Second Opinion Read online

  Also by Claire Rayner

  FIRST BLOOD

  THE MEDDLERS

  A TIME TO HEAL

  MADDIE

  CLINICAL JUDGEMENTS

  POSTSCRIPTS

  DANGEROUS THINGS

  THIRD DEGREE

  LONDON LODGINGS

  Claire Rayner

  SECOND OPINION

  A Dr George Barnabas Mystery

  ebook ISBN: 978-1-84982-025-7

  M P Publishing Limited

  12 Strathallan Crescent

  Douglas

  Isle of Man

  IM2 4NR

  United Kingdom

  Telephone: +44 (0)1624 618672

  email: [email protected]

  M P Publishing Limited

  First published 1994

  Copyright © Claire Rayner 1994, 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 written permission of both the copyright owner and the above publisher of this book

  e-ISBN 978-1-84982-025-7

  The moral right of the author has been asserted

  For Pat Gordon Smith,

  another feisty woman (and a great daughter-in-law!)

  Thanks for advice and information are due to Dr Trevor Betteridge, Pathologist, Yeovil District Hospital; Detective Chief Inspector Jackie Malton, Metropolitan Police; Dr Rufus Crompton, Pathologist, St George’s Hospital, Tooting; Dr Hilary Howells, Anaesthetist; the British Airport Authority; and are gratefully tendered by the author.

  1

  The first baby died on the morning of 14 July, or rather, as Sister Lichfield who was a stickler for accuracy wrote in her report, he was found dead in his crib then. It was hard to tell how long he’d been dead; the small body was cold but not stiff, and the eyes were half open. They would have to leave it to the pathologist to decide that, Sister Lichfield said, and busied herself getting the body down to the morgue and doing what she could to comfort the mother.

  ‘Not that I can swear to it that she’ll be exactly heartbroken,’ she confided to her senior staff midwife, Audrey Burke, before she went to the four-bedded bay where the mother had been left to sleep in peace, while her baby had been taken to the nursery for the night because he’d been restless and noisy. ‘She wasn’t what you’d call over the moon about him, was she?’

  Audrey, who had delivered Barbara Lennon, had to agree. ‘Not that you’d expect her to be really, poor thing. Been living on the streets since March, as I understand it, and couldn’t be sure who the father was. I dare say she’d have put him up for adoption anyway. All the same, I’m sure she’ll be as upset as any other mum would be.’ Audrey was a sentimental woman who always thought the best of everyone. ‘Though I have to say she wouldn’t hold him when we showed him to her. Didn’t even look at him much.’

  Sister Lichfield proved to be right. Barbara Lennon looked blankly at Sister when she told her of the tragedy, shook her head in some wonderment and just said, ‘Oh. After all that, an’ everythin’. Just goes to show, don’t it?’ And nothing more.

  Sister Lichfield made no response to that, merely smiling kindly. She sent the Chaplain to see her and arranged for some bereavement counselling too. Always efficient, there was nothing she would forget for her patients’ welfare; having done it she gave the matter no more thought and turned her attention to other more absorbing considerations.

  And that was all there was to it, until the end of October when another cot death happened. This time Sister Lichfield was far more rattled, and the whole ward was upset. The news went round like wildfire. Half the mothers burst into immediate tears of fellow-feeling and needed a great deal of comforting and reassuring before they settled again; and of course all the fuss upset the babies who cried noisily all morning while Sister Lichfield, looking crisper than even she usually did, which was very crisp indeed, tried to calm matters down and deal with the parents, who this time were hysterical with grief.

  It was understandable. Viv and Angela Chowdary had waited a long time for their first child. It had taken them and half a dozen doctors to achieve the pregnancy, Angela had confided to Sister Lichfield the evening she was admitted with her contractions coming at twenty-minute intervals, so this was a very precious baby.

