‘Er, I’m not sure I quite remember how it was arranged …’ she began, following Nanny up the shallow wooden staircase to the upper landing. Three doors ran off it and the old woman turned and peered at George when they reached the first of them.
‘Oh, well, I know how it is,’ she said indulgently. ‘With the whole family worried about the poor girl it’s natural enough. Now come along in. I’ll open the curtains.’
The room was dim, and smelled of disinfectant. Dettol, thought George, and was taken back in an instant to her childhood when minor injuries were treated with the pungent stuff. It’s the essential hospital smell, she thought, and watched as Mrs Lyons turned back from the window and looked at the bed. She’s recreating her past. She’s got a patient and she’s trying to treat her the way she was taught to with Dettol and darkened rooms.
Now she too looked at the bed and managed somehow to keep her face expressionless. The woman who lay in it was on her back, her head and shoulders propped up on three pillows set in an armchair fashion. Her hands were resting on the covers, and her head was neatly centred on the pillow. And both hands and face were emaciated to a very marked degree. This woman, George thought as she moved forwards, is starving.
‘How long has she been like this?’ she asked sharply, bending her head and looking at Marietta’s face more closely. There was a hectic flush on her cheeks, and the eyes were not fully closed, showing a white rim. Gently George raised one eyelid with her forefinger. The eye did not move, but stared sightlessly ahead. The woman was clearly deeply unconscious.
Nanny Lyons peered at her through her heavy glasses. ‘Sleeping like that? Oh, it’s been, let me see, three days now. I got fretted at first, I thought she was sleeping too much, but he said it was all right, she was supposed to be like that on this medicine.’
‘Who said?’ George asked, and her tone sounded sharp even in her own ears. But instead of it alarming Nanny Lyons, it seemed to make her stand more erect and become more professional than ever.
‘Mr Jasper,’ she said. ‘He showed me the pills what the doctor in the hospital gave her, and I checked the label and it said they were for her.’ She put her hand in her apron pocket and pulled out the bottle. ‘Here they are. You can check, doctor.’
George took the bottle, opened it and spilled the contents into her palm. They were large gelatine capsules, half blue, half green, and she frowned, trying to remember what they were; they had a vaguely familiar look. The label read only, ‘The capsules. Three to be taken every three hours.’ The last phrase was the easiest to read, though in general the label looked old and rubbed. George frowned again.
‘I said to him it was a heavy dose. I thought, I mean, I’m used to two of anything every four hours, but like he said, times change and new methods are used.’
‘This doesn’t look like a new label.’ George was talking almost to herself. ‘It’s undated, there’s no name of the drug on it, and there always is now. This was how things used to be dispensed …’
She looked again at the capsules and then caught her breath. Tuinal, she thought. Tuinal, a heavy barbiturate. There’d been a suicide, she remembered, whom she’d autopsied, who’d taken a massive overdose using similar capsules that she’d had in her medicine cupboard for many years. That was when she’d last seen the drug. ‘No wonder this label looks so old,’ she said aloud. ‘This drug hasn’t been used for years because barbiturates are now known to be so dangerous. They’re the last thing you would want to use for a deeply depressed patient.’
‘I’m sorry, doctor?’ Nanny Lyons said, unable to hear for George had spoken in a low voice. ‘What did you say?’
‘It doesn’t matter,’ George said. She put the capsules back in the bottle and turned to look at Marietta and put her finger on her pulse. It was thready, rapid and there were occasional missed beats. Not good, George thought. Not good at all. This woman needs special care and needs it fast. ‘Mrs Lyons,’ she said carefully. ‘I’m very worried about her. I think she ought to be in hospital.’
The old woman’s face crumpled as she stared back. ‘In hospital? She won’t get better nursing there than what she gets here! What modern nurse knows you can take medicines like that and open the capsules to dissolve the stuff inside into dextrose and water and give it per rectum? They wouldn’t have the sense! They don’t know, for all their university degrees. That was why Mr Jasper brought her to me. She was in a hospital and they treated her so bad she was wretched there. Doesn’t she look lovely and comfy! Not a mark on her. Most people in this state gets bedsores, you know, these days. I’ve heard how they don’t do proper back care any more. But I’ve rubbed her back and made rings for her heels and elbows so she don’t get pressure sores there, and –’
‘It’s not nursing she needs,’ George said gently. ‘You’re doing that splendidly. It’s medical care I’m worried about. Please let me arrange for her to go to hospital.’ And then she had a brilliant idea. ‘You can go with her as her special nurse, if you like. I’m sure that’ll be all right.’ Anything, she thought, she would have promised her anything to get Marietta out of the house and into safe medical hands. ‘Would you like that?’
