Death Before Time

by Andrew Puckett

  “How?”

  He smiled – “With these … “ He showed her the swabs and the blood he’d taken. “They might not grow anything,” he said, “But then again, they might. Did you get the ampicillin samples?”

  She nodded and showed him. He said, “You’d better get them all down to Tom, the sooner he can - ”

  A knock at the door …

  They looked at each other –

  “Who is it?” he called.

  “It’s me, Helen. “

  He motioned Jo to the loo.

  “Just coming,“ he said loudly to cover any sound.

  The loo door silently closed and the handle moved slowly up … he went over to the door and, arranging his features into a smile, opened it.

  “Helen … “ He kissed her “How did you get in – downstairs, I mean?”

  She came inside. “Someone was coming out – Fraser, I’ve been trying to ring you, Philip’s looking all over for you, you’re supposed to be going to a meeting with him … “

  “Ah, shit - “ He didn’t have to pretend - “I’d forgotten all about it.”

  She looked at her watch – “If you hurry, you’ll catch him.”

  “Let me get my jacket … “

  As he turned, he saw Jo’s handbag on his bed beside the samples - he snatched up his jacket and virtually manhandled Helen out of the room and pulled the door shut behind him.

  Had she seen it?

  “Where is your mobile?” she said as they clattered down the stairs.

  “In my office.“ Perhaps she hadn’t … “Thanks for coming to get me Helen,” he said.

  “If you’d had your mobile … “

  “Yeah, I know.“ He held the door downstairs open for her. “Is Philip really mad?”

  “Well, he isn’t pleased.“

  He swore again. They half walked, half ran across the road and round the corner of the unit to see Philip waiting at the entrance, looking at his watch.

  “Fraser!” he called out, “Where the hell have you been?” Extreme language, for Philip.

  “I’m so sorry Philip, I clean forgot.”

  “So it would appear – haven’t you got your bleep, or your mobile?”

  “In my white coat, in there … “ He indicated the unit.

  “Well, thank God Helen found you – come on, we’ve got five minutes.”

  With a quick, grateful glance at Helen, Fraser followed Philip over to the playing field and round its perimeter.

  His stomach rumbled, he hadn’t had time for breakfast and had been counting on a quick dash to the canteen for lunch after he’d seen Jo. They walked in silence past the social club and up the steps to the Georgian portico of the Trust.

  The boardroom was on the ground floor. Places were set round the polished oak table, but only two or three people were seated; most still mingled round the tea and coffee trolley where George Woodvine was being mother.

  “Philip,” he called as they made their way through. “And will ye take a biscuit?” he said to Fraser as he served them.

  “I’ll take two please - I missed lunch.”

  Patrick, dapper as ever, came over and said hello, then the meeting was called to order. Woodvine formally opened it, then more or less handed over to Fleming.

  Today, the Chief Executive was wearing a black pinstripe suit which made Woodvine’s tweeds look slightly shabby, and his black hair was brushed back so carefully that the widow’s peak looked as though it had been painted onto his pale forehead. His voice wouldn’t have been out of place in Christie’s and Fraser found himself disliking him even more than he had at the orgy.

  He took them through the minutes of the last meeting, and then matters arising from the minutes.

  Fraser glanced round at some of the others. The middle aged lady opposite him was making notes, paying careful attention to everything that was being said, while the younger, rather attractive woman next to her seemed about as interested as Fraser – she caught him looking and her mouth turned down slightly at the corners.

  Woodvine drooped at the head of the table, as though he might drop off at any moment, and if it wasn’t for the gathering discomfort in his stomach, Fraser thought he might have joined him. It (his stomach) obviously regarded the two biscuits it had been offered an insult and was threatening to make its protest audible.

  Fraser heaved it in, aware of the pain still lurking in his muscles … the strategy seemed to work and after a few moments, he relaxed slightly – and just as Fleming’s modulated voice paused, it (his stomach) rumbled like an ill tempered geyser.

