by Ken McClure
‘What sorts of things?’ she asked.
Dunbar shrugged. ‘Little things. There’s a kid in at the moment, Amanda Chapman. She’s waiting on a kidney transplant. Medic Ecosse gave her a marrow puncture she didn’t really need — all her blood stats were known already. Everyone seemed to know that except the people in charge of her treatment.’
‘A marrow puncture?’ exclaimed Lisa as if it meant something to her.
Dunbar felt a chill across the back of his neck. ‘Yes. Why?’
‘Amy had that done as well,’ said Lisa.
‘Amy Teasdale had a marrow puncture she didn’t need?’
‘I remember one of the housemen pointing out that it wasn’t necessary, but Dr Ross insisted she had one anyway.’
‘Tell me about it,’ said Dunbar. ‘I want to know everything that happened to Amy.’
‘You know most of it. She was a difficult case. She’d been ill almost from the time she was born, and appealing to Medic Ecosse was a last resort for her doctors.’
‘So no one was too surprised when she died,’ said Dunbar thoughtfully.
‘Put that way, I suppose not,’ agreed Lisa. ‘People were more surprised that the hospital took her on in the first place when things hadn’t been going too well for them financially and Amy seemed a bit of a lost cause anyway.’
‘A bit like Amanda.’
Lisa looked questioningly at Dunbar but he chose not to elaborate. Instead, he said, ‘Then you rocked the boat when you started saying that Amy died because she’d been given the wrong organ?’
‘I suppose so. You see, she was only a lost cause when they couldn’t find a suitable kidney for her, but within weeks of coming in to Medic Ecosse they did. By rights she should have been perfectly okay after her transplant.’
‘There was an Omega patient in the hospital at the time, wasn’t there?’ said Dunbar, still half preoccupied with his own thoughts.
‘Yes. How did you know?’
‘I checked the dates of free transplant patients before Amanda Chapman against those of Omega patients.’
‘Why?’
‘I thought at first that the hospital might be using income from Omega patients to cover the costs of expensive free referrals.’
‘And now?’
‘There’s more to it. I wonder if Kenneth Lineham was a free transplant patient too?’
‘Couldn’t you check?’
‘The list of free referral patients didn’t include names. I suppose I could-’ He broke off in mid-sentence.
‘What is it?’
‘I’ve just remembered something,’ said Dunbar excitedly. ‘Sheila Barnes, in her journal, got quite upset at one point because an Omega patient seemed to be getting more attention than her patient. That means there was an Omega patient in the hospital at the same time as Kenneth Lineham. He must have been the first free transplant patient, Amy was the second and now Amanda Chapman is number three. All apparently hopeless cases taken on out of the goodness of Medic Ecosse’s heart and always at the same time as an Omega patient.’
‘But surely that means-’
‘That Amanda Chapman is in great danger,’ interrupted Dunbar. ‘Just like the others.’
‘What are you going to do?’
‘We need more than just suspicion,’ said Dunbar, exasperation showing on his face. ‘We need hard evidence and we haven’t got any. We don’t even have a clue what they’re really up to.’
Lisa looked alarmed. ‘We can’t just do nothing,’ she said.
‘I’m going to talk to Clive Turner. He might have an idea.’ She nodded.
Dunbar called Turner at the Children’s Hospital. ‘I’m sorry I didn’t get back to you sooner,’ he began. ‘The truth is, I haven’t been able to find out discreetly why Amanda Chapman was given an unnecessary marrow puncture.’
‘As it happens, I don’t think anyone is going to be too upset, even if it was a mistake,’ said Turner.
‘What’s changed?’
‘A kidney’s become available for Amanda. Hadn’t you heard?’
‘No, I hadn’t,’ said Dunbar slowly. ‘That is good news.’ He said the words but his head suddenly seemed full of broken glass. It was happening all over again. It was happening to Amanda just as it had to the others. She was going to die. She was going to reject her transplant.
‘Amazing luck really,’ continued Turner. ‘She’s a very fortunate young lady.’
‘Clive, could I come over there? I need to talk to you.’
