‘I have his notes here,’ Zack said, pulling out a folder and setting it in front of her. ‘Do read them and get yourself filled in, huh? Then you’ll see why I’m so pleased with him. I can show you a video too. You know, before and after? I’ll go and see if I can find him meanwhile, hurry him along.’
‘That’ll be useful,’ she said and obediently bent her head to read the notes. The sooner she got her brain round all this stuff, the sooner she could get away. She was still uncomfortable with him, still had the nagging notion that he was deceiving her in some way and was still aware of Gus’s lingering resentment of her contacts with the man, even though he encouraged them for the purpose of investigation. She didn’t like the way all that made her feel, but it had to be tolerated till everything was sorted out. Dammit all to hell and back, she thought with sudden anger, but she knew that was pointless. She concentrated on the notes.
José Christophe Esposito, she read. Aged forty-two. Occupation waiter/barman. Address … All the usual basic facts that started off everyone’s medical notes were there. Then came the history.
It seemed that Josey, as he was known to everyone (the diminutive was even used in the medical history), had had an uneventful healthy life up to the autumn of 1994. In September of that year he had been referred by his GP to the neurological department of Old East with a history of tremor and rapidly developing paralysis. The GP had suspected a rapid-onset Parkinson’s disease, pointing out that the first symptoms had appeared shortly after Josey had been involved in heavy physical activity (he had swum two miles on a sponsored charity event at the local leisure centre). The diagnosis had been borne out by Zack’s opinion. George skimmed through the accounts of the examination and the tests Zack had carried out, and moved on to read about Josey’s progress.
It had been a terrible experience for him. Given L-Dopa to relieve the paralysis, he had developed the uncontrollable writhing movements that could be a distressing side-effect of the therapy and had had to come off it, only to be very miserable because of the return of the paralysis, and indeed an extension of it. He had, in fact, needed a respirator on occasion because of his breathing difficulties.
By Christmas of ’94 Josey had been a very unhappy man, and, Zack wrote, had agreed readily to be admitted to a research programme. George looked at the consent form Josey had signed, which made it clear that he understood the risks as well as the possible benefits of taking part. The signature was little more than a spidery cross, duly witnessed by one of Laburnum’s staff nurses. Clearly, he had been too far gone even to sign his name properly. A very sick man.
George turned the page to the account of the treatment he had had as part of the research. Fetal brain tissue had been used (Zack had noted meticulously that he had obtained it from the obstetric department, from a miscarried pregnancy, with the full consent of the mother) and a preparation of the nigral neurones obtained from the relevant section of infant brain had been implanted into the area of putamen controlling motor activity, but not the caudate nucleus. This, Zack noted in his rather sprawling handwriting, was not the same as previous attempts at such therapy in that it used a different sort of tissue preparation, one devised by himself.
Anyway, she read on, it hadn’t worked (and here Zack made a cross-reference to another of his patients, Miss Greenwich, for whom it had been efficacious), clearly to Zack’s chagrin. Since Josey hadn’t responded Zack had tried again with a different idea. This time he had used a preparation of fetal brain that included oligodendrocytes, together with a proportion of macrophage-generating tissue to scavenge for any antibodies that might lead to an immune response that would block the potential benefits of the oligodendrocyte implant. Zack had prepared both as intravenous injections rather than as a brain implant.
George lifted her head and stared, unfocused, into the middle distance. It read very far-fetched but it made a sort of sense that could be the basis of a real breakthrough. If Zack was putting back into the body of a man who was suffering from a disease that stripped his nerves of their vital covering a material that could replace that covering, while at the same time giving him additional cover with an injection that would prevent his own body’s immune system turning on the much-needed replacement cells — well, he truly would have done something very remarkable. Especially since it involved simply intravenous injections and not brain surgery.
