Crisis

TWO

Bannerman left the hospital at six-thirty. He noticed that Stella’s white Volkswagen Golf was still in the car-park as he edged his own Rover out of its sardine-like space at the end of the line reserved for ‘Medical Staff. He had hoped that the worst of the rush-hour traffic would be over but he still had to wait for nearly a minute at the gate before he could ease out into the slow moving line. He swore as he had to clear the windscreen yet again with his glove as condensate built up because of the rain. ‘Living in London is like living down a dark wet hole,’ he muttered, turning up the fan and switching on the rear screen demister.

The traffic came to a halt because of some unknown obstruction up ahead; it did nothing to improve his temper. He pushed a cassette of Vivaldi into the car’s tape player and tried to concentrate on the music rather than the frustration of city driving. The tapes had been Stella’s idea. Fed up with his bad temper at the wheel, she had embarked on a programme of ‘sound therapy’, insisting that he try out the soothing effect of various musical styles as an aid to relaxation.

So far the biggest success had been a tape of Gregorian chant, recorded by French monks in an alpine monastery. The sonorous tolling of bells and echoing prayer chants had induced a marked improvement in his driving demeanour with their constant allusion to human mortality. The ironic drawback was that Stella found the ecclesiastical aura in the car almost as irritating as his bad temper. She had insisted on him finding something else. It had been Mozart’s turn last week, which had only moderate success; now it was Vivaldi’s big chance with The Four Seasons.

The traffic started to move but again ground to a halt less than fifty yards further on. Bannerman slipped the gear stick into neutral and sighed in frustration. Winter wasn’t doing too well. It took a further thirty-five minutes to reach the turn off for his apartment block. A few twists and turns through quiet back streets and he was safely through the gates and into the haven of Redholm Court.

As he got out and locked the car he suddenly remembered that he had yet to get some wine to take over to Stella’s. He toyed with getting it on his way there but decided that if he did that it would be warm. There was an off-licence a quarter of a mile down the road so he pulled up his collar and hurried along to it. He was back within fifteen minutes.

With the wine safely in the kitchen fridge Bannerman took off his coat and poured himself a large gin from a bottle which stood on a tray beside the window. He closed the curtains and switched on the television to catch what was left of the early evening news on Channel Four.

Bannerman lived on the third floor. It was a pleasant two-bedroomed flat rented at a price which included all services. He had stayed there for the last two years and had no intention of moving unless he had to. It was quiet, warm in winter and pleasant in summer because of the south-facing balcony and roof garden. The building itself was surrounded by private gardens which included several mature beech trees and a series of well-kept flower beds which the gardeners stocked according to the season. There was also a garage for his car although he seldom used it, preferring instead to leave it on the tarmac apron facing the row of lock-ups.

There was little in the way of furniture in the apartment, something which owed nothing to ‘minimalist’ fashion but much to Bannerman’s lack of interest in matters domestic. Most of what there was designed to hold books although even these pieces were insufficient to cope with his collection and several volumes lived permanently on the floor, something his cleaner was at pains to point out at frequent intervals. She maintained that it interfered with her ‘Hoover’.

Unknown to her, this fact gave Bannerman perverse pleasure. Anything that impeded the progress of that monstrous machine was to be applauded. He had an almost irrational loathing of the ‘Hoover’. It was a hated enemy, the ultimate symbol of domestic drudgery. On the odd occasion he found himself in the flat when the dreaded noise started up he would be into a track suit and off running round the grounds before the cleaner had finished saying, ‘I hope this won’t disturb you too much Doctor …’

Bannerman finished his drink, kicked off his shoes and padded off to the bathroom to shower. He noticed a message on the hall table and stopped to read it. It was from the cleaner and said that one of his shirts had gone missing in the laundry. She had ‘told them off about it and, ‘by the way’ he needed some more shirts anyway. Several were looking ‘weary’. Bannerman had to admit that that was fair criticism. He was probably one of the laundry company’s best customers.

