Second Opinion Read online

  Agreeing sourly that indeed we wouldn’t, Sister Lichfield pushed herself harder than ever, not only doing more than her share of deliveries and teaching the pupils and hustling the less experienced of the house officers along so that they learned their business faster, but also spending (wasting, she called it) long hours in meetings with the head of the Family Directorate which covered Obs and Gynae. and Paediatrics as well as Family Planning and the Fertility Clinic, while they tried to sort out their finances and think of what wheezes they could use to lure pregnant mothers away from the more attractive hospitals in proximity to Old East and into their own eager arms. It was more than enough to expunge from her mind all thoughts of the sad Chowdarys and their dead baby.

  Until one evening in winter, the first of December, when it happened again. This time the baby was a boy, a large and bouncing child who had given them no cause for anxiety at all. He had been born after a mere seven-hour labour of great tranquillity to a relaxed and experienced mother, Helen Popodopoulos, who was delivering herself of her third child in the ward while expecting to be treated on a Domino basis; domiciliary care had been given right up to the time of her starting labour, so she had never attended the hospital’s antenatal clinic, and she had come into Old East only for her delivery, accompanied by her own district midwife, Ann Powell. Sister Lichfield knew her; indeed Ann Powell had been one of her own trainees long ago, and the hospital (as represented by herself) and the district (as represented by Ann) had long enjoyed a happy relationship. So there was no need for her to have any anxiety about the case. The mother was in excellent hands, and should have gone the morning after she delivered to complete the acronym: domiciliary — in — out.

  But she didn’t. Because at six a.m. when the night staff went to fetch the baby to take to his mother — the four babies from the bay Helen was in had been relegated to the nursery for the night because two of the mums were particularly tired after difficult deliveries, and the others hadn’t in the least minded being assured a night’s sleep totally free of the sounds of their crying infants — baby Popodopoulos was dead.

  And this time the reaction was very different, because George Postern Barnabas, who had been on holiday when the first baby had died and off sick with an infected injury to her left hand when the second one came down to her morgue, was very much on duty. And there was no way she was going to accept as mere coincidence the occurrence of three cot deaths in Old East within a matter of five months. George knew better than that. And anyway, she was worried.

  2

  ‘Nasty to come back to,’ Sheila said with rich sympathy. ‘It’s awful when babies die. All that wasted promise and the poor mother left with empty arms …’

  George grimaced, more irritated than usual by Sheila’s sentimentality, but very aware of the fact that she was in general irritated by everything this morning.

  The weather was foul, for a start; not cold and brisk, which she could handle easily, but dank with a bone-deadening chill from the river mist which filled the air with the acrid scent of oil and mud and old dead things. Everything she had touched since she got out of bed in her noisy little flat just over the river in Bermondsey had seemed slimy with condensation and sticky with heaven knew what in the way of pollution; and her hand felt heavy and dull and less responsive to the demands she had made on it as she worked on the small body that had been waiting for her in the morgue. Fortunately, it had been her left hand she had accidently stuck with the point of a scalpel during a PM on a vagrant’s corpse — a piece of clumsiness over which she was still furious; even thinking about it made her flush with shame — but all the same it slowed her down, even though it was now officially regarded as healed and free from infection, and made her painfully conscious of what she was doing.

  At least this morning’s PM hadn’t been observed by anyone from Ratcliffe Street nick, she thought. It would have been dreadful to have had Rupert Dudley there, looking his usual sardonic and unpleasant self, or one of the younger ones — like Michael Urquhart, who would have been sympathetic and understanding which, in a way, would have been worse than Rupert’s sneering gaze. She deliberately didn’t think about what it might have been like to have had Gus Hathaway there; he belonged in another part of her mind entirely, and she wouldn’t let him intrude where he didn’t belong. A thought which she knew was stupid and which therefore made her even more irritable.

