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George Barnabas - 04 - Fourth Attempt
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Also by Claire Rayner
A STARCH OF APRONS
THE MEDDLERS
A TIME TO HEAL
MADDIE
CLINICAL JUDGEMENTS
POSTSCRIPTS
DANGEROUS THINGS
LONDON LODGINGS
PAYING GUESTS
FIRST BLOOD
SECOND OPINION
THIRD DEGREE
Claire Rayner
FOURTH ATTEMPT
A Dr George Barnabas Mystery
ebook ISBN: 978-1-84982-027-1
M P Publishing Limited
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M P Publishing Limited
First published 1996
Copyright © Claire Rayner 1996, 2010
All rights reserved.
Without limiting the rights under copyright
reserved above, no part of this publication may be
reproduced, stored in or introduced into a retrieval system,
or transmitted, in any form or by any means (electronic, mechanical,
photocopying, recording or otherwise) without the prior
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the above publisher of this book
ISBN 978-1-84982-027-1
The moral right of the author has been asserted
For Judith and Kim,
Katy and Amy,
with love
ACKNOWLEDGEMENTS
Thanks for advice and information about death, detection, fires and sundry other topics are due to: Dr Trevor Betteridge, Pathologist of Yeovil, Somerset; Dr Rufus Crompton, Pathologist, St George’s Hospital, Tooting, London; Dr Azeel Sarrah, Pathologist, Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire; Detective Chief Inspector Jackie Malton, Metropolitan Police; Dr Hilary Howells, Anaesthetist of Totteridge, Hertfordshire; the London Fire Brigade; many members of the staff of Northwick Park and St Mark’s Hospital, Harrow, Middlesex; and many others too mumerous to mention; and are gratefully tendered by the author.
1
The gossip spread around Old East like oil on a marble slab, oozing into every corner of the hospital until not only were the staff talking about it, so were the patients.
‘I said to Sister when she was doing my dressing this morning, I said, “Well, Sister, what’s going on here then? And who’ll be the next? Is there anything worrying you?”’ The rather fat woman in the peach chenille dressing gown, sitting awkwardly festooned with drainage tubes and IV lines in the shabby dayroom on Annie Zunz Ward, shook with pleasure at her own wit and then grimaced as her operation site gave her a twinge of pain. ‘Ooh, you take your life in your hands when you laugh, don’t you? Still, you’ve got to laugh, haven’t you? It’s the best medicine, I always say.’
The woman sitting on the other side of the dayroom, who had heard enough of Peach Chenille’s opinions on everything upon which it was possible to hold an opinion, forbore to answer, but later, when she went back to her own bed, she too spoke to her immediate neighbour about it all, wondering what was going on at Old East and who might be next.
‘Three suicides in as many days, so they’re saying,’ she said. ‘If it was the patients, you’d understand, what with worrying about yourself the way you do, but the staff … Well, it makes you think about there being something wrong in the place, doesn’t it? You read a lot in the papers about morale being low in the NHS and all that, but this is really too much.’
Her neighbour, who knew herself to be dying of her liver disease and already detaching her mind from other people’s interests in consequence, managed a faint smile. ‘People don’t choose to die because of the way everyone feels,’ she murmured. ‘It’s always because of something personal.’ She closed her eyes and wondered if it wouldn’t be easier to die now herself rather than a few weeks down the line when she’d probably feel even sicker than she did at present — if that were possible. She’d always promised herself she’d choose when to go; but since she no longer had the strength either emotionally or physically to take action on any decision she made, she wisely chose not to think at all any more.
But others did: most of all, the staff. They, after all, were most affected. If people they worked with were choosing to hurl themselves prematurely and to an extent violently out of life at Old East, didn’t that mean they should look a little more closely at what life in the hospital entailed? As the patient in Annie Zunz had surmised, morale was indeed low, and the implication that you might be driven to commit suicide at any moment did nothing to raise it.
Sheila Keen, the senior technician in the path. lab and famous throughout Old East for her passion (and great gift) for gossip, seemed excited rather than depressed by what was going on. She was displaying a bright-eyed relish for it all that irritated her colleagues immensely, not least her boss Dr George Barnabas. George had been sitting in her cubby hole of an office, looking over the notes that had been sent down with Pamela Frean’s body and the post-mortem request, when Sheila came in, smiling sweetly and bearing a tray with a pot of freshly made coffee and biscuits. Since Sheila was often loudly on record as not being part of Old East’s staff in order to make coffee for the head honcho (a piece of outmoded slang which in itself set George’s teeth on edge), and the two of them had had a row only last week, the sight of her made George scowl.
‘What are you after, Sheila?’ she said bluntly. ‘And try not to be so obvious about it, for Pete’s sake. I’d prefer you to come right out with it and ask instead of all this best buttering-up stuff.’
Sheila’s fixed smile became a little more brittle but didn’t falter. ‘Oh, Dr B.,’ she said indulgently as she set the tray down on the desk and set about pouring the coffee, which smelled wonderful to George, who had as usual missed her breakfast. ‘You did get out of the bed on the wrong side this morning, didn’t you?’
