Pain

by Adam Southward

  Two of the other nurses turned. They called and headed back, reaching out to their colleague, helping her limp along. One of them took the rucksack and carried it. Mia clenched her fists, watching as the group swiped themselves inside. The door closed.

  Patience. It wasn’t one of Mia’s strengths, not in her condition. She couldn’t linger for too long in one place, and chose to walk a length of cars, keeping an eye on the door and the flow of people, waiting for her chance.

  Luck. Mia’s was getting worse. Beyond the glass door she spied a uniformed security guard. Not police, but just as much of a barrier. The guard ambled through the door and paused, taking a quick scan of the surroundings. It was dim, the sun unable to find its way into the parking lot, the shadows offering protection. Mia looked away, walking back towards the ramp, cursing under her breath. She risked a glance and saw the guard disappear inside, his rudimentary scan complete.

  Mia tapped her splinted arm against a metal railing, trying to distract herself from her increasingly shallow breathing. The clang of metal on metal echoed in the enclosed space. The vibrations travelled up her arm and Mia wondered if the impact would damage the tissue and bone so carefully trying to knit themselves together.

  ‘Are you OK?’

  An older man approached her from the shadows. A nurse, dressed in scrubs. He clasped his hands together but held back, apparently wary. Mia considered her appearance and didn’t blame him. Her eyes burned into his.

  He frowned. ‘Can I help you inside? Are you waiting for someone?’

  Mia shook her head. She studied his face, the angle of his jaw and the arch of his neck. She traced down his throat to his chest, breathing deeply, trying to catch a whiff of something, anything. She breathed out in a deep sigh, trying to rein in the craving in her chest. He had nothing to offer and Mia hated him for it.

  The nurse’s frown deepened, the expression sympathetic but unsure. He glanced at her arm, then peered into her eyes.

  ‘Look at me,’ he said.

  Mia stared, but she was distracted by a siren in the street above, blasting through the traffic. The ambulance flashed its lights as it pulled into the bays above the parking lot, and the glare reflected off every glass surface of every car. The light hit Mia and filled her mind. Her vision faded, the parking lot disappeared and Mia turned inwards.

  Her own experience. Her memories. Her waking dream.

  Shunted left and right, a blast of cold air and a floating sensation. Her feet were cold and her lungs burned with fresh air. She was being pulled along and couldn’t move.

  Panic.

  The lights flashed.

  Mia blinked and the memory evaporated. The parking lot surrounded her once again and the face of the nurse peered in. He stepped forward this time, but Mia’s good arm snapped out, grabbing his wrist.

  ‘Do you know me?’ she said, gasping as the panic attack took hold. ‘Have I been here before?’

  She shook, gripping the nurse hard. He tried to calm her, speaking softly, coaxing her to relax, but his words had no effect. He pulled his arm free and she let him go, staggering away towards the ramp, picking her feet up into a shuffle.

  She was running by the time she hit the street. The nurse didn’t call after her. Perhaps he was scared; perhaps he thought it best if she left. But she could hear her heart beating over the sound of the sirens and the traffic. It thundered in her ears as she pounded the pavement, desperate to get away from the one place she needed to be.

  There was no pursuit. Mia stopped a hundred yards from the parking lot, her heart in her mouth and her fists clenched so tightly she could feel the nails cutting the skin. Her breathing slowed, mirroring the calm of the air and the steady flow of cars in and out.

  She leaned against a wall, watching the road and the entrance, frozen with indecision. Ten minutes passed. She shivered but remained rooted to the pavement, tucked into the shadows, away from the line of cars parked against the kerb. A solitary street light flicked on, casting an orange glow across the street.

  A figure appeared, limping up the ramp from the parking lot before turning and heading towards Mia. Not staff; not medical. A young woman who dragged her leg, shuffling along. The street was empty – a lull in the traffic. No other pedestrians in sight.

  The woman crossed over. It wouldn’t be long before she walked directly past Mia. But the woman stopped. Mia saw a flash of keys in the woman’s hand, and then the parked car in front of her beeped, the hazard lights flashing against the tarmac. It was a dark-coloured hatchback, the interior light failing to come on as the woman opened the driver’s door.

