Bloodline

by Mark Billingham

They strolled through the automatic doors, walked past a small shop selling magazines and chocolates, soft toys and bunches of flowers that made the average garage look like a Kensington florist’s. ‘You think I should look on the bright side a bit more?’

  ‘Just admitting that there is one might be a start,’ Holland said.

  Once they had passed through the A and E Department’s reception area, they stopped to ask directions. Eventually they picked up signs for the Neurological Department and a few minutes later were walking towards the lifts that would take them up to the right floor.

  ‘You got any mints or anything?’ Thorne asked.

  Holland shook his head. ‘We could nip back to that shop.’

  Thorne said it didn’t matter. He was not a big fan of the smell, that was all. Bleach and whatever else. He had glanced up at the signs as they’d walked.

  Oncology. Dementia Unit. Antenatal Suite.

  ‘It’s a bloody stupid expression anyway,’ he said. He tried to keep his voice level. ‘Surely what’s in your glass is a bit more important.’

  ‘I suppose.’

  ‘What if it’s a dirty glass and it’s half full of hot piss?’

  They finally found the room they were looking for behind a busy ward, at the far end of a corridor with a shiny grey floor and paintings on the wall that looked as though they had been done by patients still recovering from head injuries. The sign on the door said ‘Neurosurgical Secretaries’ and, on entering, Thorne and Holland were confronted by three women who turned in unison and stared. Holland let them know, in a quieter voice than Thorne was used to, that they had an appointment. The eldest of the women stood up and walked past him to a door that was all but hidden by an enormous filing cabinet. She knocked, and after a few seconds’ muttered conversation, Thorne and Holland were shown into Doctor Pavesh Kambar’s office.

  Thorne nodded back towards the secretaries’ room. ‘They all yours?’ he asked.

  ‘I share them,’ Kambar said. He spoke like a newsreader on Radio 4. ‘There’s something of a pecking order.’

  ‘Are you talking about the doctors or the secretaries?’

  ‘Both.’ Kambar nodded the same way that Thorne had. ‘But it’s rather more fierce out there.’

  Kambar was a fit-looking man in his mid-fifties. His hair was thick, silvering, like his well-trimmed moustache, and the dark suit and polished brogues, though understated, were clearly expensive. By contrast, his office was windowless, no more than a quarter the size of the one shared by the secretaries, and there was only one chair other than his own. Thorne took it, leaving Holland to lean back a little awkwardly against the door. A year planner was mounted on the wall, while Holland’s head rested at the same level as a model of the human brain that sat at the end of a bookshelf, its different sections moulded in brightly coloured plastic: blue, white and pink.

  Thorne turned and looked from Holland to the model. ‘It’s probably a damn sight bigger than yours,’ he said.

  While Thorne told Kambar about their journey up, and the doctor bemoaned the vicissitudes of the London to Cambridge rail service, Holland dug into his briefcase for a photocopy of the pieced-together X-ray fragments. He handed it over. ‘What we talked about on the phone.’

  Kambar nodded, studied the picture for a few seconds. He turned to his computer and punched at the keyboard. ‘And this is where it comes from . . .’

  Thorne shifted his chair a little closer and peered at the screen. There were three images which, at first glance, appeared identical: a cross-section of a brain, grey against a black background, with a white, almost perfectly round mass towards the bottom.

  ‘I printed one out for you,’ Kambar said. He opened a drawer and took out what looked like a large X-ray. ‘These days all the images are digital, stored on disc, but we still occasionally use film if we need to.’ He fastened the X-ray to the light box that ran the length of the wall above his desk and studied it, as though he had never seen it before.

  ‘So what happened to the original?’ Thorne asked.

  ‘There was no original as such,’ Kambar said. ‘As I explained, the scans are stored on computer.’

  Thorne pointed to the photocopy lying on Kambar’s desk. ‘So where did they come from?’

  ‘Well, nobody would have had any reason to print one of these things out before I did,’ Kambar said. ‘So, my guess is that they’re from one of the series I printed out and gave to Raymond Garvey a few weeks before he died. Every patient is fully entitled to keep copies of all their medical records.’ He pointed as Thorne stared at the images. ‘The white mass is the tumour, obviously.’

