Trauma

Seven

Sarah had fallen asleep in the doctors’ room; she was sitting at the table with her head on her folded arms in front of her where she had cleared away a little hollow among the paper. Just before half past three she was wakened by the night staff nurse who gently shook her right shoulder.

“Dr Lasseter?”

“Mmm?” said Sarah sleepily.

“I think Mr McKirrop is coming round.”

The name brought Sarah to full awareness. She got up, rubbed her arms and said, “Right, lead on.”

The nurse had already turned on the lamp above McKirrop’s head so he was caught in a stage spotlight in the otherwise green auditorium. Sarah saw him move his head before she reached the Alpha 4 bay. He seemed to be in some distress, as if in the throes of some bad dream.

“Can you hear me, John?” Sarah asked, bending over him.

McKirrop stopped moving his head and Sarah felt encouraged by the response. She nodded to the nurse. “I think he can hear.”

“John, can you hear me?”

McKirrop grunted weakly and moved his head to the left.

“You’re in hospital, John, the same one you were in last week after you were beat up in the cemetery. I’m Dr Lasseter. Remember me?” Sarah spoke each word slowly and clearly.

McKirrop said his first word, a slurred attempt at ‘cemetery’.

“You’ve had another knock on the head. Can you remember anything about it?”

“Cemetery...” mumbled McKirrop. “Yobs... beat me up.”

“That was last time John,” said Sarah.

“Coffin. . They dug up... boy’s coffin...”

“That’s right,” said Sarah. She was pleased to hear that McKirrop did not appear to be suffering from any obvious brain damage. “They took the boy’s body John. You tried to stop them.”

McKirrop moved his head again as if frustrated at the struggle to get words out. “Opened the coffin... opened the coffin...” His voice began to trail off as the effort of speaking tired him out.

“That’s right John. That’s excellent. You remember what happened. We’ll have you right as rain in no time. Rest easy now. Get some sleep and we’ll talk in the morning.” Sarah got up and stood beside the nurse, looking down at McKirrop as he sank back into sleep.

“That’s fifty pence I owe you,” said the nurse.

“I’d better call Tyndall,” said Sarah.

“At this time?” exclaimed the nurse.

“He wanted to be informed when McKirrop came round.”

“I just hope for your sake that he included three thirty in the morning!” said the nurse.

The nurse had planted the seeds of doubt in Sarah’s mind. Tyndall had meant, as soon as McKirrop came round, hadn’t he?He hadn’t meant, first thing in the morning... had he? She tapped her fingers on the phone while she considered whether or not she should make the call. “Oh to hell with it,” she concluded and made it.

“Tyndall,” said the voice at the other end. He had a frog in his throat. Sarah knew that he had been asleep.

“Dr Tyndall? It’s Sarah Lasseter here at HTU. John McKirrop recovered consciousness ten minutes ago.”

“Did he indeed?” replied Tyndall, clearing his throat. “Is he lucid?”

Sarah gave a silent prayer of thanks that Tyndall didn’t seem to think the call unnecessary. “Yes sir, a bit groggy but I don’t think there’s any serious damage.”

“Does he remember anything about how he got his injuries?”

“No, but he remembers the incident in the cemetery a couple of weeks ago so there’s no impairment to long term memory.”

“Really? What’s he been saying about that?”

“He remembers being beaten up and the boy’s coffin being opened up.”

“What else?” asked Tyndall after a short pause.

“That’s about it, sir. He’s very tired and I didn’t want to press him. He’s sleeping at the moment.”

“Good,” said Tyndall. “Let him rest. You are to be congratulated Doctor.”

“Thank you sir, what should I do about the police and the priest who wanted to be kept informed?”

“What about them?”

“The police wanted to speak to Mr McKirrop as soon as he came round.”

“Oh, I see. Well, I think we can leave calling them till the morning. It’s not as if Mr McKirrop is going anywhere, is he?”

“No sir.”

“Good night, Doctor. Thank you for letting me know.”

