‘Run the stories past me again,’ he said suddenly, clearly deciding to be businesslike now. ‘I don’t recall the details.’
‘OK. First was Tony Mendez, theatre porter —’
‘What sort of bloke was he?’
‘Mmm? Tricky apparently. I didn’t know him personally. Bad tempered, not popular. Reformed alcoholic. Well, supposed to be reformed. Clearly he slipped though, and took a drink. Too big a one. He died of alcoholic poisoning.’
‘Alcohol? He must have taken a hell of a big drink to actually die of it!’
‘Not necessarily. If he’d been on the wagon for a few months and then took a drink the size he’d been used to before he stopped — and had an underlying liver problem which I seem to remember he did — then it could have killed him. I remember at the time I reckoned his death was an accident. He collapsed in the middle of a case he was working on with Mayer-France — a gall bladder — and caused a helluva drama there in theatre.’
‘So, he was the first, you say?’
‘Well, he was actually the first we knew about. He collapsed on … let me see. It was a Friday — I remember it was just before the weekend, because Fridays are hectic anyway and an extra PM was one thing I didn’t want because I couldn’t leave it till next morning.’ She reached behind the desk for her calendar and squinted at it. ‘Here we are. The second of June. I know I had to do the PM late that evening. Remember? We were supposed to be going out.’
‘And I cried off first. Yeah, I remember. You were good and mad. And then it turned out you’d have to cry off yourself anyway.’
‘Well, never mind that. The thing is he died on the Friday. The next case to come up was Lally Lamark. She was found on Monday morning, very dead, on the floor of the Medical Records department. I can remember that I was sure she’d been dead over forty-eight hours. So I reckoned she’d died some time on Friday too, only in the evening, after the department had closed. I thought her death was an accident too: she’d used too much insulin and gone into a coma. And as she was alone, she died very quickly since there was no one to spot she was ill and get her to treatment. Not suicide but an accident.’ She shook her head. ‘At least I don’t have to try to remember that. I can check on her notes when I get home. For the rest, it’s got to be memory.’
‘Which is usually very good,’ he said. ‘In you.’
She sketched a bow of acknowledgement. ‘Well, I’m delighted I can do some things right. Memory doesn’t always work and I’ve done one hell of a lot since then. Remembering the details as I’d like to isn’t as easy as you think.’
‘Still, we can investigate in other ways. What about the last one?’
‘Oh, yes, Pam Frean. That was a definite suicide. She, I recall very well.’ She made a face, angry again for the girl. ‘It was so dreadfully sad and unnecessary. She was pregnant, came from a very religious family and couldn’t take the pressure. So she killed herself in a most unpleasant way.’
‘Oh?’
‘Drowned herself,’ George said. ‘In her bath, would you believe. Goddamn difficult to do, but she was clearly very determined. She took a sedative first to help her do it. She left the sort of note that made it clear how determined she was.’ George shook her head as her anger increased. ‘Oh, God, I wish I’d kept copies of all those files! I remember the tone of the note she left, though not the detail.’
‘I bet you could if you tried,’ he said. ‘You have that sort of memory, haven’t you? Eidetic? I remember the first case we worked on: you were able to reel off all the contents of that man’s bathroom cabinet like you were looking at them, ages after you’d first seen them.’
‘Maybe,’ she said a little dubiously. ‘It used to be quite easy. Now I’m not so sure. My head gets so silted up with stuff that digging out a whole visual memory like I used to isn’t the pushover it was.’
‘Try some time,’ he said. ‘When you’re alone. It’s not that it’s all that important in itself, but maybe, when you get that back, other things’ll come back to you as well.’
‘I’ll think about it,’ she said and he tilted his head at her.
‘If you’ve got time, that is, what with helping colleagues and all.’
‘Are you starting on that again? What is it with you, Gus? Are you just trying to be awkward?’ She was genuinely annoyed now.
His lips tightened. ‘No, not trying. I just am an awkward cuss. I thought you knew that when you took me on.’
