Pain

by Adam Southward

  Mia didn’t waste any time. She pushed the door and the woman into the hallway, stepping round and slamming the door behind her.

  The woman staggered and backed up against the wall. Mia looked into her face and was immediately struck by how ill the woman looked and the radiation of pain from every feature. An oxygen tube fed her nose, secured around her neck, plugged into a cylinder on a trolley next to her. The woman’s eyes were bloodshot and weeping. She trembled with fear.

  Mia resisted. Such wonderful, gorgeous pain was emanating from this woman. She smelled it in the air, on her breath and in her sweat. This was not what she had intended. This would not end well.

  ‘Kim Norris?’ said Mia, struggling to get the words out.

  The old lady nodded. Her hands fidgeted. She opened her mouth to speak but gasped instead, drawing a long slow breath. Her chest rattled. The oxygen tube hissed.

  ‘Do you know me?’ Mia brought her face to within inches of the woman.

  Kim Norris continued to shake but appeared to examine Mia’s face. Her eyes dropped, taking in Mia’s body, clothing, everything. Mia watched her eyes very carefully.

  The frail woman’s eyes found their way back to Mia’s. The two stared at one another for several seconds before Mia blinked and moved her head back.

  This woman didn’t know her. Every sign and movement told Mia she was a stranger to this woman. She cursed and rummaged in her bag.

  ‘Do you know this man?’ Mia showed her one of the bank statements, pointing to the name at the top, Dr Paul King.

  The woman squinted at the name, but her facial expression said it all. Mia knew before she said it.

  ‘He was my doctor,’ whispered the woman, her voice cracking.

  Mia paced the hallway, walking in circles. ‘Are you a doctor?’

  ‘No,’ whispered the woman, frowning in confusion. ‘I was his patient. He treated me. I have pulmonary fibrosis. Late stage . . . as you can possibly tell.’

  The woman’s initial fear was fading. Her pain, however, was intense. Mia closed her eyes as tightly as she could, counting the seconds until her urge subsided.

  ‘What did he treat you for?’ said Mia. Her visit had been a failure. She should leave, run away before she succumbed.

  The woman indicated a door off the hallway. ‘Do you mind if I sit? I get dizzy.’

  Mia nodded, watching her wheel the oxygen through the door, following closely in case she tried to make a call. Mia hadn’t checked if anyone else was in the house, but if there had been, they would have appeared by now.

  ‘He never treated me,’ said the woman, sitting in an old floral-patterned chair. ‘He said I wasn’t a good candidate.’

  Mia stood in the doorway. Any closer and she’d be lost, committed. If she hovered, if she left, this woman might be spared the rest of her life, however short it might be.

  ‘Candidate for what?’ Mia could see the woman’s hands clasping into fists, trembling. Waves of pain flooded her every second. It was delicious. Mia’s breathing slowed. She panted, once, then again. She was falling and didn’t know how to stop.

  ‘My pain,’ whispered the woman. ‘He said he could treat my pain. He said he could make it go away.’

  CHAPTER EIGHTEEN

  Laurie didn’t call for two days. Alex made good use of the first day, catching up on his private appointments and paperwork. The second day he moped at home, trying and failing to think clearly about the problems in front of him.

  With Grace and her new man at the back of his mind, he tried to throw himself into his analysis, reviewing everything the police had collected so far. He watched the CCTV again, noting the suspect’s movements and her mannerisms, looking for any clue that might help. He re-read the witness statements of the bus driver who’d hit her and the porter who’d found her standing over a patient.

  He stared at the blank page in his notebook, tapping his pen at the top, producing nothing more than a row of neat ink dots.

  The police had gone into overdrive. Standard lines of inquiry and procedure were being followed with double the staff. Laurie was busy herding the team, but Alex could tell she was waiting for him. Waiting for Alex to give her a clue, some insight into this warped mind.

  Pain. Alex wrote it at the top. The one thing all the victims had in common was the level of suffering inflicted on them. She didn’t just kill, she tortured. So simple, yet to inflict it on others she must be driven by some overwhelming need.

