Joanna glanced at my father and gave him a subtle signal to continue the conversation as planned.
“Mr. Cardogan, my name is John Watson and I am a physician quite familiar with malaria.”
“Watson? Dr. John Watson?” Derek Cardogan seemed to come to life. “The John Watson who chronicled the Sherlock Holmes adventures?”
“The very same.”
“I am honored to meet you, sir.”
“It is my pleasure,” my father said warmly. “May we put aside our talk of murder and instead speak of malaria, in which I have considerable experience. I am afraid my medical curiosity has taken hold of me, but if you wish not to discuss your case, I will understand.”
“Not at all,” Cardogan said, now at ease. “All expert opinions are welcome.”
“May I inquire where you contracted the disease?”
“In Afghanistan, during the Second Afghan War.”
“I see. But while a member of the military, were you not given tablets of quinine to ingest as a precaution?”
“We were indeed, sir. And the quinine tablets worked wonderfully well. But then we were taken prisoner by the Ghazis and were forced to live under the harshest of conditions. Our supply of quinine ran out and I was most unfortunate to contract malaria.”
“Did the others as well?”
“Luck was with them until they came down with enteric fevers that nearly killed them,” Cardogan recounted. “Their diseases eventually subsided, but mine remained.”
“Even with quinine treatment?” my father asked.
“At first it worked nicely, but then over time I grew resistant to the drug. Now it has little effect at all.”
“What about the newer forms of quinine?”
Cardogan managed a weak smile. “Ah! I see you are truly well informed on this disease. The French have discovered the most effective form of quinine, but apparently it carries risks that can be quite serious. For that reason I was hesitant to allow the treatment while in Paris. But now, my malaria has worsened even more and I am left with little choice but to undergo therapy with an injectable form of quinine at St. Bartholomew’s Hospital.”
“There is a very fine specialist in malaria at St. Bartholomew’s named Stephen Marburg,” my father advised. “Perhaps you should see him.”
“I have already, and it will be Dr. Marburg who supervises my therapy tomorrow.”
“Will he be responsible for your overall care while you are hospitalized?”
“He, along with my very dear friend Christopher Moran.”
“Let us hope all goes well for you.”
We bade Derek Cardogan good-bye, and stepped back out into the bright sunlight. It being such a fine day, we decided to walk about the fashionable area and gather our thoughts. Shops were busy with English and foreign patrons, the restaurants full, with long waiting queues. Traffic was heavy and noisy in both directions as one expensive carriage after another passed by. We strolled on the edge of Sloane Square, where the crowd had thinned and we could not be overheard.
“I cannot believe that Derek Cardogan is so dense that he does not see the danger Moran represents,” I said.
“Cardogan is not dense,” my father stated. “He is a former soldier who trusted his life to a devoted, loyal friend during a fierce war. Remember, it was Moran’s medical skills that spared the quartet from the knives of the Ghazis. So to Derek Cardogan, Moran is a faithful, brave compatriot who saved his life. It is very difficult to envision a man who once saved your life now deciding to take it.”
“But why kill Cardogan? The poor man looks half dead from malaria now. Why not wait just a bit longer?”
“Because he may survive and improve with the new treatment.”
“But if Cardogan does survive, why does not Moran simply give him his quarter share and send him on his way?” I asked.
“Greed,” Joanna answered. “For you see, Moran is now concerned that Cardogan will demand half of Harrelston’s and Levy’s shares as well, if he has not already done so. After all, Cardogan will surely believe that he and Moran should share equally. Moran of course will think otherwise.”
“But Cardogan is already a wealthy man,” I argued.
“Greed has no end,” Joanna replied. “It is like a bottomless well that cannot be filled. And at times the wealthiest are the worst offenders.”
“It also affected Martin Morris,” I surmised. “For he no doubt demanded more and more from Moran, and that cost him his life.”
“That and the fact that he had a loose tongue,” Joanna said. “Recall how vividly he described Moran’s temper and deceit. He was cleverly covering himself in the event Moran was discovered. Moran, being the scoundrel that he is, would try to incriminate Morris to save his own skin. Were that to occur, Morris would proclaim his innocence and point back to our interview with him, in which he was so honest and helpful.”
“I never gave Martin Morris credit for that much cleverness.”
“Do not underestimate criminals, John. When it comes to survival, they can be as slippery as snakes.”
“Oh, I almost forgot,” my father interjected. “Inspector Lestrade came by this morning with some additional, interesting information on Martin Morris. On further inquiry, it seems Morris was arrested ten years ago in Liverpool for assault with a deadly weapon. He pleaded guilty and spent five years in Dartmoor prison. It was during his imprisonment that he no doubt learned to speak French. You see, his cellmate was born and raised in France.”
“It was at Dartmoor where I suspect Morris got his throat slit,” Joanna commented. “I daresay he was much more than a petty thief who had graduated to blackmail.”
“He and Moran were truly birds of a feather,” I noted.
“Of the most vicious variety,” Joanna said, then came back to my father. “Were there other interesting tidbits?”
