Past Lives

Six

Two days later, Jane Francini was transferred to Farley Ridge Sanatorium: Macandrew was there to see her off. He knew there was a danger that his presence might be construed by some as an admission of guilt but despite this, he wanted to be there. He liked her as a person in their talks before the operation and, as she had pointed out, they were fellow “Scots”.

Jane was lightly sedated and appeared comfortable in her Emma persona. Her eyes reflected bemusement at what was going on around her but nothing like the distress she showed when sedation was completely withdrawn. She continued to ask about her mother and the staff continued to assure her that she would be along presently as they wheeled her out of the Med Centre and lifted into the back of the waiting ambulance.

‘Good bye, Emma,’ said Macandrew as she passed by.

Jane turned her head towards him and Macandrew felt a hollow in his stomach. The look in Jane Francini’s eyes was perfectly in tune with her Emma character. He was looking into the clear, intelligent, innocent eyes of an eight-year-old girl who wasn’t at all sure what was going on. The attendants closed up the back of the ambulance and she was gone.

Things gradually returned to normal over the course of the following week although the Francini case was never far from Macandrew’s mind. He had resolved to find out as much as he could about Hartman’s tumours — something which involved him spending a good deal of time in the medical library and which proved easier said than done because of a dearth of published information. There was no text book material available on the subject: what information there was, had to be gleaned from medical journals and research papers.

Starting with a short list of references from Carl Lessing, Macandrew dug out what he could in the Med Centre library and made photocopies of relevant articles. There were a number of references to journals that the Med Centre did not take so he asked the librarian to put out an inter-library request for them. They arrived in due course and he was able to complete a file — albeit a painfully thin one — on the subject.

Most of the published material comprised straightforward case reports on patients who had been diagnosed as suffering from the condition: these did not tell him anything new. The condition was so rare that the reports had been published for that reason alone. There was no instance of anyone ever having made a full recovery but, as Carl Lessing had pointed out, none had died from the condition either. They had survived surgical removal of the tumour, only to be left confused and facing life in a mental institution for the remainder of their days.

There were however, a number of recent research papers which proved interesting. They originated from a laboratory in the medical school at the University of Edinburgh in Scotland. A Dr John Burnett emerged as principal investigator. He was sole author on the earlier work but appeared to have been joined later by, Drs Ashok Mukherjee and Simone Robin. Between them, these three had published several papers on the chemical changes in the brain associated with Hartman’s tumours and had managed to identify an unusual acidic substance secreted by them — it was this substance that had been responsible for the colour change in the staining reaction of the tissue samples in the Path lab and which had alerted Carl Lessing to the possibility of a Hartman’s tumour.

As a medic rather than a scientist, Macandrew found the science hard going but the gist of the research approach seemed to be centred on finding a way to counteract the effects of the secretion on adjacent cerebral tissue. If this could be done then the damaging effects of the tumour might be limited. Using material obtained at autopsy, the researchers had identified a bank of cells in the normal brain that the Hartman’s chemical appeared to affect and had subsequently gone on to describe a protein secreted by these cells that seemed to be its specific target.

By the time he had read the last of the papers, Macandrew was quite excited by their findings. If they had really identified the target protein in the normal brain then surely in this day and age it should be possible to synthesise the protein in vitro and replace it in brain-damaged patients.

Macandrew looked at the date on the last paper and was disappointed to find that it was over two and a half years old. He considered possible reasons for this — the most likely and most depressing being failure to synthesise the protein in the lab. But was the team still trying? Or had research on the subject stopped completely? There was also the very real possibility that funding had been withdrawn from the project. Competition for research funding was always fierce and Hartman’s tumours were such a rare condition that that might militate against support.

Macandrew considered contacting the university, but then it occurred to him that there might be a quicker way. He could use the Med Centre’s computer to find out if anything at all had been published by any of the three named scientists in the last three years. To survive in research, it was essential to publish. Any researcher who had failed to publish anything in three years would be in serious career trouble.

It was a system that could be terribly unfair at times and also led to the scientific journals being inundated with less than compelling work, but its best defence was that there wasn’t a better way. Peer review did much to screen out the dross but despite this, every scientific journal with perhaps the exception of the top two or three, carried a large proportion of i dotting and t crossing. Career fodder.