  The rational reasons for doing such a thing had been more or less ruled out by the police. They’d gone around in circles looking for gang affiliations and criminal connections of the victims, but they all came up blank. It was reasonable to conclude at this point that the acts were irrational, driven by psychosis. Alex agreed, but it meant the pressure was on him to offer some theory to back it up.

  Why pain? What did pain offer the killer?

  Sadistic killers were well documented and profiled across the world. A truth often hard to swallow in civilised society, sadistic minds were far more common than most people would like. They weren’t all killers, and in fact only a very small percentage of sadists physically hurt people. But sadistic tendencies – the enjoyment gained from hurting others in order to make themselves feel better – lay at the heart of the sadist.

  And that is what Alex believed they were dealing with. He wrote Sadist underneath Pain, adding a double question mark.

  To inflict pain on someone in order to see the victim’s reaction. The screams, the trembling physical reaction. The tears and the terror in the eyes. Some sadists enjoyed the begging and pleading for mercy – it bolstered their ego and self-worth. They believed themselves godlike in having complete control over a helpless victim. This tallied with most of what he’d seen. The victims in this case suffered terribly, their torment ending only in death.

  Something bugged him, though.

  Double lives. Alex scribbled it down, pondering. Most sadistic killers had double lives and could control their switch from one to the other. Seemingly normal professional people presenting sales figures in a corporate office by day could be planning their murders by night. Such double lives were part of the control process.

  So far, the police knew nothing else about the killer. The prints weren’t on file and neither was the description. Perhaps she was a software engineer or a lawyer or a teacher. The last thought sent a brief shiver down Alex’s neck. But the appearance of being normal was what enabled these killers to find their victims.

  This bugged him too. He made a mark next to his notes. This killer didn’t need to know her victims. She wasn’t pretending to be normal to get close to people – as far as they knew, anyway.

  Rituals. Alex wrote the word with another question mark. Predatory and meticulous in their planning, sadists typically knew well in advance the what, the where and the who. Some killers had been known to script their murders like a screenplay, planning every word, every movement and their timing.

  And that was the main issue Alex had with a standard sadist profile. It didn’t fit. Every single victim in this case was already in pain from some other cause. Their killer found people in pain – and inflicted more. Puzzling. Inexplicable.

  To make matters more confusing, the planning was not meticulous. She seemed to hit inner-city hospitals, but the victims could only be there by chance. There was no way she could know who would be in the emergency departments or the other wards ahead of time. That sort of information simply wasn’t available to anyone, not even to the nurses in the hospitals, according to the reports.

  So the victims were chosen at random, but all had been in pain already, except for one – Dr King, the surgeon she’d murdered in his office. Why him? Why had she deviated from her usual routine? Perhaps the location of her crimes wasn’t purely opportunistic after all. Was she drawn to these hospitals for some other reason?

  Alex thought about Dr King and the theft of unknown materials from his office. He double-underlined this note on the page.


  He drifted, his mind wandering to previous patients, previous cases. An unpleasant memory reared its head and nudged around, jostling for position. Victor Lazar, the serial killer from his last big case, and the horrific circumstances the man had suffered.

  What drives people to do such things? In Victor’s case, it was what had been done to him. The worst kind of abuse over his formative years, resulting in a monster who could identify himself as such but could not stop the urge to exact his revenge in the only way he knew how.

  Alex wondered what had happened to this killer. Nature or nurture, years of suffering or a snap in the night – a switch flicking on, turning one of those engineers, those lawyers or teachers into the monster they were now chasing?

  Alex was snapped out of his thoughts by his phone buzzing across his desk.

  ‘Laurie,’ he said, clearing his throat.

  ‘Meet me at City Hospital, thirty mins?’

  Alex checked his watch.

  ‘More like forty-five. News?’

  ‘Another victim. Kim Norris. Seventy-eight years old.’

  Alex winced. So many, so soon. The speed and frequency with which this killer acted was almost unprecedented.

  ‘In a ward?’ he said, wondering how the bolstered security would explain the lapse.

  ‘No. You’ll like this – this patient had been discharged from City Hospital many months ago. Pulmonary fibrosis. She was on her last legs.’

  ‘Fibrosis,’ whispered Alex. ‘In pain.’

