Pain

by Adam Southward

  After another hour they both stood, knees creaking and backs aching. They’d searched the entire study top to bottom, twice over.

  ‘There are a lot of books on pain,’ said Laurie, examining the huge pile of texts and journals near the door. ‘Enough to make your head hurt.’ She wiggled her eyebrows at the pun.

  ‘There are,’ he agreed, ‘but he was a surgeon. So what?’

  Laurie sighed, leaning against the door frame, cracking her neck, tilting it at an awkward angle. She pulled a face. ‘You’re right. It means nothing. Medical textbooks in a doctor’s study. So what?’

  ‘There must be something,’ said Alex, scanning the room. No safe, no locked cabinets. If Dr Willis had secrets, they weren’t here.

  ‘I’ll call the office,’ said Laurie. ‘See if they’ve had any luck.’

  Laurie stepped out. Alex heard her speaking to the team in her usual cutting tone, although the weariness was still evident. Alex nudged the pile of books with his feet, exposing a thin journal, Global Neuroscience, Vol 12, 1981. The front cover led with an article titled The Neuroscience of Empathy. Alex didn’t recognise the publication but crouched to pick it up. Something about the age of the journal aroused Alex’s interest. He scanned the shelves and floor but couldn’t find any other issues.

  He flicked through a few yellowed pages, finding the article in question. The abstract was very technical, focusing on firing mechanisms in the temporal and frontal lobes of the brain, and didn’t make an awful lot of sense to Alex. He was about to discard it when he saw the list of authors at the bottom. He did a double take, his heart skipping a beat. King’s College: C. Anderson, G. Shaw, R. Madison et al.

  The last name. R. Madison at King’s College. There was only one at that time – Alex’s father, Rupert.

  It couldn’t be.

  Alex’s mind spun. Hyper-Empathy Syndrome: his father’s hand-scrawled note in an old textbook, now in Alex’s possession. And here a decade-old article on empathy, co-written by Alex’s father, lying in Dr Willis’s study. Alex suppressed his panic before his heart hammered through his chest. He couldn’t go there, not now. It was probably nothing – the scientific research community was a small world and there were many legitimate reasons why they’d refer to each other’s literature. It happened every day – it was required, in fact, to ensure credit and proper peer review.

  But what were the chances?

  He felt the dark shadow of doubt creeping in. His father had been complicit in experimentation on children in the seventies and eighties – psychological and pharmacological, working under the reputational protection of King’s College. Dr Willis was in possession of an article written by his father from the same time period. Just the one.

  The threads spun together in Alex’s mind, the connection staring up at him from the page. His father’s work had produced a serial killer, Victor Lazar. Dr Willis and his colleagues had produced Mia Anastos. Both individuals were products of illegal experimentation. Were they following the same path, albeit separately, or was this a link, however tentative, the significance and intimacy of which Alex struggled to comprehend? His father’s work could easily have extended beyond his deeds in the eighties. Beyond his death. There could be something else at work here. But what?

  ‘You OK?’ Laurie appeared at the doorway, hand over the mouthpiece of her phone. She looked quizzically at him. ‘You look like you’ve seen a ghost. Was it Dr Willis?’

  Alex stared blankly. Should he tell Laurie what he’d found? He looked down at the open journal. But what had he found? A reference to his dead father and an innocent note in a textbook. Laurie would probably dismiss it and call him crazy. He knew what she’d ask: would it help them find Mia? And the answer was no, how could it? No, whatever this was, it was circumstantial and personal. Alex would need a whole lot more if he was going to raise the lid on his father and everything that came with it.

  Laurie stared at him until he turned away, unable to hold her gaze.

  ‘Nothing,’ he said. ‘It’s nothing. I’m OK.’

  Laurie put her phone back to her ear, narrowing her eyes at Alex before turning away. ‘There you are!’ she yelled into the phone. ‘You didn’t think it useful to call me an hour ago?’ She listened for a few moments. ‘I’m coming in. Have the files ready for me. Nobody else reads them, OK?’ She then did her best attempt at slamming the phone down while on a mobile, pressing the call-end button with a flourish.

  Alex waited. His heart rate slowed, his mind cleared. He buried it, like he always did.