  Holland had moved forward. ‘Looks enormous,’ he said.

  Kambar made a fist. ‘That big.’

  ‘How long did you treat him?’ Thorne asked.

  Kambar fiddled with a pencil as he took them through a potted history of Garvey’s diagnosis, treatment and, ultimately, his death. Holland made notes and Thorne listened, his eyes drifting occasionally to the pictures, stark against the light box. The simple white shadow, round and smooth, looked like nothing.

  ‘About three and a half years ago, Garvey had what looked like an epileptic fit in his cell at Whitemoor, gashed his head open on the side of his bunk. Turns out he’d had a few similar episodes, so they took him to the district hospital in Peterborough and did a CT scan. They would only have had the vaguest idea of what they were looking at, but we’re image-linked to most of the other hospitals, so they were able to ask us to have a look. We had . . . more than a vague idea. He came here a few weeks later for an MRI.’

  Kambar stood up and took the plastic brain from the shelf. ‘He had a massive tumour at the base of the frontal lobe. What’s called a benign meningioma.’

  ‘Benign?’ Holland said. ‘I thought it was the malignant ones that killed you.’

  Kambar was turning the plastic brain over in his hands. ‘They’ll kill you slightly quicker, that’s all. If a benign tumour grows big enough, the inter-cranial pressure will almost certainly be fatal. That’s why we needed to operate. Here . . .’ He lifted the model with one hand and pointed with the other to a pair of narrow parallel strips at the back. ‘These are the olfactory grooves.’

  ‘That’s smell, right?’ Holland asked.

  Kambar nodded. ‘Garvey’s tumour was sitting right there. A whopping great olfactory-groove meningioma.’ He looked at Holland. ‘In fact, issues with the patient’s sense of smell are often among the earliest symptoms. Garvey claimed he had been having problems for many years. Smelling burning or petrol for no reason. Smelling nothing at all, more often than not. Sadly for him, his tumour did not present fully until long after these problems began, by which time it was far too late.’

  Thorne took the model from Kambar and held it for a few seconds until he started to feel a little foolish, then passed it over for Holland to put back on the shelf. ‘So, you operated?’

  ‘Not for several months,’ Kambar said. ‘The inter-cranial pressure was building, no question, but there was no reason to think he was in any immediate danger. Anyway, it took him a few weeks to make up his mind. It was a high-risk procedure.’

  ‘But he still decided to go ahead.’

  ‘He did a good deal of hard thinking,’ Kambar said. ‘Took advice from some of the people he was close to. Not that there were lots of them, of course.’

  ‘Not too many likely to miss him,’ Holland said.

  ‘Quite.’

  ‘So he died on the table?’ Thorne asked.

  ‘Shortly afterwards,’ Kambar said. ‘An extradural haemorrhage. He never really woke up.’ He switched off the light box, took down the X-ray and handed it to Thorne. ‘You can keep this, if it will be useful.’

  Thorne looked at the three pictures of Raymond Garvey’s brain, the tumour that had grown within it. Garvey had brutally murdered seven women and, though it had happened earlier than he might have liked, he had been granted a relatively peaceful death. Now, three years on, som
eone was killing again. But why? On his behalf? In his name? Someone had left pieces of this very picture for the police to find and they still had no idea how it had come to be in his possession, nor what connected him to Raymond Garvey.

  ‘Any idea who he might have spoken to?’ Thorne asked. ‘Those people you said he was close to.’

  Kambar thought for a few moments, chewed the end of his pencil. ‘There were a couple of other prisoners, I think. Other vulnerable ones, like him.’

  ‘I don’t suppose you can you remember any names?’

  ‘I’m sorry.’

  Thorne turned to Holland. ‘Maybe we should get over to Whitemoor this afternoon.’

  Holland smiled. ‘You angling for another overnight?’

  ‘And the son, obviously,’ Kambar said.

  ‘We’ll make it back tonight—’ Thorne stopped. He watched Holland’s eyes go to Kambar, saw the confusion on his face, then spun around in his chair. ‘Sorry, what?’