  Fleming’s eyes flicked at him in irritation over his half-moon spectacles, then he continued his drone. Fraser felt himself flush and his eyes went involuntarily to the younger woman … who was trying not to smile.

  Another rumble, louder this time, which everyone studiously ignored - he grimly hauled his guts in and held them there.

  Then the middle aged woman started speaking and Fraser tuned into her “How ever did we get into this state, Nigel?” she was saying, “Twenty million pounds in debt …”

  “I’m assuming that’s a rhetorical question, Maddy,” Fleming said in a tired voice, “We have been over this before, on many occasions.”

  “Maybe we have, Nigel, but I still don’t understand it – and I’m sure I’m not the only one here who doesn’t … “ She looked deliberately round, then back at Fleming - “How did it happen?”

  Fleming, who knew perfectly well that she doing it just to rub his nose in it again, spoke quickly: “It was a combination of the building of the new community hospital which, I’m sure we all agree, was imperative in the circumstances, and the Euro conversion. Thanks to Philip here, we managed to save some money on the hospital, but the costs of the Euro conversion took us by surprise.”

  “How much was that again, Nigel?” enquired his tormentor.

  “Five million. A memorable figure as I’m sure you recollect, Maddy.”

  The younger woman obviously felt that this was the cue for her to contribute - “Why did we go on spending so much on it when it was obvious that a referendum in this country would kick it out?”

  “Ah,” said Maddy, “Now that’s something I can recall – I do clearly remember suggesting on several occasions that we should drop it before all the money was spent.”

  “As you know perfectly well Maddy,” Fleming said, his anger barely under control now, “Our political masters wouldn’t hear of it. They were sure – they still are sure for that matter – that our joining is inevitable in the end, and wanted it done as quickly as possible.”

  “Five million,” mused Maddy, lingering over the figure, “I wonder how many hip replacements that represents.”

  “Or doctors,” said the younger woman, “Or nurses …”

  “I couldn’t say,” Fleming said. “How many more times, Maddy, are you going to insist on looking backwards, to this, rather than forward?”

  “As many times as it needs to ensure this can’t happen again,” she retorted. “On which note - ”

  Fleming seemed to make up his mind about something and firmly overrode her - “As it happens, I do have some good news for the meeting, although it must remain confidential at this stage.” He looked round the table, sure of their attention now. “My sources inform me that the Grade II listing of St James’ is to be lifted, so we shall be able to go ahead with the sale of the land shortly. That should enable us to recoup a good deal of the money.”

  “Well, thank God for that,” said Woodvine, who seemed to have woken up, and there were murmurs of agreement around the table, although not from the two ladies.

  “Thank God indeed,” said Fleming, “Or at least, thank the good sense of the architectural listing committee. But I must emphasise that it is confidential at this time. The official announcement will be made next month.”

  Looking at him, Fraser had the sudden conviction that he’d had no intention – and maybe no authority - to make the announcement just then
, but had been forced to in order to deflect attention from the money spent on the Euro preparation.

  Five million…! Had they really spent that much on it?

  He knew that all the Trusts had been ordered to prepare for it, and to find the money from their existing budgets, but he hadn’t realised how much had been involved.

  He glanced over at Philip, who was staring down at the pad in front of him, and realised that the news had come as no surprise to him … then he remembered Fleming’s visit to the hospital the previous Friday with Patricia Matlock – they must have told him then.

  But why wasn’t he happier about it?

  The rest of the business was dealt with quite briskly and about forty minutes later, Fraser and Philip started back to the unit. At first, Philip didn’t say anything and Fraser thought he was going to remain as silent as he had on the way.

  Suddenly, he turned to him: “Having sat through all that Fraser, d’you still think you want a career in community medicine? Edwina told me what you said,” he added.

  “Surely, most of that wasn’t directly concerned with it?”

  “No, I suppose not.” He thought for a moment. “It was mostly concerned with money, wasn’t it? So I suppose I meant …” he paused again, “How do we balance the care of human beings against pure economics? As doctors, we have a duty to do our best for our patients – however we construe that - but how far are we constrained, adulterated, by economics?”