  ‘Not that they’re not all precious, of course,’ she added hastily as Sister set the foetal scalp monitor in place, making Angela wince slightly but able to smile bravely as well, ‘but I’m nearly past my sell-by date, let’s face it, and there won’t be many chances to have another go, will there? Even if Dr Arundel in the Fertility Clinic’ll take me again. So this baby means the moon and stars to us. It’s a girl, you know. We had the tests and the amnio and all that — Viv was a bit disappointed at first seeing she’s going to be an only one the way things are — I mean, I’m thirty-nine, after all, and — oh!’ She caught her breath and looked a little surprised. ‘That was a big one.’

  ‘A very good contraction,’ Sister said approvingly. ‘Don’t forget your breathing now, dear, the way you learned it. I’ll send your husband in, shall I? He’s staying, of course?’

  ‘Oh, yes!’ Angela said and beamed at her, relaxed again now the contraction had settled, but clearly very excited and happy. ‘He wouldn’t miss a moment of this.’

  It hadn’t been an easy birth. Angela had soon forgotten all she had learned in her prenatal classes, not breathing at all as she should despite Viv’s exhortations, and she had bawled a great deal, somewhat to Sister Lichfield’s disapproval. She was as modern a midwife as the next, she liked to tell herself, but really she did think privately sometimes that in all this fuss about birthplans and natural childbirth and did-they-or-didn’t-they-want-to-be-in-a-birthing-chair-or-under-water, the mothers forgot the virtue of a bit of old-fashioned dignity. Sister Lichfield had trained in the days when a labouring woman was expected to bite her lips and not fuss too much, and certainly not to argue when offered plenty of painkillers to knock her out and shut her up. Sister Lichfield wouldn’t have admitted it to her colleagues for the world, but she still preferred the old days when midwives were properly in charge and mothers didn’t make such a drama out of it all. A pregnancy, she was fond of saying to her pupils, was after all only a pregnancy. No need to make a career out of it.

  But she never let her patients know she felt this way, and was a good caring woman who often remained late on duty to finish a case. In Angela’s case, in fact, Sister knew she wouldn’t deliver for some time, and went off only to return next morning an hour before her shift was due to see her. And was just in time to deliver the baby who emerged looking bruised and bewildered but seeming well, and when checked over by the paediatric people was charted as indeed being in excellent shape.

  The baby, Sister Lichfield thought, showed clearly her grandfather’s race — she had soon discovered that Viv Chowdary was the son of an Indian father and Scottish mother — being dark of eyes and with a mass of black hair, and she was very pleased to be told by a now ecstatic Angela that the baby’s third name would be Celia, after Sister Lichfield. She smiled and accepted graciously, enjoying the compliment even though it was one she had been paid many times before. This part of East London had a considerable number of Celias aged fifteen and under.

  The baby was taken to the nursery to rest, because the birth had been so stormy, though Angela had protested at first, wanting her daughter to be at her side all the time. But she had agreed when Viv had added his own insistence that she should rest and had settled to sleep most of the day away, which wasn’t difficult as she wa
s in a single room, while Viv went off to celebrate with his own ecstatic parents and an assortment of brothers and sisters and inlaws of all kinds. Sister Lichfield called Fertility to let them know that another of their successes had duly arrived. Dr Arundel wasn’t there, and wouldn’t be back today, she was told, but would come to see her grateful patient first thing tomorrow morning. And the Maternity Ward swung into the daily round of deliveries — a particularly busy one today, in the event — and no one paid much attention to either Angela Chowdary or her baby.

  Or not until the late afternoon. Sister Lichfield was about to go off duty, now thoroughly tired after her too early start, when the pupil midwife responsible for Angela’s care, a rather anxious girl called Nuala Kennedy, was sent to fetch the baby to her for its first attempt at the breast. It was she who found the baby dead. She ran out into the corridor from the small separate nursery, her eyes almost as wide open as her mouth and shrieking like a steam engine. The noise brought Sister Lichfield into the corridor from her office in her mufti — she’d been changing to go home — together with several of the other nurses and midwives.

  ‘There’s something wrong!’ the pupil midwife shouted, her face showing real terror.

  Sister Lichfield’s hand had itched to provide the time-honoured remedy for hysteria, but she settled for grasping the girl by the shoulder, hurrying her back into the nursery and closing the door firmly behind her. ‘Good God, woman, do you want to set the entire ward off? When will you girls learn how to be quiet around the mothers? They burst into tears at the least excuse and then set the rest of them off. Now what is it?’

