by AB Morgan
Recounting these facts to DS Adams, I recalled in painful detail the hard work required in achieving repatriation of my patient from a French hospital. What a dreadful pickle that had been to sort out, especially as my French was not up to discussing relapse signatures, medication, and care transfer planning.
During one conversation with French Consultant Psychiatrist Dr Reynaud, I mispronounced a phrase so badly that it resembled a tasteless French expression, which made the consultant burst out laughing. The hilarity reverberated around the office she was in, as she duly informed everyone present at her end of the phone of my faux pas. I had described a scene of oral sex apparently. Mortified with embarrassment, I lost all confidence in speaking any French whatsoever.
Dr Reynaud’s English was far superior, and thus after my pronunciation calamity, we continued negotiations in my mother tongue for safety’s sake and that of international relations.
On arrest, Jan had been naked, highly distressed, paranoid and screaming aloud that she was burning hot, hence the need to divest herself of every item of clothing. I was only too aware that she had a history of stripping off her clothes when manic, and thus none of what was reported had surprised me.
When Jan had been extremely disturbed on arrival at the Corbet Unit, the team there assumed illicit substances were to blame; however, this was soon discounted after a negative result from the standard drug screening tests.
‘We had concern that your lady was toxic from anticholinergics, you know about this?’ Dr Reynaud had asked me.
‘Well, I’m not an expert, but I know it’s very dangerous.’
‘Oui, very dangerous. She was hot, flushed, and very confused, making it hard to say if she was delirious or psychotic. Difficult to tell, but she did get better quickly when we treated her for ACS. Could she have taken too much Kemadrin by accident?’
‘I suppose it’s possible, but she only uses it if absolutely necessary and she hadn’t needed to take any since she went on to olanzapine.’
‘We found some hyoscine hydrobromide in her bags, delivered by her boyfriend. So, our theory is that she took the hyoscine for travel sickness and this, added to the Kemadrin, resulted in toxic poison.’
‘Goodness. Thank you for being so thorough and helpful. Merci beaucoup,’ I bravely replied. ‘So, Jan – Mrs Collins – hadn’t run out of her tablets then, she still had some with her?’
‘Oh, oui. She had tablets with her. We don’t know if she was taking them of course.’ That was the unanswerable question. Was Jan taking her medication?
Dr Reynaud had also thrown light on the possibility that Jan had not been manic, but had instead been toxic.
Apart from toxic poisoning, the French ward team at the Hôpital Corbet had recorded that Jan had been preoccupied with the belief that her life was endangered by top-secret information known only to her and her boyfriend. Liam Brookes, the so-called boyfriend, had visited the hospital to see that Jan was safe but had only stayed long enough to deliver her belongings.
Dr Reynaud had spoken to him.
‘Oui, he was a pleasant man and upset because he was shocked that his lady had been seen naked in the streets. He said she would be ashamed but he didn’t speak with her. I think he was upset that she had smashed up their laptop. Expensive, non? After that, we try to telephone him but we could not find him and he didn’t visit the hospital again. Very sad.’
However, Liam Brookes had left an address where he was staying, which Dr Reynaud read out to me. At the time, I wondered whether Liam had returned to the UK, leaving Jan to fend for herself. What a thoughtless bugger.
I gave DS Adams a précis of the events and of my conversations with Dr Reynaud. Other than that, I only had a vague description of him. Lily hadn’t met Liam in the flesh either, and as she was my only other source of information on Jan, there was nothing of real consequence to offer DS Adams.
Our time at the police station was pretty much wasted, which was confirmed when an apology of sorts was forthcoming from DS Adams. ‘The investigating team have determined that the suicide and the robbery were two separate, unconnected incidents, although one may have been the precursor for the other. Besides which, with no real evidence of foul play, we can’t justify the time and expense for any investigation. We only had Mrs Collins’s word that there had actually been a break-in and she is now dead. I suppose I’ll be the one left to inform her brother.’