Nanny Lyons looked unsure for a while and then at last, nodded. ‘Well,’ she said. ‘If you’re sure, doctor.’
‘Oh, I’m sure,’ George said with supreme confidence. ‘I’m a specialist in cases like this, you know. I really do advise it. Doctor’s orders, you see.’
‘Well,’ said Nanny Lyons, straightening her back again. ‘Of course that’s that then, isn’t it?’
33
George carried Marietta to the car without too much difficulty. She was as light a burden as a human could be; if she weighs as much as forty kilos it’s a lot, George thought, and gently lowered her into the back seat, alongside Nanny Lyons who was already ensconced there and looking very anxious.
‘Now, Mrs Lyons,’ she said. ‘She’s well wrapped up and I’ve got the car heater on full blast, but you make sure she stays well covered, and of course that her head doesn’t loll too much. We have to keep her airway open.’
Nanny Lyons nodded seriously and put her hand behind Marietta’s head to hold it forwards; she was clearly too occupied in doing as George told her and worrying about Marietta to think of anything else. And George, running back to the house to close the door and pick up her bag, and then hurrying back to the car, was grateful for that. Clearly Mrs Lyons had been told no one was to know Marietta was at the house, let alone allow anyone in to see her; that had been made clear by her behaviour from the moment George had arrived; soon she would remember her instructions and perhaps get agitated. And Marietta was enough for George to cope with at present.
She drove into the town carefully, checking Marietta constantly through the rear-view mirror. Nanny Lyons, in a very old nursing uniform coat and matching hat, which she wore well down over her forehead, sat beside Marietta very uprightly and holding her head steady with one hand while holding on to the unconscious woman’s shoulder with the other to stop her rocking as the car turned corners. It was not a comfortable journey for George, either.
She found Durleighton’s one hospital easily enough – it was clearly signposted – and parked the car outside on the gravel and ran up the steps to the main entrance. There was the usual surly man in the porter’s lodge there who put his head out when George asked for the A & E entrance and shook it with a certain relish.
‘Ain’t got one here,’ he said. ‘You’ll have to go over to Ardenford for that. We’re just a –’
‘Oh, for God’s sake.’ She let all the tension of the past twenty-four hours boil over and roared at him. ‘Don’t be crazy, man! This woman is dying, you hear me? Dying. I’m a doctor, and I have to get her into reliable medical hands right now. At once. So get me a senior doctor and get him fast.’
The man looked terrified, as well he might, for she looked and sounded like the wrath of doom, and bobbed back into his box to reach for the phone. She heard
him mutter into it and then turned to look again out into the driveway where she could see Nanny Lyons still holding Marietta upright. She turned back, burning with impatience, in time to see a man in a grey suit come down the staircase at the far side of the hallway.
‘I understand you’re asking for A & E?’ he said with careful courtesy. ‘I’m sorry, we don’t have that service here.’
‘Have you got doctors?’ she roared again, deliberately this time; it had worked so well before, after all. ‘Have you got beds? All I need is a safe medical bed to take care of a woman whose life is at major risk. It’s not that she’s in need of desperately difficult care, it’s just that –’
The noise she was making seemed to have galvanized the place. People were peering down the stairs and heads were coming out of doors on all sides. One such door, however, opened widely, and a large woman in a white coat came striding out. She was untidy to an amazing degree, with stockings that were in rings round her ankles and badly bagged at the knee, a skirt held in place in front by an oversized safety pin and sparse hair pinned into a misshapen bun at the nape of her neck. But her eyes were bright and very intelligent and she looked friendly enough. George whirled.
‘You’re a doctor?’ she demanded.
‘Neurology,’ the woman said comfortably. ‘That is, I run a small unit for geriatric patients with long-term neurological damage. What is the noise about? What can we do for you?’
