Pulse

by Felix Francis

  ‘Yes,’ I said, nodding. ‘You’re half Greek.’

  He smiled broadly at me, clearly pleased I’d remembered. ‘Can I help you?’

  ‘I have a folder for DS Merryweather.’ I held it out. ‘Could you please give it to him?’

  ‘Sure,’ he said, taking it. ‘Are these the blood-test results for the nameless man?’

  I nodded again. ‘Have you still not found out who he is?’

  ‘Not yet but I’m sure we will eventually.’

  ‘Did you find anything at the racecourse?’

  He looked at me quizzically.

  ‘On Saturday night, after the man died, you told me you were going back to the racecourse to search the Gents where he was found.’

  ‘Ah, yes,’ he said. ‘So I did.’

  ‘So what did you find?’ I asked again.

  ‘Not a lot. There was nothing in the cubicle and mostly just paper towels in the rubbish bin by the washbasins.’

  ‘Mostly?’

  ‘There was also some other general waste, you know, a few newspapers, a couple of discarded racecards, some torn-up betting slips and one of those small flat quarter-bottles of whisky.’

  I thought back to the slight smell of alcohol that had been present on the man’s breath at the hospital. It could have been whisky.

  ‘The man had definitely had a drink of alcohol at some stage. Have you checked the bottle for his fingerprints?’

  It was clear from his expression that he hadn’t.

  ‘And did you test the contents?’

  ‘It was empty.’

  ‘There must have been some residue left,’ I said. ‘According to his report, the pathologist thinks the cocaine was probably ingested orally. I wonder if it was in the whisky.’

  ‘Can you put cocaine in whisky?’ he asked.

  ‘Sure,’ I said. ‘It will dissolve in almost any liquid. I remember a case a few years back when someone drank rum laced with cocaine. It killed him.’

  ‘Are you serious?’

  ‘Deadly serious,’ I said. ‘A man dissolved a large quantity of cocaine into a bottle of rum to smuggle it into the UK. His girlfriend carried it because he claimed he was over the duty-free limit but the man was stopped by customs and the girlfriend gave up waiting. She gave the bottle to a taxi driver without realising its contents were lethal and he died after drinking a single shot.’

  ‘Couldn’t he taste it?’

  ‘Obviously not. Probably knocked it back in one go. And that’s not the only time. Someone else died drinking pear juice laced with cocaine, again after it was smuggled into the country.’

  ‘But how can you get it back out of the liquid?’

  ‘Simple,’ I said. ‘Gently evaporate it in a saucepan and you’ll be left with the cocaine powder at the bottom.’

  ‘So you think our nameless man was a smuggler?’

  ‘No,’ I said. ‘I didn’t say that. I’m simply asking whether you’ve tested the whisky bottle as the possible source. Have you still got it?’

  ‘Yes,’ he said with certainty. ‘Everything was bagged up.’

  I suddenly felt dreadfully light-headed and rocked slightly, grabbing hold of the handrail.

  ‘Are you all right, Dr Rankin?’ PC Filippos asked. ‘You’ve gone very pale.’

  ‘I’m fine,’ I said automatically.

  I was always fine.

  But in truth, this time, I was far from feeling fine. I was dizzy, shaky and I couldn’t focus my eyes properly. In fact, I was very close to passing out altogether. I slumped further against the handrail and only the policeman’s strong arms of the law stopped me falling over completely.

  ‘I’m sorry,’ I mumbled. ‘Must be something I ate.’ Even though I doubted that. I hadn’t eaten anything at all since the previous evening and, even then, I had only consumed a reduced-calorie cup of vegetable soup.

  ‘Come on,’ he said, holding me tightly round my waist, ‘let’s get you inside and sat down.’

  He all but carried me through the door of the police station. One of his colleagues rushed to help and, between them, they lifted me onto an upright chair in the reception area.

  ‘I’ll call an ambulance,’ said the colleague.

  ‘No,’ I said, trying but failing to be forceful. ‘No ambulance.’

  I’d have had more chance of holding back the tide.

  7

  I was currently banned from entering Cheltenham General Hospital in the role of a clinician but, sadly, not as a patient.