Sarah replaced the receiver and felt pleased. She did a quick check of the patients and told the night staff nurse she was going back to the residency. She left with a smile on her face... and fifty pence in her pocket. When she got to her room, she was torn between making herself some coffee or getting directly into bed. Knowing that she would only have about three hours sleep at most, she opted for bed.

Sarah could feel the adrenaline surge of the last hour or so clearing from her veins, allowing tiredness to replace it. By the time she had laid out her clothes in order — just in case — she could feel her eyelids coming together. Her arm felt heavy as she reached out to turn off the bedside light. Within seconds she was asleep.

Sarah had an undisturbed three hours sleep before her alarm went off and she complained out loud as she always did. She reached out and made several attempts to connect with the “off” button before the room was restored to silence.

“Not already,” she grumbled. “It can’t possibly be...” But it was, and she was up and getting washed after a few more minutes. She was pleased to find Paddy Duncan at breakfast in the dining-room; she hadn’t seen him since the Chinese meal.

“Rough night?” Paddy asked.

“Not really,” replied Sarah. “Well, yes and no,” she added after reconsidering.

“What does that mean?” asked Paddy.

Sarah told him about the McKirrop case.

“Well done, you,” said Paddy enthusiastically. “And you say Logan gave him up for lost?”

Sarah nodded and said, “I think he saw him as a sort of organ supermarket.”

“That’s a particular hobby horse of his,” said Paddy. “He reckons that people should have to opt out rather than in when it comes to transplant permission. It’s a view that’s gaining popularity.”

“It’s something I’ve not really considered,” said Sarah.

“Maybe you should,” said Paddy.

“Why?”

“If you’re working in a place like HTU, it’s a problem that’s going to come up quite a lot.”

“Good point,” agreed Sarah.

“How are you getting on with dear Dr Logan anyway?” asked Paddy. “Any better?”

“I don’t think I could go that far,” replied Sarah. “But I did let him know that I’m not his door- mat and it seems to have improved matters.”

“Good for you,” said Paddy.

“How about you? Were you called out last night?”

“Twice,” replied Paddy. “A patient we carried out a routine hernia operation on last Monday. He’s developed a wound infection and it’s been a bit slow to respond to treatment. I think it might be Pseudomonas so I changed him to PYOPEN last night when his temperature was pushing a hundred and three. We should get the result of the lab test some time this morning. They were going to do a direct oxidase test on the wound exudate. I just hope to God I was right.”

“I’m sure you were,” said Sarah.

She looked at her watch and wiped her mouth with her napkin before saying, “Another day of work and play beckons. See you.”

“See you Sarah.”

Despite not having had much sleep, Sarah had a spring in her step as she climbed the stairs to HTU and walked in through the swing doors. Yesterday had been a good day and she hoped that the effects were going to last for some time. She remembered what her father had once said about medicine. “Every now and then you get a day that makes all the rotten ones worth while. Once you’ve tasted success it’s like a drug. You just go on wanting to have that feeling again. It’s like being allowed to play God for a few hours.”

Almost at once she could sense that something was wrong. Sister Roche crossed her field of view but failed to acknowledge her. Another of the nurses smiled as she passed but didn’t seem anxious to talk. Sarah went into the duty room but found it empty. She came out again and walked through to Alpha 4 to take a look at John McKirrop. His bed was empty. The linen had been removed and the hi-tech equipment on both sides of the bay lay dark and silent.

Sarah stood there bewildered, unable to come terms with the empty bed. Why on earth would anyone move him? She looked around and saw Sister Roche coming out of Beta suite. This time Roche acknowledged her and came over to join her.

“Where is Mr McKirrop, Sister?” Sarah asked, feeling embarrassed because the question sounded ridiculous. It showed on her face as vulnerability.

“Mr McKirrop died two hours ago,” replied Roche quietly.

“But that’s impossible!” exclaimed Sarah. “He came round at three thirty this morning. He was fine.”

“Dr Logan seemed to think that Mr McKirrop’s death was not unexpected,” replied Roche.

“Dr Logan?” exclaimed Sarah.

