by John Collee
'How was your holiday?' she was asking.
'A continuous romp.'
'Certainly looks like an expensive tan.'
'It is extensive.'
'I said expensive. '
'Yes, that too; shall I put you down for a private viewing?'
'You can't shock me, Dr Short.'
He often wondered about that. Her highly polished manner evoked in him a recurring urge to take her manicured hand and plunge it down the front of his trousers. Kingsley shouted her name. Richard Short winked and left. Rhona stepped through the communicating door.
She found Kingsley pacing the space in front of his desk. At intervals he dragged a hand through his hair. His mouth was tight with anger. 'I don't suppose you've read this.'
Rhona sat down and smoothed her skirt. 'It's a pathology report,' she volunteered.
'I know what it is,' he snapped. 'Listen to this: ''Niven . . . A.P. resection, Friday the fifth . . . carcinoma of the rectum . . . Blah blah." ' He scanned down to the relevant section, then read again with renewed hostility: ' ". . . extraordinary finding . . . the carcinoma had obviously undergone an acute inflammatory change . . . lymphocytic infiltration . . . macrophages apparently engulfing tumour . . . I personally have only seen, indeed heard of, one similar such microscopic appearance – that of the 'breast tumour' removed from Sandra Spears on the same day . . . " ' Kingsley slammed the report flat on his desk, knocking the phone receiver.
' "Breast tumour," he says, "breast tumour", inverted comas.'
Rhona pursed her lips around her pen and leant forwards on the writing-pad.
'I mean if I can't rely on the pathologist's support . . .' Kingsley dragged the seat out from his desk, then decided not to sit down. She had seen him like this six months previously when they first threatened to close the hospital.
'Get me Mukesh on the phone.'
'Don't you think you should just write a note, Mr Kingsley?'
'No I do not.'
She raised an eyebrow. Behind Kingsley, on the panelled wall, there was a Geigy calendar showing pictures of the Scottish Highlands. September was Eilan Donan castle.
Kingsley sat down. He removed his spectacles and pressed the ball of a thumb in his eye socket. 'OK, take this down. I want it to be sent over today, now . . . To Dr C. Mukesh, Department of Pathology.
'Dear Dr Mukesh.' Kingsley sat back in the leather chair and scowled at the ceiling, '. . . thanks for your interesting reports on Spears . . . ah, 632874 . . . and Niven . . . look up his reference number . . .
'. . . I can think of no explanation for these appearances short of your own . . . no scrub that . . . short of some technical artefact. I think we can ignore them.
'. . . new paragraph. I would just like to say that on Friday I was put in a very embarrassing position by Mrs Spears's husband who, unknown to me, had been given access to what is essentially a confidential report. I'd like to make quite clear that . . .'
The phone interrupted him. Kingsley picked it up himself.
'Mr Kingsley, I've been wanting to speak to you.'
'Mukesh, yes. I've been wanting to speak to you too.'
Kingsley's voice was a brick wall. Chandra Mukesh stopped dead.
'I'll get this out of my system,' said the consultant. He looked at his secretary. She was stroking her cheek with a fingernail. 'I've just been dictating a letter which is a good deal more polite than it could have been.'
'Oh?'
'Basically it's simple etiquette. I don't expect to have to justify my decisions to the relatives of patients . . .' His voice was rising. He checked himself. '. . . Someone told Spears's husband she didn't have cancer.'
'Yes . . . yes, he phoned and asked me. I thought he had a right to know. All I said was . . .'
'Well I don't think he has any damn right to know. Not from you anyway . . .'
There was a long hiatus. Kingsley wished the other man would offer some word of apology so he in tum could absolve him. Mukesh offered no cue.
'You wanted to tell me something,' said Kingsley flatly.
Mukesh paused, embarrassed, then: 'Well, it's just the testicular tumour you removed this morning . . . it's the same . . . lot of dead cells.'
'Listen, Dr Mukesh. I appreciate your enthusiasm. How long have you been a senior registrar?'
'Two months.'