‘I did not,’ George said, managing not to clench her teeth. ‘What do you want?’
Sheila opened her eyes wide. ‘I just thought I’d see if there was anything special you wanted done. I’m bang up to date with everything — even the cardiac clinic stuff is ready a day early — so I’ve got a little time available. I could take your PM notes for you maybe? Just to take some of the weight off you?’
‘Oh, balls!’ said George. ‘Who do you think you’re kidding? You just want to be there when I do it.’
‘Well, why not?’ Sheila dropped her air of innocence and looked avid. ‘You can’t blame me, Dr B.! I mean, what a carry on! Three suicides among the staff and —’
‘Who says they’re suicides?’ George snapped. ‘I don’t believe I made any such suggestion about the last two. And as I recall,’ she added with heavy sarcasm, ‘I think I did do the PMs, didn’t I? Not you?’
‘Oh, Dr B., come on! They can’t just be accidents. Not three times in a row. You might as well expect your lottery tickets to come up as that.’
‘The first two were accidents. I can’t say what this one is. Not till I do the PM. And I don’t need your help with it, thank you. I can cope perfectly well with Danny’s assistance.’
Sheila flushed. Danny was, after all only the mortuary porter and as such well below Sheila’s regard. ‘Well, if that’s the way you want it. I was only trying to be helpful.’
‘Oh, sure,’ George said. ‘You always are, aren’t you? If you’ve got that much free time, you can help Jerry catch up. He’s overloaded with the extra histology I gave him. He needs someone to cut his specimens for him.’<
br />
‘I’m not here to do Jerry Swann’s work, thank you very much.’ Sheila made for the door. ‘I’m the senior technician here and that means I have a supervisory role over people like Jerry. Take a look at my job description some time to remind yourself.’ And she flounced out before George could answer, even if she’d wanted to.
George went down to the PM room, clutching the notes and swearing inaudibly at letting Sheila rile her so much. Sheila had always been the most difficult member of the staff while at the same time being the most expert at her job. She never made mistakes, kept well up to speed with the lab’s very considerable output of work and knew the place inside out. If only she didn’t have to be so hard to get on with, George thought as she dumped the notes and made for her dressing room to get into her greens. A taste for gossip shouldn’t madden me so much, I like gossip myself. But she really is the end …
By the time George was ready, her hair tied up in a tight cap to protect it from the unpleasant smells that were an inevitable part of working with corpses, rubber-aproned and with her feet tucked into the oversized boots that protected her from the water Danny always sent splashing so enthusiastically over the slabs, she had managed to push Sheila and her irritating ways to the back of her mind. She had a job to do and she had to concentrate on it.
But all the same, as she and Danny prepared to start, she couldn’t help mentally reviewing the previous two cases involving members of Old East’s staff on which she had worked in the past few days: Tony Mendez, the theatre porter who had died of alcoholic poisoning, and Lally Lamark, from the Medical Records department, who had been diabetic and who had died in an insulin coma. Both had clearly been accidental, she thought, yet all over the hospital there had been this rush of gossip that they had been suicides. No wonder Sheila had been so eager to come and find out what had happened to Pam Frean. She’d want to be first with the news; just as, probably, she’d been first with the chatter about Mendez and Lamark. Goddamn Sheila, George thought furiously, and then was annoyed with herself for letting her intrude again.
Pushing Sheila out of her mind, George looked down at the body on the slab and felt the twinge of pity that she still experienced whenever the subject for a PM was young. This girl couldn’t have been into her twenties for long: her face was smooth and taut with none of the signs of wear that life had scribbled on most of the bodies George dealt with. Her hair was thick and long, and George watched as Danny twisted it into a heavy rope and pinned it to the top of the head to get it out of the way. Had the girl been proud of its soft smoothness and pampered it with expensive shampoos? Probably. And her body, so soft and pretty, in spite of the marble-like effect that was inevitable in the post rigor mortis state: had she taken a delight in that too? Who could know? George picked up one of the flaccid hands and looked at the nails. They were short, unpolished, cut straight across and had clearly never been manicured. So she hadn’t been into fashion and self-adornment, George thought, letting the hand go. This was being silly, even sentimental, she told herself. Better to find out the facts instead of surmising like this.
‘Right, Danny,’ she said briskly. ‘Let’s get going.’ She pulled down the microphone above her head so that it was suitably close to her mouth and began to dictate. ‘The body is of a female, height…’ Danny measured and told her and she repeated the fact into the mike and they were off, slipping comfortably into the routine of a post-mortem, and all musings apart from what she was actually doing and looking at slid out of her mind.
Her knife slid down the belly, from xiphysternum to symphysis pubis, cutting a wake that lay open the whole of the belly from the lowest ribs to just above the smudge of dark pubic hair. She pulled the flaps apart and began to investigate the abdominal contents, dictating continuously as she went. Danny took the various pieces of viscera, weighed them and gave her the details, which she dictated into her mike too before carrying on, checking the stomach for its contents, which she emptied into a stoppered flask that Danny held for her, then the gut, the kidneys, liver … and her puzzlement grew. This had been a healthy young woman. There was no hint of disease anywhere that she could see with the naked eye, though of course there was still the microscope work to be done. The liver, in particular, she thought, had the pristine look of one belonging to someone who had never tasted alcohol in her life.