“He was here when Mr McKirrop lost all brain function. He and Doctor Tyndall agreed that there was no chance of recovery so the patient was allowed to pass away peacefully. That’s why you weren’t called out, Doctor,” said Roche, anticipating Sarah’s next question.

“Where does Dr Logan come into it?” asked Sarah, quite bemused by events.

“I understand Doctor Tyndall called him in on the case,” replied Roche.

Sarah rubbed her forehead anxiously. “Is Dr Logan here at the moment?” she asked.

“He’s in the ivory tower,” replied Roche.

Sarah marched through to the doctors’ room and entered without knocking. “What the hell is going on?” she demanded. Her only concession to ethics was the fact that she kept her voice down when she said it. It came out as an angry whisper.

“I beg your pardon,” said Logan angrily.

“What’s all this about McKirrop having no brain function? I was talking to him at three thirty this morning!”

“Calm down, Doctor, calm down. You thought you were talking to him but it could only have been random disjointed function with the kind of damage that McKirrop had.”

“But he didn’t have massive damage at all,” said Sarah.

“What are you talking about?” demanded Logan. “What did you think that was in the centre of his head, a birthmark?”

“I know it looked bad,” said Sarah. “But McKirrop had an abnormal forehead. The unusual angle of his skull protected his frontal lobe which was recessed. It showed up on his X-rays.”

“I didn’t see that,” said Logan.

“You didn’t see the other X-rays. The X-ray department sent up two more films yesterday morning. You didn’t bother to look at them.”

Logan paused for a moment to consider the implications of what Sarah had said. Deciding that he might be on shaky ground in an argument he ignored the implied criticism and said, “All this is academic anyway. He had an EEG like the Utah salt flats.”

“Nonsense! His brain function tests were very encouraging yesterday.”

“If you saw that, you must have had the settings wrong on the monitors,” said Logan.

“How dare you!”

“I dare because I’m a senior registrar and you are a wet-behind-the-ears resident,” said Logan getting up angrily. “You screwed up, Lasseter and if you’re thinking about a second chance, I suggest an immediate change in attitude!”

Sarah ran all the way back to the residency, not seeing the way clearly because of the tears that had welled up in her eyes, not even she was sure whether they were born of anger or of self pity. “I can’t believe it,” she muttered as she sat on her bed. “I do not believe it. McKirrop was going to be fine. He was going to pull through; I know it.”

She had just blown her nose when her bleeper went off.

“Dr Tyndall would like to see you, Dr Lasseter,” said the nurse at the other end of the phone. “Right now if you please.”

Sarah washed her face at the hand-basin in her room and held the towel to it for a good thirty seconds afterwards while she attempted to regain her composure. The last thing in the world she wanted to do was burst into tears in front of Tyndall. When she felt calmer, she took several deep breaths, dealt with some rogue strands of hair and set out for HTU. The spring in her step had gone.

“Dr Lasseter, do come in,” said Tyndall when Sarah knocked on the door and opened it slightly to look round. “Please sit down.”

Sarah did as she was bid and smoothed her skirt. She had been unsure of what to expect in terms of Tyndall’s mood. Even now, she was uncertain. Tyndall was urbane and smiling as usual but he didn’t wear his heart on his sleeve as Logan did.

“Dr Logan tells me you were rather upset about Mr McKirrop? Perfectly understandable, I like my doctors to remember their patients are people first and patients second, any death is always a matter of profound regret.”

“I just don’t understand it!” exclaimed Sarah, “I was so sure that he was going to be all right. His scans agreed and when he came round this morning...”

“How often have you carried out full range of scans?” asked Tyndall. He was still smiling but Sarah knew that the first torpedo had been fired. “On your own I mean,” he added. The torpedo was fully armed.

“Yesterday was the first time,” conceded Sarah. “But I have seen a great many done and I feel sure there was no problem.”

“I understand Nurse Barnes assisted you?”

“Yes sir.”

“Sister Roche tells me that this was a first time for Nurse Barnes too.”

Sarah stayed silent. She hadn’t known that.

“You didn’t think to ask Dr Logan to check your findings?” asked Tyndall.

