Blue Shoes and Happiness tn1lda-7

by Alexander McCall Smith

  “He was a very good man,” said Mma Ramotswe.

  Boitelo’s reply came quickly. “Some doctors are good men,” she said.

  There was a note in her voice which alerted Mma Ramotswe. And then she thought:Yes, that is it! That is the oldest problem that nurses have. Doctors who make advances to them. This young woman has had a doctor pestering her. That is why she is frightened. It’s simple. There is very little new in the affairs of people. The same things happen again and again.

  But then Boitelo continued. “Do you think that a doctor can be a criminal, Mma?” she asked.

  Mma Ramotswe remembered the doctors she had met all those years ago—those two doctors, twins, involved in a profitable fraud in which they shared only one medical qualification between them. Yes, doctors could be criminals. Those had been criminal doctors; they had shown no concern for the safety of their patients, just like those doctors one read about who deliberately killed their patients as if out of sheer bravado. Those stories were shocking because they represented the most extreme breach of trust imaginable, but it appeared that they were true. And for a moment Mma Ramotswe considered the terrible possibility that Boitelo had found herself working for one of those homicidal doctors, right here in Gaborone. That would be a powerful cause for fear; indeed, just to think of it made her flesh come up in goose bumps.

  “Yes,” she answered. “I do think that. There have been some very wicked doctors who have even killed their patients.” She paused, hardly daring to ask the question. “You haven’t stumbled across something like that, Mma?”

  She had hoped that Boitelo’s answer would be a swift denial, but it was not. For a moment the young woman seemed to dwell on the question, and then at last she answered. “Not quite,” she said.

  Behind her, Mma Makutsi let out a little gasp. Mma Ramotswe had been to the doctor only a few days earlier and had been given a bottle of small white pills which she had been taking religiously. It would be so easy for a doctor to substitute something fatal, should he wish to do so, in the knowledge that his trusting patient would pop the poison into her mouth. But why would any doctor want to do that? What drove a doctor to kill the very person he was meant to save? Was it a madness of some sort; an urge that people have from time to time to do something utterly bizarre and out of character? She herself had felt that once or twice when she had been suddenly tempted to throw a tea-pot at Mr J.L.B. Matekoni. She had been astonished that such an outrageous thought had even entered her mind, but it had, and she had sat there wondering what would happen if she picked up the tea-pot from the table and threw it across the room at poor Mr J.L.B. Matekoni as he sat drinking his afternoon tea, his head full of thoughts of gearboxes and brakes, or whatever it was that Mr J.L.B. Matekoni’s head was full of. Of course she had not done it, and never would, but the thought had been there, an unwelcome visitor to her otherwise quite rational mind. Perhaps it was the same with those strange cases of the doctors who deliberately killed their patients. Perhaps …

  “Not quite?” asked Mma Ramotswe. “Do you mean …”

  Boitelo shook her head. “I mean I don’t think that the doctor I’m talking about would go up to a patient and inject too much morphine. No, I don’t mean that. But I still think that what he is doing is wicked.” She paused. “But I was going to start at the beginning, Mma. Would you like me to do that?”

  “Yes,” said Mma Ramotswe. “And I won’t interrupt you again. You just start. But first, Mma Makutsi will give you a cup of tea. It’s red bush tea, Mma. Do you mind?”

  “This tea is very good for you,” said Boitelo, taking the cup which Mma Makutsi was handing her. “My aunt, who is late, used to drink it.”

  Mma Ramotswe could not help smiling. It seemed strange to say that something was good for one and in the same breath say that one who used it is now late. There need be no connection, of course, but it seemed strange nonetheless. She imagined an advertisement:Red Bush Tea: much appreciated by people who are late. That would not be a good recommendation, she felt, whatever the intention behind it.

  Boitelo took a sip of the bush tea and put her cup down on the table in front of her.

  “After I qualified, Mma,” Boitelo went on, “I came to work in the Princess Marina. I became a theatre nurse there, and I think that I was good at the job. But then, after a while, I became tired of standing behind the doctors all the time and passing them things. I also didn’t like the bright lights, which I think gave me headaches. And I don’t think that they are good for your eyes, those lights. When I came out of the theatre and closed my eyes I could still see bright circles, as if the lights were still there. So I decided to do something different, and I saw an advertisement for a nurse to work in a general practitioner’s clinic. I was interested in this. The surgery was not too far from where I lived, and I would even be able to walk there in the cooler weather. So I went for an interview.

  “My interview was on a Monday afternoon, after the doctor had finished seeing his patients. I was due to work that day, but I was able to change my duties around so that I was free to go. I went along and there was Dr …” She had been on the point of giving the name, but she checked herself.

  “You don’t have to tell me,” said Mma Ramotswe, remembering that Boitelo had confessed to feeling frightened.

  Boitelo looked relieved. “The doctor was there. He was very kind to me and said that he was very pleased to see that I had been a theatre nurse, as he thought that such people were hard workers, and that I would be a good person to have in his clinic. Then he spoke about what the job would involve. He asked me if I understood about confidentiality and about not talking to people about things that I might see or hear while I was working in the clinic. I said I did.

