Pulse

by Felix Francis

  I went back to my seat while the coroner called the next witness, the senior county pathologist who had performed the post-mortem examination of the man’s body. His report was already on the coroner’s bench.

  ‘Please tell the court the cause of death,’ the coroner said after the pathologist had introduced himself.

  ‘Acute cocaine poisoning,’ the pathologist said confidently, ‘resulting in cardiac arrest.’

  ‘Did the administration of adenosine at Cheltenham Hospital have any effect on his death?’ the coroner asked.

  I held my breath.

  ‘I very much doubt it. I suppose it might have hastened it a fraction – by a few minutes, that’s all. And if the patient had indeed been suffering from simple supraventricular tachycardia, the adenosine might have saved him. In my opinion it was a risk worth taking.’

  The coroner was looking at me and saw me sigh in relief.

  ‘And was the absence of a specialist cardiologist at the hospital a factor?’

  ‘No, sir,’ said the pathologist. ‘The amount of cocaine in the brain tissue was incompatible with life. In fact, I’m surprised he lived as long as he did.’

  The coroner wrote something in his notebook then looked up at the pathologist. ‘Have you seen the report from the police forensic laboratory concerning the whisky bottle found in the waste bin in the gentlemen’s lavatory?’

  ‘Yes, sir,’ replied the pathologist. ‘I have. The concentration of cocaine found in the residue would be consistent with it being the source of the drug in the cadaver. Only a single teaspoonful of the liquid ingested orally would have been sufficient to cause death. Analysis of stomach contents was compatible with the deceased having consumed such a lethal dose.’

  ‘Thank you, doctor,’ the coroner said.

  ‘What?’ had now been covered.

  The last witness was the junior doctor who had certified the death, the doctor that I had shouted at, and the doctor who had made the initial complaint against me. I looked at him with contempt as he made his way to the witness box. What more was I now going to have to suffer from his mouth?

  No wonder the coroner had told me to remain.

  But, much to my surprise, the doctor restricted himself solely to the ‘Where?’ and ‘When?’, referring only to the facts recorded on the man’s medical records indicating at what exact time and place life had ceased and the patient had been declared dead.

  ‘And were you present at that point?’ the coroner asked.

  ‘Yes, sir, I was. I had been leading efforts to resuscitate the patient for the preceding hour but without any success. It was me who called a halt to those efforts.’

  ‘Was Dr Rankin not present as well?’

  ‘No, sir. Dr Rankin was dealing with a young woman who had been seriously injured in a motorcycle accident.’

  ‘Was it usual for a seriously ill patient to be left unsupervised by a consultant?’

  The junior doctor glanced briefly across the courtroom at me.

  ‘Dr Rankin was busy saving the life of another patient.’

  ‘I asked you if it was usual,’ the coroner said.

  ‘No, sir, not usual, but certainly not unique.’

  The coroner made some more notes.

  ‘Thank you, doctor,’ he said. ‘You may step down.’

  The junior doctor left the witness box and walked back to his place at the back of the court, seemingly taking extra care not to look in my direction.

  There was a lengthy silence as the coroner wrote some more in his notebook.

  ‘Ladies and gentlemen,’ he said eventually, ‘I am satisfied as to the identification of the deceased as Rahul Kumar, citizen of the Republic of India. I am also satisfied that the direct cause of death was acute cocaine poisoning as a result of consuming contaminated whisky. There may be speculation that the death of Mr Kumar was due to suicide but I am unable to come to that determination. In spite of him being found unconscious in a self-locked cubicle, and the existence of his fingerprints on a duty-free whisky bottle in which cocaine was found in extreme concentration, there is no evidence that Mr Kumar intended to consume a dose sufficient to end his own life. Therefore it is the conclusion of this court that the death of Rahul Kumar was due to misadventure.’

  There was a slight murmur in the courtroom but the coroner wasn’t quite finished.

  ‘Furthermore,’ he said, ‘I will be writing to the Secretary of State for Health asking for clarification on some of the processes in our hospitals.’

