by Ken McClure
‘Some kind of public relations exercise you mean?’ asked Giordano.
‘If you like. I thought perhaps you might consider offering free treatment to a reasonable number of Scots NHS patients who would benefit from your highly specialized equipment and professional expertise.’
Giordano had recovered his cool. He smiled and said, ‘Minister, I think that’s a splendid idea. We’ve taken a few patients in the past when approached, but I think I can safely say we would have no objection to taking a few more. It’s always good publicity for us.’
‘Good. I think our friend here should be pleased with that too,’ said Bannon, looking towards the Labour councillor.
The man shrugged and said, ‘If I had my way we’d be taking over the whole damn shebang and using it for the good of all the people.’
‘And running it on hot air, no doubt,’ said Bannon.
‘Anything else?’ asked Giordano.
‘One last thing,’ said Bannon. The room fell silent again. ‘We would like to have one of our people on-site, as it were. A sort of overseer of things in general.’
‘Another public relations exercise?’ asked Giordano quietly.
‘You could say that,’ agreed Bannon. ‘Our man would be here to monitor the prudent application of taxpayers’ money.’
‘An accountant?’
‘More than that. We would like him to have access to all aspects of the hospital’s administration, including files and records.’
‘Are you suggesting this man should have some kind of executive authority?’ asked Giordano.
‘No executive authority,’ said Bannon. ‘Just cooperation from you and the staff.’
‘In that case, I don’t see a problem.’
‘Good,’ said Bannon.
‘Do you have someone in mind for this role?’ asked Giordano.
Bannon gestured towards Steven Dunbar and said, ‘Dr Dunbar would be our man on the ground.’
Dunbar smiled and nodded. He watched the reaction of the Medic Ecosse people: their smiles were uncertain.
‘So there we have it,’ said Bannon. ‘The big question now is, do we have a basis for agreement?’
There were no dissenting voices, but everyone knew how much now depended on James Ross, and he was out of the room.
‘Why don’t we adjourn for lunch?’ suggested Giordano. ‘The food here is very good. I don’t think you’ll have any complaints.’
‘I never thought Bannon would have the balls to try something like that,’ said the man in front of Dunbar as they went out of the room.
‘Bloody criminal, the way they treated Ross,’ replied his companion. ‘Do you think they’re going to get away with it?’
‘I rather think that’s up to Ross. Without him they’re just another hospital.’
‘Or five-star hotel.’
‘D’you think he’ll resign?’
‘Depends on how much they’re prepared to back-pedal on the research cuts. He might feel obliged to move on as a matter of pride. It’s not as if he couldn’t work elsewhere. With his reputation he could get a position almost anywhere in the world. If you ask me, the Scottish Office are playing a losing hand here.’
‘No change there, then.’
‘I wonder why Ross came here in the first place,’ mused the first man. ‘If it’s research he’s really interested in, you’d think he’d have gone to one of the big medical schools.’
‘Good point,’ agreed the second.
‘Mind you, it could have been the food,’ said the first admiringly.
They had reached the dining room and were looking at what was on offer. Tables groaned under the sumptuous buffet that had been prepared for them.
Lunch was over by two o’clock. The meeting was scheduled to reconvene at two thirty, and both sides used the interim to discuss matters among themselves. Dunbar picked up what he could while circulating, coffee cup in hand. He fended off questions about his proposed role with skill and humour, saying that it was too soon to talk about such things. As yet no agreement had been reached.
As the meeting seemed set to reconvene he saw Giordano, who had been deep in conversation with Ross, move away and Bannon, looking distinctly nervous, walk over to take his place. He wondered if Bannon was beginning to have second thoughts about his intransigence. He positioned himself within earshot of the two main protagonists.
‘Nothing personal in this, Ross, you understand,’ said Bannon with a half-hearted attempt at a smile.
Ross gave him a look that suggested that politicians were akin to something he might find occasionally on his shoe. ‘Of course not,’ he said flatly.
‘I do appreciate how important your research work is to you, Doctor, and that you’ll probably need more time to consider your position, but I just wondered if perhaps you’ve come to any kind of decision yet in your own mind?’
‘Yes, Mr Bannon,’ replied Ross. ‘I’ve made my decision.’
THREE
As the days became weeks, the strain of constant travelling up and down to Glasgow, and guilt over excessive time taken off work, began to tell on Kate and Sandy.
‘I’ll have to resign,’ said Kate as they drove up to see Amanda on the Friday of the third week. ‘It’s not fair on the school.’
‘I’m sure they understand,’ said Sandy.
‘I’m sure they do too, but it’s too much of an imposition on them. They’re bound to be feeling the strain and they’re far too nice to say so themselves. I’ll have to make the decision.’
‘Maybe you’re right,’ conceded Sandy. He didn’t feel so bad because, although his two colleagues were covering for him during periods taken off in the daytime, he was taking on more evening duties to compensate. Both Charlie and Andrew had young families, so they were quite happy with the arrangement. Kate was not so happy. It meant that she seldom saw Sandy in the evenings.