Sarah bit her lip. It went against the grain to drop even Logan in it. “Dr Logan made me responsible for Mr McKirrop’s tests sir and I felt happy with the way the scans went. There were no problems at any stage.”

“I see,” said Tyndall. “You may of course, be right. It’s possible that Mr McKirrop’s brain was able, for a very short period of time, to give indications of activity but it’s also possible that some kind of amplification error was made in the settings of the equipment.”

“I’m certain that they were all right,” said Sarah.

Tyndall shrugged his shoulders and said, “Well, we can’t turn back the clock, Doctor but I must say that when I examined Mr McKirrop’s head injury myself, I did feel that any restoration to normal activity would be extremely unlikely.”

“But the X-rays sir! The angle of Mr McKirrop’s skull at the front afforded his brain a good deal of protection. I explained that on the phone to you.”

“Ah yes, the X-rays. Do you have them to hand?”

Sarah excused herself for a moment and went to fetch McKirrop’s films. She didn’t think the light box would be necessary to make her point. She held up the films, one by one, against the light coming in from the window until she found the one she wanted and then brought it back to the ivory tower for Tyndall to examine.

Tyndall held up the film in his left hand and traced the angle of the patient’s skull with the pen he held in the other.

“The angle is quite unusual,” prompted Sarah.

“I see what you mean,” said Tyndall thoughtfully. “But I suspect that the protection afforded was not enough. The PM will tell us for sure.”

“Yes sir,” said Sarah, feeling deflated at Tyndall’s dismissive attitude. “He did regain consciousness,” she said, surprising even herself at her unwillingness to concede an inch.

“I accept that the patient spoke but was it true consciousness, Doctor? Did you conduct a proper question and answer session?”

Sarah opened her mouth to affirm but suddenly realised that this would be untrue. McKirrop had not answered any questions directly. He had supplied words and phrases which she had interpreted as a two way conversation. “No sir but he appeared to remember things about his recent past.”

“They could have been words snatched from the cosmos Doctor.”

“I didn’t get that impression, sir.”

Tyndall smiled but there was a suggestion of impatience about it. “I’m sorry your chap died,” he said. “Gaining experience in medicine can be a painful business.”

“Yes sir,” said Sarah, accepting that the time for any argument was over.

“I understand Dr Logan will be carrying out full brain scans on two of our patients this morning. Why don’t you help out?”

Sarah took a deep breath and fought to control her temper. She was a naughty schoolgirl being given extra homework but, if she gave rein to her tongue right now, her time in HTU would be over. Maybe even her career in medicine. “Yes sir,” she said.

Sarah went through an awful day on auto-pilot. She assisted Logan with the scan patients, knowing that he was gloating over every second of her discomfort. “It’s very important that the gain control on the monitor matches the one on the recorder... it’s something that can be so easily overlooked...”

“I’m sorry, Dr Lasseter, was it something I did?” asked Nurse Barnes when she came on duty.

“No nurse,” replied Sarah. “I’m quite sure neither of us did anything wrong but if we did, it was my responsibility.”

“Maybe it was just one of these things?” said the nurse.

“Maybe,” replied Sarah. The comment had been meant kindly but Nurse Barnes was very wide of the mark if she really thought that. The last thing Sarah did before coming off duty was to return fifty pence to the night staff nurse.

“What’s this for?” asked the nurse.

“The official view is that McKirrop did not regain consciousness. You win the bet.”

“But I was there,” said the nurse. “I saw it happen.”

“Random words and phrases from a destroyed brain,” said Sarah.

“Who said that?”

“Dr Tyndall.”

The nurse thought for a moment then said, “He may be my boss and he’s certainly a very distinguished man and all that but this time... he’s talking rubbish.”

Sarah suddenly regained her confidence. Up until then she had been unaware of how it had been eroding away and just how close she was coming to accepting the official view of things. “Yes,” she said thoughtfully. “He’s my boss too and you’re right. He is.”

The nurse pushed the fifty pence piece back to Sarah and said, “Off with you. You seem to live in this place.”