'Why don't you send a couple of these specimens up to the Royal for a second opinion?' Kingsley chewed a finger. He was wondering how he would stand with the journalist Spears if Mukesh had made a mistake.
'The lower pole of that testicle was visibly necrotic, Mr Kingsley.'
'Do you think I don't know a necrotic cancer when I see one.'
'I'm sorry, sir.'
Kingsley hung up.
Rhona gave him her look.
'You think I was unfair.'
Rhona licked an envelope and sealed it precisely. 'I was just wondering how you'd feel if one of your operations got that kind of reception.'
'It happens.'
After she'd gone he tried to concentrate on his correspondence but his mind was full of sharp fragments from Mukesh's telephone call. He returned to the pathology report and scanned through it again. Maybe he could cram these cases into the rational scheme of things – breast cancer could get infected, so could a rectal tumour, and one end of a seminoma could outgrow its blood supply. But that was all small print, textbook stuff, and none of the cases fell accurately within the classical patterns. Kingsley chewed at the tip of his finger. The changes Mukesh described were freaks. They occurred rarely in isolation, far less in threes. On the other hand it was equally unlikely that a pathologist of Mukesh's seniority would make three such glaring errors in succession. Kingsley was not a betting man. When he was obliged to gamble with his patients' lives he did so on short odds and certainties. But suddenly the familiar laws of probability seemed no longer to apply.
Cranley, the mortuary assistant, had been across to Ranjits' Discount for his fags. To Cranley smoking was no longer a habit, but an integral part of his lifestyle. At home he had filled two drawers with coupons he would never cash, and made intricate working models with spent matches.
Now he was crossing Constitution Street, hurrying through a gap in the traffic with the peculiar swivelling gait imposed by his bad leg. The theatre porters had a joke about why he limped, but then the theatre porters had a lot of jokes. They had a joke about the dense black hair which grew from Williams's nose, a joke about where the ECG girl went at lunchtime, and a long and elaborate joke constructed around the picture-translation book for foreign sailors. Despite the sun Cranley still wore his black gaberdine buttoned to the neck. They had a joke about that too.
A ship's horn sounded from the docks as he crossed the car park, rounded the statue and entered the narrow close between anaesthetics and the mortuary. As he did so his body stiffened and a hot rush of blood suffused his face . . . The mortuary door was ajar and a man was coming out, an Indian, but of slighter build than Dr Mukesh.
'Get out of there,' he screamed as recognition dawned, and began a furious lolloping run up the close.
Dhangi looked up sharply then descended the steps, bringing the leather case with him. Cranley filled the narrow close, panting with exertion and fury.
'How the devil did you get in there . . . what the hell d'you think you're playing at?'
Dhangi was silent. He recognized immediately the futility of any explanation. He had been confronted by such people before, people so far from enlightenment that not even Shankara himself could have converted them. He was reminded of his brothers, Amrit and Bhopal, in the brick factory on the stinking Rishkamitri, of the psychiatrist in Amedabad, of Swami Vitthalnath's ignorant assassins – the mlechcha, the godless. Such a man was Cranley. Dhangi felt the righteous hatred curdle and congeal within him like ghee.
'What's in the bag?'
'Let me past.'
'What have you got there?'
Cranley made a snatch for the leath
er bag and caught one handle, but Dhangi' s skeletal frame belied surprising strength. He tugged it away sharply, bringing Cranley's weight forwards on to his bad leg; then, seizing his advantage, he elbowed the older man viciously in the chest and forced his way past him. Cranley thumped backwards against the stone. The corner of a buttress caught him in the small of the back. He lashed out wildly but his fist met with no resistance. Cranley straightened, grey and sweating, fighting for air. The stranger was already crossing the car park, eventually melting into Constitution Street.
Rather than attempt the steps to the mortuary, Cranley wrestled a cigarette from the package and placed it unsteadily between his lips.
He remained there, smoking and watching the railings long enough to make sure that Dhangi did not return.
*
Sheila had taken up cycling to school and back. Kingsley had opposed this to the point of buying her a new car but for once he didn't have reasons. She suspected it was just his good old sense of Edinburgh middle-class propriety.
