The Innocent: A Coroner Jenny Cooper Crime Short

by Hall, M R

  ‘Aren’t those the symptoms of meningitis?’

  ‘I’m told you would usually expect the antibiotics to make some inroads. It’s odd.’

  He looked away again, wrestling with unspoken thoughts.

  ‘I presume you asked me here in my capacity as coroner?’

  ‘Naturally.’

  ‘Is that all you wanted to tell me?’

  She had already made the assumption that Ed or his wife, a clinical psychologist, had overlooked warning signs or ignored early symptoms. She was expecting David to make excuses for them and to ask her to overlook the fact to save their feelings. She was ready with an answer – that she would be as understanding as she always was of parents with busy lives – but she was beginning to suspect there was something else. The reason he’d asked to see her.

  ‘Can I talk to you in absolute confidence, Jenny?’

  She thought carefully before answering. Curious as she was, she had to resist the risk of being compromised. ‘In a personal capacity, yes, as a coroner, well – you know the rules as well as I do.’

  ‘We’ll make it personal, then.’ He glanced at the door, as if fearing someone on the far side might be eavesdropping. ‘The number of deaths from hospital infection is going up all the time – you’ll be more aware of that than anyone.’

  ‘Hospital?’ You think Sophie caught this from her father?’

  ‘It’s possible. I know he’s thinking along those lines. The thing is, even if that’s the case, there’s very little he or I can do about it, not if we value our careers. None of us is considered indispensable. The moment a consultant dares raise his head above the parapet it gets shot off.’

  ‘Are you telling me there’s a problem here that no one’s admitting to?’

  David checked his watch. It was ticking round to the time he’d have to start scrubbing up for a long day in theatre. Sometimes he’d perform as many as a dozen heart bypass procedures back to back, shuttling between neighbouring theatres to do the delicate work while subordinates opened and closed the patients for him.

  ‘You did ask me here,’ Jenny said. ‘If you’ve nothing more to say, I’ll be going.’ She moved towards the door.

  ‘I’ll tell you what the problem is, Jenny. It’s not politically correct, I know you won’t like it, but it’s the truth, and something has to be done about it.’

  ‘It sounds as if we’ve drifted beyond the personal.’

  ‘Oh, I don’t care,’ he said, with a dismissive wave of the hand. ‘Look – we’ve got C. diff, streptococcus, haemorrhagic E. coli, you name it. These are rapidly mutating, highly infectious, antibiotic-resistant strains and they’re killing people– usually the sick, and now the healthy. What’s more, they didn’t develop here, they came from outside.’

  ‘Outside?’ Jenny tried to disguise her scepticism.

  ‘We’re inundated with patients from countries where they either don’t choose to or can’t afford to treat infection properly. Instead of hitting C. diff with a broad spectrum of drugs they’ll use only one or two – not enough to kill the bacteria, just enough for it to develop antibiotic resistance. So another patient brings it here and we’ve nothing left in our armoury that’ll knock it out.’

  ‘And you can’t raise this issue because … ?’

  ‘For God’s sake, Jenny – you can’t blame an infection on foreigners, no matter how true it is.’

  ‘You want to stop treating foreign patients? Is that what you’re trying to tell me?’

  ‘Someone’s got to take an honest look at the situation.’

  ‘And you’re nominating me?’

  ‘You’re the coroner,’ he said accusingly. ‘I have to go. I’ll be late for theatre.’

  ‘Are there any documents I can look at? Would anyone be prepared to give me a statement?’ Jenny pressed.

  ‘I’m just giving you a steer, that’s all.’ He looked levelly at her. ‘And if my name is ever mentioned in this context I stand to lose my job – you do understand that?’

  ‘You needn’t worry, David. I shan’t embarrass you.’

  ‘Thank you.’ He seemed briefly grateful. ‘I’d appreciate that.’

  Jenny pressed the buzzer at the mortuary door at 7 a.m., more in hope than expectation. To her surprise, the intercom was answered by a junior technician who said that Dr Kerr was already at work. He let her in, but as she sidestepped the gurneys cluttering the corridor and made for the door of the autopsy room, he appeared through the swing doors to the refrigeration unit and called after her. ‘You won’t want to go in there, Mrs Cooper.’

  Jenny glanced through the observation pane and saw that a negative-pressure isolation tent constructed of several skins of clear polythene sheeting had been placed over the dissection table. Its electrically powered filters were designed to clean the air inside and ensure that no dangerous microorganisms harboured by the body could escape. Dr Kerr was at work inside it, wearing an all-in-one biohazard suit.

  ‘He won’t be long,’ the technician said. ‘He did the p-m last night but the lab came back asking for some more samples. You can wait in his office if you like.’

  ‘Thanks.’

  He nodded, as if reassuring himself that she could be trusted, and returned to his task.

