The Aladdin Trial

by Abi Silver

  ‘Interfered in some way?’ Chambers was incredulous, his eyes bulging.

  ‘The patient had gone into cardiac arrest. I attended and administered CPR and he stabilised. But an investigation by the Trust found that Mr Qabbani had been in the patient’s room for some minutes before I entered and he was standing over him when I arrived. It…’

  Mr Chambers held up his hand to stem David’s flow.

  ‘One moment, Dr Wolf. You say Mr Qabbani, the hospital cleaner, was found standing over a patient who went into cardiac arrest on the ward?’ Chambers moved his head deliberately from David Wolf to glare at Ahmad. Ahmad ignored him.

  ‘Yes.’

  ‘Go on.’

  ‘Well…it was…the Trust felt it was necessary to write to the defendant to remind him that while he should always do what he could to assist patients, as any normal, caring person would, his obligation was simply to raise the alarm as quickly as possible and leave things to the professionals.’

  ‘I see. Very sensible. Did you know Mr Qabbani well?’

  ‘Not really. He was one of a number of hospital cleaners. I would see him around the hospital. One other time he was a bit shirty with me, but I, well, I just ignored him.’

  ‘In what way, shirty?’

  ‘I, well, I think I walked where he was cleaning. I was in a hurry, an emergency. He appeared rather cross – angry, even.’

  ‘So your previous interactions with Mr Qabbani had left you with a negative impression of him?’

  ‘Well…I’m not sure.’

  ‘I will rephrase the question. Before this tragic incident, generally speaking, did you think of Mr Qabbani in a positive or a negative light?’

  ‘Negative, I suppose, but I am trying not to be unfair to the man, you see.’

  Judge Seymour raised his hand to stop Mr Chambers mid-flow.

  ‘Dr Wolf. That is not your job in this courtroom. Your job today, in this courtroom, is simply to tell the truth, that’s all. Questions of fairness and judgement are left to other people, like me. Do you understand?’

  ‘Yes, I apologise. I understand.’

  ‘Thank you, Dr Wolf, your honour. No more questions. Please wait for Ms Burton.’

  Judith rose to her feet slowly, shortly after the judge’s public rapping of David’s knuckles, savouring her opening words in her mouth before serving them up.

  ‘Hello, Dr Wolf. Thank you for coming here today. We know the life of a doctor is a hectic one. All those patients to see, lives to save.’ She smiled and he smiled back. Constance groaned inwardly. She knew Judith didn’t like David from their night-time encounter at the hospital, neither did she, but she hoped Judith would remember the job they had to do and not get side-tracked into useless point-scoring.

  ‘You mentioned that it was your colleague, Dr Mahmood, the senior orthopaedic surgeon at St Marks, who saw Mrs Hennessy before she was admitted.’

  ‘Yes. And when she came into hospital.’

  ‘So why did she come under your care?’

  ‘Dr Mahmood had a full schedule, so he asked me if I would oblige.’

  ‘Oblige?’

  ‘Operate on Mrs Hennessy.’

  ‘And you agreed?’

  ‘Yes. It’s very much my kind of operation. I’ve done at least fifty very similar procedures. I was glad to assist where I could.’

  ‘Can you tell us, in layman’s terms if possible, what is involved in the operation.’

  ‘Yes. I’ll try not to be too graphic. Bunions are caused by a thickening of the bone on the inside of the big toe. We don’t know what causes them. Sometimes, it’s wearing the wrong shoes, but not always. The treatment Mrs Hennessy had is called metatarsal osteotomy. It involves shaving the bone and then realigning the big toe. It takes around an hour under general anaesthetic. But in Mrs Hennessy’s case it was also necessary to realign some ligaments and reposition the first metatarsal, putting some pins in. It was at the more complicated end of the bunion operations.’

  ‘But not life-threatening?’

  ‘There’s always risk whenever a general anaesthetic is used but Mrs Hennessy was a non-smoker and in good health.’