‘There’s awkward and there’s — there’s like positively terminally bloodyminded!’ she said. ‘Do me a favour, Gus, and stop it. We have a case here to sort out and it’s crass to waste time on this sort of nonsense.’
He was silent for a moment and then leaned over and very deliberately took her chin in one hand and kissed her, hard. ‘OK, doll. I’ll listen to you. I’ll make my own dinner tonight while you work with your pal Zack and I won’t feel a twinge of loneliness or jealousy or anything else I’m not supposed to, fair enough? And then tomorrow, maybe, when I’ve got a bit more evidence to bring to the pot, we’ll sit down together and see what we can stew up to explain what’s going on here.’
‘What sort of extra evidence?’ she demanded, refusing to be drawn on any other issue.
‘I don’t know. I’ll just make a few local enquiries about this and that. Maybe look into these people’s families, hmm? Mendez and Lamark and Frean. And see if there’s any news on the patch about the break-ins at Sheila’s flat and here. I don’t expect much, mind you. They didn’t look like professional jobs. But you never can be sure.’
‘OK.’ She stood up. ‘Listen, are you busy now?’ She looked at her watch. It was approaching four, and the pangs of hunger were making her belly rumble, and she wanted, even more than food, to be conciliatory. ‘I had no lunch and I could do with a bit of English afternoon tea. They do a nice line in tea cakes over at the canteen. Care to buy me one?’
He looked at her thoughtfully for a moment and then shook his head. ‘Um, no, doll, if you’ll forgive me. I told you, I want to put some other enquiries into action, and that means I have to be back at the nick right away. I just wanted to bring you those reports, and to hear what your own searches had uncovered. Now we know, we can both get on with work in our own ways, hmm? So, I’ll see you. At your place tomorrow, for supper maybe? Let’s make a proper date of it, shall we, the way you have with your other colleague? And then we can be sure of where we are. So long, doll.’ And he flicked his thumb and forefinger to his forehead as though he were wearing a hat with a brim to be tipped, and went.
15
Neurology, George decided, was the most depressing ward in the whole of Old East. One of the problems was that its need for new paint, modern famishing and similar trappings tended to be obscured by the demands of other wards which engaged in more glamorous activities, such as Cardiology or General Surgery or the Renal Unit where highly dramatic transplants were carried out every time the surgeons could get their hands on a cadaver kidney. In Neurology, however, there were few glamorous activities; it was a ward where the detritus of patients with damaged brain and nervous systems washed up. Interesting disorders demanding intricately plotted neuro-mapping techniques, heroic brain surgery and suchlike interventions were whisked away swiftly to the specialist unit in the middle of the West End of London to be studied in detail and eventually used to teach up-and-coming medics; all that remained here were the elderly Parkinson’s patients, the multiple scleroses, the Alzheimer’s and motor-neurone disease sufferers, forced to stay under Old East’s battered roofs while efforts were made to find permanent nursing homes to which they could be shuffled, since their families couldn’t or wouldn’t cope with them any longer. ‘Community care?’ snorted the daughter-in-law of one such patient in a fury. ‘If you think you’re sending that poor helpless old bugger back to my house so that I can be turned into a worn-out drudge to help out the NHS, you’ve got another bloody think coming.’ She was far from alone in making such a decision. The place
looked, sounded and smelled miserable in every way and George felt a pall of depression settle on her as she stepped out of the lift on the top level of Blue Block and turned left to go into the ward which had long ago been named, with incongruous prettiness, ‘Laburnum’.
By the time she got there, the patients’ evening meal had been served and the big battered chrome trolleys were standing outside the lift waiting to be taken back to the basement kitchens. The tired smell of minced beef and elderly steamed fish and yoghurt hung over them like a miasma and George almost turned back; why on earth should she spend her free time in such dispiriting surroundings? But a promise was a promise and she took a deep breath, straightened her back and entered the ward in search of Zack.
