by Ken McClure
‘I’m not hungry,’ replied Sandy.
‘Me neither.’
‘What do you think?’ she asked anxiously.
There was no need to ask what she meant. Sandy said, ‘I think she’s got worse in the last hour.’
‘It could just be the upset at coming into hospital.’
‘Maybe,’ conceded Sandy, but he sounded far from convinced.
‘Why don’t you go on home?’ Kate suggested. ‘There’s nothing you can do here. I’ll be here for her if she wakes in the night.’
Sandy nodded as if only half considering the suggestion. ‘I think I’m going to pop along to the lab first to see if Charlie got the specimens okay,’ he said. ‘Maybe I’ll hang around until he’s got the results. If they seem okay I’ll go on home. You will call me if anything changes?’
‘Of course,’ replied Kate. ‘And don’t stand over Charlie. You’re an interested party, remember.’
Sandy nodded; he kissed Kate on the forehead and turned to go.
The district hospital lab was situated in a small brick building, separate from the main building and hidden behind a row of conifers that bent in the wind as Sandy left the warmth of the hospital and walked down the path towards it. He got intermittent glimpses of the lights on in the building as the lower branches of the trees separated. Icy raindrops started to pepper his face as he turned into the shelter of the ivy-covered porch outside the lab. The door was locked. He fumbled in his pocket for his key but discovered that he’d left it at home. He rang the night bell and a few moments later the door was opened by a short, dark-haired, studious-looking man wearing a white lab coat with a green plastic apron over it. His dark-rimmed glasses seemed too large for his round face, giving him the look of a wise old owl.
‘Evening, Charlie,’ said Sandy as he stepped inside and closed the door behind him.
Charlie Rimington smiled and said, ‘I had a feeling I might be seeing you when I read the label on the specimens. How is she?’
‘Not good, but it’s always hard to tell with kids. How are the tests coming along?’
‘Up and running. I take it you’re going to wait?’
‘If you don’t mind.’
‘I’ve got kids too, remember.’
The insistent bleep of an electric timer distracted them and Sandy turned off the machine he was standing beside. He’d done this a thousand times before for other people’s children’s samples. It had never felt like this.
Feeling awkward because it was Rimington’s duty shift and not his, he stood back to allow Rimington to open the loading cage and extract the specimen tube. He saw the ward label on the side of the glass: ‘Amanda Chapman’. It made the hollow feeling in his stomach worse.
Rimington tore off the print-out from the machine and sat down, pencil in hand, at his desk to read it, using the pool of light from an anglepoise lamp. Sandy stood at his shoulder feeling impatient but fighting hard to hide it. After thirty seconds of silence he could stand it no longer.
‘Well?’ he asked.
‘No signs of infection and no toxic substance present,’ said Rimington.
‘But?’ said Sandy anxiously.
‘All the signs… suggest sudden renal failure.’
‘Jesus,’ said Sandy, gripping the bench and letting his head fall forward. He remained like that for a few moments before asking, ‘What are we talking here? Mild?’ He took the analysis sheet from Rimington’s hand and read the results for himself. ‘Jesus,’ he repeated. ‘We’re talking dialysis.’
‘’Fraid so,’ agreed Rimington.
Sandy stood by while Rimington phoned the result through to the ward. There was no question about it: Amanda would have to be transferred to a hospital with a dialysis unit, and the sooner the better. The district hospital did not have this facility. It would have to be Glasgow after all.
A knot of fear formed in the hollow space in Sandy’s stomach. He was worried sick about Amanda but he had to be strong for Kate’s sake. Then there were the logistics of the transfer to be worked out. Kate could go in the ambulance with Amanda, while he drove up to Glasgow in Esmeralda so that he and Kate could get back, whenever that would be. He couldn’t see that far ahead.
Charlie Rimington said, ‘Don’t worry about the lab. Andrew and I can cover for you. Take as much time as you need.’
‘Thanks,’ said Sandy, turning to leave. ‘I appreciate it.’
Outside, it was now raining heavily. Sandy was soaked by the time he got back up to the hospital. He paused just inside the door to wipe the water from his face and push his wet hair back from his forehead before entering the ward.