As a medical student he had discovered that pathologists carried the smell of their profession about with them. Even on social occasions he had noticed the sweet tang of formaldehyde or some other tissue fixative clinging to their clothes. For this reason, when he became a pathologist himself, he decided that this must not be the case with him. To this end, he kept two separate sets of clothes, one for work and the other for social use. They were never allowed to mix. Each day when he came home he would strip off and shower before putting on fresh clothes and placing his working ones in the laundry basket, the All Baba basket as the cleaner called it. It was a nice allusion; he liked it. It was a ‘working’ shirt that had gone missing and it was his range of ‘working’ shirts that were looking decidedly faded. It was only Tuesday. He would put off dealing with the problem until the weekend.

Bannerman lingered longer than usual in the shower, letting the warm water cascade on the back of his neck and slacken off the tension there while he mulled over the events of the day. Uppermost in his mind was the decision he had been called upon to make on the breast biopsy. It had worked out well in the end but it had also given him more than a few bad moments. What worried him most was the fact that he had noticed a distinct tremor in his fingers while he waited for an improved prep to be made. He had had worrying moments before in his career, many, but he could not recall ever having seen his hands shake before.

When he stepped out of the shower he towelled himself down in front of the big mirror at the back of the sink and examined himself critically, something he rarely did. Perhaps the appraisal was inspired by earlier thoughts of his approaching birthday but he hadn’t really looked at himself in a long time. He leaned forward to examine his hair, thinning a bit, a state exaggerated by it being wet but undeniable nevertheless. He frizzed it at the front with his fingertips.

His clean-shaven face carried no spare flesh and his chin line was still firm — well, reasonably firm. Perhaps there was just the vaguest suggestion of a double chin there but it disappeared when he pushed his jaw out a little — so he did. His brown eyes, when examined closely with the aid of a finger pulling down the lower lid, seemed clear and bright and his teeth were straight and reasonably white. His upper body was well muscled, though softer than it had been some ten years ago, and the thickening round the middle he would ascribe to Christmas for the time being.

He had a slightly low centre of gravity which kept his height a couple of inches under six feet. His thighs were a bit too thick and muscular when they could have done with being a bit slimmer and longer, a fact which nevertheless had helped him in his rugby playing days. He had played for Glasgow University when he was a medical student there. ‘Frankly Bannerman,’ he thought, ‘you’re not going to be in demand as a romantic lead … but then,’ he reasoned, ‘you never were.’ He wrapped the towel round his waist and went through to the bedroom to dress.

The entry phone crackled into life and Stella Lansing’s voice said, ‘Come on up, Ian.’ The door relay clicked and released the lock without waiting for him to say anything.

‘It’s not Ian,’ said Bannerman. ‘I’m a multiple rapist and I’ve come to have my way with you.’ He climbed the stairs to Stella’s apartment, bottle in hand, and found the door ajar. He let himself in and closed it with enough noise to let Stella know he had arrived.

‘I’ll be with you in a moment,’ came her voice from the kitchen. ‘I’m behind as usual. Help yourself to a drink.’

Bannerman ignored the suggestion and went straight to the kitchen where he came up behind Stella and kissed her on the cheek. ‘Hello.’

Stella half turned and said, ‘I think I’ve ruined the potatoes.’

‘Good,’ replied Bannerman. ‘I’m on a diet.’

‘Since when?’ asked Stella.

‘Since this morning.’

‘It’s not like you to care about things like that,’ said Stella.

Bannerman digested the comment in silence. It deserved some thought.

‘Why don’t you pour us both a drink,’ said Stella, intent on stirring something on the hob.

This time Bannerman did as he was bid. Stella joined him a few moments later, undoing her apron and throwing it casually away as she walked towards him. Bannerman smiled at the gesture. Stella did everything with grace and panache. He was reminded of a story he had once heard about Fred Astaire. It was said that he could walk across stage smoking a cigarette, throw it away, stub it out with his foot and all without breaking stride.

Stella smoothed her brown hair back from the sides of her head and straightened her dress before sitting down. Both gestures were unnecessary. Stella always liked to maintain that she was disorganized and ‘in a tizzy’ but it was seldom, if ever, true. If she had messed up the potatoes it must have been because God had decreed that they should be messed up.

Stella sat down beside him and smiled. ‘How was your day?’ she asked. She had a slightly round face which tempered perfectly her slim elegant figure, whereas sharper features would have made her appear forbidding. A pleasantly wide mouth broke into a smile and bestowed on her what Bannerman always thought of as an air of amused detachment. An enemy might have seen it as patronizing.

‘Fair to middling,’ he said. ‘How about you?’

