the right of the house.

  Here there was more comfort than had appeared elsewhere. Four armchairs, all different, but comfortable looking. A coffee-table radiogram. Bookcases and drinks cabinet. An old-fashioned white marble fireplace with a stone jar of yellow Spanish iris on the hearth. An electric clock and two silver candlesticks on the mantelpiece. Two small oils in gilt frames, almost obliterated but apparently views of Edinburgh Castle from widely separated points on Princes Street. Two others in black frames—obviously old—of little girls in long frilly frocks and wide-brimmed hats standing in daisy fields. The carpet was a handsome, self-figured green: the curtains a browny-fawn velvet that went well with it. Scattered about were newspapers and journals, giving the room a lived-in appearance.

  ‘Where would you like to sit?’ Sisson asked.

  They chose their seats. Masters inquired: ‘Are you a married man, doctor?’

  ‘Not me. Haven’t had time to think about it yet.’

  ‘Not even to think about it?’

  ‘Well … you know how it is.’

  Masters took out his pipe and asked permission to smoke it. Sisson got up and poured three whiskies. When they were all settled again, Masters said, ‘I know nothing about diabetes and comas. Chief Superintendent Hook told me you are an expert. Could you enlighten me as simply as possible?’

  Sisson balanced his glass on his chair arm. ‘It’s not a disease, you know,’ he said.

  ‘What is it, then?’ asked Green.

  ‘You could call it a disorder. But strictly it’s what’s known as a metabolic defect.’

  ‘Could you explain that?’ Masters requested.

  ‘You don’t know what metabolism means?’

  Green said, ‘He will. I don’t.’

  ‘It’s the physical and chemical processes within the body by which food is converted into living substance.’

  ‘You mean it turns boiled beef and carrots into living flesh?’ Green asked.

  ‘Not quite. It organizes food into a state where it can be reconverted into simpler compounds like starch and sugar, which in turn change to fat or release energy for the use of the body. That’s a very simple and not wholly accurate picture, but it will do.’

  ‘Got it,’ Green said.

  ‘Good. Now, to complete the metabolism, sugar needs insulin to oxidize it for use as energy in the muscles. O.K. so far?’

  Masters nodded.

  ‘If the body can’t produce enough insulin of its own to use up all the sugar, you get spare sugar being discarded by the body—in the urine. Hence the name of the defect—diabetes mellitus, which means honeyed urine.’

  ‘How does this defect occur?’ Masters wanted to know.

  ‘Like any other defect, such as poor eyesight. You can be born with it, have it caused by accident, or as you get older you can gradually come to it.’

  ‘But Sally Bowker was only about twenty-two …’ Green said.

  ‘I know. That’s one of the tragedies. Kids as young as eleven can develop it—and up to about the age of thirty their type of defect is still known as juvenile diabetes, which is, incidentally, the worst form, because of all the demands made upon the body by young, active life.’

  ‘How does it start?’ Masters asked.

  ‘By developing a defect in the pancreas. Or to give it the butchers’ name, the sweetbread.’

  ‘Seriously? You mean we eat …’ Green said.

  Sisson nodded. ‘Now you know where it gets its name.’

  ‘I’ll never touch it again.’ Green looked at Masters as though the latter doubted him. ‘I won’t, I promise you.’

  Sisson went on: ‘The pancreas has lots of little glands which produce insulin. Now, if those glands aren’t working, or if only some of them are, we have to inject insulin to make up the body’s requirements. Fortunately, most diabetics are not of this type. Most are what is known as maturity-onset patients. This means that in later life, together with most other parts of the body, the insulin glands are beginning to get a bit tired, and so don’t do their stuff properly. If that’s all that’s happened, we very often don’t have to inject insulin. In lots of cases we can give pills that ginger up the glands to make them start working a bit harder. That produces enough insulin for older people, because they are less active and so have smaller appetites. But when we can’t ginger up the tired glands, then we have to resort to insulin again.’

  Masters said, ‘Let me see if I’ve got this right. A girl like Sally Bowker, still in the flush of youth, hasn’t lived long enough for her glands to begin to wear out. They’ve just packed it in for some reason or another, and so there’s no alternative to injected insulin. Correct?’

  ‘Absolutely. All young diabetics have to be given insulin.’

  Masters relit his pipe. As he put the match in the tray he said, ‘Many thanks. That’s cleared that up. But I’m puzzled about diabetic comas. Shouldn’t she have taken a sugar lump or something?’

  Sisson stretched his legs and rested the heel of one shoe on the other toe. ‘Let’s put it this way—just for simplicity’s sake. There are two types of coma a diabetic can fall into. One’s what we’ll call a sugar-coma, meaning they need sugar; and one we’ll call an insulin-coma, meaning they need insulin. Those aren’t the correct names, but they’ll make it easier for you if you’ll remember that the substance mentioned in the name is the substance they are short of. Better still, call them sugar-hunger and insulin-hunger, then we shan’t get confused. Are you with me?’

  ‘I’m on your heels, doc,’ Green replied. ‘If I keep this up I’ll be applying for medical school next.’

  ‘The more the merrier. But to get back to the Chief Inspector’s remark about the sugar lump. Most people regard sugar as poison for diabetics. It isn’t. It’s the staff of life. They should all carry it with them to suck at any time, because it’s true that by far the most common type of coma is sugar-hunger. And the coma can come on fast. But it goes even fas
ter if you can get some sugar into them. They’ll literally recover in the middle of being given a glucose drink. They should be able to dose themselves as soon as they start to perspire and feel woozled. Most of them do. But insulin-hunger is a different—and far more serious—thing. Fortunately it’s not nearly so common. And the answer is to inject insulin. But because it’s a more serious condition, diabetics who suffer from it at any time usually need medical attention and nursing.’

  ‘How quickly does it come on, and go?’ Masters asked.

  ‘Much more slowly than sugar-hunger, both coming and going. It takes anything up to forty-eight hours each way, unless …’

  ‘Unless what?’

  ‘Unless there’s something to aggravate it and bring it on much more quickly.’

  ‘Meaning?’

  ‘When diabetics get other illnesses, like ’flu or a bilious attack, etcetera, they need more insulin to combat them. Not less, as some think. You see, they believe that because an illness means they lose their appetites, they don’t need insulin. This is wrong. In fact they need more to help them fight the ailment. And if they omit to take the insulin—or don’t increase it if necessary—they start to suffer from insulin-hunger, and the symptoms of a coma start coming on.’

  ‘What symptoms?’

  ‘Thirst. Desire to urinate. Tiredness. Drowsiness. Nausea. Probably abdominal pain. Shortness of breath.’

  ‘Are they the people whose breath starts smelling of peardrops?’

  ‘That’s it.’

  ‘How does that come about?’

  ‘Well, with no insulin to oxidize the sugar, the body starts to utilize the fat for energy. It burns it up, but there’s not complete combustion. Just like when you make a coal fire you produce warmth—which is your object—but you also produce smoke, soot and ash. The body gets rid of some of this through the urine—the ash, as it were—while the soot remains as a sort of poison to make them ill, and the smoke comes out as acetate on the breath. These people lose weight very rapidly.’

  ‘I can see they would if they burn up their fat. Now, Miss Bowker. She died in a diabetic coma, brought on by insulin-hunger?’

 

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