  ‘OK,’ she said. ‘The team found mostly the same stuff from his office at the hospital – texts, journals, loads of boring shit.’

  ‘And?’

  ‘And seven patient records in blue folders tucked away behind one of the cabinets. They weren’t registered with the main hospital records – as far as the hospital was concerned, the patients had never been treated there.’

  ‘And . . .’

  ‘One of the patients is called Mia Anastos.’

  CHAPTER TWENTY-FOUR

  The urge hit her out of the blue, descending with a violent wrenching into her stomach. Mia’s addiction didn’t creep this time, it leapt, grabbing her head in a cruel vice, spinning it with desire and adrenaline.

  Despite her actions over the last few days, satisfaction had eluded her. She’d hoped perhaps it had faded or at least subsided for a time.

  She was wrong.

  The final name in the address book would have to wait. She couldn’t chase anyone in this condition. Even if she found them, there would be no answers, only pain.

  Only death.

  Mia paced the warehouse, having enough presence of mind to wash and dress properly. Her shaking hand applied lipstick and a little make-up. It smudged, but it was acceptable. Better than the drawn, pasty skin she wore today. The bags under her eyes could be partially hidden. Hidden enough.

  A quick fix, that’s all she needed. Could she risk taking somebody off the street? A café or a bar? No. She’d done that once and got lucky, but Lady Luck did not smile on people like Mia. Cruel monsters got what they deserved.

  Locking the warehouse door, she prowled, heading south, unsure which location to head for. St Thomas’s or Guy’s? Both massive, easy to blend into, easy to find a secluded cubicle in.

  But they’d be watched, wouldn’t they? Mia wasn’t naive. They might not know what she looked like, but they knew she was coming. She’d been careless and had left a trail. Her months of secrecy had come to a crashing end the night she was discovered by the porter and hit by the bus. That night was the beginning of the unravelling, and Mia could see no end to the thread.

  It wouldn’t end until she had answers.

  Mia navigated through the crowds, shuffling through, trying not to be noticed. Was she still pretty? Doubtful, and today she wore it badly. Her face was twisted with cravings, her jaw clenched, teeth grinding. Her clothes were clean, but she stooped, hunched with a stiff back and tense neck muscles.

  She watched one man as he walked towards her. His head turned her way but didn’t linger, turning back just as quickly. As he passed close by, Mia caught a whiff of unease and discomfort. The man limped, not visibly, but his muscles were sore and his right hip ached.

  He disappeared into the crowds. Mia slowed, breathed, but forced herself onwards. There was no way she would take somebody in public. Not worth the risk.

  Mia’s sense of direction was good. Without realising, she was veering towards the centre and St Thomas’s. She’d rock up and pause, watching and waiting. Her desire was flowing around her, causing muscle spasms and nausea, but she could hold on, as long as she had her fix today.

  Cutting down a side street, she weaved in and out of scaffolding. The crowds stayed on the main street and she found herself in relative quiet, the background din of traffic echoing off the high buildings, several under construction, the white guard sheets wrapping the scaffolding plastered with logos and safety warnings.

&nbs
p; Mia was halfway along the street when her ears pricked up. A faint call from within one of the buildings caused her to pause. The call came again. It was familiar and sensual, the call of alarm and fear.

  The call of pain.

  She turned towards the scaffolding. The darkness beckoned. The noises within tugged at her heart, drawing her off the pavement and into the building. NO ENTRY WITHOUT PROPER EQUIPMENT, she read off the sign as she passed it by. Mia needed no equipment. Her ears heard the faint calling, the foreplay, and she continued inwards.

  The calls became clearer. The building was huge and Mia picked her way through stacks of plasterboard and gantries. The area was empty, devoid of any workers. Pushing a layer of transparent sheeting to one side, she found herself in a large atrium, dark except for a floodlight in one corner. Groans came from one side. She saw a body, prone, with a second crouched over it.

  The crouching man heard Mia and spun around. ‘Help! Call an ambulance.’

  ‘What happened?’ said Mia, approaching the two figures. They were both male, dressed in workwear, harnesses and hard hats. The injured man looked like he’d fallen from a great height, perhaps landing on his feet. Mia saw a gantry twenty feet above, tracing the line to the ground.