‘I thought we’d have had her home by now,’ said Kate. ‘They said at the outset she’d probably be home within two weeks and we’d just have to travel up on dialysis days. I think something’s wrong. In fact, I’m sure something’s wrong and they’re just not telling us.’
Sandy glanced out of the corner of his eye at Kate in the passenger seat. She was biting her lip and nervously interlocking her fingers as she stared at the road ahead without giving the impression of seeing anything.
‘No doubt Grayson will tell us,’ he said. ‘He’s not one for gift wrapping anything and Clive Turner did say he wanted to see us today.’
‘Do you think our marriage will survive this?’ Kate asked suddenly.
‘Of course it will,’ replied Sandy, taken aback by the question. He took one hand off the wheel and reached over to squeeze Kate’s hand. He felt her grow tense. ‘What brought that on?’
‘We were always so close,’ said Kate. ‘But now things seem different. You don’t even tell me what you’re thinking most of the time.’
‘We’re both under a lot of strain,’ he said. ‘Too many other things on our minds, I suppose. I never knew continual worry could be so exhausting. It’s like being an overwound spring.’
‘If that’s all it is.’
‘Of course it is.’
‘I don’t want this to drive us apart,’ said Kate.
‘It won’t,’ said Sandy supportively. ‘We’ll soon get Amanda home and then we’ll get back to being just as we were.’
‘Apart from the dialysis.’
‘We’ll even get used to that in time, and when we get a home set-up it’ll be practically no bother at all. You’ll see. It’ll become part of our routine. So much so that we’ll hardly notice it.’
Kate smiled weakly and looked across at him. ‘I don’t know what I’d do without you.’
‘Come on, love,’ said Sandy. ‘I need you every bit as much as you need me.’
‘We have a problem,’ announced Grayson with characteristic bluntness as he spread his notes on his desk and moved his glasses to a more comfortable spot on his nos
e to read them.
‘What sort of problem?’ asked Sandy. His skin tingled in fear and anticipation. It was as if his every sense had suddenly been heightened. He was aware of every raindrop running down the window behind Grayson’s head as he waited for him to begin.
‘Truth to tell, we’re not very sure ourselves,’ said Grayson. ‘Amanda’s blood is becoming contaminated almost as quickly as we clean it. She’s been requiring much more dialysis than we anticipated. We thought things would settle down after a fortnight or so, but that’s not been the case, I’m afraid. We think it may have something to do with a tissue-degradation problem in her kidneys.’
Tissue degradation! The words echoed round and round in Sandy’s head. ‘You mean her kidneys are breaking up?’ he asked. His throat was tight and it showed in his voice. He had to swallow.
Grayson shrugged and said, ‘That’s our theory at the moment. Of course, we’ll have to wait until we get a full histology report before we can be absolutely certain.’
Sandy felt that he was listening to a garage mechanic tell him what was wrong with his car, rather than a doctor pronouncing on his daughter’s condition. What made a man like this become a doctor? It wasn’t the first time he had wondered this same thing. His job had brought him into contact with a number of people in the medical profession who he felt lacked any basic compassion for the sick. They didn’t see people in front of them, only cases, intellectual challenges, problems to solve, games to win or lose in the struggle to advance a career.
‘I take it this means that we’ll not be getting her home in the near future?’ said Kate.
‘Out of the question,’ said Grayson.
Kate looked down at the floor and clasped her hands, twisting her fingers as she listened to Grayson continue.
‘The fact is, I’m sorry to say, that Amanda is one of these patients for whom dialysis just isn’t good enough. It isn’t working. She really needs a transplant.’
‘Or she’ll die,’ said Kate in a flat monotone.
There was an agonized silence in the room before Grayson said quietly, ‘That is a possibility, I’m afraid.’
Sandy saw that Kate had stopped fidgeting. Her hands lay still in her lap and her face was perfectly calm. It unnerved him. He reached across and laid his hand on top of Kate’s. They were ice-cold. The tightness in his throat still made talking difficult but he asked Grayson, ‘Surely there must be some kind of priority given to such cases?’
‘Of course. Amanda will be given urgent status on the transplant register,’ agreed Grayson.
‘What does that mean in practice?’
‘It means that she will be allowed to jump the queue if a suitable organ should become available, but of course we’ll still be constrained by considerations of tissue type. The organ has to be a good match for her.’
‘What about us?’ asked Kate.
‘I was about to suggest that,’ said Grayson. ‘It’s possible that either you or your husband might prove to be a suitable donor and we’ll certainly check your tissue type, but I don’t think you should bank on this. It happens less frequently than people imagine. A brother or sister would be a better bet and a twin would be ideal, but of course Amanda is an only child.’
‘So if neither of us matches her type we’ll just have to wait and hope?’
‘That’s about the size of it.’
‘How much time have we got?’
‘Impossible to say, I’m afraid,’ replied Grayson curtly.
‘Doesn’t it concern you at all?’ said Sandy, his patience with Grayson’s apparent callousness finally giving out.
‘I beg your pardon?’
‘Our daughter’s plight. Aren’t you concerned — as a person, I mean?’
‘Of course I am,’ replied Grayson, obviously flustered by the question.
‘You could have fooled me,’ replied Sandy flatly but Kate put a restraining hand on his arm to stop things going any further. He and Kate got up to go.