‘No problems,’ said Stella. ‘Routine removal of ovarian cysts. What happened about John Thorn’s patient?’

‘I’m afraid the section was malignant. What was the problem there, anyway?’

‘The patient had multiple breast lumps and John suspected from the X-rays that there was a deeper tumour which they couldn’t reach by needle biopsy beforehand. He wanted you on hand to examine it if they came across it during the op. Everyone trusts your opinion.’

Bannerman rubbed his forehead in a nervous gesture, then realized he was doing it and stopped.

‘Is something wrong?’ asked Stella. She put her hand on his.

‘No, nothing,’ smiled Bannerman. ‘I’m just a bit tired that’s all.’

‘Poor Ian,’ said Stella.

The comment was affectionate but it made Bannerman feel guilty. He felt sure that Stella had more reason to feel tired than he.

‘I’ll just check the sauce,’ said Stella, getting up and disappearing into the kitchen. ‘You could open the wine.’

Bannerman opened the wine and removed the cork slowly from the end of the corkscrew. ‘Stella?’ he said.

‘What?’ came the reply from the kitchen.

‘Why do you think we’ve remained such good friends?’

‘I don’t know,’ said Stella, coming into the room holding a hot dish with two hands and protecting her fingers with a dish cloth. ‘Is it important?’

‘Maybe,’ said Bannerman.

‘Why,’ asked Stella, depositing the dish on the table and turning to face Bannerman. ‘What’s brought this on?’

‘I’ve been thinking,’ said Bannerman.

‘About what?’

‘Life.’

‘And?’

‘I don’t know,’ said Bannerman.

‘Well, what can I say?’ said Stella with a grin.

‘Why haven’t you got married? Why haven’t I? Do you think it’s some defect in our characters?’

‘Personally speaking I’m quite happy as I am,’ said Stella. ‘Perhaps we don’t need the hassle. We both have demanding careers and busy lives. Maybe that’s enough?’

‘Yes but …’

‘But what? Who has been getting at you? Or have you been stricken by a sudden bout of middle-age?’

Bannerman reacted to the word ‘middle-age’ with a slight wince and Stella noticed. Stella noticed everything. ‘So that is what this is all about,’ she said knowingly.

‘I don’t know what you mean,’ said Bannerman hastily.

‘You’re having a mid-life crisis! That’s what I mean,’ exclaimed Stella. ‘You’re indulging in an orgy of self-analysis! Do you want to lie along the couch and tell me all your innermost fears?’

‘Certainly not,’ insisted Bannerman, feeling vulnerable and wishing he had never broached the subject. He should have known that Stella would see through him right away. ‘I was simply thinking.’

‘Ugh huh,’ nodded Stella. ‘And putting yourself on a diet while you were doing it …’

‘Sometimes I hate you,’ smiled Bannerman.

‘Eat up,’ said Stella. ‘You can always dance it off at the disco on the way home …’

Afterwards, as they sat on the couch with their coffee, Bannerman said, ‘I almost bottled it today.’

‘What do you mean?’

‘Lost my nerve. The tumour section wasn’t as clear as I would have liked and theatre insisted on an answer before the new prep was ready.’

That isn’t exactly the easiest of positions to be in,’ said Stella.

‘I know but it’s what they pay me for,’ said Bannerman.

Tell me about it,’ said Stella.

Bannerman told her the details of what had happened and Stella looked at him in disbelief. ‘You call that losing your nerve?’ she exclaimed. That was an absolutely nightmarish situation to be in, and you got it dead right.’

That’s the way it worked out but it could have been so different,’ said Bannerman. The woman could have lost her breast unnecessarily.’

‘Nonsense!’ exclaimed Stella. ‘She had the best histopathologist in the country examining the biopsy.’

Thanks,’ said Bannerman, but his expression showed that he wasn’t convinced.

‘You really are down aren’t you?’ said Stella. ‘What brought all this on?’

‘I’m not sure,’ said Bannerman, ‘I had a lecture this morning and before it I suddenly found myself thinking what a waste of time it all was.’

‘We’ve all thought that from time to time, especially if you get a bad class,’ said Stella.

‘But they weren’t bad at all as it turned out. We were discussing slow virus brain disease and they seemed genuinely interested. I finished up feeling guilty for misjudging them.’