  “A fair bit, I dare say,” Fraser murmured.

  “A fair bit, as you say.” He sighed. “I’ve spent my career trying not to be corrupted by money, but maybe we’re all doomed to failure in the end.”

  Fraser looked at him. “You really think you’ve failed?”

  “Yes – as I said, to the extent we that all fail.” He paused, then, “The thing is not to allow yourself to be corrupted beyond that extent.”

  “How do we know when we’ve reached it?”

  Another pause. “I suppose we have to use our individual judgement.”

  “Isn’t that the same thing as having principles?”

  “Having principles should go without saying. Maybe I’m thinking more about being on your guard against manipulation – by government, or anyone.”

  Fraser would have liked to pump him a bit more, but Philip smiled suddenly, brilliantly, and clapped him on the shoulder. “The thoughts of Philip Armitage - forgive me for burdening you with them … But think carefully about your career, Fraser. Give it time.”

  Fraser said, “Doesn’t what you say apply to all areas of medicine?”

  Philip thought for a moment, then slowly shook his head. “I’m not sure that it does,” he said, and wouldn’t be drawn any more.

  Chapter 19

  Jo had waited in the loo until she was sure Fraser and Helen had gone, then gathered up the samples from the bed and taken them to Tom. She told him about Rose Parker.

  “Who gave her the first doses of antibiotic?” Tom asked, “Was it Carrie Tucker?”

  “According to the chart it was Sophie Rogers, but I don’t know who was with her.”

  “Can you find out?”

  “I’ll try,” she said. “But Tom, there’s another problem - if it is Carrie doing it, she’s only on duty eight hours a day, so the rest of the time, Rose would have been getting the real thing.“

  “Unless these are all bogus as well.” He nodded at the drug samples she’d brought. “And they look all right to me.“

  “And as Fraser said, it would’ve been noticed if none of it was working.”

  “Mm.” He got up and walked over to the window before turning back to her, “Is it possible,” he said slowly, “That if Rose was given bogus antibiotic, say for the first three doses, that the real one would fail to work later?”

  “I think so,” she said, “You’ll have to ask Fraser. Although the way Rose was, I’d have thought the ampicillin I gave her would’ve worked.”

  “All right, I’ll talk to him.” He paused. “Is he over his wobbly now?”

  “Yeah - I think Rose’s death shook him as much as me.”

  He nodded, said, “I’ll get all these samples off to the lab – maybe they’ll be able to tell us something.” He sighed. “It’s a bugger, isn’t it?”

  “Yes,” she agreed sadly, thinking of Rose. “It is.”

  Later, when she was back on duty, she engineered a chat with Sophie Rogers, and on the pretext of asking her about the onset of Rose’s pneumonia, discovered that Carrie hadn’t been with her when she’d given her the first two doses of ampicillin.

  *

  Taking Helen out was a chore that Fraser didn’t look forward to, and yet was hardly ever as bad as he thought it was going to be.

  It wasn’t bad this Monday. They went to a pub and she laughed when he described the Trust meeting and his wayward guts. Then he told her about the Trust’s debts and the money spent on the Euro preparations.

  “Yes, it’s appalling,” she said, referring to the Euro, “When you think of all the misery that money could relieve. I’m surprised someone hasn’t gone to the papers about it.”

  “Why don’t you, if you feel so strongly?”

  “I couldn’t,” she said, shaking her head. “I know it sounds stupid, but if you’ve been trusted with confidential information, you can’t somehow. I can’t, anyway.”

  It was then that he decided she probably had nothing to do with the killings. He told her about Armitage’s reaction, or lack of it, to the news of the lifting of the Grade II listing of St James’, and his strange mood afterwards.

  “He’s got a lot on his mind at the moment,” she said.

  He asked her what. She said vaguely,

  “Oh, Ranjid … “

  “Why Ranjid?”

  “Well, you’ve seen what he’s been like lately – and there’s also Fleming, whom he cares for no more than you do.”