‘Save a life,’ George said grimly and launched into an animated explanation, describing her own status, both medically and in police terms, and making much of the fact that Marietta was a woman involved unwittingly in the Ripper murders case. And then said, ‘I believe her life is at real risk. She knows something that will incriminate the murderer, I’m sure of it. All I need is a safe bed for her under the care of a decent doctor. She’s been appallingly overdosed with barbiturates – and that of course is the doing of the murderer. I know who he is now – but she’s still alive and I believe we’re in time to pull her back. Please, will you –’
‘Will I!’ the woman said jubilantly and turned to the man in the suit on the stairs. ‘Charles, I’ve got an empty side ward on Hainault. Let me have it. Now.’
The man looked bemused. ‘But Dr Kelley, how can I? Whose case is this? What’s her address and post code? Is she coming in from a fundholder? Or on the local contract? You know that’s impossible till next April, we’re over budget as it is. Or is it an extra-curricular referral? Because, if so –’
‘Oh, Charles, go and play with your computer,’ Dr Kelley boomed. She had a voice that could be heard, George suspected, on the other side of the road. ‘I’m taking this case. We’ll worry later about who’ll pay for it.’
‘ECR,’ George said swiftly. ‘It’ll be an extra contractual referral. I’ll see to it. She lives in London usually. I’ll make her health authority pay.’
The man called Charles seemed to cheer up marginally. ‘Well, if it’s going to be paid for, well enough. Here, Davidson, get a trolley will you? There’s a new patient for Hainault Ward.’
George breathed a deep sigh of relief and went to fetch her patient from her car. Marietta’s safe, she told herself, at last.
Dr Kelley proved to be a perfect ally. She threw herself into the business of both caring for and treating Marietta with an enthusiasm that knew no bounds. She had no objection at all to allowing Nanny Lyons to act as a special nurse, under the guidance of the ward sister on Hainault.
‘She’s always short staffed,’ she said happily. ‘So she’ll be enchanted to have another pair of hands. Oh, this is a lovely change from the usual!’ And she bustled off to chivvy Sister to organize an intravenous infusion for Marietta, who was going to need all the fluids they could get into her to deal with the overload of barbiturates she had been given.
By the time Marietta was settled, with her head lowered so that her circulatory depression was aided, an IV line in place to provide her with fluids, and a catheter put in to drain her bladder and maintain her kidneys, George felt a good deal better. The only risk now was pneumonia and, looking at Dr Kelley and Nanny Lyons, she knew that was not going to be a complication if they could help it. Marietta would be made to cough and deep breathe the moment she had any responses at all, and she was not in as deep a coma as George had at first feared. In time there was no reason why she shouldn’t recover well.
‘Fortunately she’s had her overdose over a longish period of time,’ Dr Kelley said. ‘They tolerate that better than one massive dose, you’ll agree, I’m sure.’
George, who had forgotten more about barbiturates overdoses than Dr Kelley was ever likely to know, was tactful and made it clear she bowed to her colleague’s greater knowledge. Dr Kelley was, therefore, a very happy lady.
And so was Nanny Lyons. She had taken off her nurse’s coat and hat to reveal herself in her usual overall, but it didn’t look all that different from the nursing staff of the ward, about whom she was able to be very scathing indeed.
‘Call themselves nurses?’ she grumbled. ‘And not a cap or a belt in sight. More like skivvies, if you ask me. It’s a good thing I’m here to take care of the poor young lady.’
‘Indeed it is,’ George said. She was standing at the foot of the bed watching Marietta’s breathing and trying to judge whether she was doing it rather better than she had been at the house. It was hard to be sure. Nanny Lyons followed her gaze and looked anxious.
‘She’s still having her medication, is she?’
‘Um, no.’ George thought it better to be honest this time. ‘It turns out not to be the right one.’
Nanny sighed. ‘I’m glad,’ she said simply. ‘I was beginning to worry. It was all very well for Mr Jasper to say it was prescribed, but I never met the doctor, did I? And she did seem to me to be ailing more and more.’ She swallowed then and said with a little burst of confidentiality, ‘To tell you the truth, doctor, my eyes aren’t what they were. There was a time when I was known for my sharpness in every way. My hearing, my eyes and the way I thought things out …’
‘I’m sure,’ George said sympathetically and, unwilling to leave just yet, though she knew she ought to report this latest development to Rupert, sat down on another chair beside her. They both watched Marietta’s frail chest lifting and falling with her shallow breaths.