  ‘He came off the platform,’ said the worker, still crouching over his colleague, concern creasing his brow. ‘There’s no signal in here,’ he said, indicating his mobile, which was on the floor near his boots. ‘Please call an ambulance. I think he’s broken his leg. His back’s crooked. Hold on, mate,’ he said to his friend.

  Mia went closer, staring at the man on the ground. He was still conscious, his head twisted sideways, sweat pouring from his face. She concentrated, tracing the waves of pain coursing through his body. The main impact had been on his left foot, on which he must have landed. His ankle had snapped, the tibia fracturing. The blood soaking through his trousers suggested an open wound. His knee had popped out too but had taken enough of the impact to save the main thigh bone, the femur. But the pain didn’t stop there. Through his hips, possibly fractured, his spine was in trauma, pulsing with blood. The mixed sensations, apart from the pain, caused sudden and uncontrollable panic. His mind was spinning in a world of hurt.

  Mia was beside herself with excitement.

  ‘I’m a nurse,’ she said to the fallen figure. She glanced at the face of the concerned worker. ‘What’s your name?’

  ‘Steve,’ said the man. He looked in shock, his eyes darting between Mia and his friend, who groaned again, a deep, throaty noise that sent shivers through Mia’s body.

  ‘Go outside and call an ambulance, Steve. There’s no signal in the road either – you’ll have to get to the main street. I’ll stay and stabilise him.’

  Steve didn’t protest. He jumped up and ran towards the exit, pausing before running back for his phone.

  ‘Wait for the ambulance outside, Steve,’ said Mia. ‘You’ll need to guide them in. Don’t rush. Better to get this done properly. Your friend will live if you take your time.’

  Steve took a deep breath, pulling his shoulders back. He nodded and paced towards the exit, not running this time.

  Mia stared at his back.

  ‘We don’t have long,’ she whispered to the injured labourer, ‘but your pain will be gone soon. I promise.’

  CHAPTER TWENTY-FIVE

  Alex separated the entries by date and laid them on the desk. Laurie had commandeered a conference room and they locked themselves in with the patient records recovered from Dr Willis’s office. Placing six of them to one side, Alex spread out the contents of the folder with Mia’s name on the front. It was disappointingly thin – ten loose sheets of paper in total, far short of what Alex would expect in a full patient record.

  ‘Still nothing on Dr Tau?’ he asked, lining up the papers with the edge of the desk. He plucked a few clumps of dust from them and flicked them on to the floor.

  ‘Nothing,’ said Laurie, ‘and nothing from his office. If he had any records, he took them with him.’

  Alex remembered their interview. Dr Tau had clearly been agitated. He didn’t push Laurie on how hard they were looking for him. The doctor was merely ‘out of town’ and wasn’t a suspect in any crime. That was the official line Laurie was sticking to. Alex got the impression she was under pressure from above. The screw-up with her previous case was inviting additional scrutiny. Alex felt for her, glancing up. Their eyes met for a moment too long. Alex tore his away and placed his hands on the edge of the desk.

  ‘So here she is,’ he said. ‘Mia Anastos. Demographics: she’s recorded as twenty years old, but if she’s illegal then this may all be wrong. She may be younger.’ He huffed. ‘Address?’

  ‘Doesn’t check out,’ said Laurie. ‘The property has been empty for the last three years, according to the development company that owns it.’

  ‘So we can assume most of this is false.’

  ‘No photo,’ said Laurie.

  Alex shook his head. ‘Hospital records don’t, as a rule. Images from tests will be in here – if she had an X-ray, MRI or CAT scan.’ He sifted through the notes. ‘But there aren’t any. Perhaps he had them in his home office. But whatever was there . . .’ Alex left it hanging, not needing to say it.

  ‘What’s that?’ Laurie pointed at one of the sheets – faded green paper. The header had Nova AG Pharmaceuticals stamped at the top.

  ‘It’s a prescription.’ He examined it in more detail. ‘No, it’s not, but it is a list of drugs. Never heard of them,’ he said, touching the logo. ‘There are only a few big pharmaceutical companies in the world, but thousands of small specialists. This must be the sponsor.’