  And then there was the state of the department when she came back. She’d been off sick for a month, admittedly, but there’d been no need to let the paperwork pile up on her desk so appallingly. Everything looked shabbier and messier than usual, too, and she’d said as much to Sheila, seeing she was the senior technician responsible for efficiency, as soon as she returned. Sheila had bridled and looked offended, then admitted that George was right; things had slipped badly. But what could she, Sheila, do when they refused to replace either Barbara Pratt, the haematological technician, or the junior, Tracy, both of whom had left this summer, and the locum pathologist had been so uninterested in what he was doing? She did her best to keep the work going through but with staffing levels the way they were, how could she, Sheila, be expected to cope? She wasn’t a miracle worker, after all, just a humble toiler in the vineyard doing her best with what she had.

  And, she had continued, warming to her theme, it wasn’t as though it was only in Pathology there were problems with staffing; wasn’t the entire fabric of Old East under threat with all the changes the new Trust Board was making? ‘Counting the bloody paper-clips,’ she said bitterly. ‘That’s what we’re doing. Everything’s being cut to ribbons. It’s death by a thousand cuts, that’s what it is.’ She said it as though the cliché were a phrase she had newly minted. ‘There are all those bloody Union meetings all the time and you fall over protesters and their placards every time you go in and out of the place — and then to cap it all you come back and have a go at me when I’ve done all I could, I swear to you, all anyone possibly could do, to keep things going properly —’

  George had taken a deep breath and stopped listening, while biting her lip to keep back any comments regarding the amount of time Sheila might have spent gossiping on the phone — her most infuriating habit — and said merely that she would talk to Professor Hunnisett about it. The person who really had control over staffing, of course, was the Chief Executive Officer, Matthew Herne, but she knew she’d get short shrift from him if she asked for more help. The only thing that man cared about was the rows of figures he spent all his time with; if she didn’t get a clinical ally to help her lean on him, she’d never get anywhere. Professor Hunnisett, as head of the Clinical Directorates — these new labels they all had now they were an NHS Trust were another source of irritation to George — was the only person she could ask to help her; not that he could be expected to do all that much. He never did, after all.

  She got rid of Sheila by dint of asking for coffee — a request which sent her off in a huff to complain to Jerry and Jane and Peter and anyone else in the main lab who would listen that she wasn’t a domestic, for God’s sake, the woman could make her own bloody coffee, before going into the little kitchen to make it — and settled at her desk.

  The paperwork would have to wait; first there was the report on this post-mortem to do, and she took the cassette Danny Roscoe, her mortuary porter, had given her after she’d finished her dictation, and pushed it into her Walkman. It would have to be typed out so that she could read the notes at her leisure, but now she wanted to recall what she’d seen and done.

  She sat with her eyes closed, slowly rubbing her dull left hand with her right as she listened, and frowned.

  It had seemed to be a cot death. Certainly there were no signs of any kind to explain the death in any other terms; she had looked particularly carefully for needle marks and there had been none, and had taken samples for Jerry, her most sensible technician, to check for insulin. She, like every one else in the pathology world, had become particularly watchful for that ever sinc
e the fuss last year over the nurse suffering from Munchausen’s by Proxy, who’d murdered in-patient children up in Lincolnshire. But she doubted there’d be any; there had been no signs to lead her to suppose anything untoward had been done at all. Inevitably she was left with that most deeply unsatisfactory of diagnoses — Sudden Infant Death Syndrome — to put on the report for the coroner, and she opened her eyes and rewound her tape, glowering as she thought about it. It was as bad as those ghastly historical days, when they had entered things like ‘Dead of the Flux’ or ‘Succumbed to Melancholy’ in cause of death columns in church registers. Positively antediluvian.

