White death

SIX

Steven headed back into town. He decided he would have to access Trish Lyons’ medical records for himself in order to see if he could find out what Scott Haldane had been so upset about. The surgery was on the way so he would stop off and ask if the records were there although he suspected they might not be, in view of what had subsequently happened to Trish Lyons.

‘I’m sorry,’ said James Gault after checking with the practice manager. ‘They were returned to us but had to be sent off again to the sick children’s hospital to have the scalding incident entered… I should think by now the hospital will probably have sent the notes on to the central monitor. Some day they’ll come back to us…’

‘I get the picture,’ said Steven. ‘Perhaps you could let me have the address of the monitoring body?’

‘Of course; I’ll have to ask Cathy.’

To Steven’s surprise, Gault returned not only with the information he’d asked for but with a woman following along in his wake. She was introduced as Cathy Renton, the practice manager. ‘It’s not quite as simple as I thought,’ confessed Gault.

‘Health matters are devolved in Scotland,’ said Cathy. ‘But monitoring in this instance is part of a UK initiative. The bottom line is that we have to channel the records through the Scottish Executive who then forward them to the UK body and vice versa when they’re returned.’

‘Why?’ said Steven.

‘I suppose the Executive needs to know what’s going on,’ said Cathy with a half apologetic smile. She handed Steven the address and phone number of the Scottish Executive body dealing with the forwarding of medical records.

‘Woodburn House,’ Steven read out.

‘It’s not far from here,’ said Cathy. ‘It’s in Canaan Lane, just off Morningside Road.’

It took twelve minutes from the time Steven showed his ID to the girl on the desk until he was shown into the office of someone who ‘might be able to help’, the intervening time having been taken up with internal phone-calls and subsequent transfers within the building. Miss Collinwood, when he was shown into her office, wasn’t too sure either if it was ‘within her area’.

‘What is it you need exactly?’ she asked.

‘I’d like to see the medical records for a patient named Patricia Lyons, a thirteen-year-old girl registered with Dr Scott Haldane at the Links Practice in Bruntsfield.’

‘Then why come here?’

‘Because the Links Practice told me her records were sent here.’

‘I’m sorry. Why?’

‘Apparently she was a green sticker patient — one of a number of children being monitored after having been exposed to tuberculosis at a school camp in the Lake District.’

‘The Lake District? That’s in England. I don’t think we would be monitoring anything as far south…’

‘No,’ interrupted Steven, starting to run out of patience. ‘You’re not doing the monitoring but apparently medical records from Scottish children on the list have to come to you first before being submitted to the English body.’

‘Why?’

‘What an awfully good question,’ said Steven. ‘But they do. Surely somebody here must know where the girl’s records are?’

‘Give me a moment.’ Miss Collinwood picked up the phone.

Steven got up to examine the watercolours on the walls of the office, hoping to find a calming influence in them while the phone-calls mounted up. Lucky number five, he thought when he heard Miss Collinwood say, ‘You do, Jan? That’s great.’

‘Mrs Thomson’s been dealing with green stickers.’

‘Good show,’ said Steven with a smile. ‘Where do I find her?’

He was led along the corridor to another almost identical office where Jan Thomson, a short pixie-like woman with bobbed hair and a pointed nose, shook his hand and invited him in. ‘How can I help?’

Steven temporarily suppressed his belief that the person asking this question could invariably never be of help and told her what he was looking for.

‘I see.’ The woman repositioned her computer screen and typed in some details. ‘Out of luck, I’m afraid. They’ve gone south.’

‘Don’t you keep copies?’

‘No, we just forward them and return them to the relevant surgeries when they come back.’

‘Like a conduit,’ said Steven flatly.

‘Well, we like to know what’s going on.’

‘So what is going on?’

‘I’m sorry?’

‘If you like to know what’s going on, presumably you have some record of what’s going on.’

‘No, I told you, we just forward the records and then return them.’

‘Without noting anything down?’

‘Look, Dr Dunbar, I don’t make the rules.’

‘Of course not, forgive me,’ said Steven, back-tracking in a damage limitation exercise. There was nothing to be gained from conflict with authority. ‘We’re both cogs in the great government machine. Perhaps you can give me the address of the UK body that deals with green sticker patients?’

A few taps on the keyboard and Jan Thomson wrote details on to a Post-it note.

‘And maybe some information about the school camp that was the cause of all this?’

More taps and another note.

Steven thanked the woman and left thinking that he had exactly the same feeling inside him the last time he’d been in a government office. He reflected that he was experiencing the same exasperation that had upset Scott Haldane so much. He found a coffee shop in Morningside Road and ordered a double espresso while he brought out the two notes from his pocket. The monitoring body was called ‘Lakeland TBMG’ — which he guessed stood for TB monitoring group — and was located at an address in Whitehall, London. The school camp was called ‘Pinetops’ and was sited on the shores of Lake Windermere, not far from Bowness-on-Windermere and not that far from where he himself had been brought up. It conjured up images of Swallows and Amazons and children having a good time in glorious scenery.

The TB monitoring group, however, reminded him of stories he’d read in the medical journals recently about tuberculosis making a comeback in the UK after having almost been wiped out in the Sixties. For some years now, it had been thought no longer necessary to test children for the illness or offer them protection against it. This had resulted in a population which was vulnerable to the disease now being brought in by immigrants — a touchy subject in both medical and social terms. On top of this, drug-resistant strains were not uncommon and were proving notoriously difficult to treat.

As he sipped his coffee, Steven wondered if there was any point in his staying longer in Edinburgh. He supposed he could have a word with Trish Lyons’ mother but wasn’t convinced that that would serve any real purpose apart from upsetting the woman. On the other hand if Trish had said anything about her ‘accident’ since her admission to hospital it might help a great deal and this was something he should be able to find out discreetly from the hospital itself.