  Jenny glanced back through the observation pane and saw Dr Kerr emerging from the tent with a number of steel flasks, which he placed into a refrigerated transport box. It was a procedure she hadn’t observed before and she found it unsettling. He looked up and saw her face. He waved a gloved hand then pointed, a gesture she took to mean that she should retreat to his office. She followed his advice.

  More than usually aware of the warmth of the sickly sweet mortuary air, Jenny went to the office window and tried to open it. A safety catch had been fitted that allowed it to open outwards only a few inches from the frame. She pressed her face to the narrow gap and took in a deep breath. She had blithely wandered the hospital’s corridors for the past four years without ever questioning whether it was an altogether safe place to be, but now it felt alive with hidden dangers. For all his many failings, David was the most unflappable person she had ever known; for him to express concern there had to be a serious problem.

  It was some minutes before Dr Kerr came through the door, carrying the strong chemical smell of the antiseptic with which he would have doused himself after the procedure.

  ‘Sorry about that. Takes a while to climb out of all the kit.’

  ‘Those were some serious precautions,’ Jenny said.

  ‘Very necessary, I’m afraid.’ His voice had lost its usual wry edge. ‘I was just going to call you. I wasn’t sure you’d been notified.’

  ‘I got word last night. The girl’s father is a colleague of my ex-husband’s.’

  ‘Mr Freeman. Of course. You knew Sophie?’

  ‘No, not really.’ It was partly true: they hadn’t spoken since her divorce. ‘Have you established a cause of death?’

  ‘It was meningitis.’

  She felt oddly relieved. ‘My ex-husband implied there was concern it was something more sinister.’

  Dr Kerr walked past her to his chair on the far side of the desk. Jenny noticed his eyes were bloodshot with fatigue. She could tell he had hardly slept.

  ‘That’s not an unreasonable word to use. According to her notes, from the onset of symptoms to death was only a little over eight hours. That’s remarkably quick in an otherwise healthy child. And one would certainly expect bacterial meningitis to respond to antibiotic treatment in some degree, but it seems that the drugs had no effect at all. The physicians certainly threw everything at it.’

  ‘I’m no expert, but I do know that meningitis is often fatal,’ Jenny said, hoping for some words of reassurance.

  ‘The lab started work yesterday afternoon, while Sophie was still alive,’ Dr Kerr said. ‘The aim was to identify the precise strain and work out the most effective drug regime. You may not know this, but the meningitis bacterium coats itself with a protei
n that prevents immune cells from attacking it. It’s very clever: a Trojan Horse, if you like. I’ve even heard an immunologist call it beautiful.’

  ‘Not a word I’d use.’

  ‘Nor me.’ He reached for his computer mouse and opened an email from colleagues in the path’lab. It confirmed his suspicion. ‘They’re telling me none of the samples cultured have responded to any drug combinations. Cephalosporin, vancomycin, ampicillin – nothing’s worked. Of course it’s too early to say with certainty, but the concern is we’re dealing with an aggressive, drug-resistant strain.’

  ‘ “Aggressive” meaning what, precisely?’

  ‘One of the major symptoms of this strain is disseminated intravascular coagulation – it means the blood clots excessively, which perversely causes multiple haemorrhages. All the girl’s major organs were affected – liver, kidneys, brain. She had also developed grotesque swelling and gangrene in her limbs. It means either that the bacteria multiplied at an unprecedented rate, or that she remained asymptomatic until the disease was already far advanced. Neither possibility is particularly reassuring.’

  ‘But we’ve only seen this one case?’

  ‘So far.’

  Jenny thought about what David had told her – his fear of drug-resistant organisms finding their way into the hospital through foreign patients.

  ‘Do you have any idea where she might have caught it? Wouldn’t you expect to see a cluster?’

  ‘Every outbreak has to start somewhere, Mrs Cooper. One of the mysteries of infectious disease is why we see a sudden flare-up then a die-off for no apparent reason. Many of us carry meningitis bacteria in our bodies benignly. The process of activation and mutation is little understood.’

  ‘But Sophie might have caught it from someone else.’

  ‘It would be foolish not to expect more cases.’

  ‘And the body – is it safe?’

  ‘As much as it can be. It’s stored in a biohazard body bag. My concern is far more for those who have been in immediate contact with her. I’m sure the Health Protection Agency is taking the appropriate steps.’ He gave an apologetic smile that said he had nothing more to give her.

  Jenny pressed him on one final point. ‘Antibiotic resistance – that means this strain must have evolved defences, perhaps through not being properly treated in the past?’

  ‘Quite possibly.’

  ‘I need you to be honest with me – whatever your answer, I’ll treat it as off the record. Are we sure that all deaths caused by hospital infection are being recorded as such? There’s no management pressure to downplay a problem?’