She could see, hazily, the commercial development of a pair of injections, given into the blood’ system rather than deep into the brain like the Parkinson’s treatment, and better still, that could be used for diseases other than Parkinson’s. Everything that was caused by loss of the nerve covering myelin. Motor-neurone disease, maybe. Ataxias of various forms. Alzheimer’s …
Inevitably, she thought of her mother and gave a little shiver. Could this treatment be of use to Vanny? The idea sent a surge of excitement through her and with some sternness she flattened it. That was the reaction of an uninformed lay person, not a doctor. She should know better than to expect miracle cures. And yet, what she had read in Josey Esposito’s notes had been so exciting and seemed to offer so much. But I must be scientific, she thought, bending her head to the notes again. Find out what happened, examine the patient, and see if the work can be replicated with other patients. One success means nothing; it could be a fluke.
But that in Josey’s case there had been a success was undoubted. She read the account of Zack’s examinations of him over the ensuing months up to the present. Of the way he had steadily and slowly improved, losing the paralysis, regaining control of his bladder and bowels (which had encouraged him hugely and, according to Zack, had led to a lifting of mood which was very marked), until in late May he had been fit to return to work on a part-time basis.
She closed the folder and sat, still thinking. Around her the ward buzzed contentedly, and she found herself wondering why she had thought the place so miserable last time she had come here. Then she realized: it’s Zack’s research. It brings hope to a place where there was none. She watched as an elderly man in a short robe over concertinaed pyjamas emerged from the bay opposite the nurses’ station, shuffling along on the arm of one of the nurses and clearly finding it very difficult Would Zack’s treatment give life and activity back to people like that? It was a heady thought.
Then she heard Zack’s voice from the direction of the ward’s entrance and turned to look. He was striding towards her, accompanied by a man who was at least a foot shorter than he was and much slighter and who had almost to trot to keep up with him; a dark-haired man with a wide grin that seemed to be fixed in place and who was chattering in a steady monotone.
‘I tell you, doc, I could work all day and night too, no trouble. They say to me, when you start to work properly, Josey? And I say to them, you ask Dr Zack. No, they say, you ask him, so I ask you, when can I work properly, huh? They share out the tronc all unfair because I’m not there all the time. It’s all wrong, greedy buggers they are, but that’s the Cypriots for you, you should forgive me for talking racist. So, Dr Zack, you let me go back to work huh?’
‘Josey, this is Dr Barnabas,’ Zack said, totally ignoring the chatter. ‘She wants to talk to you about your treatment and how you feel. Come along now, we’ll go to the examination room at the far end. Lead the way.’ He gave the little man a push and Josey went trotting ahead obediently but still chattering, apparently not one whit disturbed by the fact that no one was listening to him.
‘So, you read the notes?’ Zack said eagerly.
‘Yes,’ she said. ‘Oh, yes. It’s quite a story. From one patient’
‘Oh, sure,’ he said cheerfully. He started to follow Josey so that she had to fall in step beside him. ‘I’m well aware of that. I’ve got one other that’s done equally well: the Greenwich girl. I’ll present her too when the funders come — she couldn’t get here this evening, though I did ask her. Her treatment was slightly different — I refer to it in Josey’s notes, remember? And yes, I know two aren’t much of a sampl
e, but it’s not easy to get the right patients, and anyway, I don’t have the funds. That’s why I’m applying for the grant, for God’s sake.’
‘You can’t get a job until you join the union,’ she said, remembering an earlier conversation.
‘And you can’t join the union till you get a job. Precisely.’
‘So you haven’t published anything about this yet?’
‘How could I? I’ve only got these two patients, and a few I’m looking at treating in the future, but I have to be so careful. I have to have the patient’s full understanding of what the therapy is, and the referring GP and the Research Ethical Committee here has to agree to the protocol — and I had a hell of a battle with them, believe me — so any attempt at publication is way out of the frame at present. But I can rest a while on what I published when I was working in Canada. There’s a fair bit of it, so there’s no panic to get into print.’
‘Really.’ She slowed her walk almost to a stop so he had to too. ‘I wouldn’t mind reading some of those.’