‘Tell me how it was in the old days, Mrs Lyons, will you? I’d love to know. I trained in medicine in the late seventies, you see, and early eighties, so I’m a bit …’ Keeping Nanny Lyons happy was essential, George thought. And most old people loved reminiscing.
Nanny Lyons cackled at that. ‘Jilly come lately? Well, it’s nice of you to admit it. Not many does. What do you want to know?’ She stretched her neck a little proudly. ‘My memory’s fine no matter how the rest of me may be gettin’ a bit battered and worn.’
George smiled. ‘Tell me what you used to do. The job you most enjoyed.’
‘Oh, no question about that!’ the old woman said readily and touched the hand of the comatose woman in the bed. ‘It was midwifery. I always hoped, you know, as I’d be able to deliver this one’s babies, the way I did her husband, but it wasn’t to be. Miscarriages she’d had, any number, poor little girl. It’d break your heart. It’s what turned her to … you know. Made her the way she is.’
George was looking at her, her mind running fast. ‘You say you delivered her husband? David?’
‘Oh yes! They wouldn’t have no one else, Lord and Lady Durleigh, in them days. I’d been with ’em five years then, you see, and I was worried. I mean, it was one thing to be delivering babies when you was doing it all the time, but I’d stopped, hadn’t I? I’d been with the twins, you see.’
‘You’re not being quite clear,’ George said carefully. There was something important here and she couldn’t be sure what it was, but she felt the significance; knew she’d already been told in some way, and couldn’t quite remember what it was. It had been hanging about tantalizingly at the back of her mind
for days now, and she still couldn’t quite catch hold of it. Now she looked at the old head bent over Marietta, and stopped trying to remember. She concentrated on Nanny Lyons instead.
The old woman sighed a little impatiently. ‘I was hired by Lord and Lady Durleigh when she was seven months pregnant with the twins. They guessed it was twins, she was so big – they had none of this fancy machinery that you can look at the babies with now.’
‘Ultrasound,’ murmured George.
‘That’s right. They didn’t have it in those days. Just experience was all, and she said she wanted the best midwife she could get and sent to my hospital and they recommended me.’ Her chest seemed actually to swell with pride as she said it. ‘So, I come down to live in Durleigh Abbey and oh, but it was fancy in those days. Servants – even I had a little maid to look after me! – and entertaining and hunting meets and hunt balls, everything. Well, she got ill, didn’t she, nearly at thirty-nine weeks she was. I checked her and the cervix was soft and a head engaged, and I thought she’s going into labour any minute. But she just didn’t really get going and I was worried about the babies. I checked the foetal heartbeat every half-hour – and we didn’t have the fancy machines for that either, just our ears and experience.’ She was proud again. ‘And I’d had a lot of experience which was why the hospital sent me to Durleigh. Anyway, I got really worried. The babies’ hearts seemed to me to be showing foetal distress – fast, irregular, the lot. And then there was some meconium in the liquor when her waters went and I thought, oh, no, that’s it. I’m not hanging about. I wanted to do the delivery myself of course, I don’t deny it, but I’m not stupid and never was. I sent for the doctor and oh, there was a panic! He said it was right to get him, that he had to do a Caesar right away. There wasn’t even time to get her to hospital! So he did it there at the Abbey. We fixed up one of the small stillrooms and he fetched the anaesthetic and I did it for him – he started it, see, and then he got me to carry on with it, though not too much because all he had was ether and that’s a worry with the babies, you see, and there you go. Big they were, considering. Richard, who was the first out, he was almost five pounds and Edward, he was only three ounces less. We put them on the kitchen scales, I remember. Bonny babies they were, so lovely. And she fed them both, she did, amazing woman she was. And I nursed her all through till her stitches healed and she was properly on her feet again and then one of the babies – Richard it was – for all he was the biggest and all that, he got enteritis and croup, so I stayed to get him well. It was as nasty a go of croup as I’d ever dealt with, and somehow I never went back to hospital. I stayed with them, and then when she got pregnant with David she swore no more Caesars for her, she’d have him natural and it was a high risk. But she insisted. I said she was an amazing woman, didn’t I? Well, she was. And so I said, well, all right, I will stay. And it all went fine. David was a small baby but vigorous and did very well. And now here’s this poor little thing, never going to have one of her own with him.’
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