Sarah went down to watch the evening news on television. She was alone in the common-room, a large square room on the ground floor of the residency furnished with a variety of unmatched furniture and which always reminded her of a dentist’s waiting room. There were a couple of comfortable arm chairs however, and she removed the pile of newspapers on the one nearest the TV to sit down. Being alone, she kicked off her shoes and put her stockinged feet up on the low table in front of her.

The national news was followed by the weather and then a bulletin of local news which she was about to turn off when the name “McKirrop” stopped her. She sank back in the chair to watch the report. John McKirrop, the down-and-out who had witnessed the exhumation of little Simon Main’s body and who had been injured in a brave attempt at tackling the culprits, had died in hospital that morning. He had been injured again in another violent incident in which a woman had died. This time, McKirrop’s injuries had proved fatal. The police were appealing for witnesses. There was some footage of the canal towpath and the police incident unit at the site. This was followed by a plan of the area and an approximate time of death for the woman. As yet, the police had failed to apprehend those responsible for the outrage in the cemetery.

Sarah had been hoping for distraction from the television. Instead she had been forced to think about McKirrop again. She had declined an offer to go out with several of the other residents for a drink down at The Quill, the hospital’s local pub, feeling that she wouldn’t be good company after the day she’d had — she had made an excuse about having some reading up to do. Maybe she should have gone to the pub after all, she thought. Apart from reminding her of the McKirrop case, the television story had forced her to consider the role of alcohol in their lives. The contrast between her colleagues laughing and joking over few drinks down at the pub and John McKirrop’s alcohol-ruined life could hardly have been more stark.

Ostensibly it was a tale of two different worlds but only at first glance. In reality they were much closer than any of them would care to admit, especially in medicine. Pressure led to stress, stress could lead to heavy drinking, heavy drinking could lead to dependence and then it was downhill all the way. Medicine was the profession with more suicides and more alcoholics than any other. That’s what they’d told her at medical school.

Sarah got up and poured herself some coffee from the heated flask that sat on the sideboard. The residency had coffee available all day but Sarah wasn’t sure how often the domestic staff made fresh stuff. Certainly not within the last four hours, she concluded after sipping it. It tasted burnt. She put it aside after a few more sips and tried to concentrate on her book.

Her father had recommended that she read Renee Weber’s ‘Dialogues with Scientists and Sages’ as an exercise in perspective. But she found she couldn’t concentrate. The McKirrop case was still uppermost in her mind. It wouldn’t go away. After reading the same page three times without taking in anything she put down the book and rubbed her forehead as she lay back in the chair. She tried again to think things through logically but it was complicated by her inability to analyse her own feelings properly. They were a mixture of disbelief, anger, sorrow and... unease. Yes, that was it, there was definitely an element of unease, the one feeling she’d not been admitting to. Now that she had, she could start defining its cause.

She had recorded an encouraging brain scan on John McKirrop, one which suggested that he would recover consciousness and some hours later he had. This was her opinion and also that of the staff nurse who’d been with her. But instead of being on the road to recovery, as she would have predicted, McKirrop was dead and her bosses were telling her that the brain scan readings had been some kind of aberration, some quirk of fate or even a mistake — a mistake on her part! What was more was that they were telling her that McKirrop had not regained consciousness at all. It was all a misunderstanding due to her inexperience.

Sarah had got the facts straight in her head but the facts were not the cause of her unease — they were the cause of her anger and frustration. Feelings of disquiet were associated with a question that arose from them. If she was right and McKirrop had been on the road to recovery, then what was she suggesting? That someone else had made a mistake? Or that someone... someone had deliberately murdered John McKirrop? The notion was just too ridiculous, but the question remained. She needed a scientific way of dealing with it.

The post-mortem on McKirrop would of course, define the extent of his injuries when they got round to doing it but the pathologist would probably be Hugh Carfax, a friend of Derek Logan. Not that she was suggesting that Carfax might be influenced by Logan’s notes and conclusions on the case but people were people and human nature was human nature. McKirrop had been a nobody; he hadn’t mattered in life. Why should society care about his death or more specifically, the exact cause of it?

