Clive’s annoyance had come about because of the death of Mr Lionel Helmond who had been found collapsed in his garden. The information from the Coroner’s office had been straight to the point and authoritative:
Mr Helmond, 78 years old, had told his wife that he was going to mow the lawn. She heard the mower going for about twenty minutes, but then it stopped. She assumed that he was having a rest and thought nothing of it for fifteen minutes or so, but then after shouting from the back door to see if he wanted a brew, which brought no answer, she became concerned. She found him lying dead on the lawn.
According to his general practitioner, Mr Helmond had a history of colonic cancer cut out in 2002, gout, high blood pressure and had recently been suffering chest pains.
It is likely that he suffered a heart attack.
No one had thought any different. After all, we have people of seventy-plus coming through the double red doors all the time, and probably half of them have died of heart disease. The exertion of mowing his lawn had quite likely done for Mr Helmond, so there was nothing to make anyone think anything else. The question might have been resolved a little earlier, though, had the post-mortem not been performed by Dr Zaitoun.
It was Maddie who was working in the dissection room that morning, as Clive was at a management meeting with Ed and other managers. After Maddie had stripped the body and made out a chart on which she put all the external abnormalities that she could see, she eviscerated the body. Dr Zaitoun came down about twenty minutes later and did what he always did, which was to dive straight in and hack things around a bit, then decide that death was due to heart disease. Maddie was busy sewing up the organs in the body when Clive returned. Being Clive, he took an interest in what was going on.
He asked Dr Zaitoun, ‘COAD, was it?’
To a doctor, COAD means Chronic Obstructive Airways Disease, which is things like chronic bronchitis and emphysema. Dr Zaitoun looked up from writing his notes. ‘No. He died of ischaemic heart disease.’
Clive shook his head. ‘No, it was definitely COAD.’
Dr Zaitoun frowned and opened his mouth. Before he could argue, Clive said, ‘He certainly Came Over All Dead, didn’t he?’
Maddie laughed into the silence that met this remark; Dr Zaitoun paused, then said again, ‘But it wasn’t COAD.’
Clive shook his head in disgust saying, ‘Forget it,’ under his breath and turned away. He spent the next few moments examining the body; in particular, he became very interested in the hands which were clenched tight into fists. After a while, he called out to Dr Zaitoun, ‘You sure he died of heart disease, doc?’
Dr Zaitoun said, condescendingly, ‘Quite.’
Clive paused, then asked, ‘This bloke was mowing the lawn, wasn’t he?’
‘I believe so.’
‘What kind of mower was it?’
Dr Zaitoun was becoming increasingly irritated, coming out of the alcove where he had been writing his notes. ‘What does that matter?’
‘Bet it wasn’t a petrol mower.’
Dr Zaitoun thought about this. ‘It was probably a push mower. The exertion might have been the final straw.’
Clive pursed his lips as if he were a car mechanic presented with a particularly tricky and expensive repair job. ‘You sure about that?’
Dr Zaitoun was now rattled. ‘Of course.’
‘You’ve looked at his hands, then?’
Dr Zaitoun said, ‘Yes,’ but he said it after a small pause and he said it uncertainly.
Clive said simply, ‘Good,’ and left the dissection room.
Maddie had followed Clive out. ‘What’s going on?’
He would say only, ‘Wait and see.’
Dr Zaitoun had finished and had, as usual, gone without even saying goodbye. As Maddie sat down with Clive in the office to have coffee, he said, ‘I knew it.’
Maddie asked, ‘What did you know?’
‘That guy is useless, I wouldn’t trust him to PM my hamster.’
Of course, she wanted to know what he meant. He got up and led her into the dissection room where the body of Mr Helmond lay, now reconstructed and washed. He went straight to his left hand that was still clenched into a fist, and unfurled the fingers. There was a deep linear burn running across the palm and across the fingers. Clive said, ‘Heart attack? My backside it was a heart attack. I just checked with the Coroner’s office; they had to make a few phone calls and talk with the ambulance crew, but it seems that Mr Helmond was using an electric mower at the time he died. The poor bloke ran over the cord and got two hundred and forty volts for his trouble.’
‘What are you going to do?’ asked Maddie.