  However, my first embarrassment was that I knew the ambulance crew – I had seen them often at the hospital as they’d delivered other people.

  ‘Hello, Dr Rankin,’ one of them said cheerfully when he saw me sitting in the police station reception, ‘I’m Derek. What seems to be the problem?’

  ‘There’s no problem,’ I said. ‘I’m fine. Lot of fuss about nothing.’

  ‘Let me be the judge of that,’ Derek replied with a smile, crouching down to be on my level. There was something very reassuring about his manner – confident and in control. I leaned my head back against the wall and decided not to fight him. ‘Let’s get you into the ambulance and do some tests.’

  The two paramedics lifted me onto an upright wheeled chair and took me out to their vehicle.

  ‘I’ll be in touch,’ PC Filippos said as he held the door open for us.

  I nodded weakly at him. I really didn’t feel very well at all. My skin was clammy and I could feel more palpitations in my chest.

  Doctors are notoriously bad at self-diagnosis, only surpassed by the general population at large who predictably diagnose a bout of indigestion as a life-threatening heart attack and a blocked sweat gland as terminal skin cancer. Doctors, however, tend to err the other way, dismissing potentially serious symptoms in themselves as trivial when they wouldn’t hesitate to refer to a specialist any patient presenting to them in a similar condition.

  However, all of that notwithstanding, I had a pretty good idea what was wrong with me – lack of food resulting in blood-sugar levels that were too low.

  Maybe skipping lunch, after having had no breakfast, hadn’t been such a good idea after all.

  In the ambulance I was wired up to their ECG machine. I was not having a heart attack, Derek assured me. I knew that. But, nevertheless, the trace was somewhat irregular from the palpitations.

  ‘Blood sugar,’ I said. ‘It’s probably too low.’

  ‘Are you diabetic?’ Derek asked seriously.

  ‘No. I’m not. But I haven’t eaten much today.’

  In fact, I hadn’t had as much as a cup of tea in the preceding twenty hours.

  ‘Tut-tut,’ Derek said. ‘You should know better than that.’

  I did know better than that. I also knew that I was starving myself and that I desperately needed to consume more food, but it was as if I needed to get to the bottom of what was happening to me before I could start eating again. Not that I even knew where the bottom was, or whether I would realise it when I got there.

  Grant urged me to eat all the time. Indeed, he begged me to.

  But it wasn’t as simple as just doing it.

  There was a voice inside me that wouldn’t allow it.

  And I was terrified that, once I started eating, I wouldn’t be able to stop and I would grow fatter and fatter until I became a completely round blob like Violet Beauregarde in Charlie and the Chocolate Factory.

  Or perhaps, by continuing not to eat, I felt that I was still in some sort of control of what was happening to me. By selecting where and when I swallowed even the smallest amount of sustenance, was I trying to convince myself that I remained on top of my emotions and in charge of my life?

  Maybe I even believed it.

  However, my psychiatrist was alarmed that what had been an initial show of self-discipline and control had developed into a full-blown eating disorder.

  ‘Don’t be silly,’ I’d told him with a nervous laugh. ‘Surely anorexia is for teenage girls.’<
br />
  But the doctor in me knew that wasn’t true. Loads of middle-aged women suffered from anorexia, and specialist eating-disorder wards in psychiatric hospitals were full of them.

  But I was surely far from being one of those.

  I was fat.

  You only had to look at me to see that. So what that Grant said I was just skin and bone, I saw myself as fat and ugly.

  ‘Three-point-one,’ Derek said, reading from the blood-glucose monitor. ‘Far too low. No wonder you’re feeling faint and having palpitations.’

  He dug around in one of the ambulance’s many lockers and produced a high-energy banana milkshake, chock-a-block with added sugar.

  ‘Here,’ he said, tearing off the top of the carton and holding it out to me, ‘drink this.’

  I pushed it away.

  ‘Come on, Dr Rankin, please drink it,’ he said. ‘Your blood-sugar figure is dangerously low.’

  I took the carton and put it to my lips but there was no way I was going to tip it. I tried but I couldn’t. The voice inside my head was now shouting, ordering me not to, and it was simply too strong to overcome.