Sarah felt embarrassed at the cynicism she was displaying. She felt the need to be more positive but how? What could she do on her own? Suddenly she saw the crux of the matter. Tyndall had said that he doubted the unusual angle of McKirrop’s forehead would have been enough to protect him from serious brain damage. Logan had in effect confirmed this view by recording a flat line on the patient’s scan, indicating that McKirrop’s skull had been pushed back into his brain causing massive damage. Why didn’t she take a look?

Sarah sat upright in the chair and her pulse rate quickened at the thought. McKirrop’s body would be lying in the mortuary. She could simply go along and see for herself. Any probing she would have to do would be disguised by the wound site. The pathologist need never know that she’d interfered with the body. The thought made her pulse beat even faster. ‘Interfered with the body’ — that sounded serious. She supposed that it was.

For a medical practitioner to interfere with a cadaver before a legally required post mortem sounded like a very serious offence indeed. “Taking a look” could turn out to be professional suicide if she was found out and someone chose to make it so. Despite the fact that she would not be altering or trying to cover anything up, the thought that Dr Derek Logan might be consulted in any repercussions if she were caught was not a comforting one. What should she do?

Sarah’s need-to-know triumphed over the temptation to play safe. She just had to know about that head wound. She checked her watch; it was just after nine fifty. The others wouldn’t be back until around eleven. That gave her plenty of time if everything went smoothly. She returned briefly to her room to change into a sweater and slacks and slip on a suede jacket.

Sarah hit the first hurdle as she hurried along the bottom corridor to the stairs leading down to the basement where the mortuary and post mortem suite were located. She suddenly realised that the mortuary would be locked. She knew that she could get a key at the front office but that would mean signing it out and then it would be known that she had visited the mortuary. There was another key, she remembered. The hospital porters had a key of their own for use when a patient died during the night and they had to remove the body from the wards. It was kept beside the ‘dead cart’, the nickname given to the covered trolley used to transport the dead from the wards when the occasion arose. The cart itself was kept in a little outhouse attached to the porters’ lodge by the front gate.

Sarah left the main corridor by a small side door and made her way to the porters’ lodge. There was little in the way of lighting on the road between the main hospital and the lodge so it would be unlikely that she would be seen. But with each step that brought her closer to the trolley shed, she felt more afraid. Her mouth became dry and something inside kept urging her to go back. Forget about it! It’s not worth the risk! Her feet refused to listen; she was almost at the porters’ lodge. Light spilled out from the mess room where she could see three men inside. One was reading a newspaper, the other two were arguing about something. She could hear their raised voices.

The trolley shed was comfortingly dark. She turned the handle slowly and felt the door release. The hinges squealed as she pushed it open and she froze with her fingers on the handle, trying to think what she would say if the lodge door opened and the porters found her there. It remained shut as the argument inside continued. Sarah let herself in and closed the door behind her, her teeth clenched as she tried to avoid making it squeal again. She was safe for the moment.

She knew that the mortuary key was kept on a hook on the wall with a skull and cross bones above it. Some porter had seen fit to add this refinement in the past with red and black marker pens. This was largely the reason for her remembering the existence of the key. She had seen it when she and the other new house officers had been shown around the hospital on their first day — their ‘orientation tour’. Right now, it was too dark to make out the skull and cross-bones but Sarah felt along the wall until her fingers touched the key and closed around it. At that moment she heard the phone ring in the lodge through the wall.

Her heart skipped a beat as she imagined the worst possibility. There had been a death in one of the wards and the porters were being called out to remove the body. Any second now they would open the door and find her there. She stood there, clutching the key in her hand with her eyes tightly shut as if in prayer. The door of the lodge opened and the voices were suddenly loud.

“That’s the third time that bloody staff nurse has called us out,” complained one.

“Maybe she needs the company,” said another.

“I know what she bloody needs.”

The door of the lodge closed and the voices started to fade as the two porters moved off. Sarah let her breath out slowly and tried to steady her nerves. As soon as everything was quiet again she let herself out of the shed, steeling herself to do it as silently as she could when all her instincts told her to make a run for it — there was still a porter left in the lodge. With a final look round as she moved off, she started out for the mortuary.