  ‘If there’s an infection, I record it – you know that,’ Dr Kerr answered carefully. ‘Whether it’s drug-resistant is another matter. I’m not usually required to conduct a fullscale genetic analysis.’

  Jenny nodded. ‘I understand.’

  He had given a non-response, but she couldn’t have expected him to go further. Were he to have told her that deaths were being caused by potentially avoidable infection, he could find himself a witness in multiple civil actions against his employers. A few unguarded words could cost him his career.

  Courteous as always, he showed her to the door, but as she started out, he said, ‘You won’t say anything to put me in an awkward situation, will you?’

  She couldn’t recall a time when she had seen him appear so nervous. He was always the embodiment of calm.

  ‘You know me better than that.’

  He gave a slow, considered nod. There was something else weighing on his mind. ‘Can you keep a confidence?’

  ‘Certainly.’

  ‘One of the senior managers called me last night – I shan’t give the name – and let it be known that rumours would be flying around this case. I was told in no uncertain terms not to contribute to them.’

  Jenny made the customary call to the Freeman household from her office at a little after 9 a.m. Ed answered. She hadn’t heard his voice in over five years, yet it might have been five days. She remembered him as a naturally athletic man who had infuriated David by routinely beating him at squash. He had also shone as a neurosurgeon specializing in the treatment of brain tumours, while maintaining a sense of humour and a happy marriage to Fiona. Jenny had looked on their family as unfairly charmed.

  ‘Ed, it’s Jenny. Jenny Cooper. I’m so sorry about Sophie.’

  ‘Yes.’ He answered in the familiar monotone of the recently bereaved. ‘It doesn’t seem real.’

  There were no words adequate for dealing with the sudden and unexpected loss of a child, and Jenny didn’t attempt to find any.

  ‘I’m only calling to say that I’ll be handling matters, if you’ve no objection.’

  ‘No, we’re glad it’s you. David called me this morning—’ The phrase seemed to hang, as if he had stopped himself from completing it.

  Jenny said, ‘I know you won’t feel like talking now, but you know where to call.’

  ‘There is one thing …’

  ‘Go on.’

  He hesitated. ‘You won’t let David take any heat, will you? It’s different for me – I’ve got Fiona to fall back on.’

  ‘I understand.’

  ‘Thank you,’ Ed said. ‘I’ll be in touch.’

  Jenny had barely set down the phone and begun to gather her thoughts when it rang again.

  ‘Jenny Cooper.’

  ‘Jenny, it’s Simon.’ The voice, which seemed to be coming from a moving car, belonged to Simon Moreton, an evermore-senior civil servant at the Ministry of Justice who, since the day of her appointment as coroner, had always made it his business to keep a watching brief on her affairs. Jenny’s mistake had been to flirt with him when they first crossed swords; and ever since he had convinced himself that they enjoyed slightly more than a merely professional relationship. ‘I’m making a few house calls in your neck of the woods today – mind if I pop round?’

  She didn’t feel she was being offered any choice.

  ‘When should I expect you?’

  She heard him exchange words with his driver.

  ‘I can be with you in ten minutes.’

  ‘That soon?’

  ‘Leaves you the rest of the day clear.’

  ‘I’ll be here.’

  ‘Excellent. Shall I bring coffee? I know – even better, why don’t I take you for breakfast? I insist. My treat, Jenny. My treat.’

  She put down the phone with a sense of foreboding. Moreton was a man whose preferred way of doing business was over several leisurely glasses of wine at the table of an expensive restaurant. For him to have left London at dawn could only mean that he was sensing trouble.

  The Innocent

  M. R. Hall is a screenwriter, producer and former criminal barrister. Educated at Hereford Cathedral School and Worcester College, Oxford, he lives in Monmouth shire with his wife and two sons. Aside from writing, his main passion is the preservation and planting of woodland. In his spare moments, he is mostly to be found among trees.

  The Innocent is a prequel to M. R. Hall’s twice CWA Gold Dagger shortlisted Coroner Jenny Cooper series which features The Coroner, The Disappeared, The Redeemed and The Flight. The latest book in the series, The Chosen Dead, will be out January 2013.

  Discover more at

  m-r-hall.com

  facebook.com/MRHallAuthor

  @MRHall_books

  Also in M. R. Hall’s Coroner Jenny Cooper series

  The Coroner

  The Disappeared

  The Redeemed

  The Flight

  The Chosen Dead

  First published 2012 by Mantle

  This electronic edition published 2012 by Mantle an imprint of Pan Macmillan, a division of Macmillan Publishers Limited Pan Macmillan, 20 New Wharf Road, London N1 9RR Basingstoke and Oxford Associated companies throughout the world www. panmacmillan.com

  ISBN 978-0-230-77198-7 EPUB

  Copyright © M. R. Hall 2012

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