“Oh, indeed there were,” my father went on. “Scotland Yard looked further into Martin Morris’s finances. He had recently opened a banking account for an amount of over two thousand pounds. Such a large deposit aroused the interest of the bank manager who questioned Morris regarding its origin. Would either of you care to guess where Morris stated the money came from?”
“The dead uncle who left him the house in Spain,” Joanna answered.
“The very same.”
“When was the large deposit made?” Joanna asked.
“Two days ago.”
Joanna nodded. “I would assume that the thousand pounds found in Morris’s closet was the first blackmail payment. The recent bank deposit was the second.”
I nodded back. “Morris must have doubled his blackmail demand.”
“And that cost him his life.”
“There is one further piece of information that I believe you will find fascinating,” my father said, and rubbed his hands together gleefully. “This will close the circle of all concerned. A moment ago I mentioned that Martin Morris spent five years in Dartmoor, which houses some of England’s worst and most violent offenders. Would you care to try your luck on who was Morris’s cellmate while he was imprisoned there?”
Joanna and I exchanged quizzical looks.
“A most violent chap, named George Girard. He is described as six feet one and weighing two hundred pounds, with a distinct apelike face.”
“The intruder!” I exclaimed.
“Precisely,” my father said.
“But why then would Moran bring Girard to the pub?” I asked. “Morris would certainly recognize his former cellmate.”
“That was my mistake,” Joanna admitted. “I initially thought Moran had planted a thug in the pub to point out Morris. But now we know the thug was George Girard who had shared a cell at Dartmoor with Martin Morris. There was no need for Moran to show Girard who his target was, because Girard already knew Morris quite well.”
“So why was Girard in the pub?” I queried.
“There is only one plausible answer,” Joanna replied. “He was there to protect Marti
n Morris.”
I shook my head in puzzlement. “You will have to explain how you reached that conclusion.”
“It is somewhat convoluted reasoning, but it fits all the facts we have at hand,” Joanna said. “We can all agree that Morris introduced Girard to Moran, so Moran could hire the thug to search Watson’s rooms. Hence, all three men knew one another. And like all thieves, there was no trust between them. Thus, when Moran failed to show up to pay the movers, Morris became concerned that Moran would not hold up his end of the agreement. At this point, Morris began to fear for his life because he knew how vicious a blackmailed Moran could be.”
“So Martin Morris hired Girard to protect himself from Christopher Moran,” I deduced.
Joanna nodded. “And that is why George Girard was in the pub.”
“But why did Girard kill Morris?”
“Because Moran paid him handsomely to do so,” Joanna went on. “Once Moran noticed Girard in the pub, he understood why the thug was present. He was there for protection.”
“Or perhaps Moran thought that Morris and Girard planned to kill him, so they could gain possession of the contents in the safe,” my father suggested.
“I doubt that,” Joanna said. “If that were the case, Girard would not have made himself so noticeable in the pub. In all likelihood, Girard was there to protect Morris, and when he stepped outside the pub he was approached by Moran and given a large sum to do the killing. It was the perfect double-cross.” Joanna smiled briefly to herself. “I tell you this Moran is a real beauty.”
“Do you think George Girard will ever be apprehended and verify your suspicions?” I asked.
“I do not think we will ever see or hear of George Girard again, for I believe he is now dead or shortly will be. You see, Christopher Moran does not like loose ends, and George Girard was the only living witness to his last evil deed.”
“With this new information, even Lestrade has become suspicious now,” my father told us. “And the last thing we need is Lestrade snooping around and alerting Moran further.”
“Were you able to throw Lestrade off course?” Joanna asked concernedly.
“I did my best,” my father replied. “I suggested he double-check the story of Morris’s family poverty and search for any hidden real estate transactions that may have occurred in Scotland. Also, I thought it worthwhile to look into the local gambling houses and see if Morris had had a run of good luck. And finally, I attempted to dissuade him from questioning Moran further on this matter.”
“How did you manage that?”
“By telling him that the good Dr. Moran had already suffered enough distress with the loss of two close friends and a valued secretary. I thought that other, more likely avenues should be investigated first.”
“Well done, Watson,” Joanna said. “That should throw Lestrade off the trail until we have brought our work to a finish.”
“And how does this finish come about?”
“We have to set a trap that will be irresistible to Moran.”
“But he will surely see through it, being the clever devil that he is.”
“If it is done correctly, he will not see it as a trap, but as a perfect opportunity.”
“Is this trap already in your mind?” my father asked eagerly.
“Only sections of it,” Joanna answered. “For I require more detailed information to put it into play. If it is not constructed perfectly, it will not succeed.”
“Will you obtain this necessary information from your books?”
“Books will be of little value here,” Joanna said. “This information has to come from the most reliable of sources.”
“Which are?”
“Our colleagues.”
20
The Staging
Grand rounds were held every Thursday in a large amphitheater at St. Bartholomew’s Hospital. There was rarely a vacant seat, for at this conference the most difficult cases were presented for either diagnostic or therapeutic consideration. This day the patient to be discussed was Derek Cardogan and his drug-resistant malaria. As was the custom, senior staff occupied the front rows, while those of lesser rank filled the benches farther back.