The fluorescent lighting stuttered into life as Sarah clicked on the switch. Her heart was beating so strongly that she had to rest for a moment leaning against the wall. There’s nothing to worry about, she told herself. You’re almost there. She looked at the row of refrigerated body vaults in front of her. Her first task was to find McKirrop’s body. There was a card index held in a metal holder on the front of each vault door indicating who lay inside and on which tier — there were three tiers to each. John McKirrop lay on the middle tier in vault 4.

Sarah undid the large metal clasp on the door and jumped back as the refrigeration plant sprang into life at the same moment. She chided herself again for being so edgy and bent down to examine the label on the big toe of the corpse on the middle tray. It confirmed that the sheet-wrapped body was that of John McKirrop. Sarah dragged the transporter trolley over and adjusted it to the required height by winding the handle at the side. When it was in position and the brake applied firmly she slid out the tray with John McKirrop’s body on it and locked it on to the transporter with the metal pin that hung down on a chain. She moved it back a few feet and shut the vault door. It closed with a clunk that seemed to echo throughout the whole suite.

Sarah wheeled McKirrop’s body through to the post-mortem room and turned on the lights. The light switch also turned on a series of extractor fans which whirred into life. Sarah reckoned that she would not need to get the cadaver on to a table; she could carry out the examination with it lying on the transporter. She doubted whether she could have manhandled McKirrop’s body on to a table on her own anyway. She did however, wheel the transporter parallel to one of the three PM tables so that she had access to water and electric power if required. She turned on the big flat lamp above the table and angled it so that McKirrop was bathed in white, shadowless light. Next, she collected a series of instruments together on a metal tray and laid it on the table beside her. She undid the sheet wrapping McKirrop’s head, grimacing a little at the cold clammy feel of it.

McKirrop’s face had taken on the parchment pallor of death and the wound in the centre of his head was so dark that it looked like a black hole. Sarah adjusted the lamp slightly so that the wound was illuminated perfectly. She picked up a metal probe from the tray beside her and investigated the depth. Her heart sank almost immediately. It was perfectly clear that the skull bone had indeed caused massive damage to the front of McKirrop’s brain.

“But how?” Sarah murmured. “Why had the X-ray of McKirrop’s skull suggested that his frontal lobe had been protected? Why had it not shown actual penetration of the brain by the bone?” After all it had penetrated to a depth of... Sarah measured the extent of invasion... one and a half centimetres. “Crazy,” she said, shaking her head. She ran the metal probe gently up and down the anterior surface of the bone and was suddenly struck by something odd. “This wasn’t the angle!” she murmured. She checked again and was now convinced that the angle of McKirrop’s skull bone was different from the angle that had appeared on the X-ray.

Sarah’s pulse rate, which had calmed down over the last ten minutes, started sprinting again. There was only one logical explanation. McKirrop’s skull had been pushed back into his brain after the X-ray had been taken! Sarah dropped the probe she’d been holding and it bounced off the hard tiled floor. For a few moments she stood absolutely still, then she started to think about priorities.

She needed proof! She needed solid evidence! The post mortem carried out on this body would simply report that the patient had died from massive brain damage caused by his skull being broken and forced back into his brain by a large blunt object, the base of a wine bottle. Exactly what everyone had suggested. She searched through the pathology cupboards until she found what she was looking for, a Polaroid camera. Another brief search and she came up with film for it. She angled herself behind the trolley to photograph the wound but stopped after taking two photographs. What was this going to show? A photograph of a gaping wound wasn’t going to prove anything at all.

Sarah thought for a moment then came up with an idea. She ran through to the small office next door to the PM room and rummaged through the desk drawer until she found a clear plastic protractor. She hurried back with it and positioned it to one side of the wound. She then inserted a metal probe so that it lay along the angle of the bone. She brought up the protractor close behind it so that it showed the angle of the bone relative to the horizontal. She took four photographs. These photographs when compared to the X-ray of McKirrop’s skull should demonstrate a significant alteration in the angle of the bone.