Macandrew tried entering John Burnett’s name first and asked for a full list of his publications. This wasn’t as straightforward as he’d hoped because there was more than one John Burnett in the database and he had to sort through them before establishing that it was the John Burnett who worked in cell biology at Edinburgh University that he was interested in.

The publication list came up on the screen and Macandrew read through an impressive record, finishing with the three-year old paper in Cell Biology he’d just read. John Burnett had not published anything at all in the interim, not even a review — the traditional stop-gap of senior scientists when times were tough and ideas scarce.

Macandrew stared at the screen and wondered if Burnett had retired. He didn’t know anything about the man. It was conceivable that he had reached retirement age and was now growing roses by the sea. If that were the case, he might be able to confirm this by judging his age from his publication list. He looked back to the beginning of the list and found two papers that were cross-referenced to Burnett’s doctoral thesis. He noted the date and made a mental calculation. Assuming Burnett had had a conventional academic background, with four years for an honours degree followed by three or four more for his doctorate, he reckoned that John Burnett would be in his mid to late thirties. A bit young for roses.

He drummed his fingers lightly on the desk while he tried to think of alternative possibilities. The librarian shot him a disapproving look and he stopped with a half apologetic smile. Librarians could be so intimidating. He instigated a new search and entered Ashok Mukherjee’s name. This produced the work he’d published jointly with John Burnett and nothing else.

The only Simone Robin in the database was listed as being on the staff of the Institut Jacques Monod at the Seventh University of Paris, France but her publication list immediately told Macandrew that she was the lady he was looking for. He found the papers that she had published with John Burnett in Edinburgh and then four more, submitted from the French institute in the last three years but in a different area of research. He calculated that Simone Robin had left the University of Edinburgh around the time Burnett had stopped working on Hartman’s tumours. She had obviously returned to France and was now working on something else entirely.

The depressing thing from Macandrew’s point of view was that, as far as he could tell, Burnett’s team had been the only one in the world carrying out research on Hartman’s brain damage. If they had given up then no one was doing it. He copied down details of addresses and phone numbers from the on-screen information and logged off. He might not pursue things any further but then again, he just might. It would be interesting to find out why such promising work had suddenly stopped.

Two days later, Macandrew was in the scrub room after completing a long operation when a nurse relayed the information that Saul Klinsman wanted to see him. He dried himself quickly and slipped on some fresh surgical greens before hurrying up to Klinsman’s office. Carl Lessing was sitting there. Neither he nor Klinsman were smiling.

‘What’s wrong?’

‘You’re not going to like this, Mac,’ said Klinsman.

‘Like what?’

Lessing was looking embarrassed. He said, ‘Christ, Mac, I’m sorry, I don’t know exactly how it happened and when I find the guy responsible I’m going to cut off his...’

‘What’s happened? What’s going on?’ asked Macandrew. He sensed big trouble and looked to Klinsman for answers.

Klinsman responded by looking to Lessing.

Lessing said, ‘The plain fact of the matter is that we can’t provide the Mao Clinic with tumour tissue taken from Jane Francini.’

‘Why the hell not?’

‘We no longer have it. Someone chucked it.’

Macandrew looked at Klinsman as if pleading to be told that this couldn’t be true. No reassurance was forthcoming.

Macandrew found it almost impossible to speak for a few moments then he said, ‘Christ, I can’t believe I’m hearing this.’

‘One of the technicians discarded the Francini tumour by mistake. I’m sorry Mac.’

Macandrew rubbed his forehead nervously. ‘Can’t you recover it?’ he asked.

Lessing shook his head and said, ‘It had already gone to the incinerator before we realised what had happened.’

‘Jesus!’ said Macandrew, sinking down into a chair. ‘So we can’t prove that Jane Francini ever had a malignant tumour?’

‘That’s about it,’ agreed Klinsman.

Macandrew sank down into a chair. ‘Francini is going to be more convinced than ever that I butchered his wife.’

‘Christ, I just don’t know what to say,’ said Lessing.