She cycled past the bus queue. The schoolgirls with their berets crammed on their little heads shouted 'bye Mrs Kingsley', and she smiled at them. She had nothing to hurry home for. Alistair was rarely back from work before seven.
Autumn was the best season. Warm lemon sun and the coloured trees along Colinton Road. She would persuade Alistair to take time off. They could go to Denholm, take long walks, prune the roses, read, paint. Mr Oliver, English, tooted as he passed, craning discreetly over the sill of his Morris to look at her legs. She crested Church Hill. On a day such as this, across the valley of red roofs, one could see the Pentland Hills, and the artificial ski slope standing out like a thin white scar. She free-wheeled downhill, one leg straight on the pedal.
The paper usually arrived after they had both left the house. It was on the doormat when she entered. She took it through to the lounge, dropped it on the floor, switched the radio on, went to the bathroom and washed the school chalk off her hands. Then she went upstairs and put on her black leotard.
There was a square of bright sunlight in the centre of the lounge carpet. She closed her eyes, saw black and red, put her left ankle in her right groin and tried to empty her mind. After a while her leg started to hurt and she uncrossed it. The paper reflected the sun. Eventually it ceased to dazzle and she could read it: CHILDREN DIE IN M6 HORROR. She turned that page, leafed through idly. There was a small section on the woman's page: BREAST CANCER DIAGNOSIS – A CAUSE FOR CONCERN?
The article quoted the prevalence of the disease in Scotland. It went on to explain the diagnostic process of examining a frozen section of the lump for cancer: '. . . but how reliable is frozen section? Is every mastectomy really necessary? Recently the Courier has received information pertaining to one such case – this mutilating operation performed on a young, active woman on the basis, according to the pathologist concerned, of "ambiguous pathology". The Courier investigates . . .'
Sheila Kingsley read this, scanned through it again, then licked her finger and carefully tore it out.
It was dark when Kingsley came home. He looked harassed. She kissed him. His lips puckered absently in return. 'What's cooking?'
'Casserole.'
He took off his coat and walked through to the lounge. He put his briefcase on the grand piano. Then she heard him opening a beer and imagined him standing with his back to the fire, toasting the seat of his trousers. He was quiet.
In the kitchen Sheila Kingsley took the newspaper article out of her pocket, crumpled it up and threw it in the bin with the potato peelings. She was surprised by a fat tear that ran down the end of her nose and dropped in the stew. She stirred it in. She didn't feel particularly sad but was aware of a vague foreboding which she could not yet identify.
Chapter 5
The wind that dried the golf course had vanished now and the sky had turned a clear, remote blue. A breeze still loitered on the fairways. The city stretched below them like glasspaper, punctured by the castle and the blunt nose of Arthur's Seat – beyond that the Firth of Forth and the thin, grey coast of Fife. Richard Short wore slacks and the checked cardigan given him by his wife the year before their divorce.
There was no one before or behind them, only the cold distant birds and, somewhere over the rise, the phenomenally inefficient greenkeepers on loan from Gogarburn mental hospital.
'It's my belief,' Richard Short placed his feet carefully in the sand, 'that you should take a bloody great swipe with your first bunker shot. If you make contact you frighten the hell out of your opponent. If you cock it up you lull him into a false sense of security.'
Short raised his head to smile at his own glibness. His ball exploded from the sand, caught the lip of the bunker and sang off into the gorse.
'Nothing false about my sense of security,' said Kingsley. 'I'll help you find that.'
'Forget it, Alistair, I'll take another.'
'No harm in looking; those things don't grow on trees.'
'You certainly don't find them under bushes.'
'I do,' said Kingsley. He raked the ball out and tossed it back. Short's second attempt bounced twice and overshot.
Kingsley crouched on the green. 'I reckon you play your first bunker shot like every other shot – in isolation. Forget the psychological mumbo-jumbo, just play the shot. That's where people like Ballesteros win out.'
'That kind of attitude really gives me the pip.'
'It's called logic,' said Kingsley. His careful putt stopped just short of the hole.
Short glanced over at it. 'I'll give you that.' He chipped badly from the rough and put £4 on the debit side of his score card.
