Pestilence

by Ken McClure

  “The question is, were these measures necessary Doctor? Or were they the headstrong action of a doctor with little or no regard for authority?”

  “Of course the transfusion was necessary!” stormed Saracen. “The girl was close to death.”

  “Dr Garten disagrees.”

  So that’s it, thought Saracen, Garten’s gone on the attack. “Dr Garten was not there,” he said coldly.

  “I am quite satisfied that Dr Garten has had access to all the relevant information and notes. I…we,” Saithe turned to Grimshaw, “are confident of his judgement in this matter.” Saithe put his glasses back on and looked directly at Saracen. He said, “Dr Saracen, you have by your irresponsible action placed this hospital and its health board in an embarrassing and potentially damaging situation. You are accordingly suspended from duty pending a full inquiry.”

  Saracen was stunned and for a long moment there was silence in the room. Then he recovered and said, “This is ludicrous!

  “You will have the opportunity to defend yourself at the inquiry,” said Saithe evenly as he gathered together his papers from the desk.”

  Saracen was furious. He looked at Garten and said, “I see, you keep Chenhui quiet by locking her up under sedation and now you get me out of the way with this law suit nonsense. Well it won’t work! I’m still going to go on asking questions about Myra Archer and Leonard Cohen!

  Saithe interrupted Saracen saying, “Dr Garten has told us something of your outrageous allegations. Just what is it you are suggesting Doctor?”

  “I am suggesting,” said Saracen slowly and making a conscious effort to keep his temper under control, “That there were serious irregularities over the deaths of two patients admitted to A amp;E.”

  “And what were these ‘irregularities’?” asked Saithe scathingly, his forehead creasing into a well practised frown that was meant to imply a superior intelligence in action.

  “The first case, a woman named Myra Archer was recorded in the book as being dead on arrival at Skelmore General. She was not. I know for a fact that she was alive when the ambulance brought her in. Saithe looked to Garten who adopted an air of mild exasperation before smiling as if about to correct the foolish notion of a child. “There is a perfectly simple explanation,” he began. “Mrs Archer was indeed alive when the ambulance arrived… the first time, but not when she was admitted.”

  Saithe adopted his frown again. Grimshaw pulled out an exceedingly large handkerchief and blew loudly into it causing Garten to pause before continuing. “Dr Tang, who was the medical officer on board, came and told me that she suspected the patient might be suffering from an infectious disease. Under the circumstances I thought it wiser that she be taken on to the County Hospital.”

  “What infectious disease?”

  “A Salmonella Infection.”

  “How did Chenhui diagnose that?” asked Saracen.

  “From her initial interview with the patient.” replied Garten.

  “But she was unconscious when Medic Alpha got to her,” protested Saracen.

  “Dr Tang says different and she was there,” said Garten with a cutting edge to his voice.

  “What happened next?” asked Saithe.

  “The patient died shortly after leaving the grounds of the hospital. Dr Tang radioed for advice and I told her to return here whereupon Mrs Archer was then classified dead on arrival.”

  “Why did you bring her back?” asked Saithe.

  Garten smiled conspiratorially at Saithe and said, “I’m sure you are only too well aware Martin that the County believes we send them too many of our cases already. I thought it wiser to re-call Medic Alpha and do the paper work myself.”

  Saracen glanced up at the ceiling in frustration. Not only was Garten sounding plausible he was beginning to sound like a Saint.

  Saithe grunted his approval. Saracen parked his tongue in the side of his cheek.

  “Any more ‘irregularities’?” asked Saithe, his voice tinged with distaste.

  “Lots,” replied Saracen, making the word sound like an expletive. “When Myra Archer’s husband arrived at A amp;E he was told that his wife had been taken to the County Hospital.”

  “A regrettable misunderstanding,” said Garten smoothly.

  “Then he was refused permission to see his wife’s body.”

  “I thought it wiser in view of the Post Mortem that the request be denied,” said Garten.