  ‘What? Uh, yes. Probably. The only doctor available to comment gave us a brief overview. Horrible disease, and she didn’t have long.’

  ‘So what will I like about it?’

  ‘Her doctor. He’s our dead surgeon. Dr Paul King treated Kim Norris for her condition nine months ago but suddenly discharged her from his care. The clinical director at City Hospital is going to do some digging, but she wasn’t sure what Dr King was doing treating Mrs Norris in the first place.’

  ‘Why not?’

  ‘Because he’s a surgeon. You don’t treat pulmonary fibrosis with surgery, or at least only as a last-resort lung transplant. She wasn’t on the list.’

  Alex tried to join the dots.

  ‘Medical records?’

  ‘Nope,’ said Laurie. ‘The appointments are in the record, but if she had a care plan or consultation notes, they’re missing.’

  Alex leaned back in his chair, feeling the soft leather wrap itself around him. His heart thumped with the excitement that came with a breakthrough, however minor.

  ‘What are we missing?’ he said.

  ‘Plenty,’ said Laurie. ‘We followed up on Dr King. We have some colleagues we need to talk to, but the man kept himself to himself. We’re looking at professional affiliations and sponsorships.’

  ‘Sponsorships?’ Something about the term spiked Alex’s heartbeat. He’d been here before. ‘Relating to what?’

  He heard Laurie shuffling papers. ‘Not sure. Like most prominent surgeons, he was in demand, bombarded non-stop by private companies – pharmaceutical and medical device manufacturers.’

  ‘And?’ Alex caught himself, hearing his demanding tone. A wave of anxiety caught him by surprise, along with the sound of his father’s voice. You’ll never understand, Alex. You’ll never get it.

  ‘And I don’t know,’ said Laurie, sounding defensive. ‘This is your world, isn’t it?’

  Alex’s throat dried up. Why did memories of his late father pop up without warning? He knew why. Because of what they were discussing. It didn’t make it any easier.

  ‘I’ll be there in forty-five minutes,’ said Alex, hanging up. He dropped his phone on to the desk and reached into his jacket. Just one, he thought. Two a day, that’s my limit. He popped the pill into his mouth and forced himself out of the chair.

  Medical devices, pharmaceuticals. Sponsoring a surgeon in London.

  Sponsoring him to do what?

  Alex sent Laurie a text from the parking lot. Once again, she met him in Outpatients reception, leaning against the staff entrance, hands in pockets. Alex thought her face looked full of mischief and he found it relaxed him more quickly than the Xanax had done. He smiled and stopped in front of her, noting another sharp, fitted suit and a different pair of brogues.

  ‘Eyes up, Doctor,’ said Laurie, catching him.

  Alex blushed. ‘I was . . . You’re more smartly dressed than most detectives I know,’ he said, hoping it sounded like a compliment, as it was meant.

  Laurie smiled, genuine, the mischief fading for a moment. ‘And you’re a better-dressed doctor than most I’ve seen recently. Although,’ she said, indicating the waiting area, ‘most of the people in this place look pretty rough, so don’t take much from that. Come with me.’ She winked at him.

  ‘We’re going . . .’

  ‘. . . To see a colleague of the late Dr King,’ she said. ‘Dr Piers Tau. A somewhat reluctant interviewee. We managed to corral him in his office. I don’t think he can help us.’

  ‘You’ve spoken to him?’

  ‘Briefly.’

  They trod the same route as on their last visit. The hospital appeared back to normal, as it must, the daily patient lists full and the staff struggling to keep up. They headed past the pre-op bays and through the waiting area towards the surgeons’ offices.

  ‘The end office on the left,’ said Laurie, leading the way.

  It was a small but tidy room, one wall lined with bookshelves and filing cabinets, the other with pieces of odd abstract artwork. A man sat hunched over his desk, round-faced, with messy hair and a gut that looked as though it enjoyed the finer things in life. The doctor was scowling at the uniformed officer perched near the door. Alex noticed a large scar below the doctor’s right eye, pink and raised. He tried not to stare.

  ‘Thanks,’ said Laurie to the officer, who exited, pulling the door shut behind her.