‘He’s a charmer, isn’t he?’ I said sarcastically. I was ignored. So, I tried a different tack. ‘Was anything found to indicate a forced entry? I reported to your officers that I’d seen a man when I was at Jan’s house.’
‘We made a note that you think you saw someone leaving through the gate, but that wasn’t much to go on, I’m afraid. No sign of forced entry at the back of the house but the lock had recently been replaced, it’s brand new.’
Taking a business card from the baby-faced DS Charles Adams, I promised to find out what I could from Jan’s friends in case there was anything else awry. In return, I was given permission to call him by his first name.
‘Charlie, Chuck or Chas?’ I enquired cheekily. This was met with a stern look, and I realised far too late that the detective sergeant was lacking a sense of humour. He wouldn’t survive long in his job without one, I thought.
‘Charles, if you don’t mind.’
Out of the corner of my eye I saw Eddie grinning like an idiot at my rebuke from the humourless detective.
6
With time unexpectedly available, I suggested to Eddie that a trip to St David’s Church Hall might be in order, not only to check on the support offerings for the vulnerable by the Pathways Project, but also to catch up with Father Raymond as I had promised.
‘St David’s isn’t Catholic,’ remarked Eddie. I explained, as far as I could, about the project and their links into the homeless teams, soup kitchens, and refuges run by other church volunteer groups in the town.
Eddie, announcing how impressed he was, agreed we should check out the workshops. ‘We can’t be seen to recommend or refer patients if there’s not a sound evidence base for what’s on offer, remember, besides which, the project will be in direct competition with our own services.’ Eddie seemed to be thinking out loud. ‘If it turns out to be load of faith-healing mumbo jumbo or bible bashing then we have to back off,’ he informed me. As if I needed reminding.
‘No, you’re right. There’s nothing worse than being preached at, but, “each to their own”, as they say,’ I replied. If people wanted to go to church that was great, as was having a strong belief to guide and bring comfort. Looking back, I admitted to myself that any religious faith must have been knocked out of me as a child when forced to attend church, not once, but twice on a Sunday. I couldn’t wait to escape from the clutches of the righteous.
When Eddie and I arrived at the hall, I think we were both pleasantly surprised by how organised the project appeared to be. There, on a neat colourful poster, were the timetabled current events: discussion groups, anxiety management courses, assertiveness skills training, and rolling programmes for sleep problems.
As we were nosing around in the entrance hall, I spied Father Raymond through some Georgian double doors, overseeing what looked like a creative workshop. Small groups of adults were clustered around tables with coloured pens and sticky notes, deep in serious discussion and joining in with ideas. There was a soothing hubbub of low-level chatter, which reached us as we stood peering through the rectangular glass panels.
Father Raymond recognised me immediately and beckoned to Eddie and me to enter the room. As he strolled towards us, his dog collar was the only giveaway as to his religious occupation. I introduced Eddie as my boss, and after shaking hands Father Raymond explained what the group was so busily attending to.
‘This would usually be a discussion group of current events, but to be honest we’ve had to modify today’s plan. We only found out this morning that one of the ladies, Jan, who used to come here regularly, ha
s sadly taken her own life. Her friends here are struggling to make sense of the events leading up to her death, as are we all.’
The jungle drums work extremely fast in the mental health community and word had leaked out from Pargiter Ward. I noticed a couple of Jan’s close friends and asked if I could offer my support to them directly. They had seen us and were making their way towards me with open arms and tearful, distraught faces. Noticing their response to Eddie and me, Father Raymond herded us into a small room to one side of the large main hall.