  ‘The Chowdary baby, Sister,’ Nuala gibbered. She gulped as sudden tears appeared in her eyes. ‘I think it’s dead — I tried to pick it up and it’s sort of floppy and …’ She shuddered suddenly, quite uncontrollably. ‘It’s not what I’d expected. Not here in Maternity. I’m sorry to be so —’

  But Sister wasn’t listening to her. She bent over the cot and looked at the baby. The dark hair looked the same, a thick shock that seemed to grow part way down the side of the face too, but the skin that had been a pleasant sallow pink was now blue and the eyes that had been so bright and wide this morning at the moment of birth stared blankly from beneath unevenly open lids. There was no question that the child was dead. Sister Lichfield felt a stab of regret so deep and so painful she could have joined the young pupil beside her in her tears. But she just stood up straight and snapped, ‘Who else has been in here today?’

  The pupil shook her head miserably. ‘Don’t know, Sister. This is the only baby in here right now and I was told to leave her to rest and …’ She gulped again and Sister looked at her briefly and then away, her disdain at the girl’s feebleness so visible that the pupil herself winced at the sight of it. But Sister said nothing. She lifted her chin at the glass door through which Audrey was peering, with several of the other staff behind her, and Audrey at once obeyed and came in.

  ‘You people, get on with your work,’ Sister Lichfield said sharply and turned to Nuala. ‘You too — go and get yourself some coffee. And don’t go near Mrs Chowdary, whatever you do. Leave her to us. Now, Audrey —’

  ‘Oh, lor’,’ Audrey said as she looked at the pitiful little creature in the cot. ‘Another one? How long is it since the last? We haven’t lost a baby here for … I can’t remember how long. And now two, so close together. It’ll cause an uproar upstairs.’

  ‘That’s the least of my worries,’ Sister Lichfield said. She looked down at the baby again. ‘That poor couple. This was the most precious baby … Oh, shit!’

  Audrey glanced at her and then away, almost embarrassed. It was unusual in the extreme for Sister Lichfield to indulge in street language. ‘Yes,’ she said. ‘Will you tell her?’

  ‘I’ll have to. Oh, blast it all to hell and back.’ Using her own form of swearing again seemed to strengthen Sister Lichfield and she straightened her shoulders. ‘I’ll get back into uniform, then. Look, tell the staff to keep quiet about this. It’ll get out, of course, but if we can contain it for a while it’ll help …’

  But she was too late. Already all the staff and most of the mothers knew a baby had died, and there was a great deal of noise and running about going on as the mothers wept and demanded an immediate check on their own babies and wanted to know what the baby had died of and was it catching? Audrey set to work to soothe them all and make what reassuring noises she could while Celia Lichfield steeled herself to talk to Angela.

  At least, Sister Lichfield thought, her husband was back with her, and at least she was in a single room which helped. But not a lot. At first they stared at her blankly when she told them their daughter had been found dead.

  ‘A cot death, I think,’ Sister said wretchedly, breaking her own rule about saying anything about diagnoses until she was sure, but needing to say something to these two people who stared at her with uncomprehending eyes and blank faces. ‘It’s something that happens sometimes, I’m afraid. I am so sorry. I can’t tell you how sorry. It’s a tragedy, a dreadful thing to have happened …’

  It was Viv who spoke first. ‘It’s not possible,’ he said, his voice hoarse. ‘I saw her this morning. I held her. She was wide awake and looked at me. She knew me. It isn’t possible.’

  ‘I’m sorry, Mr Chowdary,’ Sister said clearly and very directly. She felt her heart sinking even lower. This was going to be particularly difficult. ‘I’m afraid it’s true. I — er —’ She thought quickly about how the baby had looked. Tolerable, she decided. ‘Would you care to come and see her? I’m afraid there can be no doubt, and she looks rather different to the way she did when she was newly born, of course, but —’

  Angela stirred for the first time, opened her mouth, and screamed. It was a penetrating, agonized howl and Sister Lichfield felt the skin on the back of her neck crawl. She said, more sharply than she meant, ‘Now, please, my dear —’

  ‘What have you done to my daughter?’ It was Viv who was shouting now, clutching the still shrieking Angela to him and staring at Sister Lichfield over her head with wide eyes, so wide that rims of white could be seen above the iris. ‘For Christ’s sake, what did you do?’

