He rubbed his face wearily, looking very young with his baby blue eyes and fair hair over a rubicund complexion.
Colin Jackson came over to him, and sat on the arm of his chair.
‘What happened? Sir James left me to finish his list after doing the gastrectomy, and I’ve only just left theatre——’
‘It’s the gastrectomy that’s the problem,’ Jeff said. ‘One hell of a problem. I tell you, this morning’s been a right——’
‘What happened?’ Jackson said again, sharply. ‘The operation went all right—he was fine when he left theatre——’
‘With a blood transfusion going—I know,’ Jeff said.
‘He was anaemic on admission,’ Colin said. ‘That’s why I asked for blood for him. Sir James agreed—it was a routine sort of thing. Nothing to worry about. I’d have given him the blood in advance if I’d had the chance, but the feller wouldn’t come in in time. So we put it up in theatre. And he was fine when he went back to the ward. Sir James said he’d go and see him before he left—he had to go early to see a patient in Harley Street. One of his influential civil servants sent for him in the middle of the case——’
Jeff nodded heavily. ‘I know all that. He told me, at some length, that my crass stupidity was mucking up his entire morning, quite apart from what it was doing to Quayle——’
‘Oh, for heaven’s sake, Jeff! Will you tell me what happened, or have I got to go over to the wing and find out for myself?’ Colin snapped.
‘He suddenly showed a reaction,’ Jeff said heavily. ‘Looked for all the world like the reaction you get when a patient gets an incompatible batch of blood. I told the old boy it couldn’t be that, not possibly, but he just swore at me and told me to get the hell out, so I did.’ He sounded very aggrieved. ‘Honestly, these high powered consultants—they’ve got the manners of pigs. If I dared to speak to the most junior nurse the way that man spoke to me this morning there’d be all hell to pay—but he can get away with it! Sister was in the room, and young Caspar, and a junior nurse, and he swore at me as though I were a—a hospital porter or something. It just isn’t good enough! Quite apart from implying I hadn’t done my job properly and sent over incompatible blood for a patient!’
The door swung again, and Harry Caspar, the junior housesurgeon who alternated between the genito-urinary surgeons and Sir James’s general surgery, came in, his face bleak and worried. When he saw Jeff, he turned as though to go out again, but Jeff jumped up, and shot across the room to grasp his elbow.
‘Well?’ he asked sharply. ‘What’s going on over there? Has he thrown you out, too?’
Harry reddened, and looked at the taller man with troubled eyes. ‘Look, I’m sorry, Jeff. The old man’ll be over in a minute and tell you himself, and I’d really rather not——’
‘What do you mean, he’s coming over? Hasn’t he gone to Harley Street yet?’ Peter asked.
Harry shook his head. ‘Hardly. There’s no end of a flap going on——’
Jeff almost shook him in frustration. ‘What sort of flap? And why?’
‘Quayle. He’s dead,’ Harry said baldly, and the room slid into immediate silence as the other men stared at him.
‘Dead?’ Colin was the first to speak, and he sounded stupefied. ‘Dead? But why? He was in perfect shape when he left theatre!’
Harry looked acutely embarrassed, and moved away from Jeff to stand fiddling with the coffee things on the table by the door.
‘Incompatible blood,’ he said after a long pause, and then shrank as Jeff grabbed him by the shoulder and whirled him round.
‘Incompatible blood? What the hell are you talking about! Just because that goddamned old bastard implied it, it doesn’t give you licence to spread a slander like that!’ he roared. ‘Just you dare say a thing like that again, and I’ll——’
‘But it’s true, Jeff—I’m sorry, but it’s true——’ Harry Caspar cried, and then dodged as the other man tried to hit him.
There was a moment’s flurry, as Colin Jackson grabbed Jeff, and Barney and John Hickson pulled Harry out of the enraged Jeff’s reach.
It was Peter who brought some semblance of calm back into the room. He pushed Jeff into a chair, and stood in front of him as he spoke very sharply to Harry.