  She leaned back and rubbed her face, trying to make her left hand feel less heavy, and knew the problem was as much her own mood as anything else. If she kept thinking about her hand, of course it would feel odd. Somatizing, that was what she was doing. She was anxious and pushing her anxieties into her work and thereby into her body. If she hadn’t been thinking about her mother that day when she’d done the post-mortem on the vagrant’s sadly decomposing body (they’d found him in a pile of dustbins where he had clearly been for almost a week, unnoticed because the street-cleansing work of the local council had been privatized and somehow the collections were ‘all over the place’, as the policeman who brought in the body had told her gloomily), if she hadn’t, she repeated inside her head, she wouldn’t have let her hand with the scalpel slip. If it hadn’t slipped she wouldn’t have stuck the back of her other hand and let in the infection that sent it swelling to terrifying proportions and pushed her temperature sky high. And if that hadn’t happened she wouldn’t have had to spend almost a month in the Communicable Disease Ward while they sorted out the causal organism and got rid of the infection. Time she had spent thinking about her mother …

  With a sharp gesture she reached for the pile of paperwork and tried to start on it, but it was no use. She still had to decide what to do, for it had been over a month since Aunt Bridget had written, and the sooner she did it, the sooner she’d get her head together.

  After a few minutes she pushed the work away and pulled out from her drawer a piece of blank paper. She’d do it in columns the way she usually did when she had a problem to solve. Neatly she ruled a line down the centre of the page, then wrote across the top: ‘EPB. WHAT TO DO.’

  ‘ONE’, she wrote. She stopped and chewed her pen. After a while she bent her head and wrote firmly: ‘Ignore A.B.’s letter as nonsense.’ And then stopped again.

  Aunt Bridget, as she had called her since infancy, even though the woman was just her mother’s friend and not a relative at all, had never been one to fuss. That was why her mother had loved her and why George herself had quite liked her. So if things were worrying her about Vanny — George’s mother — as she had said in her letter, then she was indeed deeply concerned. This wouldn’t be a small matter.

  ‘She’s not quite as good at caring for herself as she thinks she is,’ Bridget had written in that strong backwards-leaning script that was so familiar.

  I can’t go into details here and I’m not sure I want to. I just want you to come home and take a look at her. That’s all. I’ve talked to your Uncle Nathaniel and you know what an old bastard he is, and I’m sure you’ll forgive me the description for isn’t it no more than the plain truth? He said it’s none of his affair and he has his own problems, and that was that. Though I have to say what the old devil could do is limited, even if he were willing. He’s almost seven years older than your ma and I don’t have to tell you her seventieth comes up next January. So, what are the chances of you coming over to visit with her for a while? It would please her one hell of a lot, of course, and it would help me to decide what’s best to do next …

  And apart from some inconsequential chatter about the doings of some of George’s scatter of cousins, most of whom still lived in New England well away from Upstate New York where Bridget and Vanny had been contented neighbours and friends this past forty years, that was all. Not another word about what it was that worried her. And even when George, anxious about what little she had said, had phoned her, Bridget had not been forthcoming.

  ‘Come and see for yourself,’ was all she would say. ‘I’m not the doctor, George. You are. Not that’s she’s sick, exactly. I don’t mean that. It’s just that — well, come and see.’ And that had been that, and George, remembering the stubbornness of the woman, had given up trying.

  No, she couldn’t ignore Aunt Bridget’s letter. So she looked at her piece of paper again and wrote another line. ‘Go home to Buffalo.’

  She leaned back in her chair and contemplated that. And then shook her head. It just was not feasible. The job here was not one she could easily leave for a month or more, not after such extended sick leave, and there would be little point in going for a shorter time, surely? Even if she could afford it, and truth to tell she’d be hard pressed to do so.

  It had cost a fortune to get her tiny flat in Bermondsey; she’d tried to find somewhere in an area still untouched by the creeping tendrils of gentrification which had invaded the whole Docklands area, but had had to give that up. No one had any flat to offer in what she called the ordinary streets. They were all council tenants or people who had lived in the same houses for so long no one would get them out till they died, and then the council had a waiting list so long that — No, she’d had to give up that idea, and find herself a flat to buy amongst the smartened-up streets, with their brass carriage lamps and gleaming white paint at which the locals sneered and which made the shopkeepers watch out for the residents so that they could overcharge them. And that had cost money. She’d scraped the bottom of her savings account to get the place, had borrowed to the hilt to furnish it and heaven knew when she’d be out of debt.