  ‘And why did she not have her operation till Thursday the 11th of May? She was admitted on the Tuesday. Why the delay?’

  ‘Like I said, Dr Mahmood brought Mrs Hennessy in, but he had some emergencies which took priority on Tuesday and Wednesday. When he knew he was also going to be too busy on the Thursday as well, that’s when I was asked to take over.’

  ‘Is that usual?’

  ‘Not usual but it does happen.’

  ‘Dr Mahmood is the senior consultant at St Marks?’

  ‘Yes, he’s the head of our team but we work together, as I said, sharing responsibility.’

  ‘Was Mrs Hennessy taking any medication, before her operation?’

  ‘Not as far as I am aware.’

  ‘And is it correct that on the day she was admitted, she was asked to fast?’

  ‘Yes. That was in case we operated that afternoon.’

  ‘But you didn’t?’

  ‘No.’

  ‘This happened again, the following day.’

  ‘Yes.’

  ‘And on the Thursday.’

  ‘Yes, when the operation took place. Look, the delay was far from ideal, but she would have eaten in the evenings, once we knew the operation couldn’t take place, and we constantly monitored her blood pressure.’

  ‘The nurses checked her blood pressure?’

  ‘Yes, many times; it’s recorded in her notes.’

  ‘And the operation was successful?’

  ‘As far as we could tell immediately afterwards. You have to wait till the swelling goes down to be certain. I would have seen her again two weeks later for a follow-up.’

  ‘Was she in pain?’

  ‘Standard painkillers were prescribed for her.’

  ‘Did you know Mrs Hennessy lived alone?’

  ‘Yes. She said she was divorced and lived alone.’

  ‘Is it unusual for patients in their seventies to come in to hospital alone?’

  ‘Fairly, but it does happen, yes.’

  ‘Did you suggest to her that she contact someone else, her son or daughter to take her home?’

  ‘No. I’m not a social worker. I was interested in what was wrong with Mrs Hennessy medically, and how to fix it.’

  ‘Of course you were.’

  Judith decided to try a different tack. She wasn’t getting anywhere with this line of questions.

  ‘When did you see Mrs Hennessy next?’

  ‘The afternoon of the operation, Thursday. Well it was probably evening, around seven o’clock.’

  ‘And how was she?’

  ‘She was recovering. Said she was a bit sore. But that was to be expected.’

  ‘And that was the last time you saw her?’

  ‘Yes.’

  ‘Dr Wolf, would all the treatment given to Mrs Hennessy be recorded in the log book by her bed?’

  ‘Yes.’

  ‘You still use a handwritten copy?’

  ‘We write the medication by hand into a book and then, at the end of each shift, it gets recorded on the digital file.’

  ‘Ah. So you would ensure there was also a soft copy record for each patient?’

  ‘Well, the nurses do this, at the end of each day, but yes.’

  ‘Was Mrs Hennessy able to walk after the operation?’

  ‘Yes she was, although she would have been in pain. The notes record that she was attended by our physiotherapist and that she walked around the ward with him.’

  ‘Unaided?’

  ‘The notes mention crutches. It’s important not to put weight on the foot at the beginning.’

  ‘She needed crutches to walk?’
/>
  ‘Yes.’

  ‘Is it possible for Mrs Hennessy to have walked the length of the corridor, from her bedroom to the staff room, from which she fell, with the aid of her crutches?’

  ‘Yes. That’s why the physio would have attended, to make sure she could get around. But the crutches were found in her room.’

  Judith swallowed hard. She had allowed herself to be led into that one.

  ‘Can we stick to my questions, please. I am interested in what Mrs Hennessy could have achieved, physically, post-operation, and you have confirmed that she would have been able to walk along the corridor with her crutches?’

  ‘Yes.’

  ‘Could she have walked without the crutches?’

  Dr Wolf considered the question carefully before replying.

  ‘She could have. Maybe if she held on to things as she walked, for support. But there is no reason for her to walk down the corridor. If she needed a nurse she could simply have rung the bell next to her bed.’

