by M. R. Hall
‘Don’t worry about Ross,’ he murmured from somewhere in the hazy realm between wakefulness and sleep. ‘He’s finding his feet. I was in the Air Force at his age. He’s a good kid. He loves you.’
‘You really think so?’
‘We both do.’ His breathing grew even slower, and he sank into unconsciousness.
Jenny’s mind was buzzing. Michael had never told her that he loved her before. Why now? What had changed? Had he spoken to Ross when she left him together? Is that why he said Ross loved her too? Her excitement gave way to worry. Was whatever Michael had said the reason Ross had gone? Had he felt he was intruding on them? She needed to talk, she wanted to know everything. She gently shook Michael’s shoulder, but he was deeply and irretrievably asleep.
Restless, she slid out of bed and, wrapped in her robe, padded downstairs to her study. She needed to think, to find some words to explain to Ross that her relationship with Michael needn’t trespass on theirs; that more than anything she wanted them all to be friends. She decided to write him an old-fashioned letter.
Rummaging amidst the semi-ordered mess, she searched for something to write with amongst the heap on her desk. A word in a footnote on one of the scientific papers she’d been reading caught her eye: Slavsky. She found a pen and a notebook and started to write, but the name had lodged in her mind like a thorn in a finger. She glanced back at the footnote. It referred to an article authored by Professor Roman Slavsky entitled ‘Techniques in Site-Directed Muta-genesis’. Slavsky: he was the author of the book that Adam Jordan had bought in Oxford
Jenny roused her sleeping laptop and ran a search on the author’s name. There were few results: a handful of mentions as a conference delegate, several highly technical published papers, one of which had a brief accompanying biography that read simply, Professor Roman Slavsky, born 1951, was a leading Soviet biologist who defected to the West in 1989. He continued his work in the UK until his death in 2010. She entered the title of his book, Warrior in White, and found that it had been out of print for over five years. Adam Jordan had bought a used, out-of-print title written by an obscure Russian scientist. It was just the sort of thing she might have done while killing time in a city filled with bookshops. Curious to know what it contained, she searched in vain for a second-hand copy for sale online, and had to content herself with placing a request with a book-search service.
Closing her laptop, Jenny told herself it was one less thing to worry about. She put it from her mind and tried to work out how she would win back her son.
TEN
JENNY ARRIVED AT THE SMALL STREET courts on Monday morning still feeling as if she were moving in and out of the weekend’s light and shadow. Her sadness that Ross had only managed a cursory phone call, and made only the vaguest promise to introduce her to Sally the following weekend, alternated with the residual glow of a weekend spent making love with Michael. She was happy and astonished, she had felt things she thought she would never experience again, but entering the cool solemnity of the Victorian court building, she began to feel the stirrings of guilt at having let her thoughts drift so far from the families who were desperately waiting for her to give them answers. Passing through the security door, the familiar words of the funeral service slipped into her head – ‘in the midst of life, we are in death’ – and then turned themselves on their heads: in the midst of death, we are in life.
Alison was already busying herself in the small, window-less courtroom, setting out glasses and decanters of water.
‘Good morning, Mrs Cooper.’ She could have been addressing a virtual stranger.
Jenny hadn’t spoken to her since her hospital appointment. Another person she had neglected.
She tried to repair the damage. ‘How are things?’
‘We’ve got the court for a full day and tomorrow as well if we need it,’ Alison answered officiously. ‘Dr Kerr has asked if he can be away before this afternoon.’
‘And your appointment?’ Jenny asked hesitantly.
‘Oh, that.’ Alison turned away and sorted through the oath cards on the clerk’s desk. ‘Pretty much as expected.’
‘Anything to worry about?’
‘Nothing that will affect my work, if all goes to plan.’
She set the cards on the edge of the witness box. Jenny waited, knowing her well enough to anticipate the ebb and flow of her emotions. Alison glanced around the court, looking for another distraction, but there was nothing left to be done.
‘A small secondary on the other breast,’ she said dismissively. ‘A few blasts of radiotherapy should see it off. Nothing out of the ordinary, apparently. Just one of those things. Best just to forget about it and get on.’