‘What you need is a change,’ said Stella. Take some time off, re-charge your batteries.’

‘I can’t. I’ve got too much to do.’

‘No one is indispensable Ian, not even you. I’m sure the hospital could survive for a couple of weeks. Leeman could cope with the lab couldn’t he?’

‘Yes,’ agreed Bannerman.

‘And you have a first-class chief technician in Charlie Simmons?’

‘Yes.’

‘So, do it.’

‘I have two more lectures to give on brain disease for the course.’

‘Ah,’ conceded Stella, ‘that’s more difficult. When do your lectures finish?’

‘The last one is a week on Friday.’

That’s not long,’ said Stella. ‘Finish your lectures and then take time off.’

‘I’ll consider it,’ said Bannerman.

‘Do it!’ urged Stella.

Bannerman thought for a moment then said, ‘Maybe I’ll do something I’ve planned to do for a long time but haven’t quite got round to.’

‘What’s that?’

‘Go winter climbing in Scotland.’

‘You’re serious?’ asked Stella.

‘Absolutely. I used to do it when I was a student at Glasgow. I promised myself that I would do it again one day.’

Stella looked bemused and said, ‘I must confess I was thinking more along the lines of you lying on the beach in the sunshine, chatting up dolly birds, drinking ice-cold beer, but if this is what you really want …’

‘We’ll see,’ said Bannerman attempting to close the subject, but Stella made him promise that he would give it some serious thought.

‘I promise,’ said Bannerman. ‘Can I give you a hand with the washing up?’

Stella declined the offer, saying that she would do it in the morning. She wasn’t due at the hospital until eleven. ‘How about you?’

‘I said I’d do the autopsy on the Bryant kid who died at the weekend and I’ve got a meeting at ten-thirty so I’d better get an early start.’

‘I heard about that,’ said Stella. ‘Very sad, brain cancer wasn’t it?’

‘Almost certainly,’ said Bannerman, ‘but I suppose I’ll know for sure tomorrow. If it is, the MRC will want a full report for their survey.’

‘What survey?’

They’re monitoring the incidence of brain disease in the UK to get an overall picture of the situation.’

‘Is this a routine survey or has something prompted it?’ asked Stella.

They’re pretending it’s routine but it has a lot to do with the BSE scare we had last year. People suddenly realized that no one has a clear picture of what is going on because brain disease is so difficult to diagnose and classify. The temptation is always to use vague generalities like, “dementia”.’

‘Somehow I get the impression that things like Alzheimer’s disease are on the increase. Is that right?’

‘I fear so,’ said Bannerman, ‘but the survey should give us a clearer picture when it’s complete.’

Stella looked at her watch and said, ‘It’s late and if you’ve got to get up early …’

Bannerman nodded and got to his feet. He thanked Stella for dinner and took hold of both her hands to say, Thank you for being my friend.’

‘Off with you,’ smiled Stella. ‘And …’

‘Yes?’

‘Don’t stay too long at the disco.’

Bannerman woke at three in the morning with the sweat pouring off him. He had awoken from the nightmare just at the moment when the naked woman had raised the knife above her head to stab him. The act of stretching had caused the jagged surgical wounds on her chest, where her breasts should have been, to split open and weep blood over him.

Bannerman sat bolt upright, breathing heavily and repeating an oath under his breath. After a few moments he swung his legs out from below the duvet and sat on the edge of the bed to light a cigarette. He took a deep lungful of smoke and let it out slowly while he massaged his forehead with his fingertips.

The nightmare had been so vivid that there was no question of lying back down again and risking sleep. The woman with the knife would be waiting for him just below the brim of consciousness. He pulled a dressing-gown round him and went through to the living-room to turn on the television. It didn’t seem very interesting — some American film from the sixties by the look of it — but it provided a distraction, and that was the main thing. The soundtrack was therapeutic as he shuffled into the kitchen to turn on the kettle to make tea.

James Stewart and an actress he didn’t recognize were about to live happily ever after and there were two more cigarette stubs in the ashtray before Bannerman felt like risking sleep again.

At ten-fifteen in the morning, Bannerman returned to his office from the post-mortem suite with the taped report he had compiled of the autopsy on Paul Bryant, aged nine. ‘I’ll need an MRC report form Olive,’ he said to his secretary on passing. ‘He had cancer of the brain.’