  So, she was broke and that was the core of her predicament. She couldn’t visit Ma, because she daren’t take time off for which she wouldn’t be paid and she couldn’t afford the price of an air ticket anyway.

  Again she reached for the piece of paper and this time wrote more slowly: ‘Get Ma to visit me’, and put down her pen and rested her chin in her hand.

  She loved her mother dearly — at a distance. When they had shared a home, long ago when her father Oscar Barnabas was still alive, the only thing that had kept them from arguing all the time had been his gentle buffering; he’d told George firmly that he loved his wife and wouldn’t let the impetuous young George drive her crazy; he’d told his wife he loved his daughter and wouldn’t allow her strong-minded mother to run her life. And they’d listened and managed to live together amiably enough on that basis. But since her father had died — oh, no. There could never be any peace if they lived together.

  Face it, woman, George told herself now. You don’t want to go to Buffalo because you just don’t want to have to live with her. You could get a job there, probably, but you’d rather stay here. And if you can’t live with her in Buffalo, having her here will be just as bad.

  ‘I’ll ask Bridget too,’ she said aloud, and then grinned in relief. Of course. She wrote that down on her sheet of paper and then screwed it up and threw it into the waste basket. It had worked again, writing it down, and for the first time that morning she felt better, in control of herself and what was going on around her.

  Now she could put her mind to her job. She pulled the paperwork back and started to sort it with swift fingers into piles of urgent, not-so-urgent, and get-someone-else-to-do-it. It only took her half an hour to finish by managing to get a good deal of it on to the someone-else pile (Sheila? Probably. Do her good, she thought with a shaft of malice), leaving herself with some stuff she could get through before the end of the day if she put her mind to it. Which meant she could now go back to the matter of the Popodopoulos baby.

  She looked again at the note that had been written on a scrap of paper and attached to the forms that had come with the body. ‘This is the third infant death we’ve had in Maternity since the summer. ?? Linked.’ The note was typed and unsigned but she assumed it
had been written by the registrar who’d verified death, and she riffled through the forms to find out his name. Ah, yes, she thought. Didier St Cloud. A stocky young man with a great deal of untidy fair hair and no hint of a French accent in his speech, even though he had been born and reared in Lyons; she remembered seeing him in the canteen laughing and sitting rather close to one of the prettier young nurses and being told all about him by Hattie Clements, her closest friend among the nursing staff, who was as eager and amused by hospital gossip as was George herself.

  ‘Very bright, according to Audrey Burke. She rather fancies him, I think. She’s quite jealous because he’s obviously got a thing for Alison Gurney — that’s the girl he’s talking to — and she knows that Celia Lichfield dislikes him and that makes him even more attractive in her eyes. She can’t stand Lichfield though they always seem to get on well together. But then, as Audrey says, you have to try when you’re stuck with each other.’

  None of which, George told herself now sternly, is at all relevant. The thing is, if this is his note and he’s right and there’ve been three sudden infant deaths in Maternity then there is indeed something to worry about. I’ll have to ask him if he did attach it to the request form, and why he didn’t sign it — because if there’s something odd going on, his coyness in being direct about it gets to be significant.

  Her spirits lifted suddenly and she found herself whistling softly through her teeth as she left her small office and went to check on the state of things in the labs; it wasn’t so bad being here, after all, rotten though the weather was. She’d get Ma over on one of those special tickets that meant she had to go home after a fixed time, so even if they did argue while she and Bridget were staying with her (and it was going to be dreadfully crowded; she only had the one bedroom and they’d have to share, which no doubt they’d fuss about), well, it would only be for a few weeks. And she had an interesting mystery to get herself buried in. Lately, there’d been nothing much to interest anyone.