  Mia stiffened. The woman’s face was visible in the faint glow of the evening sky and the street light. Mia saw what she wanted; what she needed. Staying in the shadows, Mia crept towards the car, hidden against the wall, stopping as the woman slung her handbag on to the passenger seat. Distracted, she didn’t look up, and Mia slunk past to the rear of the car, alert to the signals radiating from the woman’s laboured breath. Her sweat caught the air and flowed into Mia’s nostrils, lush and enticing.

  A patient in pain. Satisfaction would be hers.

  The driver’s door closed. Mia reacted, her desperation surging through her muscles as she grabbed the handle on the rear door. She jumped in, reaching forward and dragging the woman by her hair into the back seat.

  She had the presence of mind to slam the door just in time to stifle the first scream.

  CHAPTER EIGHT

  Alex squinted in the morning sun. The pathologist introduced herself as Dr Hickman. Short and nervous, she threw a worried frown at Alex before leading them inside.

  ‘I’m the psych consult,’ said Alex, taking a small breath, feeling the energy drain from his legs. The smell in the morgue was hard to pinpoint, like a battle between bleach and death. Neither was winning.

  Hartley had called him early that morning. There was another body. A violent death at City Hospital during the night.

  They’d met at the station and taken Hartley’s car. Alex was surprised to find she drove a new BMW coupé. He realised he shouldn’t have been. Why shouldn’t a senior detective appreciate a fine car? She didn’t hold back on the speed either, and Alex felt a little less guilty about the way he drove around London in his Merc.

  Dr Hickman nodded, her frown disappearing. ‘That’s good,’ she said. ‘The person who did this needs help.’

  They headed straight into one of the examination rooms. Alex saw two metal autopsy tables, one empty, the other with a female body lying on it. The body was pasty and grey, but with dried blood covering a large amount of the skin.

  ‘We brought her out of the cold chamber a few minutes ago,’ said Dr Hickman. ‘I’ve done a preliminary exam – we’ve photographed and taken hair, fingernail scrapes, fibres and an internal. She was mostly naked when they found her, her clothing ripped. We haven’t cleaned her yet, hence the blood.’

  Alex swallowed, trying to get the taste of the air out of his mouth. He lingered behind Hartley, who stood with the pathologist next to the table. Alex saw that the dead woman’s hands were bagged, standard procedure for a murder investigation, but the sight of it still made him shudder. This wasn’t a person any more, it was a crime scene and a collection of potential evidence.

  ‘Post-mortem?’ said Hartley.

  ‘Scheduled for tomorrow. I wouldn’t usually invite the police in at this stage, but I thought you’d want to see the injuries beforehand, given the alert you put out.’

  Hartley nodded, holding her hand to her mouth before taking a deep breath. Alex sidled closer, praying this would be quick. He’d avoided looking at the body thus far. Now he had no choice.

  The woman looked to be in her twenties or thirties. Slim with dark brown hair. Her features were hard for Alex to determine. His heart thudded in his ears.

  ‘The fatal injury was this,’ Dr Hickman said, pointing to a narrow slit through the woman’s left breast. ‘Possibly a penknife, straight through the heart. No puz
zle there.’

  Hartley leaned in to look at the knife wound. Alex stared below it, at the woman’s stomach, trying to avoid her face. He saw a young woman, killed in the prime of her life. He wanted to cover her in a sheet, hide her away, comfort her loved ones.

  ‘The more disturbing injuries are the non-fatal ones,’ said Hickman. She pulled out a biro and moved around the table, starting at the woman’s groin. ‘Her genitals are mutilated, ripped and bruised. Quite significant damage.’

  ‘Rape?’ said Hartley.

  Hickman paused. ‘No,’ she said. ‘Not rape. In fact, I don’t think it was sexually motivated at all. The injuries are not typical of that type of assault.’ She moved on, her voice calm, her emotions held in check, Alex suspected, through experience and practice. Alex couldn’t hide his reaction quite so well and looked away, clenching his jaw. He had to count to ten before looking back.

  ‘OK?’ said Dr Hickman, pausing.