Macandrew just shook his head. ‘What a fucking mess,’ he whispered.

Klinsman put his elbows on his desk and leaned forward. He said, ‘In the final analysis Mac, what Francini thinks, doesn’t matter. It’s facts that matter. We all know that Jane Francini’s condition was caused by a malignant brain tumour and that’s the important thing. You are a good surgeon, one of the best and you did your best for the Francini woman. Nothing that happened subsequently was your fault. It’s a real bummer about the Mayo not being able to rubber stamp our pathology report but shit happens and we just have to accept that and get on with it... whatever they throw at us now.’

Macandrew felt sick. He nodded absently and got up. ‘If you’ll excuse me,’ he said and left the room.

With every step along the corridor, Macandrew wanted to slam his fist into the wall. The pain would be a welcome relief from what was going on inside his head. Tony Francini was going to go through the rest of his life believing that he had brain-damaged his wife and then colluded with the path lab in a cover up of his mistake. The story would do the rounds. Lots of families had tales to tell about incompetent medical practitioners and how they had blighted the life of one of their own. These stories were handed down through the generations. He himself was now going to feature in that list. ‘Fuck!’ he raged as the elevator descended. ‘Fuck, fuck, fuck.’

He was finding the thought unbearable. The theatre nurse, Lucy Long, was waiting to get in as Macandrew stepped out of the elevator.

‘Hi Mac. How’s it going?’ she asked.

Macandrew looked at her as if she was an alien from a different planet. He couldn’t say anything.

‘Excuse me,’ murmured the nurse under her breath.

Macandrew sat alone in his apartment for nearly an hour without doing anything other than stare out at the sky. He could not believe that fate had been so cruel, or maybe it wasn’t fate, he reasoned. What kind of half-assed operation was Lessing running down there in the path lab anyway?

It didn’t help his state of mind to realise he was doing exactly what Tony Francini had been doing, looking for someone to blame! In his heart he knew well that Carl Lessing was an excellent pathologist and that his lab was extremely well run and normally 100 percent reliable. He also knew that Saul Klinsman had been right to point out that these things happened. It just didn’t help to believe any of that right now.

A knock came to his door a little after seven thirty and Macandrew opened it to find Mort Jackson, his landlord, standing there.

‘You haven’t forgotten have you?’ asked Jackson.

‘Forgotten?’ repeated Macandrew.

‘You were coming down this evening to look at the slides Ginny and I took up in Michigan.’

Macandrew had completely forgotten but even in his current mental state, he didn’t want to hurt Mort’s feelings. If only he had remembered earlier he might have been able to come up with a plausible excuse for postponing it. As it was, he had to insist that he hadn’t forgotten and would be down in a few minutes.

‘I’ll have Ginny pour a glass of her elder flower for you,’ said Mort as he disappeared back down the stairs.

‘Jesus,’ whispered Macandrew under his breath. It was going to take a lot more than Ginny’s home-made wine to take the edge off reality this evening. He poured himself a large whisky and threw it down his throat before going downstairs to be welcomed by Mort and Ginny.

Ginny was everyone’s idea of what a grandmother should look like. She was plump, smiling and had a magnificent head of pure white hair. She had prepared a large plate of sandwiches and handed Macandrew a glass of wine as he sat down. Mort was about the same height as Ginny but he was thin and stooped and had a complexion the colour of leather from a lifetime spent on the open air as a lineman for the phone company. He held his left arm at an awkward angle, the legacy of an accident at work — the one which had ultimately forced him to retire.

Macandrew did his best to make light conversation while Mort set up the projector. It was easy to feed Ginny the right questions. She loved talking about her family. The lights finally went down and the slides faithfully recorded the Jacksons’ visit to their daughter up in Michigan. Macandrew did his best to concentrate on what appeared on the screen rather than what was in his head but he was fighting a losing battle. The Francini case was winning.

He was almost relieved when his pager went off and gave him an excuse to leave the room although this was almost immediately replaced by concern as he ran upstairs. His pager shouldn’t have gone off. He wasn’t on call this evening and he’d had a fair bit to drink. He wasn’t drunk but he certainly wasn’t fit for surgery.