Clive Turner, who had been silent throughout, followed them outside. ‘I’m sorry,’ he said when the door had closed behind him. ‘Dr Grayson’s a bit of a cold fish. I’m sure he means well, but he doesn’t always come across that way.’
Sandy nodded. ‘How soon can we be tested for tissue type?’ he asked.
‘We can do it before you leave,’ replied Turner. ‘But as Dr Grayson said, I don’t think you should build your hopes too high.’
Sandy’s look suggested that this was the last thing he wanted to hear.
‘Look, why don’t we all go and get some tea?’ suggested Turner. ‘There’s something I’d like to talk over with you.’
Sandy’s first inclination was to decline the invitation but he changed his mind when he saw that Turner wasn’t just being polite or mounting a damage-limitation exercise on behalf of his boss. The man looked as if he really did have something to say. ‘All right,’ he said. ‘I think we could all do with some.’
The visitors’ tea room smelt of strong tea and plastic. The tall windows looking out on to the courtyard were misted over, thanks to a tea urn with a faulty thermostat which bubbled constantly and sent wafts of steam up into the air. Here and there a cleared patch on the glass permitted views of the rain speckling the puddles in the courtyard below. At Turner’s suggestion, Sandy took Kate across to one of the red-topped tables and sat down with her while Turner got the tea and brought it over on a brown plastic tray. There was a slight hiatus while he righted the cups in their saucers, placed them around the table and poured out the tea. As he sat down, he said. ‘This must be a nightmare for you.’
‘It all happened so quickly,’ said Sandy, searching for something sensible to say in reply. ‘She was as right as rain one moment and then suddenly she’s in here and…’
‘She’s dying,’ said Kate.
Turner’s silence was worse than anything he could have said at that moment, thought Sandy.
‘What was it you wanted to speak to us about?’ he asked, determined to end the silence.
Turner rested both forearms on the table and leaned forward as if to impart a confidence. ‘We have to think ahead about what to do for Amanda if neither of you should prove to be a suitable donor.’
‘I thought we’d just have to wait,’ said Sandy.
‘I don’t know how you’ll feel about this,’ said Turner, ‘but I thought there was one possibility we might explore together for Amanda. It’s only a possibility, mind you, and it might come to nothing, but I think it’s worth considering.’
‘What is?’ asked Sandy.
‘We had a circular from the Scottish Office recently concerning the Medic Ecosse Hospital here in Glasgow. Apparently, because of some political agreement reached between the hospital and the government over funding, they’re taking on a number of NHS patients recommended to them for specialist treatment. They’ve done this occasionally in the past but it was only out of the goodness of their hearts. Now it’s been put on a more formal basis. I suppose it’s still a PR exercise but the fact remains that a patient accepted by them under the new scheme will be treated as one of their own patients and completely free of charge.’
‘How does this affect us?’ asked Sandy.
‘It just so happens that Medic Ecosse has a world-renowned transplant facility.’
‘You mean you think they might accept Amanda as a private transplant patient?’
‘As far as I could see, there was no qualification about what kind of patient could be referred to them. If a case could be made out that a patient would clearly benefit from their expertise or facilities, then the criterion for referral would be met. That, I have to say, may be wishful thinking on my part but on paper there’s no bar.’
‘Do you think Amanda would benefit from such a referral?’ asked Sandy.
‘I think…’ Turner paused as if considering his words carefully. ‘I think that Amanda might conceivably get her transplant quicker at Medic Ecosse than here in the unit, and in her case time is of
the essence.’
‘But how, if there’s an international register and a waiting list?’ asked Kate.
Turner paused again, then said, ‘I suspect there may be several international registers, not all of them available to NHS-funded hospitals.’
‘I don’t think I understand.’
‘I’m afraid that where there’s any kind of demand there’s always a supply based on currency rather than need,’ said Turner. ‘The international trade in donor organs is no different from any other commodity in short supply.’
‘How awful,’ said Kate.
‘But even if that were so,’ said Sandy, ‘surely they couldn’t admit to that and accept Amanda on those grounds?’
‘No indeed,’ smiled Turner. ‘But in addition, and this is important, they have the most modern dialysis equipment available anywhere in the world. I think a case could be made out that Amanda would benefit greatly from that alone. What she needs most right now is time. The Medic Ecosse unit could give her that. If they can come up with a kidney for her too, so much the better.’
‘How do we go about asking Medic Ecosse?’ asked Sandy.
‘The referral would have to come from here. I’ll speak to Dr Grayson if you like.’
‘Would you?’ said Kate, gratitude obvious in her voice.
‘Maybe I shouldn’t have rattled his cage,’ said Sandy ruefully. ‘I was pretty rude.’
‘Don’t worry about it,’ said Turner. ‘He’s too thick-skinned to have taken it to heart. He’ll have put it down to your being upset. Insensitive people always put it down to a misunderstanding on someone else’s part. I’ll get back in touch as soon as I’ve talked to him. Why don’t you go up and see Amanda for a while, and I’ll get in touch with the lab about tissue-typing you before you leave. It’s a simple procedure.’