  It went downhill from there. The parents wept, refused to be comforted, began to scream together and carried on doing so until Angela, given an injection of a sedative, collapsed into dim uncomprehending silence, and Viv, offered brandy by the Registrar in Obstetrics, Didier St Cloud (who had been hurriedly sent for by Audrey to help in the reassurance of the mothers), took it and also lapsed into a stunned and miserable quietness. Which made it possible for Sister Lichfield and her staff at last to reassure all the mothers that this was a rare event, a one-off that could not possibly hurt their babies, and for Didier St Cloud to look at the pathetic little body of Baby Chowdary and pronounce her dead.

  ‘PM as soon as we can fix it,’ he said. ‘I’ll do the paperwork, shall I? You’ve got enough on your plate with the mothers.’ Sister Lichfield looked up at him briefly and nodded. They often fought, she and St Cloud, since he, in her estimation, cherished a great deal too many fancy notions about obstetrics that he pushed on the basis of damn-all evidence, and she, in his eyes, was a fuddy duddy who ought to have been put out to grass years ago; but in this situation they had a lively awareness of each other’s worth and were grateful for the mutual support they provided.

  ‘If you would, yes please,’ she said. ‘I suppose there’ll be no end of a fuss, seeing it was my delivery. I saw no problem, so I didn’t call you or Fay Buckland. I didn’t think it necessary. I had the child checked by the Paed. team, though. So maybe —’

  ‘It’ll be fine,’ he said, picking up the notes to take them with him to the office he shared with the other registrars so that he could write up his last examination of the infant. ‘No one can blame you for anything. These things happen. A stormy delivery or a normal one, it makes no odds. If they’re going to go in a SIDS, go they will.’

  ‘I suppose that’s what it
is,’ Sister said a little fretfully. ‘It couldn’t be anything else, could it?’

  ‘Precisely,’ Didier said and went away. ‘It couldn’t be anything else.’

  And greatly to Sister Lichfield’s relief, the coroner agreed.

  The inquest was little more than a formality, and when it was over Angela and Viv Chowdary went drearily home and Sister Lichfield did her best to forget them, though it wasn’t easy. The woman who had been so excited and pleased with herself the morning her baby was born looked, by the end of the first week after the birth, twice her age and half her size and grey with misery. Her husband had a remote and chilled air about him and, watching them leave, Audrey murmured to Celia Lichfield, ‘I wouldn’t be surprised to hear he’d dropped her and found himself someone new after a while.’

  Celia looked at her and frowned. ‘You’re being dramatic again.’

  ‘No, this time I’m not. Did you see that man’s face when the child was born? It was like someone had lit a bonfire in him. And look at him now. He’s the same age as she is, lots of time for him to start again, find someone else to have babies with. She’s got a very small chance, after all. Poor cow.’

  And Sister Lichfield couldn’t argue with that. She’d come across similar stories before. She knew, better than most, that there was more to having babies than just long labours and stitches and painful perineums. She could write a book, she sometimes told people, about the things she saw and heard in her Obstetric Unit.

  But she didn’t write a book. She went back to work and for a while everything went as smoothly as could be wished. The department managed to streamline its systems to get the patients in and out faster, and so pushed up the throughput (‘What a horrible word!’ Sister Lichfield said to Fay Buckland, the senior consultant on the unit. ‘Makes it sound like those things they use to clean rifles.’ ‘Hush,’ said Fay Buckland. ‘They’re pull-throughs. And the marketeers’ll get you if you talk like that.’) and the Finance Department found them some money to upgrade some of their wards a little. ‘We have to market our Obs department very vigorously, Sister,’ said Margaret Cotton, who was the Director of Finance for the NHS Trust that the hospital had become the previous April. ‘Because if we don’t the London Implementation Group’ll come and close us down. And we wouldn’t want that, would we?’