‘Dr Klinsman for you,’ said the hospital operator.

‘Mac? I’ve just had Kurt Weber on the phone. Carl Lessing called him about the missing tissue and he felt obliged to advise Francini’s attorney of the situation.’

‘And?’

‘Kirschbaum asked if he would be willing to stand up in court and testify that Jane Francini’s condition could have been caused by surgical malpractice.’

‘And?’ asked Macandrew, feeling as if he was pulling the pin from a grenade a second time.

‘Weber told him that he hated the idea but, in the circumstances, he’d have to say it was theoretically possible,’ said Klinsman. ‘Weber just wanted us to know that it’s nothing personal and he doesn’t believe for a moment that that’s what happened.’

‘Nice of him.’

‘He really doesn’t have much choice in the matter,’ said Klinsman.

‘Right,’ said Macandrew.

‘Weber says he’ll point that out if he gets the chance.’

‘Thanks for letting me know.’

‘Least I could do,’ replied Klinsman.

Macandrew put the phone down and went downstairs to rejoin the Jacksons. He would sit through the remainder of their holiday slides on autopilot.

‘Everything all right Mac?’ asked Ginny as he slipped back into the room.

‘Just fine, Ginny. Sorry about that.’

‘This is us up at Mill Glade,’ announced Mort as the next slide came up. ‘That’s Charlotte’s friend, Sandy with us there and that’s her dog, Rupert.’

‘Rufus,’ corrected Ginny.

‘Sorry, Rufus,’ conceded Mort.

‘And this is us up near Jansen Creek: real pretty country up there.’

‘Looks it,’ agreed Macandrew, suddenly realising that a comment was called for.

‘More wine, Mac?’ asked Ginny in a whisper.

‘Please,’ replied Macandrew.

Ginny moved across the room to the table in front of the window; she did it in a crouch to avoid the projector beam but totally without success as her shadow filled the screen.

‘This was a Saskwatch we saw while we were up there,’ joked Mort, winking at Macandrew when he saw that Ginny didn’t realise she was the butt of the joke.

‘And this is us with Clint, Daisy and Charlotte on the day we went down to the county fair...’

CRASH! The front window of the room exploded in a million shards of glass and Ginny reeled backwards with blood streaming down her face to fall on the floor. The glass of wine she had been pouring for Macandrew flew from her grasp and splashed across the screen.

‘What the...’ exclaimed Mort. ‘Ginny! Ginny!’

Macandrew beat him in the race to get to Ginny and was already assessing the damage. ‘Get me a clean towel Mort,’ he said. ‘Quick as you can.’

‘Is she gonna be all right?’ asked Mort as he handed over the cloth and hovered over Macandrew and the unconscious Ginny.

Macandrew cleared the blood away from Ginny’s face and stemmed the flow from the major cuts. Something had come through the window and hit Ginny on the forehead, something heavy. It had knocked her out but she would be all right. He said so to Mort.

‘Thank God,’ exclaimed Mort. ‘What the hell was it?’

Mort started hunting round the room as the hollow in Macandrew’s stomach started to grow.

‘Jesus H Christ!’ exclaimed Mort. He had found something and was picking it up gingerly to avoid the broken glass. ‘What do you make of this?’ he asked.

Macandrew saw what Mort was holding: it was a butcher’s cleaver.

‘It was a message Mort,’ he said in a dazed monotone, ‘for me.’

‘The crazy bastard,’ said Saul Klinsman when Macandrew told him what had happened. ‘How is Mrs Jackson?’

‘She’s got a real sore head and quite a few cuts, one that required stitching, but she’ll be OK.’

‘You called the cops?’ asked Klinsman.

‘No, I didn’t,’ confessed Macandrew. ‘I persuaded the Jacksons not to either.’

Klinsman looked shocked. ‘Why not?’

‘I’m not absolutely sure myself,’ said Macandrew. ‘It was obvious that the cleaver was meant for me and we both know where it came from. I got to thinking that Francini had probably gone out and gotten hammered after what Weber had told him about the missing tumour tissue. It must have been eating away at him and he had to make his point somehow. It was probably something he did on the spur of the moment. He got my address from somewhere — not realising that I shared the place with the Jacksons — and came over to vent his anger. I’m counting on this being a one-off thing.’