‘Have a word with Ed Burberry. He won’t thank me, but I can’t let this go.’
Ten minutes later, Clive returned with Ed and they went into the dissection room; I could see from Ed’s expression as he emerged that he was not happy. He went out but was soon back again, this time in the company of Dr Zaitoun; back into the PM room he went while Maddie and Clive stayed in the office and waited. There were raised voices for a few minutes and then they heard the PM room doors open and Dr Zaitoun hurried out. Ed followed, but came into the office and sank into a chair with loud sigh. ‘Oh dear,’ he groaned.
Maddie made him some coffee. Clive said, ‘This won’t be the last time, Ed. You mark my words. There’s more to come.’
Ed said nothing but apparently the look he gave Clive spoke volumes.
All this, I had walked into after taking the morning off. I could tell Clive was upset that his judgement had been ignored by Dr Zaitoun. Although I did wonder if he really cared what Dr Zaitoun thought of him, I came to the conclusion that deep, deep down he did, but would never admit to this.
Maddie, on the other hand, looked as though she was ready to throw in the towel and made it clear that it was her turn to have a weekend off.
FORTY-FIVE
Over the next few days, all three of us got to see how Dr Zaitoun operated, which was pretty shoddily. Clive was totally pissed off when he took just ten minutes doing a road traffic victim, not even bothering to chart the external injuries. ‘No respect for the family at all,’ Clive said loudly enough for him to hear. You could always tell when Clive was angry, because he became tight-lipped and quiet, growling when he spoke; and he would stalk around threatening to kick things like the wall and the door. He mumbled to himself, stuff that was difficult to hear but you knew it was about Dr Zaitoun’s behaviour. This was Clive all over. He took it personally although, technically speaking, it wasn’t really his problem; Clive, though, considered it would reflect badly on the mortuary and thus on us if the PMs weren’t done properly.
Things were quiet for a week or so, and then Dr Zaitoun did the autopsy on an old gentleman who had died shortly after having an endoscope put down his throat to investigate swallowing difficulties. They had seen a tumour at the entrance to the stomach and had biopsied it; then, though, after three hours, he had collapsed, sweating and fevered. He had been rushed to ITU, but had died before the night was over. Dr Zaitoun – not reading the hospital case notes as usual – decided that it was a spontaneous perforation of the tumour. The distinction is important because spontaneous perforation would be a natural cause of death, whereas if the act of biopsying it had caused the hole, then it would be an unnatural death, and there would have to be an inquest. We wouldn’t have known any different, except that the endoscopist rang up the mortuary a couple of days later to find out the results of the post-mortem. He was most surprised when Clive read out what Dr Zaitoun had written.
‘Really? That’s odd. I could have sworn I’d made the hole.’
Clive put the phone down, shouted a loud swear word, sighed, and said some more things under his breath about Dr Zaitoun.
The final straw came not long after and concerned John Lester, a twenty-year-old heroin addict, found dead in his flat. His father was a rich businessman and had paid a lot of money to have his son treated at a private clinic; the trea
tment involved inserting under the skin of the groins tiny slow-release beads of heroin, the theory being that this constant supply of heroin would stop the patient craving more, and the supply would eventually decline to zero, thereby gradually weaning him off the drug. This was not a big enough hit for John Lester, though, and he decided to top it up by a heroin injection, which resulted in an overdose costing him his life.
Clive tried to tell Dr Zaitoun that he really ought to read the notes carefully but, as usual, he didn’t listen. He did the post-mortem in his usual ten minutes and wasn’t even going to take blood and urine for toxicology until Clive reminded him. ‘Oh, yes,’ he said. ‘I suppose we’d better.’
‘What about these beads?’ asked Clive. ‘Best we keep a hold of them just in case?’
Dr Zaitoun looked perplexed for a moment, then: ‘I don’t think we need them.’
Clive said with a frown, ‘I’m not sure . . .’
But the good Dr Zaitoun was definite. ‘No, it will be fine; I’ll have no use for them. The guy died of a heroin overdose. All we need is a level from the blood.’
Clive looked really unhappy, but clamped his jaw shut. ‘OK,’ he said tersely, at which Dr Zaitoun smiled and left the dissection room.