  “What Post Mortem?” asked Saracen, playing his ace. It failed to have the effect he had anticipated. Garten exchanged an exasperated glance with Saithe then he looked at Saracen and shook his head. Saracen felt his stomach go hollow. Something was wrong. He had played his trump card and Garten hadn’t even flinched.

  “Surely you know that there has to be a PM on all sudden deaths Doctor?” said Garten. “Why should Mrs Archer be an exception?”

  “I would like to see the report,” said Saracen feeling like an automaton and fearing the worst.

  Garten remained motionless for a moment like a spider surveying a fly caught in its web then he delivered the coup de grace. He picked up his briefcase from the floor and took out a document. He slid it over the desk to Saracen.

  Saracen read the heading on the paper. ‘Findings of the Post Mortem Examination on Myra Louise Archer’. His heart sank as he leafed through the preliminaries to look for the pathologist’s signature. His eyes followed every curl in the ink as he read, Cyril A. Wylie. Cause of death was given as myocardial infarction. Listed as a complicating condition was Salmonella otangii type IV. Saracen looked up to meet Garten’s eyes.

  “How else could I have signed the death certificate?” said Garten with such quiet menace that Saracen felt transparent.

  “Can I ask a question?” asked Grimshaw.

  “Of course,” replied Saithe.

  “What exactly is this infection that was mentioned?”

  “Salmonella? It’s a serious form of food poisoning. It’s related to the bacterium that causes typhoid.” said Saithe.

  Garten added, “Dr Tang was quite right in her suspicions and just as well as it happens. On the strength of her diagnosis we requested British Airways to contact Mrs Archer’s fellow passengers on the flight from Zimbabwe and arranged for them to have some covering therapy.”

  “So you think that it was something she caught on the plane?” asked Grimshaw.

  “It was a possibility I could not overlook,” replied Garten.

  “Of course not,” Grimshaw concurred.

  Saracen found himself with a grudging admiration for Garten. The man had had a busy night, preparing a line of defence for every conceivable line of attack.

  Saithe looked at his watch pointedly and said, “We are all busy men. Unless you have something sensible to say Dr Saracen I suggest we terminate these proceedings.”

  “Where is Leonard Cohen’s body?” said Saracen.

  “I beg your pardon,” said Garten.

  “I think you heard,” said Saracen. “I asked where Leonard Cohen’s body was.”

  “You know very well that Mr Cohen’s body was taken to the premises of a local undertaker when our refrigeration system failed,” replied Garten. You went there yourself this morning to examine the body though for what reason I cannot imagine.”

  So Dolman had been in touch with Garten, thought Saracen. He took comfort from a slight look of unease that had appeared in Garten’s eyes as he failed to follow Saracen’s line of questioning. It was something he had not been prepared for. “I did go there this morning,” he said,” and I did examine a body but it was not that of Leonard Cohen.”

  “What are you saying Doctor?” asked Saithe.

  I am saying that I went to the premises of Maurice Dolman and Sons this morning to examine the body of the patient Leonard Cohen whom Dr Garten had transferred immediately after his death. The undertakers showed me a body but it was not that of Leonard Cohen.”

  “What do you mean it wasn’t Leonard Cohen?” snapped Garten.
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  Saracen told him his reasons and saw a first hint of fear on Garten’s face.

  “I’m sure there must be a perfectly rational explanation if what you say is true,” said Garten. “Perhaps the attendant showed you the wrong body.”

  “He showed me the only male corpse they had,” said Saracen, driving home his advantage.

  “What time was this?” asked Garten.

  Saracen got the impression that Garten was stalling. He told him what time it was when he went to Dolman’s.

  “Ah, that explains it,” said Garten with feigned relief. “Cohen’s body would have been away for autopsy by that time.”

  “And you have the report,” said Saracen quietly, seeing that Garten had recovered the initiative. The man had had a busy morning.

  “Of course,” replied Garten, pulling out another document from his case.

  Again Saracen saw Cyril Wylie’s signature on the report. He handed it back and said, “I’d still like to see the body.”