‘Explain yourself,’ he ordered briefly, and Harry, flexing his shoulders to get out of Barney’s and John’s grasp said sulkily, ‘It’s true. Sir James took a specimen of Quayle’s blood and crossmatched it with the bottle he was having, and it showed clumping. The blood was incompatible, and that’s all there was to it. And then the patient suddenly went into collapse and died. And that’s all I know.’
Jeff sat very still in his chair, an expression of almost ludicrous horror on his face. And then Barney started to laugh, heard his own cracked unnatural laughter as though it came from someone else a long way away.
‘Oh, my God, Jeff!’ he gasped. ‘Oh, my God! That makes two of us! Any more for the Killer’s Stakes? Who’ll be the next to dispose of a poor unsuspecting patient? Come on, you sick and lame and halt, come and get killed!’
And his laughter rose to an almost shrill pitch as the other men stood and stared at him in frozen horror.
CHAPTER FOUR
BY TEATIME the entire hospital was buzzing with it. Ward maids stood in clusters in the corridors, their heads together as they surmised and gasped and tut-tutted agreeably; nurses made excuses to run errands to the Pharmacy or the laboratories just so that they could stop on the way and gossip about the news with other nurses similarly escaped from ward routine; even the patients sat around in wheel-chairs in the ward day rooms and wondered and worried about it.
At top level the talk could not be described as mere gossip, but as Conference. Mr. Stroud sat heavily in his swivel executive-type chair, with Sir James in the only other comfortable chair the room possessed. The others stood about awkwardly, their faces showing clearly just how they felt about the matter.
Jeff Heath and Barney were perched side by side on the deep window sill, Barney looking numbed, but a little less hopelessly miserable than he had. There was a sort of comfort in not being alone in his dilemma, a thought that made him feel faintly guilty as he looked at Jeff. Jeff just glowered heavily, but the sulkiness of his expression barely hid the real fear that underlay his anger.
On the other side of the room, the nursing staff stood tidily together, Sister Osgood and Sister Palmer, from the second floor of the Private Wing, in uniform, and Staff Nurse Cooper in defiant mufti. It was her half day, after all, and worrying—and fascinating—though the situation was, she was justifiably annoyed at the interference with her free time.
Leaning against the wall beyond them, Harry Caspar, Derek Foster and Colin Jackson had schooled their faces into a polite blankness, though there was some sympathy to be seen in Harry’s expression as he looked at the two men in the window seat from time to time.
There had been a moment’s silence, and then Mr. Stroud spoke again.
‘I’m not quite sure what we can do, Sir James,’ and there was a faintly pleading note in his voice. ‘Not until the inquests show there is something to be done. It is quite possible, isn’t it, that the post mortems on these—er—unfortunate patients will show understandable causes for their deaths? If we go off half cocked now, and start a great hue and cry all we’ll do is disturb the hospital for no good reason, upset patients, and collect a lot of very unfortunate publicity. And I’m sure we all feel that it would be most undesirable to have the Royal dragged through the newspapers——’
‘Look, Stroud,’ Sir James growled, ‘I’m as aware as you are of the undesirability of publicity. But I am also aware, as you apparently are not, that something is very amiss in this hospital—and as a senior consultant on the staff, bringing my private patients here, you must surely see that I have to be certain just what it is.’ He paused significantly and then went on, ‘Unless I can find out exactly what caused these deaths, I cannot possibly bring my private work h
ere any more. If that is the price you are prepared to pay for keeping this matter under wraps, well and good——’
Mr. Stroud immediately became very fussed. The revenue the Private Wing earned from Sir James’s very rich private patients was essential to the hospital, despite the fact that it had far more National Health beds than private ones. And what was more, if Sir James stopped working in the wing, it was odds on several of the other consultants would follow suit. A possibility like that was almost worse than a nine days newspaper wonder about patients dying under odd circumstances.
On the other hand, such publicity in itself would have the effect of frightening potential private patients away. Stroud was firmly pinned in a cleft stick, and the way he fiddled with papers on his desk, and ummed and erred showed how helpless he felt, faced with the implacable Sir James.