  ‘I’ll look them up,’ said Laurie, tapping away at her laptop. Alex scanned the list of drugs, not recognising them. Proprietary brands, he assumed.

  ‘Funny,’ she said, clicking through the first few pages of search results. ‘No results for Nova AG.’

  Alex shrugged. ‘They may not be public. It might be a subsidiary business. I’m more concerned about what they were up to.’

  Laurie pushed her laptop to one side.

  The demographic sheet was probably useless, so Alex moved on to the reasons for current visit – that is, why Mia had been at City Hospital in the first place.

  The report was brief. Road traffic accident, car overturned, trauma to lower abdomen and spine. Internal bleeding. Unconscious during conveyance by ambulance, but regained consciousness shortly after arrival.

  The report stopped there.

  ‘These are copies,’ he said, searching the desk, ‘and they’re incomplete. There should be more.’

  ‘What?’

  ‘The examination and findings in emergency triage. It should be right here.’

  ‘So what’s this?’ Laurie tapped the next loose sheet of paper. It was in the format of a management plan, where doctors would normally set down the agreed actions, stating the diagnosis and initial treatment plan. For Mia’s record, it simply said Threshold achieved – Nova trauma pathway.

  ‘Threshold for what? Nova?’

  Alex chewed the inside of his cheek. He reached for his coffee cup. It was empty, with brown stains around the rim.

  ‘Pain,’ he said. ‘Pain threshold. It’s what Dr Willis said. She met the criteria.’

  ‘You sure?’ said Laurie.

  Alex shrugged. ‘What else have we got?’ he said, aware there was very little of substance in what they had in front of them.

  ‘We’re still hunting the police records,’ said Laurie. ‘It’s a manual process.’ She looked peeved at her department’s inability to speed things up.

  ‘Can’t you just search by the date written on the hospital report?’

  Laurie’s jaw dropped rather dramatically. ‘Genius,’ she said. ‘Why didn’t my detectives think of that?’

  ‘The date on this is false,’ said Alex, his face flushed.

  Laurie gave him a wink, returning her gaze to the desk. ‘These last three pages are handwritten,’ s
he said. ‘All headed Nova Pathway.’

  Alex pulled them towards him, starting at the first, skimming the text. ‘This isn’t a proper record,’ he said. ‘Not standard terminology – it’s opinion. Dr Willis’s, I’d bet. His impression of the treatment.’

  ‘Which was?’

  ‘Let me see.’ Alex scanned down a third of the way. ‘He talks here about preparation. 14:00 The Nova rep was in the room; inappropriate, he writes. He spoke into a voice recorder in English then in Russian. He makes several notes about the surgery prep and his impressions. He wasn’t happy, by the sound of it.’

  ‘Nova rep?’

  ‘A representative from the pharmaceutical company was in the theatre.’

  ‘Is that normal?’

  Alex considered it. His limited experience of clinical trials suggested that yes, the drug companies were part of every stage. They funded, sponsored and ran a lot of trials end to end. Such actions were, however, strictly controlled by the industry. Everything had to be published in advance, including the names of the participants. ‘It doesn’t say who, just that they were part of it. That’s normal, I guess.’

  ‘What else does it say?’ Laurie shuffled her chair in closer.

  ‘Um, hang on. Page two covers the procedure – emergency surgery followed by the Nova drug programme. Page three is observations . . . Let’s see. The rest appears to be a log, journal entries of the subsequent days.’ Alex leaned back, scanning the rest of the pages. ‘This isn’t a patient record. This is what Dr Willis kept secret, for himself. His log. It was never meant to be read.’

  Laurie nodded. ‘Insurance?’

  ‘Possibly. Perhaps he was in over his head.’

  Alex read from page two. ‘Driver DOA. Father? Possibly. Shipped over to St Thom’s morgue, tagged as homeless. Second passenger: Mother? Severe abdominal haemorrhage. Terrible state. Didn’t meet criteria or threshold. Sent to Barts with no ID. (Should I follow up)?’

  ‘They sent her family to other hospitals?’ Laurie’s face dropped. ‘Bastards. What the hell did they think they were doing?’