Vanessa, Karen, and Pip had known Jan for years. They had been to art groups together and at one time or another met when they were inpatients on Pargiter Ward. Since then, they had formed a cohesive self-support group nicknamed the Coffee Tuesday Comrades, for obvious reasons. The benefits had been immeasurable. Willowy, tall, and wise, Pip was like an older brother to Karen and Vanessa. He put his arms around the shoulders of his two younger comrades, as if trying to protect them from the dreadful reality of losing their mother figure. Her loss was overwhelming them. All three gushed with questions through their sobs, most of which Eddie and I had no answer for.
‘But why would she kill herself, Monica?’
‘Why?’
‘Monica, something’s not right about this. I spoke to her last Sunday and Monday,’ Pip said. ‘She was fine. Honestly. We talked about Liam and she said there were things we didn’t understand, but that Liam had to stay in France. She’d been having dreadful trouble getting hold of him and was waiting for him to phone her back.’
Helpfully, Pip, Karen, and Vanessa spilled forth about Jan and Liam Brookes. The more I heard the more confused I became. He, apparently, had started to go along to the discussion group not long after the project first started and had taken to Jan almost immediately. She and her three friends of the Coffee Tuesday Comrades had been stalwarts of the group right from the outset. Liam, I was told, had been accepted by them as a friendly, knowledgeable individual who had a cheery disposition and showed concern for the wellbeing of the people who met regularly at St David’s Church Hall. He’d also helped out with one or two of the homelessness programmes, according to Father Raymond, who had returned to see how we were faring.
‘It appears he may have fooled us all. Poor Jan,’ Father Raymond said with a shake of his head. While the facts about how Liam met Jan were interesting, it appeared nobody knew where Liam was from, where he lived, or what his background was. He was purporting to be a retired businessman, whose mental health had taken a negative turn when his wife had left him destitute through a nasty divorce. He had been lodging locally but no one in the group had seen him for weeks. That was it.
After making offers of further support, Eddie and I spent a short while with Father Raymond over a welcome cup of tea. By the time we left, we were reassured as to the intentions of the Pathways Project and the way it was facilitated. ‘The group leaders have additional qualifications in motivational interviewing, solution focussed therapy, and one or two have a bona fide certificate of accreditation in CBT techniques,’ Father Raymond announced proudly. ‘And, there are plans afoot to merge services, or at least to share group work, with local drug and alcohol services.’
We walked back to Eddie’s car, slowly taking in the potential consequences of what we had discovered inside the doors to St David’s Church Hall. ‘How on earth did we miss out on the information about this particular project, Mon?’ Eddie was plainly embarrassed by the fact that we were oblivious to the sterling work the project had been doing for six months.
‘Awkward, wasn’t it?’ I could only assume we had become so blinkered to meeting targets and running around chasing policy requirements, that we had failed to appreciate the effective mental health work happening on our very doorstep.
‘We’d better start looking at the job adverts, if this keeps up,’ Eddie said with a sigh of resignation, which was not like him. A wholehearted supporter of the NHS, he normally gave short shrift to any threat to our monopoly of provision for the mentally unwell. As we seemed to be working harder and going nowhere these days, I for one could see no reason not to advocate for new services. There were several patients on my caseload who would definitely benefit from what was on offer at Pathways. I thought of Ian.
With this in mind I called Sean Tierney, Ben’s father, to update him on my findings. A delighted Sean thanked me for my incredibly rapid response to his enquiry. However, I would have bet my week’s wages that nothing whatsoever would drag Ben to any church hall.
Selfishly I also thought that if I handled the situation carefully enough, he might, as an alternative, appease his parents by agreeing to my plan to go regularly to Len-DAS, where I could leave him in the capable hands of my friend Emma, who has a gift for achieving the impossible.
Slightly devious of me to think in this way, but it was with the best intentions.