‘But what can I do?’ he said again, and looked round at the other people in the room, who stared silently back at him. ‘I’ve called everyone who might possibly know anything to this conference, as you asked, Sir James, but for what purpose, I——’
‘To see if we can discover something from talking about what happened,’ Sir James said, and turned heavily in his chair to look at the eight people ranged around him. ‘Let’s start with the strangulated hernia. Who saw him first?’
‘Night Sister,’ Derek Foster said promptly. ‘He came in by ambulance from the docks, and Sister saw him in Casualty, reckoned he was an acute abdomen of some kind, and got the man who’d come with him from his ship to sign a consent form for an operation, just in case. I found out that much when they called me to see the bloke around five o’clock this morning.’
‘Has his ship been notified of his death?’ Sir James asked.
‘No,’ Stroud cut in. ‘It sailed this morning at six. The Polish Embassy are listed as the next of kin, in this case. They’ve been notified—and I’m relieved to be able to say they don’t seem particularly bothered. I got the impression, talking to them this morning, that they almost expected him to succumb to his operation,’ and he couldn’t resist shooting a malicious glance at Sir James’s oblivious back.
‘So at least we’ve no irate relatives to contend with,’ Sir James said. ‘Only an extremely irate surgeon—me.’
He turned then to Barney, who jumped a little. ‘Now, Elliot. I want a blow by blow account of that anaesthetic. At the time it happened I was disturbed enough—but in the light of this latest development, I am even more disturbed—and convinced that there was something extremely odd about this death. And I want to know what you did, and what you think.’
‘I can tell you what I did, sir,’ Barney said helplessly. ‘But no more than that. I mean, I was knocked sideways by it—still feel extraordinarily bothered. But why it happened—I wish to God I knew! As far as I’m concerned the sooner it can be sorted out the better I’ll be pleased. If there’s been some dirty work going on, I want it uncovered, because as things stand now, I’m right in line for being struck off at worst—and being set right back in my chosen speciality at the very least. So if anyone thinks there’s the remote chance of there being a case for the police here, I want to see ’em called in. And to hell with the publicity,’ and he glared defiantly at Stroud.
‘No doubt,’ Sir James said dryly. ‘If some outside agent played a part in the death. But before we can be sure of that—and I’m damned if I’m just going to assume it—I want to be sure that there hasn’t been some old fashioned common or garden bloody inefficiency here! And I warn you fairly, young man, that if there has I personally will do all in my power to have it dealt with very severely. If there’s one thing I won’t tolerate in any shape or form it’s inefficiency—and the only thing I abominate more is attempts to cover it up! That’s why you’re all here—to corroborate what everyone else has to say, and show us immediately if there has been some negligence. So, I want a clear account of what you did this morning!’
Barney flushed a heavy brick red, and there was a faint rustle of movement around the room. But Sir James ignored it, just fixing Barney with his glare.
‘Right!’ Barney said, keeping his voice as even as he could. ‘Since we’re working along the lines that a man is guilty until proven innocent——’
‘Now, we’ll have none of that!’ Sir James barked. ‘This isn’t a court of law, and nothing that’s said here will ever get to a court of law if I have my way. But I want this business thrashed out, and thrashed out it will be! So start talking!’
How he managed it he’d never know. He spoke in a level even voice that belied the sick fear that filled him, and the overlay of deep anger at Sir James’s autocratic ways. He told the silent listening room of everything that had happened, of his conversation with Nurse Cooper, even about the ridiculous little bit of fussing over the unlocked anaesthetic room door (at which Nurse Cooper flushed a sick red and then went pale, and Sister Osgood shot a malevolent look at her). He described the anaesthetic he had given, punctiliously announcing the dosages as well as the drugs he had used, the way he had double checked the anaesthetic machine after Gellard had checked it—pointing out with some satisfaction that this was his normal practice—and going on until the point was reached at which the patient’s heart had begun to fail. His voice faltered a little then, but he went on as carefully as he could.