‘Is there anything I can do?’ Jenny said. ‘Do you need time off?’
‘The best thing you can do for me is not to mention it, Mrs Cooper. I’ll let you know when there’s something to tell.’
‘How’s Paul?’
‘He’s fine. Very matter-of-fact. But Terry doesn’t know, and he mustn’t.’ Terry was her estranged husband, and having escaped their tired marriage, was now deeply jealous of Alison having moved in with Paul – an old friend and colleague of his – who had come back into her life after more than twenty-five years.
‘You know I wouldn’t say anything,’ Jenny said.
‘It’s who he might tell that worries me. I know what people are like – they hear the c-word and they write you off. I’ve done it myself.’ Alison drew in a sharp breath. ‘I’m fine, Mrs Cooper, I really am. I’ve set out coffee in your room. Would you like to talk to Mr and Mrs Freeman before we sit?’
‘If they’d like to.’
‘I’ll see if they’re here.’
She walked quickly away.
Ed Freeman seemed to have aged more than a decade in the five years since Jenny had last seen him. His once-black hair was steel grey and he had put on weight. He was the tired, shapeless middle-aged man David was determined never to be. Fiona, his wife, had worn far better – if anything, she was slimmer than Jenny remembered, her skin taut against her cheekbones and smooth all the way down the front of her neck. Clinical psychology evidently took less of a toll than neurosurgery. The three of them were seated in the small, functional office behind the courtroom that was misleadingly called the ‘judge’s chambers’: a desk and three chairs took up most of the floor space. Ed declined Jenny’s offer of coffee, but Fiona accepted, able to lift her cup to her lips with a steady hand. In only a few brief exchanges Jenny had picked up the fact that while Ed couldn’t see beyond his oldest daughter being snatched away, Fiona had moved her attention to protecting Sophie’s younger sister, Emily. There was something primal about her focused determination: a forty-eight-year-old mother, she had only this one chance of continuing the family line. Her husband had no such restriction, and something in her manner towards him told Jenny that consciously or subconsciously she had set up defences against him. She hardly seemed to spare him a glance, as if ashamed, or afraid, of his weakness; Jenny couldn’t decide which.
Jenny explained that in the normal course of events, a death from a recognized disease wouldn’t merit an inquest, but that the suddenness of Sophie’s death coupled with the fact that the meningitis was of an unusual strain made it worthy of inquiry.
Fiona Freeman interrupted her. ‘What exactly do you hope to achieve? Surely the only people with anything to learn from Sophie’s case are the immunologists?’
Jenny replied sympathetically. ‘I understand it’s an ordeal, but I won’t be empanelling a jury. I anticipate a very low-key hearing.’
‘That’s hardly answering my question.’
Ed Freeman gestured to his wife as if to silence her. Fiona ignored him and awaited Jenny’s reply.
‘I’d like to explore the areas of diagnosis and treatment, whether there have been any other cases, what the lab tests have revealed, whether all necessary measures are being taken to prevent a recurrence—’
‘The hospital have tre
ated us extremely well. There’s nothing more anyone could have done.’
Jenny found herself exchanging a glance with Ed. His worn-down expression told her Fiona had coped by convincing herself that Sophie’s death was inevitable, and she wouldn’t hear anything to the contrary. He was no longer the man she had spoken to on the phone; his desire for the truth had been consumed by Fiona’s need to draw a line and concentrate her energy on safeguarding the daughter she still had. Jenny had known many grieving men and women like Fiona Freeman pass through her office: natural survivors who valued certainty over truth. Jenny sensed Ed Freeman was a late arrival in the opposing camp. It didn’t bode well for the future of their marriage.
Jenny ended their conversation as reassuringly as she could. ‘I’m sure we all want this over as quickly and painlessly as possible.’
Alison knocked at precisely ten o’clock.
‘I’m afraid it’s not as quiet as you might have expected, Mrs Cooper. I think people must have been talking online. It’s standing room only. Mrs Freeman’s going spare. She’s asking her solicitor to apply for proceedings to be held in camera.’
‘There are no grounds.’
‘That’s what I tried to tell her.’