The nurse sitting at the work-station in the centre of the long corridor looked vague when asked for his whereabouts and muttered that he was probably around the place somewhere; George sighed and set off to make a bay-by-bay search. There were four four-bedded ones on each side of the long corridor, with occasional single rooms between them, and going from one to the other made her feel even lower, if that were possible.
Laburnum was a mixed-sex ward, though each bay had single-sex provision. Sometimes, however, it was hard to tell one from another. In bed after bed, individuals with sparse grey or white hair and pinched yellowish faces which showed few particular female or male characteristics — even the incidence of whiskeriness seemed the same for all of them — lay still, staring blankly upwards, or sat slumped uncomfortably in straightbacked chairs beside their rumpled beds, showing little awareness of what went on around them. Certainly none looked at her as she came in. There was a TV set on in each bay, sometimes turned irritatingly low so that even if a patient should want to watch he or she would be unable to make any sense out of the soundtrack, or, in one in particular, so loud it made George’s ears sing. She marched over to the set and adjusted the volume knob to make it more tolerable, but the patients seemed as unconcerned as they had been before she did it, and a sudden rush of anger filled her.
‘Why don’t you ring for the nurse when someone leaves it deafening you like that?’ she demanded of the old woman whose bed was closest to the set. ‘You shouldn’t have to put up with that sort of din!’ But the old woman just looked through her and said nothing, while the patient on her other side turned her head fretfully on the pillow and called in a thick yet high voice, ‘Is that you, Charlie?’
George had a sudden vivid memory of her mother, long ago, when she had been young and full of energy: they had gone to see a movie and had shared a huge pack of popcorn, eating it so fast they both started hiccoughing. George’s eyes brimmed with sharp tears. It had been a Charlie Chaplin Festival at the local Arts Theatre in Buffalo and they’d had such fun that night, she and Vanny. And now Vanny was in much the same sort of state as these people; only she was three thousand miles away and George was here.
She wouldn’t stay, couldn’t possibly stay, no matter what sort of promise she had made, she thought. She headed for the entrance of the bay, intending to get back to the lift and away from this horrible place as fast as she could; but was stopped when she ran headlong into Zack.
‘Nurse McGreedy said you were here!’ he cried delightedly. ‘I’m so sorry I wasn’t out there to greet you, I’d just gone to my office to fetch some notes. Hey, what’s up?’
‘Nothing,’ she said, swallowing. ‘Not a damned thing. So where do we go from here?’
He looked over her shoulder into the bay and seemed to understand at once. ‘I’m sorry,’ he said. ‘These are Alzheimer’s … I should have been here to head you off.’ He slid a hand into the crook of her elbow and led her away, tactfully not looking at her.
By the time they reached the seminar room at the far end of the ward, she had recovered, and was able to speak in what would pass as a normal voice. ‘So, what are we going to do? Point me in the right direction. Do I write? Chart? Or what?’
‘First, you listen,’ he said, arranging a chair for her beside the window. ‘Will you be comfortable here?’
‘I’ll be fine,’ she said. She sat down, still ruffled, wanting to be anywhere but here and knowing she couldn’t leave now, which made her feel unpleasantly trapped. ‘Please, let’s just get on with it, shall we?’
‘Right,’ he said. ‘While we wait for the other two — they’ll be here in a moment or two — let me just give you a bit of background, OK?’
‘OK.’
‘I told you it’s the demyelinating diseases — the ones where the nerve sheaths are damaged — that I’m interested in.’
‘I know what demyelinated means,’ she said a little sharply. ‘No need to cross every T for me.’
‘Oh, but you’re wrong! The thing is, the people I have to present to, they don’t speak the language the way you and I do. I’ll have to spell things out to them, but not in a way that makes ’em feel stupid. That’s what I need help with, you see. That was one of the main reasons I had for asking you. I’ve heard you talking to people about your own speciality and it seemed to me you have a gift for clear explanation in that area — for simplifying. So, won’t you just listen, pretend you don’t know anything, and see if I get it right?’
She took a deep breath, aware that she was letting her own discomfort get in the way of what she’d come here to do. ‘Sorry, Zack. Yes, I see what you mean. OK. What’s myelin?’