  Good luck with that, I thought. Doctors had been trying to get that sort of clarification from the Health Secretary for decades.

  ‘All stand,’ shouted the usher.

  The coroner stood up as well, bowed towards us, and then departed.

  ‘Misadventure,’ said DS Merryweather, turning to me. ‘I’m happy with that.’

  I wasn’t. Misadventure implied that Rahul Kumar’s death had been unintentional – an accident or mishap brought on by his own actions.

  Why was I the only person who believed that it was murder?

  24

  ‘Anyone fancy a coffee?’ I asked as we exited the courtroom. ‘I’m buying.’

  I saw DC Filippos hesitate and look at his boss.

  ‘We just about have time,’ said the sergeant.

  The two of them sat at a table at one end of the vestibule while I collected three cups of coffee from the vending machine in the corner.

  ‘So you were happy with that verdict,’ I said, sitting down to join them.

  It was not a question but a statement.

  ‘It seemed reasonable in the circumstances,’ said DS Merryweather. ‘There are too many holes in our knowledge to be sure it was suicide.’

  I shook my head. ‘It was surely not suicide. I think he was murdered.’

  ‘He was found in a locked cubicle,’ the detective said with more than a trace of frustration.

  ‘We heard how the lock was slid open using a cleaner’s mop. Why couldn’t it have been closed in the same way?’ Now that had been a question. No doubt about it. ‘And why would anyone fly all the way from India just to kill himself?’

  Another question.

  My promise to Grant had clearly been thrown to the wind.

  ‘People do funny things,’ replied the detective. ‘I knew someone who bought a new house when he had terminal cancer. Cost him a small fortune and then he died just two days after moving in.’

  That I could understand. It was called denial.

  ‘And we don’t know what he’d been doing in the seven days after he got here,’ said DC Filippos. ‘Maybe something happened during that week that made him do it.’

  ‘Perhaps it was a girl,’ said his boss. ‘Maybe he flew all this way and then was rejected. Enough to drive anyone to suicide.’

  ‘That’s just wild speculation,’ I said.

  ‘So is your notion that he was murdered.’

  ‘But, if you’re right, where’s the girl now? There was enough press coverage. She would have surely come forward.’

  ‘Not necessarily. The Indian community in this country can be very secretive, especially if he was coming here expecting an arranged marriage and was rejected. The family honour would mean they would all close ranks and say nothing.’

  It all sounded very improbable to me, but so did my theory that he’d been murdered.

  ‘But where did he get the cocaine from?’ I said, all pretence at not asking questions now completely gone.

  ‘Maybe he brought it with him from India,’ DC Filippos said. ‘After all, it was you that told me about smuggling cocaine through customs by dissolving it in alcohol.’

  ‘So what happened to the rest of it?’ I asked.

  ‘Perhaps he’d already taken that beforehand,’ DS Merryweather said, ‘during the week he was here. Maybe this last time he just took too much.’

  I wondered if a test on the man’s hair had revealed whether or not he’d had a long-term cocaine habit. It hadn’t b
een mentioned in court. I looked to see if the pathologist was one of the people still milling around outside the courtroom to ask him, but there was no sign. However, I did spot Rupert Forrester, the racecourse managing director. He was talking with the usher. Probably checking that Cheltenham Racecourse wasn’t to blame for anything.

  ‘And why aren’t any of the jockeys here as witnesses?’ I asked. ‘They saw Rahul Kumar at Cheltenham races on the day he died. They admit that they were arguing with him in the car park, even if they lied about why.’

  ‘We have no evidence that they were lying,’ said DS Merryweather.

  ‘Trust me,’ I said. ‘They were lying. All that nonsense about parking his car in their spaces. If it was true, where’s the car now?’

  But, if not his parking, what had the man and the jockeys really been arguing about?

  Was it to do with the spot-fixing?

  Had Rahul Kumar been an illegal Indian bookmaker who had been trying to set up the ‘fix’?

  But, if that was true, why was it still going on after his death?

  Maybe he’d been trying to stop it.