  “Then he said to me, ‘I have a friend who has just had an operation in the Princess Marina. Maybe you can tell me how he is doing.’

  “He gave me the name of his friend, who is a well-known person because he plays football very well and is very handsome. I had been on duty for that operation and I was about to say that I thought that it had gone very well. But then I realised that this was a trick and that I should say nothing. So I said, ‘I cannot speak about these things. I’m sorry.’

  “He looked at me, and for a little while I thought that he was very cross and would shout at me for not answering his question. But then he smiled and he said, ‘You are very good at keeping confidences. Most people are not. I think that you will be a very good nurse for this clinic.’”

  Boitelo took a further sip of her tea. “I had to work out a month’s notice at the Princess Marina, but that was simple enough. Then I started and I found that the work was very enjoyable. I did not have to stand about as I had to do in the theatre, and I was also permitted to do things that nurses sometimes are not allowed to do. He let me do little surgical procedures on people—dealing with an in-growing toe-nail, for example, or freezing off a wart. I liked freezing off warts, as the dry ice made my fingers tingle with the cold.

  “I was happy in my work, and I thought that I must have been one of the luckiest nurses in the country, to work for this doctor and to be allowed to do all these things. But then something happened which made me wonder. I was puzzled by something, and I decided to check up on it. And that was when I learned something which made me very worried. I have been worrying about this thing so much that I decided to come and speak to you, Mma Ramotswe, because people say that you are a good woman and that you are very kind to those who come to you with their troubles. That is why I am here.”

  Mma Ramotswe, listening intently, had allowed her bush tea to become cooler than she liked it. She preferred to drink bush tea when it was fresh from the pot, piping hot, and this cup, now, was lukewarm. Boitelo’s story was a familiar one, at least in that it followed a pattern which she had come across so often. Things started well for somebody and then, and then … well, then a path was crossed with a person who would change everything. That had happened to her, with her former husband, Not
e Mokoti, the jazz player and ladies’ man who had, for a brief period, transformed her world from one of happiness and optimism to one of suffering and fear. Such people—men like Note—went through life spreading unhappiness about them like weedkiller, killing the flowers, the things that grew in the lives of others, wilting them with their scorn and spite.

  As a young woman she had been too naïve to see evil in others. The young, Mma Ramotswe thought, believe the best of people, or don’t imagine that people they know, people of their own age, can be cruel or worthless. And then they find out, and they see what people can do, how selfish they can be, how ruthless in their dealings. The discovery can be a painful one, as it was for her, but it is one that has to be made. Of course it did not mean that one had to retreat into cynicism; of course it did not mean that. Mma Ramotswe had learned to be realistic about people, but this did not mean that one could not see some good in most people, however much that might be obscured by the bad. If one persisted, if one gave people a chance to show their better nature, and—and this was important—if one was prepared to forgive, then people could show a remarkable ability to change their ways. Except for Note Mokoti, of course. He would never change, even though she had forgiven him, that final time, when he had come to see her and asked her for money and had shown that his heart, in spite of everything, was as hard as ever.

  Boitelo was looking at her. Mma Ramotswe thought that the nurse must be wondering what she was thinking. She would have no idea that the woman before her, the traditionally built detective with her cup of rapidly cooling bush tea before her, was dreaming about human nature and forgiveness and matters of that sort.

  “I’m sorry, Mma,” said Mma Ramotswe. “Sometimes my mind wanders. Something you said made my mind wander. Now it is back. Now it is listening to you again.”

  “One of the things that I didn’t do,” continued Boitelo, “was to take the blood pressure of patients. All nurses can do that. There is an instrument which you wind round the patient’s arm and then you pump a bulb. You will have had your blood pressure taken, Mma? You will know what I am talking about.”

  Mma Ramotswe did. Her blood pressure had been taken and had caused her doctor to say something to her about trying to keep her weight down. She had tried for a short time, and somehow had failed. It was difficult. Sometimes doctors did not know how difficult it was. Traditionally built doctors did, of course, but not those young thin doctors, who had no feeling for tradition.

  “My blood pressure was a bit high,” said Mma Ramotswe.

  “Then you should lose weight,” said Boitelo. “You should go on a diet, Mma Ramotswe. That is what I have to say to many of the ladies who come to the clinic. Many of them are … are the same shape as you. Go on a diet and reduce your salt intake. No biltong or other things with lots of salt in them.”

  Mma Ramotswe thought that she heard Mma Makutsi snigger at this, but she did not look in her assistant’s direction. She had never been told before by a client to go on a diet, and she wondered what Clovis Andersen would make of such a situation. He was always stressing the need to be courteous to the client—indeed, there was a whole chapter on the subject inThe Principles of Private Detection —but it said nothing, she thought, on the subject of clients who told one to go on a diet.

  “I will think about that, Mma,” she said politely. “Thank you for the advice. But let us get back to this thing that you found out. What has it got to do with blood pressure?”

  “Well,” said Boitelo, “I was rather surprised that I was never asked to take the patients’ blood pressure. The doctor always did that, and he kept the sphygmomanometer in his room, in a desk drawer. I saw him using it if I came into the room to give him something, but he never let me use it. I thought that maybe it was because he liked pumping up the instrument—you know how men are sometimes a bit like boys in that way—and I did not think too much about it after that. But then one day I used the instrument myself, and that was when I had a big surprise.