  Alex nodded. Hartley gave an unamused expression, but Alex could see her perspiring, her jaw clenched.

  ‘Both nipples have been ripped off,’ continued Hickman, ‘bitten, by the look of the tearing. I’ll confirm at the post-mortem. Her armpits are gouged and bruised, and her stomach – her solar plexus – it looks like it was punched repeatedly with a fist. See this marking here?’ The doctor glanced at Hartley. ‘A small fist, I might add.’

  ‘Moving on, her fingertips have been bitten and three fingernails cracked, again with teeth. Her ear canals have had forced entry – perhaps a finger inserted . . .’

  Alex had had enough. He stepped away and turned. The room spun, vertigo gripping him.

  ‘Sorry,’ he murmured. ‘This is, uh . . . I might need some air.’

  The doctor paused. She seemed to consider things, then put her biro back in her pocket.

  ‘There are further injuries,’ she said, ‘to the feet and knees, but they are less severe. She appears to have a swollen ankle from a previous injury.’

  ‘We’re tracing her movements to see if she was a patient at City Hospital,’ said Hartley, turning to look away from the body. ‘But those wound locations . . . All of them are clusters of nerves, hypersensitive to pain.’

  Dr Hickman nodded. She looked impressed. ‘Yes. Obviously, the genitals, but these other injuries would also have caused intense pain.’

  ‘You’re sure all of these were inflicted before death?’ said Hartley.

  ‘Yes,’ said Hickman. ‘Absolutely. My full report will be available after the post-mortem, but that’s about the size of it. This woman was extensively tortured before being put out of her misery.’

  Alex sucked in the fresh air of the parking lot. He was shaken and had given up trying to hide it from Hartley. She gave him a few moments, stepping aside to check her phone.

  Alex had seen a lot of dead bodies during his work with the police. His cases had ranged from domestic abuse and fratricide through to serial killers like Victor Lazar. Alex had always tried to maintain a professional distance, assuming with his training that he could apply his techniques to himself. As he reached into his pocket for another Xanax, he realised he was far from being able to achieve that. He hid the pill from Hartley, slipping it into his mouth, slumping against the side of the car.

  He stared at the tarmac, watching a crisp packet drift between the tyres. A cat scooted out from its hiding place and gave chase. It brought light relief to the sickening churn of his stomach. He saw the mutilated body in the morgue. He thought of Grace and Katie. He thought of his mum in her nursing home, her mind gradually slipping away. He thought of his father’s death at the hands of a suspect Alex should have stopped. He spiralled.

  ‘Alex.’ Hartley tilted her head, looking concerned.

  Alex cleared his throat and his mind cleared. Back in the moment.

  Hartley unlocked the car and they headed back to the office. She drove more sedately on the return journey, perhaps herself affected by what she’d seen.

  ‘We had a possible sighting,’ she said. ‘Our suspect outside City Hospital yesterday.’

  ‘What time? Before or after that young woman was murdered?’

  ‘Before, and in the vicinity, spotted in the underground parking lot. The description matches, broadly. A nurse found her. He said the woman’s arm was injured, taped up; he assumed she was a junkie. She got spooked and ran off and he reported it to Security.’

  Alex pondered. He considered the victims so far, the injuries and the sickening methods employed by the killer.

  ‘It’s about pain,’ he said.

  Hartley turned. ‘Torture, sure. A sadist. My question is why, Alex?’

  He didn’t answer immediately, trying to untangle his thinking. ‘That’s why our suspect goes to hospitals – they’re an easy place to find injured people. But there’s something else . . .’ He paused. ‘Hospitals are staffed and busy. Most have security. Why risk it? If all you want to do is hurt people, why not do it in a dark alley? Avoid the crowds . . .’

  ‘Like she did to that woman in there?’

  ‘If it was our suspect.’

  Hartley shrugged. ‘The forensics unit isn’t finished with the car yet. We’ll see what we can find.’

  Alex nodded. Perhaps Hartley was right: this was nothing more than a sadistic killer on a rampage. He just couldn’t shake the feeling that he was missing something.

  They pulled into the Met parking lot, both deep in thought. Hartley excused herself and hurried off, already on another phone conversation.