‘Thank you for a most interesting question, ma’am,’ he said and grinned. ‘OK … And he launched himself into a detailed account of his work with the structure of nerve cells and their myelin sheaths, and their methods of transmitting messages between body and brain. Much of it she knew, of course, but she managed to pretend she was an intelligent but medically unqualified listener and interrupted occasionally to make him use clear language instead of medical jargon, corrections which made him look doubtful.
‘But isn’t there is a risk of making it sound too … I mean, I don’t want to oversimplify, do I?’
‘I think that would matter less than blinding them with science and making the listeners feel inadequate. As long as you don’t fall into the trap of being patronizing you’ll be OK.’
She got to her feet and indicated her side of the room. ‘You sit down and listen to me. I’ll have a try.’
She stood beside the central table for a moment and closed her eyes and then opened them and smiled at him briefly.
‘Good evening, Mr Moneybags. OK, let me explain what it is I’m trying to do here. My patient, Mr Smith — you can see his notes if you care to, or I’ll arrange for you to meet him. He is a very sick, unhappy man, I’m afraid. He has widespread loss of muscle power: can’t walk, can’t do anything for himself. Has to be tube-fed because he can’t swallow, can’t control his own bladder or bowels. And, worst of all perhaps, he has no loss of any intellectual capacity. He knows perfectly well what his condition is. He’s locked in a body he can’t control or use. Can you imagine the hell of that?
‘Now, why is he in this state? It’s because he has lost the insulating material called the myelin sheath that in healthy people clothes their nerve cells and lets messages from the brain be delivered safely and accurately to the muscles. Generally speaking this insulating material, once it’s damaged or vanishes for any reason, can’t be replaced. But I have a new system for dealing with the problem. Now, here is my patient, Mr Jones.’ She looked at Zack. ‘I take it you have Mr Jones who has been treated and is doing well? You’ve plenty of Mr Smiths for them.’ She indicated the ward beyond the room they were in.
‘Well enough,’ he said. ‘She’s Dawn Greenwich,’ and grinned at her brilliantly. ‘Don’t stop.’
‘So here’s my patient, Miss Greenwich. In this case, which was just the same as Mr Smith’s, I have performed a small — technique or operation or intervention?’
‘Call it operation. They understand that, and it sounds more dramatic,’ he said.
‘OK. Operation. My operation is thus and thus — here you have to
go into a little more detail, Zack, but the important thing is that Miss Greenwich shows us what you did for her. You put her through her paces, comparing her abilities with poor old Smith or any of the other patients in the ward.
‘That should convince them of the need for what you’re doing. I take it this project has been agreed with the Research Ethics Committee? You’ve got all your informed consents and so forth?’
He looked reproachful. ‘What do you take me for? I’m not an amateur!’
‘Sorry I asked. Well done again. There you are. That should help persuade Mr and Miss Moneybags to cough up, I hope.’
‘God, you’re good, George! I knew you’d have the right answers for me. I’ve been fiddling round with this stuff for so long I breathe it and eat it and sleep it, so I just couldn’t see my way clear to explaining it for lay people. You’ve really cracked that for me. Bless you.’
He was glowing and for a moment she was embarrassed in an almost British way by his enthusiasm. She said hastily, ‘Is Miss Greenwich your only patient suitable for demonstration? And is she here at Old East?’
‘She’s at home now, she’s done so well. And she’s not the only patient. There’s José too.’ He came over to her at the central table and her unease at his excitement made her move away from him a little, but he didn’t appear to notice.
‘José? Who’s he?’ she said quickly.
‘A Spanish chap. People here can’t pronounce his name properly, so they call him Josey. He was referred to me by his GP, in a dreadful state. Paralysis had started with his feet and the lower part of his legs, and he was sent here via A & E. By the time I got to him the paralysis was spreading fast. I had him on a respirator eventually, desperately ill. As far as I could see, he was going to die in a matter of days. So —’
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