  “Really Dr Saracen this is all becoming too much,” protested Saithe.

  Garten gave an apologetic smile and added, “And rather academic I’m afraid. In the absence of any next of kin Leonard Cohen’s remains were sent for cremation after the Post Mortem this morning.”

  Saracen felt the numbness of defeat. Liquid lead flowed in his veins. Saithe got to his feet and said to Saracen, “Doctor I must remind you that you are suspended from duty until further notice.”

  Saracen returned to the flat feeling angry and impotent. His worst fears were becoming reality. This was no minor skirmish with authority; this was his exit from medicine unless somehow he could turn the tables on Garten. He called Moss at the County Hospital and told him what had happened. Moss agreed to meet him for lunch in Skelmore rather than talk further on the phone. They met, as arranged outside The Green Man pub at twelve thirty.

  “I thought you said that there was definitely no Post Mortem done on Myra Archer,” said Saracen, unable to keep the accusation out of his voice.

  “That’s right. There wasn’t.”

  “Garten had a PM report on her signed by Cyril Wylie. He’s just crucified me with it.”

  “Has he now?” said Moss quietly. “What date?”

  “The thirteenth.”

  “I checked Wylie’s schedule from the twelfth right through to the fifteenth. Myra Archer wasn’t on it. He simply didn’t do it, unless of course he took his work home with him.”

  Saracen did not feel like laughing. “Can you prove that Wylie did not carry out a PM on Myra Archer?” he asked Moss.

  The smile faded from Moss’s face. “Do you know what you are asking?” he said seriously.

  Saracen nodded and said, “It’s my only chance.”

  “All I have to go on is the schedule. Even if he hadn’t done it he could simply say that there had been a change in the listings and he had done the Archer woman instead of somebody else.”

  “I think it has happened twice.”

  “What do you mean?”

  “Garten showed me a PM report on Leonard Cohen that Wylie was supposed to have done this morning. I don’t believe he did it.”

  “I can check,” said Moss. “I’ll call you this afternoon.” Moss got to his feet and said, “I’ll have to go.” Saracen was left with an empty feeling in his stomach as he realised that he himself had nothing to hurry back for.

  Saracen started to walk back to the flat in the watery sunshine that had broken through after a morning of mist and drizzle but the looming prospect of brooding in silence made him change his mind. He opted instead for a walk. He needed distraction and noise and the unwitting camaraderie of the streets would make him feel less vulnerable.

  The sun broke from behind its thin filter of cloud and warmed Saracen’s cheek as he turned off the main thoroughfare to enter Coronation Park. He held the iron gate open for a young mother pushing a pram before letting it bounce back on its post and continuing down the central path to its junction with a riverside walk. The people he met on the way were either young women with children or old men and it made him wonder about the lack of old women. What did they do while their men folk followed the meandering trails of the park? Was it just that, after a lifetime of going out to work, the men felt a greater compulsion to be out and about while women were more used to the confines of the home? There did seem to be an artificial sense of purpose about the way the men moved. Even the oldest of them, backs bent as if some unseen hand were pushing them into the earth, never seemed entirely aimless in their choice of direction.

  Saracen stopped as he came to a willow tree. It arched out from the embankment and hung over the river, boughs heavily pregnant with the new season’s leaves. He wondered what would have happened to him by the time it was full and green. At the moment it seemed that his only hope of professional survival lay in Moss being able to come up with some kind of proof that the PM examinations on Archer and Leonard Cohen were never carried out. But what would that mean? That the reports were forgeries? Surely not. Garten would not be that crude. But if Cyril Wylie had actually prepared them without actually doing the autopsies what did that mean? Why would he do such a thing? If the worst came to the worst, thought Saracen as he threw a pebble into the river, I’ll ask him.

  The telephone was ringing in the flat when Saracen finally got home. He had the feeling that the caller would hang up just as he reached it but, for once, it didn’t happen. It was Jill. “James? I’ve been trying to reach you for ages. Where have you been?

  “I went for a walk.”

  “I heard what happened, you must be feeling awful.”