‘Why… yes, I suppose so. Is something the matter?’
‘I’m not sure. How about now?’
‘If you like.’
‘I’ll be there in fifteen minutes.’
He found Turner in the duty room, talking to a colleague.
‘Clive? I’m Steven Dunbar.’
Turner broke off his conversation and turned to shake hands. ‘We can talk next door,’ he said. He ushered Dunbar into a small, sparsely furnished room and offered him coffee from a half-full flask that sat on an electric heating plate. This and a computer terminal were the only furnishings in the room, apart from two hard chairs and an old Formica-topped table. It said something about modern-day priorities.
‘Thanks. Black, no sugar.’
Turner handed Dunbar his coffee and sat down opposite him. ‘You sounded a bit concerned on the phone?’
Dunbar nodded. ‘The truth is I don’t quite know where to begin. I know you’re going to find this hard to believe, but something very wrong is going on at Medic Ecosse and I think Amanda Chapman is about to be caught up in it.’
‘Go on,’ said Turner, now looking serious.
Dunbar told Turner who he really was and why he had been sent to Medic Ecosse.
‘So you think Amanda is at risk like the previous two,’ said Turner.
‘I do. I don’t know how or why exactly, but I do feel she’s in great danger.’
Turner moved his hands in a gesture of confusion and tried but failed to find words.
‘I’m sorry to have sprung this on you like this, but I need your input. You’re a transplant expert,’ said Dunbar.
‘There’s rather a lot to take in,’ said Turner. ‘James Ross has an international reputation. It’s difficult to believe he’s mixed up in anything shady. On the other hand, if what you say is true… What is it you want from me?’
‘I’d like to be able to call on you if it proves necessary at any point. I’d also be interested in any suggestions you might care to make as to why the kids died.’
‘You say both previous patients were given ostensibly compatible transplants yet they rejected them strongly? That would be unusual in itself.’
‘The computer agrees with you,’ said Dunbar. ‘I checked. They were the only two in the country to die with compatibility ratings as high as they had.’
Turner nodded. ‘You know that Ross has been experimenting with animal organs but you say you don’t think he risked trying them on the patients?’
‘I’ve seen his research data. There was no hope of success with pig organs the way they are at the moment. There would have been no point in attempting it.’
‘What about a mistake in the compatibility ratings given to the donor organs?’ suggested Turner.
‘Checked at both ends in Amy Teasdale’s case,’ said Dunbar.
Turner made a face. ‘They agreed?’
‘To within five per cent.’
‘Maybe we should check up on the kidney they’ve found for Amanda?’
‘Good idea,’ agreed Dunbar.
Turner logged on to the computer terminal in the corner of the room and asked for access to the donor database. While the machine was considering his request, he suddenly swore as if he’d just remembered something and got up to go next door. He came back clutching Amanda Chapman’s old notes. ‘We’re in luck,’ he said. ‘I thought they might have been taken down for filing. I need to know her tissue type.’
He thought for a moment, then went on,
‘It won’t be any good asking for a kidney match if the kidneys have already been booked for Amanda, but it might still be possible to ask about the availability of the liver.’ He entered the request for a liver, along with Amanda Chapman’s tissue type.
There was a delay of about thirty seconds before the screen filled with information. ‘There we are,’ said Turner quietly. ‘There’s our donor. Eighty-four per cent homology. A first-class match. Amanda should have no problem at all. All straight and above-board.’
Dunbar stared at the screen without emotion. ‘You’d better decline the liver,’ he said. ‘They’re holding it for you.’
Turner was about to enter the cancellation when Dunbar put a hand on his arm. ‘Before you cancel, can you find out where the organ is coming from?’
‘Sure.’
Turner requested the information, still under the pretext of searching for a liver for someone with Amanda’s tissue type. ‘Here it comes,’ he said as the screen blinked and changed. ‘The organ is available through the Kohl Clinic.’
‘Where’s that?’ asked Dunbar.
‘Geneva.’
‘Sweet Jesus,’ muttered Dunbar.
‘Something wrong?’
‘Ross has some connection with Geneva, a consultancy, something like that.’