  ‘What sort of private security organisation did Kumar work for?’ I asked.

  ‘According to his sister, it was a firm in New Delhi,’ said DC Filippos.

  ‘Didn’t you find out its name?’ I asked.

  ‘We sent a request to the Indian Police Service but heard nothing.’

  ‘Shouldn’t the inquest have been adjourned until you found out? Don’t you think it might have been relevant?’

  ‘No,’ said the detective sergeant decisively, standing up. ‘All these questions are not relevant. The coroner has given his verdict. Rahul Kumar died from misadventure. End of.’

  ‘Inquests can always be reopened,’ I said.

  ‘Not after a misadventure verdict, not unless there’s a judicial review by the High Court, and only then if significant new evidence comes to light. It has taken us five long months even to find out who he was, so that’s unlikely.’

  Especially if they weren’t going to be looking, I thought.

  Dead end. But I wasn’t giving up that easily.

  Giving up!

  What was I thinking of?

  We walked out to the car park.

  ‘I suppose this investigation is now over for you two,’ I said.

  ‘Definitely is,’ replied DS Merryweather, ‘and good riddance too. I only have another twenty-two open files on my desk.’

  Should I ask? Should I?

  Why not? I’d already broken my promise to Grant. In for a penny . . .

  ‘Who owns the black Mercedes?’

  ‘I’m not allowed to give you that information,’ he said, ‘due to data protection.’

  ‘I promise I won’t tell anybody.’

  Not that my promises were worth anything.

  ‘I still can’t tell you.’

  ‘Can’t or won’t?’

  ‘Either and both,’ said the detective sergeant. ‘Leave it, Dr Rankin. Go back to treating your patients and concentrate on staying well. This is over.’

  The two policemen climbed into their car.

  ‘How about my son’s bike?’ I shouted at them as they drove off. ‘Who did that?’

  It may have been over for them but it wasn’t for me.

  Grant arrived home from work as I was sitting on the sofa, sipping tea and watching the six o’clock news on the television.

  ‘How was it?’ he asked.

  ‘OK, I suppose,’ I said. ‘I took a bit of a grilling from the coroner over hospital procedure and that was quite uncomfortable but, apart from that, it was fine.’

  ‘I’m sorry. I should have been with you.’

  Grant had intended coming with me to the inquest, but then he’d been asked to make an important presentation at his work – something to do with new instrumentation for a jet fighter being made for an Arab country. The ruling sheikh was going to be there.

  Grant had been in two minds and, in the end, it had been me who’d insisted that he should give the presentation, because I knew that was what he truly wanted.

  ‘It was OK,’ I said. ‘I was fine, and I think I coped all right. How did your presentation go?’

  ‘Really well,’ he said, smiling. ‘The sheikh seemed very happy, which was the most important thing as he holds the purse strings, and my bosses were delighted too.’

  ‘Good. Well done.’

  ‘Do you fancy a glass of wine to celebrate?’ Grant asked.

  ‘Not for me, thanks. I have my tea, but you have one.’

  ‘Are you all right?’ Grant asked with some concern.

  ‘Of course,’ I said. ‘I’m fine. I just don’t want a drink.’

  Too many calories, I thought.

  He went out to the kitchen to open a bottle while I thought back to my time in the witness box during the inquest, in particular when the coroner had seemingly implied that I had somehow failed to keep an eye on what was happening everywhere on the night the man had died.

  I really had been fine about it.

  A couple of months earlier and I would have probably broken down in tears or descended into a full-on panic attack. I might even have ended up back in hospital myself.

  I had recently made progress in my recovery, not that I could consider myself as being completely well. For a start I still wasn’t eating properly, taking every available minor excuse to skip a meal.

  Even though Grant and my family kept telling me I was far too thin, I still couldn’t see it when looking in a mirror.

  All I saw was myself as big, fat and ugly.

  Going back to work had helped, if only because I couldn’t spend the whole day studying my reflection. But I was still taking far too many damn pills, and trying to balance my hormone and thyroxine levels was still proving difficult, if not impossible.