‘They’re not very good,’ he said lightly. ‘I was just desperate to get myself into a journal of record. But you can see them if you like. I’ll dig some out for you.’
What she did then she was never fully to understand, even long afterwards, when the whole business had been sorted out and explained. It was to mystify her for the rest of her professional life. She opened her mouth and heard words coming out of it and was appalled at herself as she said them.
‘Zack, have you had anything to do with the things that have been happening to Sheila?’
He stopped as though he’d hit a glass wall. ‘What did you say?’
‘I think you heard,’ she said, unable to repeat the words. What have you done, she was shrieking at herself inside her head. You stupid, crazy — What have you done?
He stared at her, the bewilderment on his face plain; he was completely thrown by her question. There was no hint of defensiveness, not a scintilla of calculation there that she could see. He was completely and utterly amazed.
‘I — What?’ He swallowed. ‘That is one hell of a question, lady! How do you mean, have I had anything to do with it? Do you mean did I do them? Did I put nicotine in chocolates, is that what you’re asking? Or what? I just —’
She tried to keep her voice steady. ‘I had to ask. It’s all so — There are things you do that worry me. You hang around me and make a fuss of me and come on to me like — well, you know you do. And, no, don’t say anything. Hear me out. You always seem to be where the trouble is. You were in the car park when Sheila’s car went up; you were in the ward when the chocolate thing happened; you’ve been over to my lab and not many non-path, people do that and — and now, you’re leaning on me so much to help with this research. I added it all up together and came to —’
‘Some crazy total! Now listen here — oh, shit’ The door of the examination room, now just fifteen feet away, had opened, and Josey had put his head out curiously. ‘We’ll be there in a moment, Josey. I have to explain things to the doctor here. Just you wait there and behave yourself.’
Josey looked a little hurt at the suggestion he’d ever misbehave, but withdrew his head and closed the door.
Zack turned so that he was standing right in front of her and took her by the shoulders. ‘OK. You’ve been straight with me. Amazingly straight, for God’s sake! I feel like I’ve been head-butted. Yes, I have been coming on to you. You’re an attractive woman.’ He let go of her shoulders then and took a step back. ‘But that’s not the only reason I’ve been hanging around you. Not the only reason I’ve tried so hard to get you involved with my research. And I suppose not the only reason you’re here now.’
‘Well, that’s something to know at any rate,’ she said a little unsteadily, pushing her hands deep into her white coat pockets to hide the tremor that had suddenly afflicted them. As though I have Parkinson’s, she thought with a sudden wild-ness. Stupid, crazy woman you are, coming out with that stuff — what possessed you?
‘I’ll be as direct with you and hope it doesn’t turn you right off me. Right. You’re a pathologist. You have control of a large laboratory in which a great deal of investigative work is done. I’m scrabbling for every last cent I can get to do research that is the most important thing in my whole life, and I have to get what I can where I can get it. One thing that eats up a great chunk of my budget is pathology. If I can get you interested and involved enough, maybe I can persuade you to do some of my path, work for me and lose the bills. OK? I don’t want a joint project, so I’m not prepared to offer you equal billing on this if I pull it off. I tell you frankly that if I succeed, I stand to make a lot of money. I’ll patent anything I develop so that I can get my share and the goddamn pharmaceutical company doesn’t get the lot. It’s my research and no one, but no one, is going to get a glimmer of credit or cash but me. I don’t want a shared Nobel. I want a whole one all to myself. I have been coming on to you, yeah, in an effort to get what I want on my terms. It’s nice you’re an attractive woman, but that’s just bunce, frankly. Simple profit. What this is really down to is money. You’ve got something I want, and I have inadequate resources, so I’ve been trying to con them out of you. But that is as far as my vice goes. I am not into booby-trapping cars or poisoning candy or hurting people in any way whatsoever. So now you have it.’
There was a long pause and then she said, ‘I see.’ She was amazed at how steady her voice was.
He shook his head at her, with an almost comic air of exasperation. ‘Apart from anything else, lady, you are known all over the hospital as a. close friend of the police. Am I likely to mess with something illegal involving you? Do me a favour. All I want to do is get you to do some research work for me for nothing. It’s no crime.’