  Judith thought about a further admonishment to Dr Wolf for embellishment but she held herself back.

  ‘I just want to pick up on your description of an interaction you had with Ahmad which you provided to Mr Chambers. You said he “got shirty” with you?’

  ‘Yes.’

  ‘I want to try to visualise the scenario. Ahmad was cleaning the floor?’

  ‘Yes.’

  ‘Mopping the floor?’

  ‘Yes.’ David’s second ‘yes’ was louder than the first, and tinged with irritation.

  ‘Does he put up one of those signs when he cleans – you know, a plastic one, warning people that it’s slippery?’

  ‘Yes I think he does, probably.’

  ‘But you were in a hurry?’

  ‘Yes. I don’t remember precisely why.’

  ‘You don’t remember precisely why, but you said, in your evidence earlier, that you were on your way to an emergency?’

  ‘Well, I –’

  ‘Are you disputing that you said that? I can have the transcript read back to you, just to be certain.’

  ‘No, I…I –’

  ‘Would you like to clarify your evidence?’

  ‘I don’t precisely remember why I was hurrying but I do remember I was in a hurry.’

  ‘Thank you. And my client was in the way?’

  ‘Yes.’

  ‘So you ignored his sign to take care, which was placed there to warn people. Why do you think Ahmad puts that sign out when he is cleaning?’

  David’s upper lip twitched a few times, then he fingered the end of his moustache with his right hand.

  ‘To make sure they know the floor is wet.’

  ‘Yes. So that they don’t fall?’

  ‘Yes.’

  ‘Or at least, if they do, they have been warned?’

  ‘I suppose so.’

  ‘So you ignored the warning, because you were in a hurry and you walked through the clean floor as my client was mopping it. Did you leave footprints on the floor?’

  ‘I probably did.’

  ‘And, think hard, what did Ahmad say or do, as a result of this?’

  ‘He, well, he just sort of looked rather annoyed.’

  ‘Did he say anything to you?’

  ‘No.’

  ‘Did he do anything threatening at all?’

  ‘No.’

  ‘So, you charged on through his cleaning zone and left dirty footprints and he looked “rather annoyed”?’

  ‘Yes.’

  ‘Dr Wolf, do you think of yourself as a patient man?’

  ‘Yes I do, actually.’

  ‘Thoughtful, calm, collected?’

  ‘Yes.’

  ‘Do you do the cleaning at home?’

  ‘Sometimes.’

  ‘If your wife were to barge through your cleaning area in a hurry, without warning, do you think you might look “rather annoyed”? Or perhaps you might actually say something?’

  David stood and twirled his moustache.

  ‘Ms Burton, I think we have got your point. Move on please,’ Judge Seymour sighed loudly.

  ‘Thank you, your honour, much appreciated. Can we speak, just briefly, about this warning you mentioned that the Trust, I think you said, administered to my client a year ago.’

  ‘Yes.’

  ‘And by the Trust, just so we are clear, you mean the hospital authorities, rather than yourself or any of the other doctors.’

  ‘Yes, that’s right.’

  ‘Something that you didn’t remember when you were first interviewed, or in your second interview. It was only when you provided a written statement, some four weeks later, that you recalled this incident.’

  ‘As I said, I don’t know Mr Qabbani well and I hadn’t connected the two.’

  ‘I see. So, on this previous occasion, which you remembered four weeks after you were first questioned, an alarm went off, you went running into a patient’s room and there was my client “interfering” with the patient. Are you suggesting that my client did something which caused the patient’s emergency?’

  ‘No,’ David replied nervously. ‘Absolutely not. If I or any of my colleagues had thought that, then Mr Qabbani would have been dismissed and the police called, not just a warning. No, if the decision had been mine then there would have been no further action taken. I mean the fellow is only a cleaner.’

  ‘I see. It didn’t appear serious to you at the time?’

  ‘No.’