  ‘Yes, thinking about it, his son probably ended up with all Garvey’s things,’ Kambar said. ‘The X-rays and so on, after the funeral.’

  ‘Garvey had no relatives,’ Thorne said. ‘Well, there’s an elderly uncle somewhere, but certainly no son.’

  Kambar pulled a face, as if he were struggling with a particularly cryptic crossword clue. ‘Well, there was definitely someone claiming to be his son. Someone who made my life rather a misery for a number of weeks after Garvey died. Leaving all sorts of messages, ranting on my answering machine. I’m pretty sure the same went for the governor at Whitemoor. Pestered the poor chap for ages.’

  ‘What was his name?’

  ‘Anthony Garvey.’

  ‘“Anthony” was Ray Garvey’s middle name,’ Thorne said. ‘Sounds iffy to me.’ He sat back, shaking his head. ‘No . . . can’t be.’ He looked at Holland, who could do no more than throw up his hands.

  ‘Well, Garvey thought he was his son,’ Kambar said. ‘This man visited him several times a week for years. He had hundreds of letters from Garvey, too.’

  ‘What do you mean he made your life a misery?’ Holland asked. ‘Did he blame you for what happened to his father?’

  ‘Not so much that,’ Kambar said. ‘Although he obviously wasn’t happy about the consequences of the operation. No, he thought there should be a retrial—’

  Thorne sat up very straight. ‘What?’

  ‘He wanted me to give evidence on his father’s behalf.’

  ‘Why on earth would there be a retrial? There was never the slightest doubt that Garvey was guilty.’

  ‘Never the slightest doubt that he committed the murders, certainly. ’

  ‘I’m not with you.’

  ‘Anthony Garvey was convinced that, were there to be a retrial, his father’s conviction would be overturned. They had been talking about it ever since Garvey was first diagnosed.’ He jabbed the tip of his pencil at the X-ray in Thorne’s lap. ‘They were convinced that the tumour had altered his personality; that effectively he had not been himself when he had killed those women. He wanted me to clear his father’s name.’

  Thorne looked again at Holland, who was scribbling furiously. He glanced up, shrugged and returned to his notebook. Thorne turned back to Kambar, but could not think of anything to say. The information was still settling, the different strands becoming tangled as quickly as he tried to tease them out.

  ‘You still haven’t said what this is all about,’ Kambar said. ‘Raymond Garvey has been dead for over three years.’

  Holland stopped writing. ‘I’m sure you understand that we’re not really at liberty to go into details.’

  ‘Of course.’ Kambar looked a little embarrassed, began to straighten some papers. ‘Just curious, that’s all. It would be nice to know what was going on.’

  ‘You’re at the back of a very long queue,’ Thorne said.

  THIRTEEN

  The Addenbrooke’s staff canteen was no more pleasant a place to eat lunch than its equivalent at Becke House. The food was probably a little better, as was the standard of conversation at the tables, but even on the top floor, which was dedicated to administration, there was no escaping that hospital smell.

  Bleach and whatever else.

  They carried their trays to a table in the corner, put down plates and cutlery, a bottle of still water and a can of Diet Coke. Both had plumped for the lasagne, though the doctor had chosen to accompany it with a green salad, which had almost, but not quite, prompted his visitor to put back his chips.

  ‘What will your colleague do for lunch?’ Kambar asked.

  ‘Not sure,’ Thorne said. They had rung through to make an emergency appointment with the governor at Whitemoor and, once it was confirmed, Holland had taken a cab back to Cambridge station. From there, it was a thirty-minute train journey to the small station at March, which was a short taxi ride from the prison.

  ‘He might get there in time to eat with the governor.’

  ‘Maybe,’ Thorne said. He guessed that Holland would prefer to make other arrangements. As far as smells that stayed with you long after you’d left the premises went, there wasn’t much to choose between a hospital and a prison. ‘He’ll probably just grab a sandwich on the train.’

  Thorne and Kambar began to eat.

  ‘Is it possible?’ Thorne asked. ‘This change of personality business.’

  ‘Oh, personality change is certainly possible. I’ve dealt with a number of cases. But to the degree where you might murder someone? ’

  ‘Where you might murder seven someones.’