  Alex paused and hung back. Hartley was giving him time and space, but he’d need to start earning his money soon. The problem was that he had so little to go on. To determine a psychological condition and motive behind such acts required more than the evidence presented so far. Alex was at a complete loss.

  He pulled out his phone and dialled. It was answered on the fourth ring.

  ‘Hi, Alex.’ Grace’s voice was warm. It seeped into him, tempering his anxiety, allowing him to escape the vision of the last hour. ‘What can I do for you? Katie’s at a friend’s, sorry. You can call or text her?’

  ‘It was you I wanted,’ said Alex. ‘No, nothing. I just wanted to . . .’ His throat closed, a lump forming. He still found this so hard but he wanted to hear her voice. He needed it. His family was the only thing that kept him sane, even if they did it from a distance.

  ‘Are you OK?’ Concern crept into Grace’s voice.

  ‘I love you, Grace, and Katie. So much,’ said Alex, taking a gulp of air. ‘I’m not . . . you know. I’m not trying to suggest anything. I know you have your life . . .’

  ‘Alex—’

  ‘I wanted to tell you. That’s all. Just to let you know. I’m here for you if you ever need me.’

  A few moments of silence. He heard Grace sniff.

  ‘Thank you,’ said Grace finally. ‘It means a lot.’ She paused again. ‘We love you too.’

  Alex found himself nodding, a smile escaping at the corners of his mouth. His jaw remained clenched.

  ‘We’ll talk soon, OK?’ said Grace.

  ‘OK,’ he said. Grace hung up and he did the same.

  Turning into the wind, his eyes watered. He sniffed until the tears stopped forming, and then headed back into the office.

  CHAPTER NINE

  Three and a half thousand miles north-east of London, an icy wind crept through the open door of a wooden cabin. The cabin stood isolated on top of a hill, overlooking a complex warren of squat concrete buildings, each connected by covered walkways, each rooftop thick with snow. The buildings sat hidden in the middle of a forest clearing in the shadow of the Ural Mountains, the native Siberian larch trees surrounding the complex like a protective blanket of white and green. The protection was intentional, for this complex was not on any map and its true purpose was not in any government file or account. Very few people came this far north, which was exactly why the directors had chosen the location.

  The man in the cabin doorway paused, dusting off his th
ick jacket, pulling the hood down to reveal matted black hair and a thick beard. Flakes of snow drifted from the fur hood, melting as they hit the wooden floor.

  ‘Shut the bloody door.’ A voice from an armchair, near the window, which was set at an angle to the roaring fire and gave the occupant a clear view of the room. The usually warm voice of the young woman who occupied the cabin was cold and tense. She knew something was wrong. She’d already packed her few belongings in anticipation.

  The man snorted, but obeyed, turning to slam the wooden door behind him. He remained where he was, dripping, thawing after the short trek up from the complex. The woman in the chair had watched him through the window, insisting he came to see her, to speak face to face.

  ‘It’s getting complicated,’ said the man. He paused, stomping his feet on the floor, leaving a puddle of dirty water.

  ‘I forget when life was simple,’ said the woman. She didn’t look at the man, preferring to stare out of the window at the grey skies.

  ‘Not just the girl. There’s another party involved. They said you should know. They said you must—’

  ‘Who?’

  The man paused. He pulled out a notebook from his jacket pocket, unfolding the cover and turning several pages.

  ‘Dr Alex Madison.’ The man pronounced the name with care. ‘The UK police are using him. He has been under observation for some time now. Apparently, he . . . Apparently, this is . . .’ The man struggled for the right words. ‘It’s your problem to deal with.’

  If the woman was surprised, she hid it well, her eyes barely wavering from the window. Only a person who knew her history would have seen the flicker, the recognition and the emotion that crept up through the cold. Dr Alex Madison. She curled the name on her tongue, enjoying the memories it triggered, scared at what the future held in store.

  ‘When?’

  ‘Now,’ said the man.

  The woman’s head snapped round, her eyes boring into his. The man swallowed, glancing at the floor. ‘I mean,’ he stuttered, ‘the message I was given was for you to leave immediately.’