Kingsley filed his putter. 'Problem with you, Richard, is you never play the sensible shot.'
'Who needs sensible shots. You can destroy the game if you're too rational about it.'
'Can't be too rational – it's a rational world,' said Kingsley. He studied his finger. A gorse thorn had become imbedded deep in the tip. He pulled it out. Strangely the puncture did not bleed.
They played the next hole in relative silence. Eventually Kingsley said, 'Do you remember a patient called Sandra Spears?'
'No.'
'Yes you do. Pretty woman. I did her breast ten days ago.'
Richard Short looked blank. Kingsley continued. 'There was some artefact on frozen section. The husband phoned up and started regaling me with the fact that I'd operated irresponsibly.'
'Hope you told him to fuck off.'
'Not in so many words.'
'Cardinal mistake. I always tell them to fuck off.' Richard Short stooped to place his tee. 'Had a chap once, said my anaesthetic had rendered him impotent… silly idiot . . . oh, sorry, it's you to drive.'
'No, on you go.'
Short placed the ball and drew out a driver. His club came round in a long, lazy arc, then screeched downwards again, making contact with a satisfying crack. The ball lifted and swam off into the distance.
'You're driving's improved.'
'I've been practising a lot on my own.'
'Where?'
'At the hospital,' said Short.
'The hospital!'
'I've made a practice range – I'll show you later.'
Kingsley pictured Richard Short blasting away in the confines of the anaesthetic department. It seemed the anaesthetist's behaviour became increasingly bizarre with each succeeding year, as if he was trying to prove something.
'It's your birthday soon Richard, isn't it?'
'I don't have birthdays any more, Alistair. I just grow old disgracefully . . . Talking of which,' Richard Short lowered his club, 'how old's your secretary?'
'Rhona? She's thirty-four.'
'She's very attractive.'
'Yes?'
'Don't you think?'
'I don't know,' said Kingsley. 'She's my secretary.'
'Surprising she never got married,' said Short.
'Yes?'
'Don't you think?'
'Yes.'
'Y
ou're not listening to me.'
'No.' Kingsley was adjusting his grip and sighting on the green.
Short tucked his driver under one arm and swigged from his hip flask. 'Still thinking about the breast woman?'
Kingsley sliced his drive badly.
'I'm sorry,' said Short. ‘I’m distracting you.'
Kingsley packed his driver. 'There've been others,' he said.
'Other what?'
'Like Sandra Spears – ambiguous pathology. Every patient I've operated on since. Chap called Niven with bowel cancer. Then a seminoma, two prostates and another breast. Chandra Mukesh reports them all the same – "resolving carcinoma".'
Richard Short looked up quickly. 'No such thing.'
'Damn right.'
'Hell. He's not been misdiagnosing the biopsies has he?'
'I thought so at first. Gave him a bollocking. The bloody thing is he was right all along. The Royal confirmed everything he said . . . it's a totally undocumented appearance. Never seen before – cancer apparently melting away.'
'Christ – you could really be on to something.'
As they finished on the sixth green two figures appeared on the skyline behind them. Kingsley waved them forwards. He and Short moved over to the seventh tee waiting for them to play through. He took out his pipe and began to load it. Beneath them the grass fell away like the sweep of a breaking wave. Far in the distance the seventh green was the olive yellow of iodine on skin. He cupped the match to his hand. The tobacco took light.
The cancer story had inflamed Richard Short's imagination. Now he was full of it.
'You see, either way you're on a real winner. Even if it is a total red herring, spontaneously resolving cancer is big news. The press will be on it like a shot.'
'The press are on it.'
'Well, fantastic. Just the kind of publicity we need. You can forget about them closing down the hospital. It certainly beats bloody gymkhanas and car stickers.'
Kingsley bit on the stem of his pipe. 'That's all beside the point, Richard. The fact remains. I've cut off a woman's breast, I've ripped out half a chap's bowel, I've ballsed up at least one old boy's waterworks. Now I'm told they might have recovered without the operation. Wouldn't that play on your conscience?'