‘Switzerland is full of private clinics,’ said Turner. ‘I don’t think you can read anything too sinister into that.’
Dunbar held up his hands in defence. ‘I know, I know,’ he said. ‘It’s just that everywhere I turn I find little clues like that. I just can’t fit all the pieces together yet.’
Turner looked at him in silence for a few moments before saying, ‘I wish you luck. I feel sort of responsible for Amanda; I suggested the referral in the first place.’
‘And I didn’t raise any objection,’ said Dunbar with a wry smile. ‘That makes me equally guilty. You said the organ was “available through the Kohl Clinic”. What exactly does that mean?’
‘I’m not sure,’ confessed Turner. ‘I suspect it means that the patient isn’t actually in the clinic but the clinic is handling the arrangements.’
‘I see,’ said Dunbar thoughtfully. He sensed that Turner wasn’t telling all he knew. ‘Handling the arrangements?’ he prompted.
‘All right, I have my suspicions,’ said Turner. ‘There’s a black market in human organs just like there’s a black market in anything else that there’s a demand for. I suspect this Kohl Clinic may be a front for that sort of thing.’
‘I’ve heard stories of healthy people selling a kidney to make money in places like India,’ said Dunbar. ‘I didn’t realize how widespread it was.’
‘It goes on. I’ve heard tell that they even have a tissue-type register of people who are prepared to do this so they can call them in when a request comes through.’
‘God, what a world,’ sighed Dunbar.
‘That’s just a guess,’ insisted Turner. ‘And these organs don’t come cheap. It wouldn’t make any sense in Amanda’s case if Medic Ecosse are doing the paying.’
‘No, it wouldn’t,’ said Dunbar. ‘But not making sense is par for the course.’
‘I’m sorry, I’m not being much help.’
‘You’ve given me something else to think about.’
‘You really are worried about this transplant, aren’t you?’ said Turner.
‘I’ve got such a bad feeling about it. But on the face of it, Amanda’s in a top-class hospital under the care of a world-famous surgeon and she’s about to receive a kidney with an eighty-four per cent compatibility rating. What can I do?’
‘Not a lot,’ said Turner.
‘Incidentally, they did a marrow puncture on Amy Teasdale too. It wasn’t a mistake. Ross knew she’d had one done before.’
‘He must have wanted stem cells,’ said Turner. ‘Wonder why? Maybe something to do with his immuno-preparation work.’ He shrugged and asked, ‘Is there anything else you’d like me to do?’
‘Just be available,’ said Dunbar. ‘Right now, I don’t know why or what for.’
‘I’ll give you my home number and a mobile as well.’
Dunbar returned to Medic Ecosse. He supposed he felt better for the chat with Turner, but he was far from easy in his mind. As he parked his car and walked round to the front of the hospital, a taxi drew up outside the front entrance and two men got out. They were well-dressed and had the aura of successful professional men, Dunbar noted as he passed that one was carrying a very expensive alligator-skin medical bag. Both had American accents.
Out of curiosity, Dunbar lingered near Reception, pretending to look for something in his briefcase.
‘We’re expected,’ said one of the men as they reached the desk.
‘Dr Ross left word,’ said the receptionist. She rang the bell for the porter and said to him, ‘Show these gentlemen up to the Omega wing, will you?’
Dunbar waited until the three men had disappeared before approaching the receptionist.
‘Dr Dunbar, what can I do for you?’
‘Those two men. Who were they?’
‘I couldn’t rightly say, Doctor. Dr Ross just advised me that two medical gentlemen would be arriving sometime this afternoon. Sounded American, if you ask me.’
SIXTEEN
Dunbar sat at his desk and embraced the silence. He took slow, deep breaths as an aid to thinking clearly and rationally; mounting frustration had been preventing this. He knew exactly what he wanted to do. He wanted to put a stop to Amanda Chapman’s transplant operation, but he couldn’t. This was the unpalatable bottom line that was making him so uncomfortable. He couldn’t because he had no good reason to. If he tried, he would be seen by all and sundry as some kind of interfering lunatic, at best suffering from a sudden nervous breakdown, but more probably reviled as a madman of the sort who mowed down the innocent.