I purposely seated myself near the very rear, so I could be within whispering distance of Joanna who had secured a space directly behind me. She was dressed in a starched nurse’s uniform, but it did not stand out because there were other nurses in similar attire around her. At the podium below was Dr. Stephen Marburg, a world-renowned expert on malaria, and standing next to him was Christopher Moran. Although the men were engaged in earnest conversation, Moran appeared to periodically scan the audience and on one occasion I had the distinct impression he was staring at me.
“Cardogan looks even more dreadful today,” Joanna whispered. “His jaundice has deepened to the point he no longer appears to be Caucasian.”
“It is the lighting in the amphitheater that projects a yellow glow on the fairest skin,” I whispered back. “But you are correct in that he is obviously sicker than when we saw him last.”
“They had better hurry with their new treatment or they will not have a living patient to treat.”
“I am sure they are aware.”
Joanna lowered her whisper further. “And if he dies, we will lose our bait for the trap.”
“So, all is ready?”
“Not quite. I still require two more vital pieces of information.”
“When and from where will this information come?”
“It will come now and from Dr. Stephen Marburg.”
As if on cue, Marburg brought a heavy hand down on the podium and the amphitheater immediately quieted. He was a tall, distinguished physician, with salt-and-pepper hair, sharp features, and a commanding voice that even those on the very last row could hear well.
“The topic today is drug-resistant malaria which, as many of you know, is becoming more and more prevalent,” Marburg began, then went on to describe how Derek Cardogan had contracted the illness while serving in the Second Afghan War. He emphasized that had Cardogan been able to secure quinine tablets during his captivity by the Ghazis, he may never have been afflicted with the disease. Upon his release, Cardogan was treated with quinine, but the response was modest at best, and over the years the parasite responsible for malaria grew resistant to the drug.
“And the effects of drug resistance can be clearly seen in Mr. Cardogan,” Marburg said to the audience, then pointed out the jaundice and other physical features of the disease, including an enlarged liver and spleen.
Joanna leaned forward and whispered, “I am surprised that Cardogan would submit to being placed on display.”
“He had no choice,” I replied in a whisper. “It is Marburg who makes the rules here, not Cardogan.”
“Cast your eyes on Moran, who is observing the proceedings so intently,” Joanna said. “He is the wolf measuring its prey.”
“Are you convinced he will carry out his act here?”
“Oh, yes. It is the perfect setup. Cardogan is held captive while Moran has free rein.”
“But here? In a hospital with Moran under constant observation?”
“Do not underestimate Moran,” Joanna warned. “He is a very clever physician and St. Bartholomew’s is his home turf, which gives him the advantage.”
The clinical discussion at the podium now turned to the treatment of drug-resistant malaria. According to Marburg, two French researchers, Pierre Pelletier and Joseph Caventou, had discovered the form of quinine most effective in treating malaria. The drug was always given orally until the French found that some patients did not absorb quinine from the gastrointestinal tract and thus none entered the bloodstream. In these patients, the failure of quinine to control the disease was not due to drug resistance, but rather to the failure of the drug to be properly absorbed into the patient’s system. It was hoped that Derek Cardogan fell into the latter category and could be successfully treated with quinine administered by intramuscular injection.
For reasons I did not know, Joanna was most interested in this portion of the discussion and moved to the edge of her seat so as not to miss a word.
“Unfortunately, the side effects of large doses of intramuscular quinine can be quite dangerous,” Marburg was saying. The expression on his face indicated he was not going to downplay the dangers because of Cardogan’s presence. “By far the most serious adverse reaction to the drug has been cardiac arrhythmias that can be fatal. These abnormal heart rhythms range from ventricular extrasystoles to complete cardiac arrest, with ventricular tachycardia being the most common.”
“How often do these severe arrhythmias occur?” asked a voice from the audience.
“Approximately ten percent of patients so treated developed serious arrhythmias,” Marburg reported.
“That is quite a high percentage.”
“We shall try to avoid this adverse effect by preparing the patient with a cardiac-soothing drug.”
“How much time elapses between the injection and the occurrence of the arrhythmias?”
“All of the cardiac abnormalities have come to the fore within four hours.”
“As the drug level peaks in the circulation.”
“Exactly.”
Another voice asked, “When you mentioned the ten percent figure, is that referring to fatal arrhythmias?”
“For the most part.”
There was an audible gasp from the audience. The ten percent figure was high indeed. It was so extraordinarily high that most physicians would never consider using such a large dose of intramuscularly administered quinine. It flagrantly violated the most important law of the Hippocratic oath, which starts, “First, do no harm.” But in the case of Derek Cardogan, there was little choice, I thought grimly. Either take your chance with the drug or die.
“Obviously the patient will require constant and careful observation once the quinine is injected,” Marburg went on. “This will include close cardiac monitoring.”
“Certainly there can be no side effects more drastic than those affecting the heart,” Christopher Moran said from the front row.
“Not as deadly, but nearly as terrifying,” Marburg said. “A few of the patients suffered deep comalike somnolence, others confusion and convulsions, all within the four-hour time frame.”
The Daughter of Sherlock Holmes Page 22