Kate was talking to George Telford, who was telling her the results of the tests. There was anguish on her face. She saw Sandy arrive and came towards him.
‘Oh, Sandy,’ she sobbed.
Sandy took her in his arms and held her tight. ‘Come on now, Kate,’ he encouraged her. ‘She’s going to be okay. We just have to get her to the right place.’
‘Dr Telford says she has to be transferred tonight,’ said Kate.
‘It’s for the best,’ said Sandy.
‘But how will we-’
Sandy put his finger on her lips. He said, ‘Let’s just take everything one step at a time. You travel in the ambulance with Amanda. I’ll drive up. Then, when we’ve heard what the doctors in Glasgow have to say, we’ll decide what’s best.’
Kate nodded and wiped away her tears.
‘Come on now,’ soothed Sandy. ‘Let’s be strong for Amanda.’
Sandy had to fight against recurrent feelings of disorientation as he followed the ambulance on the road to Glasgow. He was having difficulty in coming to terms with just how quickly everything in their lives had been turned upside down. Only a few hours before he had expected to be watching television with Kate in front of the fire in their cottage while Amanda slept safely upstairs in her room. Now here he was heading north through driving rain on a dark night, with Amanda seriously ill in the vehicle in front and Kate in a terrible state. He wanted it to be a bad dream. In a moment he would wake up and find he was in bed at home with absolutely nothing amiss. Ahead, the ambulance pulled out to overtake a heavily laden lorry in the nearside lane of the dual carriageway. Sandy did the same and hit the wall of spray coming from the lorry’s wheels. He turned the wipers up to maximum speed. This was no dream. It was a nightmare.
Kate and Sandy sat on a bench in the hospital corridor while Amanda underwent further tests. They stood up when the doctor who had been dealing with her came out and introduced himself.
‘Mr and Mrs Chapman? I’m Dr Turner.’
‘How is she, Doctor?’ asked Kate.
‘She’s pretty low at the moment but I should stress that she’s not in any danger. There’s just been a build-up of toxic substances in her blood because of the kidney problem. Once we clear these away she’s going to feel a whole lot better, I promise you.’
‘Any idea why she went into renal failure?’ asked Sandy.
‘Impossible to say at this stage,’ replied Turner. ‘But there are a lot of tests we still have to do over the next few days.’
‘Is there a chance that this was just a one-off problem?’ asked Kate.
Turner displayed the unease of a man being asked to provide an encouraging answer he knew he couldn’t give. ‘I… I don’t really feel that’s likely,’ he said.
‘So you think she’ll need further dialysis?’ said Sandy.
‘It’s early days yet, but in all honesty I fear so. That’s usually the case.’
Sandy felt his spirits sink and his limbs become heavy. The chances were that Amanda was going to need regular dialysis from now on unless… He shut out thoughts of what might lie ahead and tried to confine himself to what was going to happen tonight.
‘Is it okay if we stay?’ he asked.
‘Of course,’ replied Turner. ‘But if you’ll take my advice you’ll go home and get some rest. She’s in good hands.’
‘But what if she should need us in the-’
Turner shook his head. ‘We’re going to keep her well sedated. Come back tomorrow. We’ll be able to tell you much more after we’ve carried out some more tests.’
Reluctantly, because all Kate’s instincts said that she should stay near Amanda, Sandy and Kate took Turner’s advice. It was a thirty-mile drive back to Ayrshire but the roads would be quiet in the early hours of the morning and the rain had settled down to a drizzle rather than the earlier downpour. They didn’t speak much as they walked to the car down the wet cobbled lane at the side of the hospital. They were both preoccupied with their own thoughts and could think of nothing encouraging to say to each other. A black cat that scurried off among the dustbins seemed to be the only other living creature in the darkness of the night.
The house was cold when they got in; the heating had switched itself off some hours ago. The coldness added to the feeling of quiet and emptiness that met them.
‘Are you hungry?’ Kate asked as Sandy knelt down to light the gas fire in the living room.