  ‘This is almost a Jekyll and Hyde thing we’re talking about.’

  ‘So?’

  ‘I was . . . dubious.’

  ‘You’re not saying it isn’t feasible, then?’

  ‘Almost nothing is hard and fast where the brain is concerned,’ Kambar said. ‘It’s nigh-on impossible to rule out anything completely, but there was no way I would have been willing to say that in a court of law.’

  Thorne began picking up chips with his fingers. ‘I think I get it,’ he said.

  ‘Good. The lasagne’s better than normal today. It’s usually solid.’

  Thorne knew plenty of doctors and scientists who would have trotted happily up to the witness stand in search of notoriety or a hefty fee. Who would have said that, although such a thing were unlikely, they could not say for certain that it had not happened. People of that sort - many of whom were virtually professional expert witnesses - were gifts to defence barristers seeking to get the likes of Raymond Garvey off the hook. Such testimony was almost designed to plant the seed of reasonable doubt within the mind of even the most sceptical juror.

  The relatives of those murdered by Garvey should have been very grateful to Pavesh Kambar.

  ‘These cases you’ve dealt with,’ Thorne said, ‘how do these changes happen?’

  Kambar raised his hand to demonstrate and it looked as though he might stab himself in the forehead, until he remembered and put down his fork. ‘The frontal lobe is what controls our cognition,’ he said. ‘It’s where the brain’s natural inhibitors are, where all the levels are set. It’s what makes us who we are.’

  ‘And a tumour can change that?’

  ‘Any foreign body, or any injury that affects that area. If the brain gets damaged, the personality can be affected. Altered.’

  ‘I read something in a paper once,’ Thorne said. ‘This woman suffered a massive head injury in a car accident and when she woke up she was speaking in a completely different language.’

  Kambar nodded. ‘I’ve seen similar cases reported,’ he said. ‘But I’m not convinced. I think those kinds of things make good stories.’

  ‘So, what sorts of changes have you seen?’

  ‘Shy people who can suddenly become extremely gregarious. It’s usually a question of inhibition, of barriers coming down. Alcohol works in the same way in that it disinhibits the frontal lobe. Imagine someone who is very drunk, but without the falling over and the slurred
speech. There are no . . . niceties, you know? Social graces go out of the window, the mark is overstepped.’

  ‘I’ve seen that,’ Thorne said.

  Kambar shoved the last forkful of pasta into his mouth and waited.

  Ignoring what was left of his lunch, Thorne found himself telling this man he had known for only an hour about the Alzheimer’s that had blighted his father’s final years and a few of his own. About the old man’s bizarre obsessions and the lifestyle that had grown increasingly erratic and disturbing. Kambar told him that the disease acted on the brain in precisely the way he had been describing.

  ‘People think it’s all about forgetting people’s names or where you’ve left your keys,’ Kambar said. ‘But the worst thing is that you forget how to behave.’

  Thorne laid down his cutlery. Straightened it. ‘What about the whole genetic thing?’

  Kambar nodded, understanding what he was being asked. ‘Look, it’s far from being definitive, but only something like fifteen per cent of patients with Alzheimer’s had parents who suffered from it; and even then the strongest genetic link is with the rarest forms, like early onset. We’re not talking about that, right?’

  Thorne shook his head.

  ‘The fact that your father had it might increase your own susceptibility a little, but no more than that.’ Kambar smiled. ‘Dementia is very common, though, and chances are you’ll get it anyway, so I’d stop worrying. ’

  ‘Sometimes it was good,’ Thorne said. ‘With my dad, you know? There was this one afternoon we were all playing bingo on the pier and he just lost it. Started swearing and shouting, proper filth, and everyone was upset, but I was pissing myself. And he knew it was funny. I could see it in his face.’

  ‘I’m glad it wasn’t all gloom and doom,’ Kambar said. ‘How was it at the end?’

  Thorne suddenly found his appetite again. He had discovered only recently how the fire in which Jim Thorne perished had started; the part he had played in the death of his own father. He had not even felt able to share the truth with Louise. He heard Kambar from the other side of the table telling him that it wasn’t a problem, that he had not meant to pry.