  “Why is that?” he probed. “He can’t have much effect on Philip, can he?”

  “He holds the purse strings. It’s what administrators do, why they can make life difficult for those under them.” She obviously didn’t want to talk about it anymore, so he didn’t press her.

  She didn’t ask him in when he dropped off either, and he drove away feeling guilty that he was so relieved. In a pally platonic sort of way, he’d rather enjoyed her company, but he couldn’t feel any more for her than that … exactly what did she feel for him, he wondered? She seemed to want to go on seeing him, and yet she was two-timing him with Ranjid …

  *

  The next morning, Tuesday, Gavin in Glasgow came back to him with his figures: deaths there were 28% from pneumonia, 25% Cancer, 18% heart conditions, and the pneumonia deaths were recorded as such. Not much different from Wansborough’s – as they stood …

  With an eye on the door, he worked out what he thought were the numbers of pneumonia deaths recorded at Wansborough as something else, then adjusted the figures to take account of it. Now the figure for pneumonia came out at over 40% percent of the total. Far too high ...

  The figures from Bristol came an hour later. They were much the same as Glasgow’s. He went down to Tom’s hotel at lunchtime and showed him.

  “Does this put your mind at rest?” Tom asked.

  He nodded. “Aye. It was anyway, after Rose – if you can call it that.”

  Tom asked him whether the real antibiotic could have failed if she’d been given a dummy one first. “Jo seemed to think it was possible,” he said.

  “She’s right, any infection can get to a point of no return where it’s too late for any antibiotic, however good.”

  “Could that be how it’s being done?”

  Fraser hesitated, “If it were, we’d see some of them getting better.”

  ”Yeah, Jo said that as well.” He sighed. “Maybe the results from the lab’ll tell us something. Anything else?”

  Fraser told him about the Trust meeting, the Euro and the lifting of the Grade II listing St James’ –
<
br />   “Hang on,” said Tom, reaching for his notebook, “Let me try and get this into some sort of context … “

  So Fraser described the St James’ scandal and how the committee had been formed to find a way out of it.

  *

  Over the next few days, Fraser and Jo kept watch on the patients at risk as best as they could. Of the five, they thought Shirley Norman was the most likely, because of her immobility - she wasn’t responding to treatment and was getting depressed about it.

  Tom acquired some cefataxin for them and on Wednesday, Fraser thought he was going to have to use it when Stanley Forbes, who wasn’t on the list, went down with a chest infection, then he realised it was another false alarm.

  Jo, meanwhile, had a couple of domestic problems to deal with.

  On Wednesday, Debbie, one of the HCAs, came looking for her: “Jo, Mrs B’s at it again … “

  Jo strode determinedly into Room Four – “What is it this time, Mrs Bailey?”

  “This food, it isn’t fit for pigs.” Mrs B was a scrawny, vinegary woman who’d come in with a broken arm. “It in’t just me you know – “ she looked round – “We all feel the same, don’t we girls?”

  Mrs Sherlock, whom Jo thought weak in the head, nodded in agreement. One or two of the others mumbled.

  Then Lily Stokes said, “Don’t you go including me Daisy Bailey, I think it’s fine.”

  Mrs B shot her a look of pure poison.

  Jo said, “It’s exactly the same food that we all have, Mrs Bailey. All the patients, all the staff.”

  Mrs B snorted. Jo went on:

  “If you really don’t like it, you can always ask a friend to bring you some in.” If you’ve got any friends, she added silently.

  She looked round. “Anyone else have anything they wish to say?”

  They didn’t. One or two were clearly having difficulty in hiding their schadenfreude.

  Then on Thursday, she was accosted in the corridor by a big, red haired nurse.

  “I hear you’ve been asking about me,” she said, “Carrie Tucker.” Which, being construed, meant something like: What’s your caper then, missus?

  “That’s right,” said Jo, who’d recognised her from Fraser’s description. She explained her interest in the pneumonia cases and how she simply wanted to talk to someone who’d seen them.