‘The man seemed quite well until that point—normal good deep respirations, even blood pressure. And then his breathing became very shallow, and he looked very pale. He started to sweat too, and I wondered if he was beginning to come out of deep anaesthetic to a shallower level—I’d kept it fairly light deliberately because he was in a state of shock on admission. But it wasn’t that—and then—then——’
It was difficult to describe the way he had tried to resuscitate the man, the giving of the heart stimulants, the cardiac massage, but doggedly he went on.
‘—and then you said he was dead, and I—I couldn’t believe it. And that’s all I know,’ he finished.
There was a moment’s silence, and then Sir James nodded in a satisfied way.
‘Right. I can certainly corroborate what happened once the man came into theatre. So can you, Jackson.’
Colin nodded wordlessly.
‘You left out the fact that that impertinent young houseman came sniffing around—what’s his name?’
‘What? Oh, John Hickson,’ Barney said. ‘I didn’t think that was significant.’
‘Everything is significant,’ Sir James snapped. ‘Now, Staff Nurse—what’s your name? Cooper? Can you corroborate what Dr. Elliot has told us? About what happened before I arrived?’
Nurse Cooper gulped, and whispered, ‘Yes sir.’
‘Speak up, girl! In every detail?’
She nodded. And then jumped as Sister Osgood spoke very sharply.
‘This matter of the unlocked anaesthetic room——’ she said, and her voice was harsh as she looked at Cooper. ‘Why was it locked in the first place? I don’t normally expect the anaesthetic room to be locked overnight. The anaesthetic machines are locked into the main store room, and the theatre unit as a whole it locked up—so why? I find that odd enough to be worth discussing,’ and she turned and looked at Sir James in a challenging way.
Nurse Cooper looked miserably at Sister Osgood, and swallowed again, very near to tears.
‘I—I’m sorry, Sister,’ she said.
‘What is all this?’ Sir James said quickly. ‘Something odd about an unlocked door? Explain yourself, girl.’
Nurse Cooper was now frankly crying, and found it difficult to speak, but when Sister Osgood said bitingly, ‘Explain at once, Nurse,’ she gulped, and began to speak.
‘Sir James’s list starts very early,’ she said in a husky voice. ‘And it’s always such a rush and panic to get set up in time for him—and Sister gets—gets angry if everything isn’t just perfect when she comes on duty just before the list starts. So—so—well, I try to save time, you see. And—and the night before Sir James is operating, I set up the
anaesthetic room, and lock the door, ever so carefully, so that I can just get on with setting up the actual theatre in the morning. Only this morning it was unlocked, and I know I locked it last night——’
‘You do what?’ Sister Osgood sounded as horrified as she would have done had Nurse Cooper confessed to throwing orgiastic parties in the operating theatres. ‘You do what!?’
Nurse Cooper turned on her, goaded to indiscretion. ‘Well, I do—I always have. I can’t help it! You make such a hullabaloo if everything isn’t spot on, and there just isn’t time! So I put out the gowns, and set up the agony wagon—I mean, the patient’s trolley, and set in the anaesthetic machine after Gellard’s checked it, and put out the drugs, and everything! And if I had another junior on with me in the morning, I wouldn’t have to!’ And she burst into noisy tears, turning her back on Sister Osgood’s scandalised face.
‘Stop that caterwauling at once,’ Sir James roared. ‘Now we’re beginning to get somewhere! You say the anaesthetic machine was not locked up safely last night? That it could have been tampered with? Is that the explanation of this wretched sailor’s unfortunate death?’ He turned on Barney then.
‘Are you sure that machine was fit to use? Was the oxygen coupled up properly? You didn’t give the man carbon dioxide instead of oxygen, did you?’
‘No,’ Barney said dryly. ‘I read that novel too—and there was nothing like that. I know an oxygen deficiency when I see one—and I tell you I checked the machine myself——’
Colin Jackson’s voice rose sharply above the sound of Nurse Cooper’s gulping sobs. ‘It can’t be that, sir,’ he said.
‘Why not?’
Death on the Table Page 4