  ‘Dr Tau,’ said Laurie, ‘so sorry to keep you waiting. My colleague here broke down on the way.’

  Alex caught his reaction in time, unsure whether or not to apologise. ‘Dr Madison,’ he said, extending his hand.

  Dr Tau shook it, his hand warm and clammy. ‘Dr Tau,’ he said. ‘Look, I have a full surgical list this afternoon. I can’t stay here chatting.’

  Laurie dragged a chair over from by the wall. Alex thought she made a point of taking several seconds to line it up with the desk before sitting. The frustration was evident on the doctor’s face. Alex remained standing, unsure what game she was playing.

  ‘You must be upset,’ said Laurie. She patted her jacket pockets before pulling out a small notebook and pen.

  The doctor’s eyes narrowed for a moment. Alex caught it.

  ‘Of course,’ said Dr Tau, ‘Paul’s death was tragic and, from what I’ve heard, horrific.’ The doctor’s voice cracked. He cleared his throat. Grief, thought Alex, or something else?

  ‘You were in surgery at the time,’ she said. It wasn’t a question, but Dr Tau nodded.

  ‘Yes. I’ve already told one of your colleagues.’

  ‘I know. My apologies,’ said Laurie.

  Alex watched Dr Tau. He fidgeted, picking at a fingernail. If Alex had been able to see the man’s feet, he was sure they’d be shuffling. His expression was tense, his jaw clenching and releasing. Not grief. This doctor was anxious as hell. Not the typical behaviour of an experienced surgeon.

  ‘We’re trying to get through all of his colleagues, build up a picture of his life, his contacts, et cetera,’ said Laurie.

  The doctor nodded, a glimmer of relief evident on his face. Why should he be feeling relief? The hairs prickled on Alex’s neck with a feeling of déjà vu. The feeling of seeing a doctor abusing their position of power.

  Laurie proceeded to ask Dr Tau a list of scripted questions, mainly about Dr King’s patients. Did they have any in common? Had he seen any acting strangely, appearing at the hospital when they shouldn’t? Any relations of patients turning up unexpectedly? Any unr
esolved negligence cases? Laurie ran on for several minutes before closing her notepad and nodding to herself.

  ‘Tell me about your sponsorships,’ said Alex. He could tell the question had caught Dr Tau off guard, his eyes shooting to Alex’s.

  ‘That’s none of your business,’ snapped the doctor. Laurie paused, glancing up at Alex.

  ‘I mean, it’s confidential,’ said Tau. ‘I can’t discuss my professional arrangements outside of my employment here.’

  ‘That’s not true,’ said Alex. ‘And anyway, my colleague here has already researched your affiliations with several medical suppliers.’

  It wasn’t a lie, but if Laurie had found out anything, she hadn’t shared it with Alex. He tried not to look at Laurie, focusing instead on the doctor’s face. Tau swallowed. His anxiety increased.

  ‘And we are the police,’ said Alex. ‘It would be better to share now, rather than in court.’

  Laurie’s head snapped around.

  Dr Tau paled. ‘Court?’ he said. ‘Don’t be absurd.’ He swallowed again, his mouth clearly dry with nerves. Alex could read all the signs. This man was fighting his panic.

  ‘Er, Dr Madison,’ said Laurie, ‘a word?’

  Laurie ushered Alex out of the office, apologising to the flustered doctor but telling him to stay put.

  ‘What the hell?’ said Laurie. She didn’t look angry, just confused.

  Alex paced in the dark corridor. The uniformed officer hovered at the other end.

  ‘He’s hiding something,’ said Alex.

  ‘He’s nervous.’

  ‘Why?’

  ‘Because one of his colleagues was butchered in the next office?’

  ‘That’s not it.’

  Laurie put her hands on her hips. ‘We’re not interrogating this surgeon,’ she said.

  ‘I’m not,’ insisted Alex. He paused. ‘But what did you find out about his relationships with medical suppliers, pharmaceuticals?’

  Laurie frowned. ‘Not much, Alex, short of searching his house and office. His name is mentioned against several clinical trials and research programmes. He’s a distinguished lecturer at the medical school. Much the same as our deceased Dr King. They’re both good surgeons. What can I say?’