  ‘If you won’t drink it, I’ll have to put you on an IV glucose drip,’ Derek warned, almost aggressively. ‘Do you really want that?’

  Not particularly, I thought, but, even so, there was no way I was going to swallow his sickly-sweet banana concoction. It would have made me retch.

  Derek was still encouraging me to consume his poison when we arrived at the hospital but, far from that being the end of my troubles, it was only the beginning.

  Things at that point descended from being bad to worse, much worse.

  Maybe it was just fellow-professional courtesy, but I was taken straight through without waiting into Resus, that part of the emergency department where serious trauma and other life-threatening conditions were treated.

  It was my customary place of work and I was among my usual colleagues; however, far from feeling relaxed in familiar surroundings, I was self-conscious, ashamed and humiliated.

  A senior staff nurse, the very individual I suspected of making the formal complaint against me, was now the person wiring ECG electrodes on my chest to the monitoring equipment. She did it without saying anything and with minimal eye contact. Maybe she was embarrassed too.

  One of the other nurses took my right index finger and pricked it with a needle to get the drop of blood required for another blood-sugar test.

  Then I was left alone in the cubicle lying on the hospital trolley, with the blue privacy curtains drawn around me.

  The time seemed to drag but it must have been only a few minutes before Jeremy Cook appeared, sticking his head through a gap in the curtains.

  ‘Hello, Chris.’ He said it almost with a sigh. ‘How can I help?’

  ‘You can’t,’ I said, swinging my legs over the side of the trolley. ‘I’m grateful for your concern, Jeremy, but I really don’t need your help. I’ve no idea why I was brought here. I was a bit dizzy, that’s all. I just needed a little sit-down.’

  He definitely sighed this time. ‘Your blood sugar.’

  ‘What about it?’ I asked.

  ‘It’s dangerously low.’

  ‘That’s simply because I didn’t have breakfast and ran out of time for lunch,’ I said in my best ‘don’t make a fuss’ voice. I even forced a laugh. ‘I’m sure it’ll be back to normal this evening after my first glass of red wine.’

  He sighed again and shook his head.

  ‘Don’t lie to me, Chris,’ Jeremy said. ‘We’ve known each other for too long.’ He paused. ‘I’ve just been speaking to Grant.’

  ‘Oh,’ I said, understanding the significance. ‘Is he here?’

  ‘No, I called him at work. He’s on his way over here now. You stay right where you are until he arrives. In the meantime, I’m going to give you an injection of glucagon.’

  Glucagon was a glucose-increasing hormone. Many insulin-dependent diabetics have a preloaded self-injector of the stuff readily available just in case they suffer a ‘hypo’, a sudden drop in blood sugar that, if left untreated, could rapidly lead to coma and death.

  He held up the syringe in his right hand.

  ‘Is that really necessary?’ I asked.

  ‘Not if you will eat this.’ He held up a chocolate bar in his left.

  I shook my head and said nothing. I just stared at him.

  He stuck the needle into my arm and, after a while, I did begin to feel a little better.

  Grant arrived at the hospital about half an hour later but he wasn’t alone. Stephen Butler, my psychiatrist, was with him. The two of them came into the cubicle with Jeremy Cook.

  ‘I have an appointment to see you later today,’ I said to Stephen with a laugh.

  ‘I know,’ he replied without a trace of humour. ‘Grant called me and explained the situation so I came over now.’

  ‘What situation?’ I said. ‘I just felt a bit dizzy, that’s all.’

  Grant was staring down, saying nothing.

  Stephen sat on a chair next to me and took my hand.

  ‘Chris,’ he said. ‘We are all very concerned about you.’

  ‘You don’t have to be. I’m fine.’

  I sounded like a broken record – I’m fine . . . I’m fine . . . I’m fine . . .

  ‘You are not fine,’ Stephen said emphatically. ‘I’ve been talking to Dr Cook and also to Grant. He has told me all about your trip to Bristol on Sunday night.’

  I looked across at Grant but he was still resolutely studying the blue vinyl floor.