‘That’s charitable of you,’ said Klinsman.

‘Not entirely,’ confessed Macandrew. ‘If I am to be perfectly honest I worked out that if I or the Jacksons had called the police and Francini was arrested, he would have enjoyed his day in court, telling the world exactly why he did it.’

‘Do you think he was bright enough to have planned it that way?’

‘I wasn’t betting against it.’

A week passed without further incident then Carl Lessing phoned. ‘I’ve been a bit of an idiot,’ confessed Lessing.

‘How so?’

‘I still have the slides.’

‘The slides?’ repeated Macandrew, unaware of what Lessing was getting at.

‘Mrs Francini’s slides! The microscope preps that were made for diagnosis! The Mayo could use them for verification of a malignant tumour!’

‘Are you serious?’ exclaimed Macandrew. ‘Would that be good enough?’

‘Sure,’ said Lessing. ‘I just wish I had thought of it sooner. The two slides I used for the actual diagnosis were discarded but four were made up by the technicians from the microtome sections. I still have the unused two.’

‘But surely Francini could argue that the slides weren’t prepared from Jane’s tumour material?’

‘I asked the guys down at forensics about that. They assure me that DNA fingerprinting will be possible from the material on the slides. We just have to get a cell sample from Jane Francini for comparison and it can be shown conclusively that the tumour tissue came from her — as indeed it did.’

‘Hallelujah,’ said Macandrew.

‘I’m sorry Mac, I should have thought of this earlier,’ said Lessing. ‘I’ll get straight on to the Mayo.’

Macandrew felt better than he had done for ages — in fact, since the day of the Francini operation. The phone rang and his good humour showed in his voice. ‘You sound happy,’ said Karen Bliss.

Macandrew told her the good news.

‘Mac, that’s great,’ said Karen. ‘I was actually calling to ask if you’d like to come over to dinner with Jeff and me tonight but now we could make it a celebration.’

‘I’ll bring champagne.’

As he drove out of Cherry and turned right to head south to Mission Hills, Macandrew noticed a BMW saloon with the “Show Me” plates of Missouri take off from the kerb and settle in behind him. He didn’t think anything of it until it registered that it was still there some three miles further on. He had left home in plenty of time and had consequently not been driving fast. The BMW had had ample opportunity to pass. It had tinted glass screens but Macandrew could see that there were two men in the front. He tried persuading himself that thinking he was being followed was just too melodramatic but it didn’t stop him slowing down for a while and then speeding up to see if he could lose his tail. The BMW stayed with him. It was still there when he turned off into the street where Karen lived.

As he slowed on nearing her apartment block, it suddenly speeded up and swerved in front, causing him to brake violently and mount the sidewalk. Almost before he knew it, the two men had jumped from the car in front and were running towards him. They were big and dressed in jeans and plaid shirts.

‘What the hell do you think you’re doing?’ demanded Macandrew, getting out the car. He was unprepared for the punch that seemed to come from nowhere and dropped him to his knees. He had barely time to taste the blood in his mouth before a boot swung into his stomach and the wind was completely knocked out of him. Up until that point neither of his assailants had spoken, now he heard one say to the other, ‘Turn him over.’

Through a haze of pain Macandrew felt himself being rolled over on to his face before he took another vicious bow to the side of the head. He was dragged forward by the hands and left face down by the open door of his car. He didn’t have the strength to turn his head to see if his attackers had gone but he heard their car start up.

Slowly, he reached out and gripped the door sill of his own car to with both hands to start pulling himself up. Unknown to him, he was supposed to do this. It was part of the plan. Only one of the men had returned to the BMW, the other had been standing behind him, waiting for this to happen. As Macandrew gripped the door sill, the man slammed the door shut.

Pain flooded through Macandrew’s head like a nuclear explosion. The bones in his hands broke like matchsticks and, through his agony, he heard a man’s voice rasp, ‘You won’t be fuckin’ around with no one else’s wife from now on.’