7
All scheming and tactics related to work were long forgotten as soon as I arrived home. Once I had taken Deefer for a long walk, over the fields and back again, I had the house to myself for a while. Those daily dog walks helped to clear my mind and allowed me to switch my head from nurse to wife. Max had thoughtfully called to let me know he was planning to meet up with his old mate, Robbie, at the bike club, before heading home. They were sure to be plotting which motorbike investment to seek out next. What I needed them to do, was to make a decision and disappear for a day or two to a classic bike show or to John O’Groats in search of the Holy Grail of bikes and allow me a whole weekend of reading through the cabinet journals belonging to G.C. The Paracelsus riddle wasn’t too difficult to solve as it turned out, I just hadn’t heard of him before, but clues were missing as to the identity of G.C.
Before starting the dinner preparations, I decided to whet my appetite for history by leafing quickly through one of the journals, which had only ‘G.C.’ printed on the front cover. A number of the journals had a title, such as Tinctures or Liniments and these were crammed full of complicated equations and recipes. I wasn’t interested in them. Not now.
The first G.C. journal was badly water damaged and I turned several pages before I could discern more than a line or two. When I did, I was ecstatic with what was uncovered.
… with Laudanum, there were many examples of poisoning, especially during the Victorian and Edwardian eras, when use of arsenic ‘The inheritance poison’, was favoured. Thallium was ascribed the name of ‘the poisoner’s poison’ because of its colourless and odourless nature …
… strychnine and cyanide will be found to be anomalous at post mortem, thus alerting authorities to foul play.
Cremation, previously the poisoner’s best friend, is no longer, as even the ashes will reveal secrets if asked …
A skilful poisoner considers circumstances in which the intended victim, these days referred to as ‘the mark’, could conceivably have accidentally ingested, or perhaps inhaled poison. This only requires knowledge of such poisons and their individual characteristics.
Most essentially the conventions of ‘the mark’ are required to be known. Do they habitually stroll in the woods with their dog? Do they order a special item from the bakers? It is most advantageous if ‘the mark’ is in receipt of regular treatment with prescribed medication – this can be so effective in overdose – one simply requires access to information on the toxicity of the medicine and a reference list or compendium is a prerequisite.
Oh my God! This man is giving advice about poisoning. Is he a murderer?
The coincidence was not lost on me. I had, only the day before, been confronted by death from an overdose of prescribed medication. Whether Jan’s death was suicide or not was still unclear, and a number of doubts had plagued me for more than twenty-four hours despite distracting myself.
A sense of urgency arose in me, galvanising me into action, making me arrange the journals in relevant and chronological order. Did I possess all the journals and how would I know if I didn’t? How awful it would be to discover that I�
��d bought tantalisingly few of the total set.
I was shaking in anticipation.
‘Wine, I need vino plonko … and chocolate.’
Setting about the task with grim determination not to panic and not to spill any wine on the precious books, concentrating hard, I worked out that there were eight salvageable chemical recipe books and four others. Two of the journals turned out not to contain recipes, but revealed numerical coding of some sort, much of which had initials to anonymise the relevant parts, I assumed, and on each page, were running totals carried forward to the next. The totals were in pounds, shillings, and pence sterling. The dates ranged over decades from the 1940s to the 1970s and were made in two different sets of handwriting. One type of handwriting did not occur again after the 1960s, and the other, I deduced belonged to G.C. The sums of money in the running totals were considerable. Hundreds of thousands of pounds.
G.C., whoever he was, had lots of money and only two initials, which was bothering me. Some recent research had apparently proven that people with three or more initials were believed by others to be more intelligent and therefore did better in business. Richer by courtesy of their names. I thought I was the only unfortunate individual whose parents had found it too taxing to arrive at a middle name for their child, and a first-born at that. Once I had discovered my own parents’ omission, I felt quite aggrieved at not being given a middle name. Why was it that G.C.’s parents had also been unable to settle upon a suitable set of names for their son? I wondered if he was adopted or perhaps orphaned and only had two names for one of those reasons. Like, Oliver Twist. Very possible, I thought.
Revisiting this conundrum and the unrecognisable coding in the journals would have to wait. It was too onerous a task for a simple mind like mine after a couple of problematic days at work.