‘In the new NHS it is.’ She managed a smile. ‘Every single item used has to be budgeted for and listed and audited and Christ knows what else. So getting path, work done for you and not billing your department for it the way I should’d be like stealing from the NHS. A crime in anyone’s book.’
‘Jesus!’ He sounded disgusted. ‘What is going on here? People who work in hospitals have always had their perks from it! God knows they don’t get as much as they should in hard cash! That’s why I never heard of any nurses buying things like — like cotton wool or cough drops. There are things you take from the hospital that everyone takes and if you get away with it, good luck to you. That’s as true in Canada as it is here — our hospitals are State-owned too, remember — and I cannot believe you’re serious if you say you’re going to shop me for —’
‘Who said anything about that?’ she said mildly ‘I was just saying that trying to get expensive path, work done for nothing is stealing. And yeah. I agree with you. It’s been done in hospitals since they were invented. And I’m not about to change the world on that score. I just wish you’d asked me straight out, is all, instead of going in for all this flirty stuff.’
‘If I had, would you have agreed?’
She hesitated. ‘Possibly not.’
‘I’m not crazy then. I knew you wouldn’t, so I tried it the old-fashioned way, with a bit of soft soap aimed at flattering a female complexion.’ He laughed, his voice sounding more like dark treacle toffee than it ever had. ‘And the fact that you’re such a shit-hot feminist made it more fun.’
‘Hey, I am not shit hot! I mean, I don’t go around shouting my head off about feminism. I just take it for granted that —’
‘That you’re as good as the next guy. So you are. But you’re also a female and it was fun to see if I could get what I wanted and — well …’
‘Get me too,’ she finished for him.
‘Yup. And let me remind you, if I was up to some sort of villainy would I tangle with a woman who hangs around the goddamn police as much as you do? I ask you!’
She gazed at him standing there, he too with his hands deep in his pockets, and wanted to laugh. She’d been crazy to ask him, she knew, but now she w
as glad she had. It was like watching a thick fog roll back to leave the air and the view crystal clear. He seemed to see the relief in her face because he smiled back at her even more widely.
‘Mind you, George, you were taking your chances asking me that, weren’t you? If I had been the sort to go around doing nasty things to people like Sheila and I thought you’d rumbled me, I might have tried to do nasty things to you, right?’
She smiled back. ‘Right’
‘But now you know I won’t, right?’
‘Right,’ she said again and shook her head in self-deprecation. ‘I screwed up. Let’s forget it. Your patient’s waiting.’
He nodded and pulled his hands from his pockets. ‘OK, Dr Barnabas. I take it we’re still in business? That you’ll still help me?’ His face split then into the wickedest grin he’d ever produced. ‘Maybe even to the point of a few free tests and suchlike? Have I ruined my chances there altogether? Or can we still be a sort of team?’
23
‘You did what?’ Gus said in amazement.
George felt her face go a mottled pink, ‘I know, I know. I was crazy but I — well, it sort of just came out, you know? I felt so lousy, snooping around like that and — anyway, I have to say the relief once I’d asked him was terrific. I felt better.’
‘I never before heard you complain that snooping made you feel bad,’ he said waspishly and she made a grimace at him.
‘That’s right. Rub it in.’
‘Yeah, well … Honestly, George, how could you be so foolhardy? If the guy’s been the cause of all this stuff — the attacks on Sheila, let alone anything else — then you’ve tipped him off And put yourself at risk. Can’t you see that?’
‘Of course. I thought that at first, but I don’t think I have. I mean, even if I was still in any doubt about him I don’t think I’d have done any harm. He said it himself He knows perfectly well that I work closely with the police. He knows that anything I know, you know, and he’d have to be really stupid to mix it with me. And he certainly isn’t stupid. A smooth operator with his eye to his own main chance maybe, but stupid? No.’
Fourth Attempt Page 22