No one would listen and they couldn’t be blamed. There was really nothing of substance to consider. For that reason they would all be against him, the hospital, the transplant unit, Amanda’s parents, Sci-Med, everyone. Even if he were to succeed in stopping it, the chances were that Amanda would still die because she couldn’t get a transplant in time when — as others would not be slow to point out — one had been available. He would be seen as her murderer and all because he suspected things weren’t going to turn out well for her.
He knew that unless he worked out exactly what Ross was up to by the time the donor kidney arrived from Geneva, he was going to have to sit still and do nothing. If, as he suspected, Amanda should reject her transplant, like Amy Teasdale and Kenneth Lineham, it would still be his fault because he hadn’t done anything to stop it. Talk about the devil and the deep blue sea. Damned if you do, damned if you don’t. He cursed and got up to start pacing the room.
Once more he juggled the pieces of information in his head, trying to make a coherent picture, but they still wouldn’t fit. Maybe there weren’t enough or maybe there were too many and not all of them relevant.
He was distracted by the sound of a taxi’s diesel engine as it drew to a halt and idled noisily at the front door. He looked down to see another person carrying a medical bag had arrived. There was certainly lots of activity surrounding the Omega patient. Soon, he reflected, there would be lots of activity surrounding Amanda Chapman. He frowned and asked himself again: what’s the connection?
Amanda had been taken to the Omega wing for her unnecessary marrow puncture. He hadn’t been able to come up with a reason for it but at least he knew that the test itself wasn’t a simple mistake of duplication. Amy had been subjected to the same procedure. Ross had insisted on it. What was it that Turner had said? He must have wanted stem cells for his immuno-preparation work.
Dunbar suddenly saw the light. The tests hadn’t been performed for the benefit of the patients at all. Ross hadn’t wanted duplicate tests done. He’d needed stem cells from the patients for a purpose other than the obvious one of checking their immunotype. There was no repetition of unnec
essary tests at all. There never had been.
He felt a frisson of excitement. He was getting somewhere at last. Immuno-preparation work? Where had he come across that term recently? Turner had used it but he had seen it somewhere else. If only he could remember… The phone rang and broke his train of thought. He cursed and answered it. It was nothing important.
Dunbar tried to recover his concentration but failed. The moment had gone. He decided to cut his losses and waste no more time wondering. He connected his notebook computer to the phone line to call up Sci-Med. He wanted the latest information they had about James Ross.
His interest quickened at once: they’d found out something about Ross’s Geneva connection. Their earlier problems had been due to an inability to trace a Medic International hospital or clinic in Geneva. The reason for this was simple. There was no such place and Medic International had no interests at all in Geneva. Ross had been going there for other reasons; he also owned a house there, a villa overlooking the lake. He had paid $2 million for it three years ago.
‘Jesus,’ muttered Dunbar. So money was involved after all. Big money. You didn’t buy a house like that on eighty grand a year. He saw that there was more information to come and scrolled down the screen. Ross had an interest in a Swiss medical recruitment agency called Roche Dubois. It specialized in the recruitment of high-grade staff for private clinics all over Europe. Doctors, nurses, technicians of all sorts, could find highly paid work if they were good enough. The agency was above-board and had a good reputation. It specialized in finding positions for American nursing and medical personnel wishing to work in Europe for whatever reason, although exchanges for European nationals were also arranged.
Dunbar wondered if this was relevant. Did Ross have reason to recruit medical staff on his own behalf? He thought about the American doctors being shown to the Omega wing. Could all the secrecy, stone-faced guards and strange medical people coming and going really be ascribed to a need for confidentiality? No, there had to be more to it.
The Omega patients were the key to the whole damned thing, Dunbar decided. It wasn’t that the money they brought in was being used to subsidize NHS charity patients. Quite the reverse. The NHS patients were being used in some way for the benefit of Omega ones. That must be why Ingrid had feigned ignorance when he had mooted a connection between them and Omega patients over funding. She knew what was going on. He had thrown her by making the connection but for the wrong reason.