  “It was a Friday, I think, not that that matters, Mma. But it was because it was a Friday that the doctor was not in the clinic at the time. On Fridays he likes to meet some of his friends for lunch at the President Hotel, and sometimes he is not back until after three o’clock. There are some other Ugandan doctors who work here, and he likes to meet with them. Their lunch sometimes goes on a bit long.

  “I never make an appointment for a patient between two and three on a Friday afternoon, to give him time to get back from the hotel. Well, on that Friday the patient for the three o’clock appointment arrived early. It was a man from the Ministry of Water Affairs, a nice man who goes to the church round the corner from my place. I have seen him on Sundays, walking with his wife and their young son to church. Their dog follows them and sits outside the church until the service is over. It is a very faithful dog, that one.

  “This man had half an hour to wait, and he started talking to me. He told me that he was worried about his blood pressure and that he had been trying hard to get it down, but the doctor said that it was still too high. The doctor’s door was open while this man was saying this, and I saw the sphyg on his desk. So I thought that there would be no harm in my taking his blood pressure, just out of interest, and just to keep up my skills. So I said to the patient that I would do this, and he rolled up the sleeve on his right arm.

  “I inflated the band around the arm and looked at the mercury. The pressure was normal in every respect. So I did it again, and I was about to say to the patient that everything was fine. But I stopped and thought, and I realised that if I did this, then he would say to the doctor that I had taken the reading and that it was now normal. I was worried that this would make the doctor cross with me for doing something to a patient without his permission. So I muttered something about not being able to understand these figures and I replaced the instrument before the doctor came back.

  “Now, Mma, that was not a busy afternoon and I was able to catch up on the filing of the patient records. Every so often I go through the files just to check up that all the records are in the right order. The doctor gets very cross if he cannot have the records on his desk when a patient comes in to see him. Well, I was sorting out the records and I came across the record of the man who had come for the three o’clock appointment. And I noticed that the latest entry was about the consultation that this man had just had.”

  Boitelo paused. Mma Ramotswe was sitting quite still, as was Mma Makutsi. The nurse had a simple, direct way of talking, and the two women had been caught up in her narrative.

  “I see,” said Mma Ramotswe. “The record. Yes. Please go on, Mma. This is a very interesting story.”

  Boitelo looked down at her hands. “The doctor had taken his blood pressure and had entered the reading. It was very high.”

  Mma Ramotswe frowned. “Does blood pressure go up and down?”

  The nurse shrugged. “It can do. If you are very excited your blood pressure can go right up, but it doesn’t seem very likely, does it?”

  Mma Makutsi now intervened. “Perhaps there was something wrong with the instrument. Things go wrong, you know, with these complicated machines.”

  Boitelo half-turned to stare at Mma Makutsi. “These instruments are very simple,” she said quietly. “They are not complicated machines.”

  “Then it must have been a mistake,” said Mma Ramotswe. “Does the doctor drink over lunch?”

  “He never drinks,” said Boitelo. “He says that he does not like the taste of alcohol, and he also says that it is far too expensive. Water is cheaper, he says.”

  There was a brief silence as Mma Ramotswe and Mma Makutsi contemplated the possibilities. Neither was sure about the significance of the misreading—if that was what it was. It sounded important, but what did it mean? Doctors made mistakes all the time—as everybody did—and why should this make the nurse so anxious? It seemed that an important part of the story was yet to come, and this was what Boitelo now provided.

  “I was p
uzzled by this,” she said. “As you said, it could have been a mistake, but now there was something that was making me wonder if something strange was going on. It seemed odd that the doctor should be so determined that I should not take blood pressure and then that he himself should go and make such a mistake. So I decided to carry out a little investigation myself. I have a friend who is a nurse too. She works in another clinic, and she had once told me that there was some old equipment lying about in a cupboard there. I asked her if there was a sphyg, and she said that she would look and see. When she reported back that there was one, I asked her if I could borrow it for a few weeks. She was a bit surprised, but she agreed.

  “I hid the sphyg in my drawer at work. And then I waited for my chance, which eventually arrived. I had been paying attention to the medical records now, and each time I got them out for the doctor I looked to see whether it was a high blood pressure case. There were many of them, I noticed, and I began to wonder about them. All of them were on the same drug, which is quite an expensive one. We give them supplies of it from the clinic.”

  Mma Ramotswe sat up, almost upsetting her cup of cold tea as she did so. “Now, Mma,” she exclaimed, “I think that I can already see what is happening here. The doctor is giving false blood pressure readings. He tells patients that they have high blood pressure when they really do not. Then he makes them take the expensive drug, which he provides for them. It must be a very good business for him.”

  Boitelo stared at her. “No, Mma,” she said flatly. “That is not what is happening.”

  “Then why did he enter the false reading? Why did he do that?”

  “It must have been a genuine mistake,” said Boitelo.

  Mma Ramotswe sighed. “But you said that you yourself were suspicious of it. You didn’t think it was a mistake.”