  ‘But it remains serious enough to mention now at my client’s trial.’

  David shuffled around and twisted his moustache in his fingers again.

  ‘I remember a little more now. The Trust felt that your client could have done more. The emergency button rings through to the nurses’ room and a light goes on outside the room too, or he could have run for help himself. All those things might have been more effective in bringing help sooner, instead of just standing there.’

  ‘You’re not suggesting, then, that he should have assisted the patient in any way himself – sort of good Samaritan, that kind of thing.’

  ‘No, not at all. Quite the opposite. The letter he was sent reminded him that he must not touch the patients but should seek help in future.’

  ‘It…put him in his place, so to speak.’

  ‘I suppose so, yes.’

  ‘And if he had, notwithstanding this warning, “touched” patients – I mean, had physical contact with patients in future – would his job have been in jeopardy?’

  ‘Yes. But quite rightly. I mean. We can’t have cleaners playing doctors.’

  ‘No further questions, Dr Wolf.’

  ‘Thank you. We will break for lunch,’ Judge Seymour announced loudly. ‘See you back at 2:15 prompt.’

  45

  The next witness was Lottie Li, the staff nurse on duty the night Mrs Hennessy died. Since Constance’s chat, when she had agreed to assist the defence, she had ignored their calls and emails, and here she was now on the other side. And Maia had disappeared completely. A letter sent to her had been returned, and a call to the hospital administration revealed she no longer worked at St Marks.

  Somehow, out of uniform, Lottie seemed even more tiny and gossamer-like than in the hospital setting.

  ‘Nurse Li. How long have you been working at St Marks?’ Chambers began.

  ‘Two years.’

  ‘And before that you were a nurse in the Philippines?’

  ‘Yes. For five years.’

  ‘How did you make the transition to nursing over here?’

  ‘Some people came over to my country to employ nurses. They came to our hospital, they tested us and then they offered us positions in the hospital.’

  ‘And you live locally?’

  ‘Yes, there is acc
ommodation provided close by.’

  ‘Nurse Li, how well do you know the defendant, Ahmad Qabbani?’

  Lottie glanced at Ahmad, who was sitting head down, rolling one thumb around the other.

  ‘He started when I did, about two years ago.’

  ‘How often did you see each other at work?’

  ‘Yes, often. He kept his cleaning things on the private ward so he was there always at the beginning and end of his shift.’

  ‘Was he hardworking?’

  ‘Very, yes. And strong. So, we used to ask him to help out if things needed doing.’

  ‘You’re saying he’s strong? Is he the kind of person who would help if something needed lifting or carrying, that kind of thing?’

  Judith coughed. She did not want Lottie dwelling on Ahmad’s physical strength, even if he used it historically for chivalrous acts.

  ‘Yes, but he was also good at fixing things, too.’

  ‘How was your relationship? Would you say you were friends?’

  ‘We were colleagues. We work in same place, but we do separate things; that’s all,’ she said a little too quickly.

  Judith studied Lottie’s face closely. What had happened to the glowing testimony she had been prepared to provide some weeks earlier? Constance’s jaw hardened behind her as she, too, noted Lottie’s lacklustre performance.

  ‘You didn’t socialise outside work?’ Chambers continued, delighted so far with his muted, understated witness.

  ‘No. He went home quickly when he finished work.’

  ‘Did Ahmad like to talk to the patients?’

  ‘Sometimes.’

  ‘What kinds of things would they talk about?’

  ‘I don’t know, just chatting.’

  ‘Did you ever see Ahmad in Mrs Hennessy’s room?’

  ‘I have been thinking about this very hard as it is so difficult to remember. I think he may have been cleaning once in Mrs Hennessy’s room when I was there. But I’m not sure. I definitely saw him outside her room, cleaning in the corridor.’

  ‘On the night Mrs Hennessy died, you were on duty?’

  ‘Yes.’

  ‘Did you see anything unusual, any new people on the ward?’

  ‘No.’

  ‘What time did you go off duty?’