‘Not really. But I could use a drink.’
Kate poured them both a whisky. They sat on opposite sides of the fire. They hadn’t yet taken their coats off.
‘Everything’s been going too well,’ said Kate. ‘Something like this was bound to happen.’
Sandy looked at her questioningly.
‘You get your job, then I get mine. We find the cottage in the perfect village. Everything has been going just too smoothly. It had to stop.’
‘Nonsense,’ said Sandy softly. ‘That’s a very Scottish thing to say.’
‘We’re very Scottish people,’ replied Kate.
‘That doesn’t mean we have to subscribe to the “Weary Willie, we’ll pay for this somehow” philosophy.’
‘I suppose not,’ agreed Kate with a wan attempt at a smile.
‘Anyone found enjoying themselves will be dealt with severely,’ mimicked Sandy in severe Presbyterian minister tones.
Kate’s smile grew broader. She got up from her chair and said, ‘I’ll make us some toast. We’ve got to eat something.’
Neither of them managed much sleep. Both were relieved when it was time to get up and busy themselves. They phoned the hospital and were told that Amanda had had a comfortable night and that it would be best if they waited till early afternoon before going in. By then the doctors would have the results of the tests they planned for Amanda and should have something concrete to tell them.
Kate phoned Isa Jenkins to tell her what had happened and that she would not be at school today.
‘Don’t worry about it,’ said Isa. ‘I rather thought that might be the case. The wee soul didn’t look well at all. I took the precaution of calling one of the supply teachers over in Ayr last night and warning her she might be needed today, so everything’s under control.’
Sandy called Charlie Rimington at home and was given similar assurances. ‘Nice people,’ he said when he put down the phone. Kate nodded.
‘Dr Grayson and Dr Turner will see you now,’ said the nurse who put her head round the door of the waiting room. Sandy and Kate followed her a short way along the corridor and were shown into a small, sunny room where the two men were sitting. Both got up when Kate and Sandy entered, and Grayson was introduced to them as the consultant in charge of the renal unit.
‘She’s looking better this morning,’ said Turner with a smile to Kate, who was looking anxious.
Kate nodded. ‘Yes, she is.’
‘She had a good night’s sleep, which I dare say is more than either of you two did.’
Sandy nodded his agreement.
With the pleasantries over, Grayson got down to business. He was a man in his mid-forties with thinning grey hair and a pepper-and-salt moustache. His dark suit looked expensive and appeared to have been made to measure with millimetric precision. The cuffs of his white shirt showed one centimetre on both sides and his gold cuff links seemed to rest at precisely the same angle on the table as he sat with his hands clasped in front of him. His shirt collar seemed to ride a little high and looked distinctly uncomfortable to Sandy’s way of thinking but it was the perfect foil for the dark university tie that hung below. The overall impression was of a man precise in all things.
‘Frankly, the news is not good.’
Sandy felt as if he had been hit by a train. He swallowed and looked at Kate, who seemed to be reeling too. He took her hand and squeezed it.
‘Amanda’s renal failure is quite severe, though we can see no reason for it. She has responded fairly positively to dialysis, although not as well as we expected. As regards prognosis, I think we should be looking at dialysis as a way of life well into the foreseeable future.’
Sandy rubbed his forehead. Grayson didn’t fool around with dressing up what he had to say. His worst fears were being confirmed at an alarming rate.
‘Can I ask what you do?’ continued Grayson.
‘I’m an MLSO at Dunnock District Hospital,’ said Sandy. He looked to Kate to see if she was going to reply for herself. She was looking down at her shoes. ‘Kate’s a teacher,’ he added.
‘Good,’ said Grayson. ‘Then, thinking ahead, I feel we should be considering a home dialysis unit for Amanda when one becomes available. You’re both obviously quite capable of dealing with its demands.’
Sandy raised his right hand slightly. It was a gesture designed to slow Grayson down. He was reeling from the onslaught. ‘You said, “foreseeable future”,’ he said. ‘What exactly does that mean?’
‘It means that Amanda will need dialysis until such time as a kidney transplant becomes available for her.’