  “Not good,” agreed Saracen with a half hearted attempt at a laugh.

  “Oh James,” sighed Jill, recognising the resignation in Saracen’s voice, “They can’t possibly make it stick. Everyone knows the child would have died. Dr Tang knows it; Sister Lindeman knows it. You’ll be cleared, you’ll see.”

  In his heart Saracen could not share Jill’s conviction. Chenhui was in no position to back him up and Sister Lindeman’s opinion would not be sought in a purely medical dispute. But he did not say so. He said simply, “We’ll see.”

  “Can I come round tonight or would you like to come round here? I’m still at the flat.”

  Saracen hesitated while he thought what he had to do. “Can I leave it open at the moment? I’m waiting for Dave Moss to call.”

  “Of course,” said Jill. “If you want to come round just come. I’ll be there.”

  Moss called at three thirty. “Sorry I took so long. I had to wait my chance. It’s as you suspected, there’s no record of Wylie doing a PM on Cohen this morning. He did carry out an examination but it was on an eighty three year old woman named Isabella Leith.”

  Saracen felt relief flood through him. “I can’t thank you enough Dave.

  “There is one thing…” Moss began.

  Saracen thought he detected a note of uneasiness in his voice. “Yes?”

  “There’s really not much more I can do…I’d appreciate it if somehow you could leave me out of things from now on?”

  “Of course, I understand,” said Saracen and thanked Moss again before putting down the receiver. He smiled wryly. Perfect friends were for books and films, real ones were human.

  Saracen gave himself a moment to compose himself before dialling the number of the Pathology Unit at the County Hospital but his pulse rate rose while he waited for an answer.

  “Pathology.”

  “Dr Wylie please.”

  “One moment. Who’s calling please?”

  “Dr Saracen.”

  A lengthy pause.

  “Yes what is it?” snapped Wylie’s voice.

  “I wonder if I might talk with you, Dr Wylie?”

  “Who is this?” demanded Wylie, making no attempt to disguise his irritation.

  “James Saracen, I am, or rather, I was Nigel Garten’s registrar at Skelmore General.”

  “Garten you say,” said Wylie, his tone
of voice changing though Saracen could not tell whether it was from surprise or something else. “What do you want to see me about? I’m a busy man.”

  “Myra Archer and Leonard Cohen,” said Saracen bluntly.

  There was a pause before Wylie asked quietly, “What do you mean?” This time Saracen had no difficulty in interpreting the nuance in Wylie’s voice. It was fear. Hearing it filled him with confidence. Wylie was going to be Garten’s Achilles heel, the weak link that he was going to break. “I want to know why you signed Post Mortem reports for these patients without carrying out the autopsies,” said Saracen. He heard Wylie swallow hard at the other end of the phone before he replied, “This is preposterous!”

  “I agree,” said Saracen evenly. “The trouble is it is also true.” He endowed the words with the slow but irresistible momentum of an ocean liner nudging the quayside.

  “You are Garten’s registrar you say?” Wylie stammered. Saracen could almost see the sweat on his brow. “Garten won’t save you,” he said, “I know all about Garten’s involvement. He is in it up to his neck. I just thought I would ask for your side of things before I went to the Police. It would be a pity of you had to take all the blame on your own.”

  The words had the desired effect. Wylie started to panic. “The Police? Surely there is no need for the Police. I mean, there must be some alternative?”

  “I don’t think so,” said Saracen, turning the screw.

  “Look, can’t we discuss this?”

  “I don’t see that there is anything to discuss really,” said Saracen coldly. “Do you?”

  “But you don’t understand. At least give me the chance to explain. That’s all I ask.”

  “Go ahead.”

  “No. not over the phone. I’ll stay on in Pathology this evening. Come round here about nine. I’ll tell you everything you want to know.”

  Saracen could hardly believe his luck. The bullying, blustering Cyril Wylie had collapsed like a house of cards and it had been so easy. He concentrated on keeping a hard edge to his voice when he said, “I’ll be there, and one more thing.”