  I was still seeing Stephen Butler every other week and we had been working on my emotional state.

  He considered that the lack of a loving relationship with either of my parents when I’d been a child was still somehow hindering my ability to fully interact emotionally with friends and family, and especially with my husband.

  I loved Grant, and I was sure he loved me, but there was an emotional disconnect between us that I felt had recently widened. I couldn’t exactly put my finger on the reason, and it may have been more in my head than in reality, but I believed we were drifting slowly apart. Maybe it was nothing to do with my illness, perhaps it was just what happened after eighteen years of marriage but, either way, it frightened me.

  In the past, I would never have made a solemn promise to Grant not to ask questions and then so easily broken it, as I had done earlier. And I often found myself lying to him about my weight and especially about my eating, telling him happily that I’d had a big lunch when, in fact, I’d consumed nothing at all.

  And what worried me most was that it was so easy, and I felt no guilt afterwards.

  My mobile phone rang and I picked it up.

  ‘Hello,’ I said.

  ‘Ah, yes, hello, Chris,’ said a voice. ‘Er, Adrian Kings here, from the racecourse. How are you keeping?’

  He sounded all sweetness and light. Too much so, in fact.

  ‘I’m fine, thank you,’ I replied without any warmth.

  What did he want?

  ‘I hear you are back working at Cheltenham General.’

  ‘Yes,’ I said, and wondered how he knew. But it was not a secret and there was a healthy grapevine in local medical circles.

  ‘I’m delighted that you are back to full fitness.’

  ‘Thank you.’

  I wasn’t yet completely at full fitness but I wasn’t going to tell him that. To say that I was slightly wary of this conversation would not have been an exaggeration. The last time he’d spoken to me he’d been spitting blood with anger.

  ‘Er,’ he said.

  I realised that he was embarrassed – I could tell from his voice. Clearly, he could also remember our l
ast encounter.

  I remained silent. I wasn’t going to help him out.

  ‘Chris?’ he said finally.

  ‘Yes.’

  ‘Would you be interested in acting as a medical officer at the upcoming April meeting on Wednesday?’ He said it in a rush as if trying to rid himself of the words as quickly as possible.

  ‘At Cheltenham?’ I asked.

  ‘Yes, of course at Cheltenham.’

  Did I detect a hint of irritation?

  ‘I don’t know,’ I said. ‘Last time you spoke to me, you told me in no uncertain terms that you didn’t ever want me to act for you again. In fact, you shouted at me to get out of the jockeys’ medical room and stay out.’

  ‘Yes. Well, er, I may have been a trifle hasty.’

  It was as close to an apology as I was likely to get.

  ‘Short, are you?’ I said.

  ‘No,’ he said firmly, too firmly. ‘Nothing like that.’

  I didn’t believe him, and I was right.

  ‘What with Easter being so late this year, it’s just that some of the usual team are away on holiday with their children and I thought you might like to step in.’

  So he was short.

  But I didn’t care about the reason why. I was just pleased that he wanted me at all. I was even off duty at the hospital until Friday night and therefore available.

  ‘I’d be delighted to,’ I said.

  ‘Great,’ he said, the embarrassment finally banished. ‘I was talking to Rupert Forrester earlier and he said that he’d seen you giving evidence at an inquest this morning. It seems that he was impressed.’

  Was he telling me it had been the racecourse managing director’s idea to ask me to act rather than his? Maybe he was, but I wasn’t bothered. I’d thought my days as a racecourse doctor were over and now I was looking forward to them again.

  ‘Who was that?’ Grant asked as I disconnected. He had come back in from the kitchen with a glass of red wine and had caught only the tail end of the conversation.

  ‘Adrian Kings,’ I said. ‘Senior medic at the racecourse. He wants me to act as a medical officer on Wednesday.’

  I could tell that Grant wasn’t pleased. ‘Wasn’t he very rude to you last time? I’m surprised you agreed. And, to be honest, I’d much rather you didn’t do it. In fact, I would prefer it if you never went near that damn place ever again.’