‘You aren’t forgetting the monthly Health Board meeting at ten-thirty are you?’ said Olive.

‘No,’ replied Bannerman without enthusiasm.

Olive Meldrum smiled. She knew how much Bannerman hated routine meetings.

Bannerman sat down behind his desk and picked up the telephone. The events of the previous day and night had been preying on his mind too much. He resolved to do something about it. He pressed a four digit code and waited for a reply.

‘Drysdale,’ said the voice.

‘Dave, it’s me, Ian Bannerman. Do you think we could have a talk sometime today?’

‘What about a drink at lunch-time?’

‘I meant a more professional talk,’ said Bannerman.

‘Oh I see. Well I think I should warn you that I suspect your “patients” are a bit beyond psychiatric help,’ said Drysdale.

Bannerman did his best to respond to the joke but it was laboured and Drysdale sensed it. ‘How about two-thirty?’ he asked.

‘That suits me fine,’ said Bannerman. ‘Your place or mine?’

‘Come up,’ replied Drysdale.

For Bannerman to arrange a meeting with a psychiatrist it had been very much a case of the singer not the song because he had little time for psychiatry. On the other hand, he had great respect for David Drysdale whom he had known and liked for five years. Drysdale knew and freely admitted the shortcomings of his speciality. He never hid behind meaningless jargon as Bannerman suspected so many of his psychiatric colleagues of doing. When he heard Drysdale describe electro-convulsive therapy as ‘wiring the patients up to the mains to see what would happen’ he knew that he had found a psychiatrist he would like. As he got to know him better, he discovered that the man had a genuine and sincere concern for the welfare of the mentally ill. It was his regret that so little could be done to help in so many cases.

Drysdale’s office was two floors above the pathology department. The walls were decorated with examples of schizophrenic art and a small print of Edvard Munch’s, The Scream. Drysdale, a sallow-skinned man with dark hair and heavy-rimmed spectacles, which made him look like an East European student, invited Bannerman to sit. ‘What can I do for you Ian?’ he asked.

‘I think I may need help,’ said Bannerman awkwardly.

Drysdale considered making some comment about ‘not thinking he would see the day’ but thought better of it, seeing the troubled look on Bannerman’s face. Tell me about it,’ he said.

Bannerman told him about his experience with the emergency section. ‘My hands were actually shaking,’ he said. ‘And then I had a nightmare about it last night.’

Drysdale nodded and said, Tell me.’

Bannerman related all that he could remember about the dream and then asked, ‘Do you mind if I smoke?’

Drysdale made a sign with his hands that indicated resignation but not approval. ‘You should give it up,’ he said.

Bannerman ignored the comment.

‘What else should I know?’ asked Drysdale.

‘Sometimes I’m sick after doing post-mortems.’

Drysdale nodded. He had started making notes. ‘How old are you Ian?’

‘I’ll be thirty-eight next birthday.’

‘How do you feel about that?’

‘Rotten.’

‘Me too,’ said Drysdale. ‘I’ll be thirty-nine. Any other problems?’

‘Insomnia.’

‘You waken up at three in the morning and feel wide awake. You can’t get back to sleep for about an hour. This happens every second night on average?’

‘How did you know that?’

‘Sheer bloody brilliance,’ said Drysdale. ‘But apart from that, I recognized the symptoms. They’re textbook. It’s depression not insomnia.’

‘So you think I’m clinically depressed,’ said Bannerman.

‘A little,’ replied Drysdale, ‘but the main problem is stress.’

‘Stella thinks it’s a mid-life crisis,’ said Bannerman.

‘She’s right,’ said Drysdale, ‘but there’s another factor involved and I’m not quite sure what it is. I’ll have to have a think about it.’

‘What do I do about it in the meantime?’ asked Bannerman.

‘I can suggest pills but you know as well as I do they’ll just dull your senses so you won’t feel so stressed. That’s probably not such a good idea in our line of work. How about booze in the evening?’

‘I think I’ve used up that option,’ said Bannerman.

‘Me too,’ said Drysdale. ‘How about a break? A holiday might be just what you need.’

‘Stella suggested that. I’m considering going climbing in Scotland.’

‘In January!’ exclaimed Drysdale. ‘You’re sicker than I thought!’