Jenny got up from her desk and followed Alison through to the compact courtroom – the smallest in the building – which was full to capacity. Jenny recognized familiar faces on the two benches set aside for the press, but there were thirty or more people occupying the seats reserved for the public. Squeezed into the two front rows were Ed and Fiona Freeman, representatives from the Severn Vale District Hospital and the Health Protection Agency, along with their teams of lawyers.
Anthony Radstock, a local solicitor who dabbled in inquest work only to break the monotony of his probate-and-property practice, was first to address her.
‘Good morning, Mrs Cooper,’ Radstock said, in a gentle Somerset burr. ‘I represent Mr and Mrs Freeman.’
Jenny said, ‘We’ve met before, Mr Radstock.’
‘Indeed, ma’am, and you may be as surprised as my clients to see so many members of the public attending what is essentially a private, family inquest.’
‘Inquests are public hearings. Members of the public are perfectly entitled to attend.’
‘Ma’am, the fact is we have evidence that this case has attracted attention through the spread of misinformation.’ He produced a handful of papers. ‘If you’d care to look at this.’
As Alison brought them to the bench, Jenny glanced at the other two lawyers sitting alongside Radstock. Her note told her that the tall, quietly observant man dressed in a hand-tailored suit was Alistair Martlett, a London-based barrister representing the Health Protection Agency. The third lawyer was Catherine Dyer, a deceptively attractive woman with shoulder-length auburn hair, whom Jenny knew to have a lucrative practice defending top consultants accused of negligence. She had also been brought up from London, and represented the Severn Vale District Health Trust. The two big-city lawyers sat quietly and inscrutably, content for the local man to fight this opening skirmish.
The papers Alison handed to her were printouts of screen-grabs from social-networking sites and discussion forums. Word seemed to have spread that Sophie Freeman’s death was the latest in a string at the Severn Vale District Hospital rumoured to have been caused by a mysterious superbug. It was idle misinformed chatter, but had clearly taken flight. She glanced through a discussion thread which had already attracted more than four hundred contributions.
Jenny spoke to the whole courtroom. ‘I can see from what Mr Radstock has handed me that there has been a lot of groundless speculation about this case. I would like to remind everyone present that the function of this court is of course to use its powers of inquiry to isolate the facts and to find out the truth. I have no reason to exclude the public from this hearing, but I must warn anyone who may be tempted that there are strict rules governing the reporting of court proceedings. It doesn’t matter if you’re writing for a newspaper or commenting online – anything less than an accurate portrayal of the evidence is a serious contempt.’ She addressed the press and members of the public. ‘I hope I make myself clear.’
Radstock nodded, conceding defeat. The two lawyers to his left remained silent. Fiona Freeman scowled and turned a few degrees further away from her husband.
There were three witnesses scheduled to give evidence: Dr Morley, the physician who had supervised Sophie’s treatment, Dr Kerr the pathologist, and Jenny’s recent visitor from the Health Protection Agency, Dr Anita Verma. Before calling Dr Morley to the witness box, Jenny first read aloud a short statement Alison had obtained from the nurse at the private girls’ school Sophie had attended. Sophie had gone to her during the morning break complaining of a headache and rash. Alerted by the combination of symptoms, the nurse had tried and failed to reach her parents, both of whom were busy at work. In the meantime she had called for an ambulance, which delivered Sophie to hospital before noon. The thread of the story was then picked up in a brief statement from Mark Ashton, a junior registrar, who had diagnosed Sophie with meningitis within ten minutes of her arrival. He immediately called in Dr Morley, a consultant physician specializing in the treatment of infectious diseases.
Dr Andrew Morley looked as wrung-out by his work as any hospital consultant Jenny had known. He was forty-three years old but could have been sixty. Long hours spent working in artificial light had left him too tired to smile, with grey, pallid skin and gaunt features. Having read the oath, he apologized if he seemed a little weary – he had been on call two nights in a row.
Jenny established at the outset that Dr Morley was a colleague of Ed Freeman’s, but not a personal friend. He was at pains to emphasize that he had never met Sophie before her admission; he had treated her just as he would any other acute patient. Immediately on examining her in Accident and Emergency, he had performed a lumbar puncture to collect a sample of cerebrospinal fluid. With little doubt of what the lab would find, he had her immediately transferred to the hospital’s isolation unit. There, she was place in a negative-pressure tent and attended to by specialist staff.