What Clive did next flabbergasted me. He took a scalpel and, opening up both groins, he took out the tiny white beads, putting them into a sterile pot. ‘What are you doing?’ I asked.
‘Doing his job for him, the twat. This won’t finish here, Michelle, you wait and see. This will jump up and bite him on the arse, this case.’
Clive was right of course. Ed came down to the mortuary a few days later looking a worried man. He sat in the chair by Clive’s desk, while I made him an instant coffee, and Maddie (who had been dealing with undertakers) came and joined us. He asked, ‘So, all in all, what’s the general opinion of Dr Zaitoun?’
I think Ed wasn’t quite sure what hit him as Clive gave him exactly what he thought about Dr Zaitoun, and Maddie and I chipped in with some choice observations. Looking slightly shell-shocked, he sat quietly for a moment, and then groaned. ‘Oh, bugger.’
Clive then made faces at Maddie and me, indicating that we should find other things to do in the mortuary because this was going to be managers’ talk, so we made ourselves scarce. Afterwards, when Ed had gone, Clive gave us the low-down. ‘It’s not only down here that the twat doesn’t function. Apparently half the hospital’s complaining about him.’ As we absorbed this, Clive went on, ‘The last nail in the coffin is that heroin death. The Coroner’s received his report and is seriously shouting the odds about it.’
Trying hard to remember the events of that PM, Maddie and I looked at Clive questioningly, and he explained. ‘His report just goes on about death being due to a heroin overdose and doesn’t mention the implanted beads.’
Maddie asked, ‘Do they matter?’
Clive made a face. ‘Only a lot. According to Ed, this treatment with the beads isn’t licensed. The General Medical Council was already interested and, now that someone’s died, they’ve moved into overdrive.’ I didn’t know much about how this all worked, but I knew enough to realize it was serious. Mention the GMC to a doctor and they will usually go white and start shaking. Clive went on, ‘The Coroner’s not happy that Dr Zaitoun’s report doesn’t go into great detail on the implanted beads and, apparently, he’s had to tell the Coroner he neglected to keep them as evidence.’
Maddie said, ‘But you kept them, didn’t you?’
Clive looked Maddie in the eye, and then grinned suddenly. ‘I haven’t worked here for years not to see a cock-up before it happens.’
This was the beginning of the end as far as Dr Zaitoun was concerned, although it only came slowly. Clive revealed that he had kept the beads and produced them for toxicological analysis when asked, and Dr Zaitoun had to rewrite his report and admit that he had ‘forgotten’ to mention the beads when he submitted his first version. The GMC continued to investigate the clinic and Dr Zaitoun left to go and work somewhere else, much to our relief.
We all thought that we would hear no more of Dr Zaitoun, but we were to be proved wrong. One day Bill Baxford came to call at the mortuary. He looked worried: the inquest into the death of John Lester had been called and, at the last moment, Dr Zaitoun was unavailable. ‘He’s working in Coventry now,’ he said. ‘He claims that his secretary OKed the date with us without telling him, and now he’s gone and booked a holiday in France for the same time.’
Clive looked sour. ‘Has he really? Very convenient,’ he said sarcastically.
Bill shrugged. ‘Of course, ideally we’d like him there, but the Coroner wondered if you wouldn’t mind stepping in . . .’
Clive erupted. ‘You must be joking! Me? Why should I have to do the work of that idiot all the time? The guy was a total womble. Are you going to pay me the same expenses as you’d pay him?’
Bill, looking suitably embarrassed, mumbled something about making sure that Clive would be treated ‘properly’.
After Bill had gone, Clive went for a walk around the car park, a sure sign that he was stressed, then went up to see Ed, who had bad news for him. ‘Unfortunately, the Coroner’s court is like any other court. If the Coroner requests your attendance and you don’t comply, he can summons you and then fine you; I think he can even imprison you.’
After which, Clive went for another, longer walk around the car park. Maddie and I were feeling pretty unsettled at this point. Our relaxed atmosphere had turned into one of anger and uncertainty; we decided to busy ourselves so as not to cause too much more stress, and to stay out of the way.