To each his own, Doctor,’ said Bannerman with a smile. He got up to go.

‘I’m sorry I couldn’t be of more help,’ said Drysdale, ‘but keep in touch. I don’t think it’s anything serious and Stella’s probably right about it being fear of forty but if you should begin to feel worse give me a call, any time, day or night.’

Bannerman thanked Drysdale and promised to buy him a drink in the near future. He returned to the Pathology Department where Olive had left a package on his desk. It was marked ‘On Her Majesty’s Service’ and had come from the Medical Research Council by special delivery. He opened it and found three microscope slides and a covering letter. The letter was from the coordinator of the MRC’s Survey on Degenerative Brain Disease, Dr Hugh Milne. It asked if he would mind examining them and reporting his findings as quickly as possible. There was also a message to say that Stella had phoned; it was nothing important but he was to be reminded that he couldn’t call her back because she would be in theatre all afternoon.

Bannerman took the slides to his personal microscope and removed the dust cover. He clipped the first to the stage and adjusted the tungsten light before focusing on the stained section of the brain. There had been a marked lack of details with the package and no indication about the source of the material, save for the fact that they were brain sections. There was an air of anticipation about him as he scanned around to find the clearest fields. It didn’t take long to find what he was looking for — unequivocal evidence of degenerative disease.

It was so obvious that Bannerman was puzzled to the point of feeling mildly annoyed that he had been asked for his opinion on something so clear-cut. He had rarely seen spongioform areas so well marked. This was the kind of slide that could be used for illustrating text books. The second and third slides were almost identical to the first. ‘What on earth are they playing at?’ he muttered as he removed the last slide and turned off the lamp. He asked Olive to get him the MRC coordinator on the phone.

‘Dr Bannerman? Good of you to call,’ said Milne after a short wait. ‘I take it you received the slides?’

‘I’ve just had a look,’ said Bannerman.

‘What do you think?’

‘I think I’ve just looked at three perfectly prepared brain sections from the same patient. He or she would be in their mid to late seventies and has just died of Creutzfeld Jakob Disease.’

‘You’d be wrong,’ said the coordinator.

‘What?’ exclaimed Bannerman.

‘What would you say if I told you that each of the slides came from a different patient, all were under thirty and none had been ill for longer than three weeks?’

‘I’d say there had been a mix-up in the slides,’ said Bannerman.

‘We are assured that there has been no mix-up.’

‘I find that incredible,’ said Bannerman.

‘Suppose I was to add that the three dead patients worked with infected sheep?’

‘What?’ exclaimed Bannerman. ‘You’re not suggesting that they died of Scrapie by any chance?’

‘I wish I wasn’t. Can we meet to discuss this further?’

‘When?’ asked Bannerman.

‘I think it had better be as soon as possible,’ said the coordinator.

‘Why me?’ ventured Bannerman.

‘Your reputation, Doctor. Your work on degenerative brain disease is second to none and right now we need the best we’ve got. I’ll explain more when I see you. Would tomorrow at eleven be a possibility?’

Bannerman checked his diary before saying that it would.

‘Did you see about taking time off?’ asked Stella when Bannerman saw her later.

Bannerman brushed the question aside and told her about the call from the MRC. ‘I saw the slides Stella! They were classic Creutzfeld Jakob but Milne said they came from three men who had been working with Scrapie infected sheep!’

‘You mean the men died of Scrapie not Creutzfeld Jakob?’ exclaimed Stella.

‘That’s what Milne seemed to be saying.’

‘But that can’t happen surely? Scrapie is a disease of sheep. It can’t pass to man. There’s a what-do-you-call-it?’

‘A species barrier,’ said Bannerman. ‘Last year cows, this year people …’

‘What was that?’ asked Stella.

‘I was just thinking that last year Scrapie was shown to have passed from sheep to cows through the food chain

‘You’re not seriously suggesting that it could do the same to humans?’

‘Up until today I would have said that there was no chance of that at all,’ replied Bannerman.

‘Then what do you think is going on?’

‘My initial reaction is to think that some kind of mistake has been made, some kind of mix-up in the path lab, but the chap I spoke to said not.’

‘Maybe I should think twice about having lamb for Sunday dinner?’

‘It’s a bit early for that,’ smiled Bannerman. ‘I’ll know more when I see the MRC people tomorrow.’