The word ‘transplant’ seemed to have put Kate into shock. She sat with her eyes wide, staring at Grayson as he spoke.
‘A transplant,’ repeated Sandy slowly.
‘Yes.’
‘It’s that serious? But how? When? I mean, how long?’
‘Far too soon to start talking about that,’ replied Grayson. ‘We’ve lots more tests to do.’ He looked distracted, and almost before they could respond he had made his excuses and left, leaving them alone with Clive Turner.
Turner seemed more sensitive to their feelings and almost embarrassed at Grayson’s manner. ‘I know what you must be thinking,’ he said softly, ‘but these days kidney transplants are very common and very successful.’
‘But you need a suitable donor,’ said Sandy.
Turner nodded. ‘True, and that’s where the waiting comes in. Amanda will be tissue-typed and her details entered on an international register. As soon as a match comes up we can get the organ and do the surgery.’
‘How long?’ asked Kate. Sandy barely recognized her voice.
Turner shrugged uncomfortably. ‘It could be some time,’ he said.
‘Weeks? Months? Years?’ Kate persisted.
‘It could be a year or so,’ admitted Turner.
Sandy looked at Kate. He couldn’t remember ever having seen her look so unhappy. Her world was collapsing around her.
TWO
The convoy of three official vehicles accompanied by a police car swung through the gates of the Medic Ecosse Hospital in Glasgow and came to a halt at the entrance. Their drivers opened passenger doors and stood by respectfully as the eight occupants got out and waited around like camels at an oasis. They orientated themselves with their surroundings, straightened their ties and fidgeted with the buttons of their jackets until the official welcoming party emerged through sliding glass doors to greet them. The smiles were all on the welcoming side.
Leo Giordano, administrative secretary of the Medic Ecosse Hospital, part of the Medic International Health group, stepped forward and shook the hand of the junior minister from the Scottish Office, Neil Bannon. Giordano was tall, dark and good-looking with an olive skin that implied Mediterranean ancestry, although he himself was second-generation American. Bannon was short, ginger-haired and running to fat. He had recently grown a moustache in the
mistaken belief that this would lend gravitas to his presence. Unkind observers thought it made him look more like a second-hand-car salesman than ever.
Bannon and Giordano had met on several occasions during the planning stages of the hospital and now exchanged a few pleasantries before Giordano commenced the formal introductions. These were dealt with quickly in deference to the drizzling rain and icy wind and the bowed huddle moved inside.
‘I thought we might have coffee first before getting down to business. It’ll give people a chance to get to know each other.’
Bannon nodded his assent without enthusiasm or comment and followed Giordano across the carpeted entrance hall to a long, low-ceilinged room with large picture windows looking out on to a formal garden. At this time of year the garden displayed all the starkness of winter in northern climes. Bare branches criss-crossed a grey sky and moss crept along stone paths, flourishing as nothing else could in the damp and cold. As a centrepiece, it boasted a lily pond with, at its head, a sculpture clearly influenced by ancient Greece. The hunting figure seemed pathetically far from home.
Coffee was brought in by waitresses carrying silver trays and wearing pale pink uniforms with the Medic Ecosse logo on them.
‘It’s no bloody wonder they’re in financial straits,’ whispered one of the visiting party, a local Labour councillor. ‘This isn’t a hospital, it’s a bloody gin palace. Look at it! Carpets everywhere, air-conditioning, tailored staff uniforms. Hospitals shouldn’t be like this.’
‘On the contrary,’ replied his colleague. ‘You may prefer Victorian slums smelling of disinfectant and echoing to the profanity of Saturday-night drunks, but frankly I happen to believe that all hospitals should look exactly like this, and the sooner they do the better.’
‘Privatization, you mean,’ sneered the councillor. ‘Fine for the rich, but what about the rest of us? Tell me that. And what about the chronic sick and the mentally ill? Who’s gonna look after them?’
The second man clearly had no heart to enter an old argument all over again, particularly one there would be no resolving. He put a stop to the tack they were on with a raise of his hand. ‘All right, I know the words of the song. Let’s not sing it this morning.’