Sophie had exhibited all three of the classic symptoms of bacterial meningitis: extreme headache, fever with delirium and stiffness of the neck muscles. Dr Morley treated her with a broad spectrum of antibiotics as well as drugs to relieve her pain and to sedate her. There was no way of sweetening the pill: despite the cocktail of drugs, Sophie’s condition had deteriorated with shocking speed and she had suffered horribly. As the bacteria multiplied, she had started to haemorrhage in all her major organs. Ed Freeman had arrived in the ward an hour or so after her admission, and Fiona shortly afterwards. Both had witnessed the convulsions that had preceded the final descent into coma and death. The only positive to be drawn, Dr Morley said, was that it was over so quickly.
When Jenny asked if the antibiotics had had any noticeable effect on the disease, Dr Morley said they had not, confessing that it was unusual, but not unprecedented.
The lawyers asked only a few questions. Radstock inquired whether there was any other course of treatment that might possibly have had an effect. Dr Morley answered no, there was not. He had tried everything. Seeking to underline this point, Martlett broke his silence to ask the doctor if he had encountered other cases where meningitis had killed so quickly.
‘Not personally, I have to admit,’ Dr Morley answered, ‘but there are plenty of similar cases in the literature. Sometimes a patient will go to bed suffering flu-like symptoms and be dead by morning. It’s a terrifying disease.’
Catherine Dyer was anxious to cement the rapidly forming impression that they were simply dealing with a tragic, but unremarkable case. ‘Dr Morley, it’s true, isn’t it, that many people carry these bacteria in their noses and throats, and that the reasons for them suddenly springing into life, as it were, are little understood?’
‘That’s correct.’
‘And is it also correct that sometimes there is a natural mut
ation in the bacteria which can cause a sudden outbreak among people with insufficient immunity?’
‘It happens. Thankfully not often. We have only a handful of deaths in the UK each year.’
‘Have there been other cases at this time?’
‘None of which I am aware.’
‘And are you able to draw any conclusions from this fact?’
‘If we were dealing with a cluster we would be concerned that a new variant had developed with potential to spread rapidly into the wider population. But where all we have is an isolated case, it’s more a question of determining why that particular patient was vulnerable.’
‘In your view, is there any need for alarm as a result of this one case?’
‘None whatever,’ Dr Morley replied.
Jenny noticed Fiona Freeman nod in approval at his answer. Ed Freeman saw her, too, and looked away in apparent disgust.
‘Thank you, Dr Morley,’ Jenny said. ‘I think that’s all we need from you.’
He stepped gratefully from the witness box and Jenny called Dr Kerr to take his place.
Exposed to a courtroom filled with critical and expectant faces, Dr Kerr had none of the confidence he possessed in the mortuary. His hand shook as he held the oath card; droplets of sweat formed on his brow.
Jenny allowed him a moment to compose himself, then led him step by step through his post-mortem findings.
According to her medical notes, Dr Kerr said, Sophie Freeman was an otherwise healthy thirteen-year-old girl who had suffered only the usual childhood illnesses. But in the course of eight hours the disease had so ravaged her body that it would scarcely have been recognizable. Meningitis bacteria secreted toxins that caused systemic inflammation, haemorrhage and cell death. The body responded with an increasing cascade of immune responses, one of which was the dilation of the capillaries, which allowed the bacteria to penetrate even further and more easily, all the while tricking the body into believing they were friend not foe. As the bacteria multiplied, they crossed the blood–brain barrier, causing inflammation of the delicate tissues – the meninges – surrounding the brain. Faced with this elemental threat, the body slowly started to shut itself down in a last-ditch bid at self-defence. Through a complex sequence of biochemical reactions, blood flow was diverted from non-vital organs – skin, lungs, kidneys, digestive tract – to the two organs most essential for life: the heart and brain. But the bacteria continued to multiply and secrete ever-higher doses of toxin, and as secondary organs faded, cardiac output and blood pressure steadily lowered until Sophie suffered an inevitable and fatal multiple-organ collapse.