But that was a fanciful notion. She set it aside as unworthy of a practitioner who was supposed to have a scientific mind as she set to work on the pelvic contents. Ovaries and fallopian tubes: normal and, to the naked eye, healthy. The uterus: here her gaze sharpened and she looked even more carefully.
Bulky, she thought. Moving even more carefully now, she lifted it over the bony pelvis and set it on the slab where she could do a further dissection. Danny watched her in his usual imperturbable fashion, his lips pursed as though he were whistling, though he never emitted a sound as her knife slid over the membrane and then bit into the thick strong muscle of the uterine wall.
She wasn’t unduly surprised when she finally had the uterus open. She had expected it, but all the same it deepened the pity she felt; standing there looking down on the twelve-week foetus that lay curled up and very dead inside its equally dead mother. She could almost have wept for it.
*
It took her some time to regain her equilibrium. She finished the PM, finding the cause of death without any difficulty: the lungs were full of water, and there were other signs which made it clear Pam Frean had drowned. Since she had been discovered in her bath under the water, that had been the most likely explanation anyway; but George had deliberately given no thought to that fact when making her examination. It would not be the first time she had found that a corpse which had been recovered from under water had been dead before it entered it. But in this case, it was a true bill; death by drowning. Later, however, the blood-chemistry tests added another dimension: the girl had taken a large dose of diazepam.
But try as George might to stop thinking about the case, she couldn’t. She did all she could to keep the facts about the PM quiet, but of course she failed. Sheila had them wormed out of Danny immediately; she might regard him as one of the lower orders, but when she wanted something from him she could turn on the charm to great effect and without shame. So in no time everyone around the hospital was talking of the three deaths — and still calling all three of them suicides. And though George tried not to let the gossip get to her, she found herself wanting more information than she had, certainly about the last case. Because with this one the gossips were almost certainly right.
That was why she went over to A & E to see her old friend Hattie Clements. There had been something in the notes which suggested that Hattie might be able to give her more information about Pam Frean. And that was something George badly wanted.
‘I know people are overreacting a bit,’ Hattie, the senior sister on Accident and Emergency said as she gave George a beaker full of the department’s famous bitter black coffee. ‘But it’s understandable. I mean, one suicide a day for three days! No wonder people are uneasy.’
‘But there weren’t three suicides!’ George said. ‘It’s people like Sheila whipping them up, that’s all. And it wasn’t one a day. That was just the way people heard about it.’
‘You’re wrong, George,’ Hattie said. ‘And I don’t often think that, you know I don’t. But right now Sheila’s irritating you so much you’d blame her for the war in Bosnia if you could. But truly, she’s not the only one talking. Now, just listen!’ She raised her voice to override George’s attempt to interrupt. ‘On the Monday they found Lally Lamark dead on the floor of her office, stiff as a board and —’
‘Which shows she didn’t die on Monday,’ George said. ‘Goddamn it, Hattie, who’s the pathologist around here, me or you? She’d been dead since the Friday. Rigor mortis had —’
‘They found her on Monday.’ Hattie was stubborn. ‘And that caused enough drama, the way it happened. And then on Tuesday, there was Tony Mendez
collapsing in the middle of a case and frightening the crap out of Gerald Mayer-France so much that he had to hand over the gall-bag he was doing to his registrar.’
‘Any excuse to cut short his NHS sessions are balm in Gilead to Mayer-France,’ George retorted. ‘He’s the sort of consultant who gives the NHS an even worse name than it’s got. He was probably cuddling up to one of his private patients in Wimpole Street before the poor sap of a registrar had the skin clips in —’
‘And then,’ Hattie said, riding over George magnificently, ‘yesterday, there was Pam Frean. Is it any wonder they’re all looking over their shoulders to see who’ll be the fourth one?’
George put down her cup with a little clatter. ‘Oh, Hattie, really, listen to yourself, will you? This is sheer nonsense! Those first two were accidents! Lally Lamark had been having trouble with her diabetic control ever since they’d changed her to the new sort of insulin. And Mendez, well, they thought he’d kicked the booze and was OK, but he hadn’t. And when he took a drink he just overestimated how much he could safely take and poisoned himself. Accidentally. I did the PMs on them both myself, goddamn it! If they’d killed themselves I’d have spotted something to prove it. And they left no notes or —’
‘But Pam Frean did!’ Hattie cried. ‘She definitely did, didn’t she? And as for the other two being accidents, everyone says that Lally got her insulin right and people who knew Tony well swear he was well and truly in control. I have no trouble believing they were all suicides, no matter what you say!’
‘Don’t confuse me with facts, is that it?’ George said dryly. ‘Because guessing is so much more fun? Come on, Hattie, I expected better of you.’
‘Fiddle-de-dee,’ Hattie said, refilling George’s cup. ‘You wait and see. You’ll come and apologize to me yet. I know a suicide when I see one.’