  Stephen went on. ‘He also tells me that you still won’t eat anything and that it is getting worse. You have already lost far too much weight. Starving yourself is very dangerous, Chris, and Dr Cook is very worried that you are putting your heart under undue strain. You need to eat. You have to take in more energy simply to stay alive.’

  ‘I have plenty of energy,’ I laughed. ‘I’m hardly fading away, am I? I’m still far too fat.’

  ‘You are not fat,’ Stephen said in an uncharacteristic moment of irritation. He collected himself. ‘Chris, listen to me. By not eating, you are seriously endangering your life. Your husband and your boys love you, and they don’t want to lose you. Do you understand?’

  He had been more talkative in the last few minutes than he had been in all the nine months I had been going to see him.

  ‘Do you understand?’ he said again.

  ‘Yes,’ I replied, but I’m not sure I did. Surely I was not so ill that my husband and psychiatrist had to come rushing to see me in A&E. I had only felt a bit dizzy.

  ‘Good,’ Stephen said. ‘Because Grant, Dr Cook and I consider that it would be best if you were admitted to hospital for a while. Just long enough to get you sorted.’

  Hospital? I was not sure I was hearing him right.

  ‘This hospital?’ I asked blankly.

  ‘No, Chris. Not this one. We think you should go to Wotton Lawn.’

  Wotton Lawn was the acute mental-health hospital for Gloucestershire.

  ‘No,’ I said firmly. ‘I don’t need to go there.’

  ‘We think you do.’

  ‘Well, I’m not going.’ I was adamant.

  Stephen was very calm. ‘We consider that it is essential for your own protection. I have already spoken to Wotton Lawn and they have a bed waiting for you in their eating-disorder unit. If you won’t go voluntarily, you will be sectioned under the Mental Health Act, 1983.’

  I looked again at Grant but he steadfastly refused to meet my eye.

  I could feel the anger rising again, grabbing me by the throat and trying to suffocate me.

  How could Grant agree to this?

  He knew how I hated the prospect of being in hospital.

  ‘Grant!’ I shouted at him. ‘Help me.’

  He finally looked up. There were tears in his eyes.

  ‘I am trying to help you,’ he said.

  I now wished that I had jumped off Clifton Suspension Br
idge.

  PART 2

  March

  8

  The arrival of March was always an exciting time in Cheltenham.

  Everyone had only one thing on their mind – the annual Cheltenham Racing Festival. Four days of exhilarating action on the hallowed track at Prestbury Park, when the stars of both Irish and English steeplechasing came together to establish who were the champions.

  The Grand National might be the most famous steeplechase in the world but, for horseracing folk, owning, training or riding a winner at the Cheltenham Festival would be the defining achievement of their careers, with the Gold Cup, on the final afternoon, being the really big one – at three and a quarter miles over twenty-two fences, with all the horses carrying the same weight, it was the true championship race.

  Every hotel within fifty miles of the racecourse was fully booked months in advance, many by the tide of Irish punters that surged across the sea each year to gamble extensively, consume huge quantities of Guinness, and cheer home their equine idols.

  ‘So, Dr Rankin, you can act as a racecourse medical officer for the Festival next week?’

  ‘Yes,’ I said excitedly. ‘I can.’

  I was on the phone to the Clerk of the Course at Cheltenham. He had called me in some agitation on behalf of the senior racecourse medical officer. It seemed that one of their regular doctors, who had already been signed up, had carelessly collided with a tree while on a skiing holiday in the French Alps and had broken his right leg in six places. He was currently laid up in traction at the Hospital Center De Moûtiers, and was likely to remain so for the foreseeable future.

  ‘Er,’ said the Clerk of the Course uneasily, ‘I’m afraid there is one question I am required to ask you.’

  ‘Go ahead,’ I said.

  ‘If I remember rightly, I couldn’t use you for the International Meeting in December because you were suspended from your usual employment and therefore unavailable under the racing authority rules. Is that still the case?’

  ‘No,’ I said. ‘It is not still the case.’

  There was a sigh of relief from the other end of the line. ‘Good,’ he said. ‘I thought so because your name is back on the authority’s list of approved medics.’