In the end it was a big inquest, the court room packed out with barristers, solicitors, doctors, pharmacological experts and substance abuse experts. Clive went on his own, strikingly kitted out in his customary bright waistcoat, tweed jacket and dark trousers. He claimed not to be nervous, but I knew him well enough by then to see the lie in that. Maddie and I waited in the office for him to return and, when he did, were relieved to see that he appeared to have come through the ordeal with his customary swagger. It had been an open verdict, the Coroner unable to decide on the available evidence the precise circumstances that had led to poor John Lester’s death. The GMC were continuing to investigate the clinic that inserted the implant, and further proceedings might well follow.
‘Nothing to it, really,’ Clive told us. Ed had come down and was also interested to hear how it gone. Clive said to him, ‘He’s a nice chap, the Coroner, isn’t he? Looks after you when you’re in the box.’
‘Oh, yes. Very fair.’
‘Doesn’t take any prisoners, though,’ he told us. ‘The younger brother of the deceased was in court and he was chewing gum. When the Coroner spotted it, he stopped proceedings straight away. “Excuse me,” he said, looking straight at him. “Are you chewing?” Should have seen the look on the poor bugger’s face! He stopped chewing, went bright red, and nodded sheepishly. “Well, don’t, young man. This is a court of law, not a football match.”’ Clive sighed. ‘Excellent.’
FORTY-SIX
I hope you don’t think that Clive, Graham, Maddie and I are horrible people because we have a laugh and joke as we go about our work. Some might think that it’s wrong to listen to Radio 2 while you are pulling the organs out of a body, or do the morning Pop Master quiz (Maddie never knows any of the answers, much to Clive’s and Ed’s delight) while opening up a skull, but it doesn’t mean that we don’t respect the people we are dealing with, or the people who have been left behind by their deaths. I honestly think that we are more respectful and more concerned about both the living and the dead than anyone else, certainly as much as the chaplains and priests and rabbis and imams are.
We see everything. Certainly we see a lot more than most people do. Until I started to do this kind of work, I hadn’t appreciated just how separated we are from death now. When do most people see a dead body? A hundred years ago, everyone had probably seen a dead person by the time they were five, be
cause they cared for their loved ones in death just as they had done in life. The dead person would be laid out in the house and there would be proper mourning over them; everyone would visit and view the deceased. Now, the body is taken away and it’s put into the hands of professionals, people like me. Most of us do our best and get the job done with appropriate thought and compassion, but to us it’s just a job, something we are paid to do. Relatively few people come in to view the body, and often the deceased receives no visitors at all. Once the life is gone from the body, people want to get the whole thing over as quickly and cleanly as possible, paying to have someone else do the dirty work.
And how many of us – me included, I suppose – actually see someone as they die? Dying’s become a lonely business, done in private, so as not to distress others. Since starting this job I have often wondered what it must be like to die, and to do so without someone there to hold my hand and talk to me softly. It makes me shiver and sometimes I have shed tears. I wouldn’t want to go like that.
Charles Cartwright-Jones didn’t die alone at least, although things conspired to make his death long and slow. He lived with his wife in a large, rambling house in the Stroud valley. Clive vaguely knew the place and said that it was partly derelict. Apparently they had been married over half a century and never had children, so all they had was each other. When he came into us just before lunch one dull and cold but dry day in late January, all we knew was that it was some sort of gunshot wound. We hadn’t yet got any information from the Coroner’s office, so we had to rely on what the undertakers told us, and that turned out to be one of the saddest stories I think Maddie or I had ever heard.
There was no suggestion that Mr Cartwright-Jones had set out to take his own life, and his death had almost certainly been a terrible accident. Clive, who knows a few things about guns, reckoned from what he heard that he must been carrying the gun out of the house one morning with the safety off and a cartridge in the breech. Some guns have a very light trigger and Mr Cartwright-Jones probably dropped it so that it discharged into his stomach. His wife heard the sound and came out to look for him, finding him near a garden shed. She had rushed back into the house and phoned at once for an ambulance, then gone back to comfort him and try to stop the blood that was leaking from the wound.
Down Among the Dead Men: A Year in the Life of a Mortuary Technician Page 19