If Trish had scalded herself deliberately when psychiatric help at an earlier stage might have prevented it, then suicide was still a possibility for Scott Haldane despite all that his wife had said. If, however, the girl could confirm that it had been an accident, the puzzle over Haldane’s death would remain and the possibility of murder, however unlikely, could not be dismissed entirely although there were no forensics to support this and no apparent motive either, only the belief of a grieving widow.

Steven arrived at the Royal Hospital for Sick Children shortly after 3 p.m. and spoke to the registrar involved in treating Trish Lyons, Dr John Fielding.

‘She’s still a very ill young lady,’ said Fielding.

‘The scalding was that bad?’

Fielding appeared to be uncomfortable with the question. He scratched his head in a nervous gesture and said, ‘The scalding was bad but… it’s the healing process that really concerns us…’

‘In what way?’

Another nervous gesture. ‘Well… it’s not really happening.’ The words hung in the air like the calm before a storm. ‘It’s as if there’s some psychological reason for her not improving.’

‘I understand she was suffering from vitiligo,’ said Steven.

Fielding nodded. ‘That’s what’s making us think there’s a psychological factor involved. Apart from the burns, the vitiligo seems to be spreading. She’s developed patches on her legs and feet.’

‘Poor girl, she’s having a nightmare time of it.’

‘Actually… she’s disturbingly calm and detached about it. Worryingly so.’

Steven remembered Trish’s mother apparently having said something similar about her daughter’s state when she found her on the kitchen floor. ‘A long time for shock to persist,’ he said.

‘Quite,’ said Fielding.

‘Has she said anything at all yet?’

‘Not much.’

Steven put his cards on the table and admitted that his real interest was in establishing whether the scalding had been accidental or not.

‘I can help you there,’ said Fielding. ‘She claims it was an accident.’

‘Ah,’ said Steven, pleased and somewhat surprised that his question had been answered. ‘She did speak about it then?’

‘She said she slipped on the kitchen floor and her arm caught the pot handle on the way down.’

‘Well, that clears things up,’ said Steven but he noticed that Fielding’s expression harboured doubts. ‘But you don’t believe her?’ he asked tentatively.

‘I don’t know for certain but I think there’s a possibility she might be saying that to spare her mother’s feelings.’

‘What makes you think that?’

‘When her mother asked her about the agony she must have suffered from the boiling water, Trish maintained that it was nothing, she didn’t feel a thing.’

‘Oh,’ said Steven, feeling a bit deflated. ‘I take it she’s been seen by a psychiatrist?’

Fielding nodded. ‘Who didn’t get anywhere with her. She seems locked in a world of her own.’

‘Her mother must be going through hell.’

‘She is,’ agreed Fielding. ‘But there’s an even bigger hurdle on the horizon. If the healing process doesn’t start kicking in soon, Trish is going to lose her arm.’

Steven walked back along the seemingly endless corridors of the Victorian building, noting how out of sync with his feelings the cheerful Disney characters on the walls were. He suspected that generations of anxious parents had felt the same way.

He called Sci-Med to say that he would be returning to London on the following day. He asked Jean Roberts to contact the Whitehall body responsible for ‘green sticker’ monitoring to request that they send Trish Lyons’ notes to Sci-Med.

‘Not spending the weekend with Jenny?’ asked Jean.

‘Maybe next weekend,’ replied Steven, suddenly feeling even worse, although when he started contemplating the hell children could put their parents through, he had to admit his own problems faded to nothing when compared to what Trish Lyons’ mother was going through.

Jean Roberts had the file waiting for him when he entered her office. He had taken the first BA shuttle down from Edinburgh and had dropped his bag off at his apartment before walking over to the Home Office.

‘I hope you appreciate the trouble we had to go through to get these,’ said Jean.

‘Why so?’

Jean shrugged. ‘They really didn’t want to part with them. I had to get Sir John to intervene.’

‘Can’t think why,’ said Steven, looking genuinely puzzled. ‘But thanks as always.’

‘As always, you’re welcome,’ said Jean, tongue in cheek.

The door to John Macmillan’s office opened and he looked out. ‘Thought I heard your voice. Got a moment?’

‘Wild goose chase?’ asked Macmillan when Steven had closed the door.

‘Pretty much,’ agreed Steven. ‘There’s no reason to believe Scott Haldane was murdered. On the other hand there was no real reason for him to commit suicide either. The girl patient, however, says her scalding was an accident so there was no reason for Haldane to go off on a guilt trip… although that’s far from clear too.’

‘Sounds like a foggy night,’ said Macmillan.

‘You could say.’

‘Can I ask why you requested the girl’s medical notes?’

‘Haldane’s wife said that her husband had terrible trouble getting his hands on them and finding anyone to talk to about the case. I suppose I wanted to see what the fuss was about. Why do you ask?’

Steven’s question was designed to highlight the fact that Macmillan did not usually question his investigators’ motives for doing anything.

‘Don’t misunderstand me; I’m not interfering,’ insisted Macmillan with a smile. ‘I just thought you should know that I had considerable difficulty in obtaining them after Jean told me she’d hit the wall with a simple request. It may be nothing but if government departments start getting obstructive when we ask them for things, it usually means… it’s something worth knowing. I just thought I’d tell you.’

‘Thanks,’ said Steven. ‘It’s probably tied up with the green sticker business.’ He told Macmillan about the children’s exposure to TB at the Lake District camp. ‘I suspect they’re a bit sensitive about giving out information. They wouldn’t want the press having a field day over it.’

On impulse, Steven decided to walk back to his apartment and sit by the river for a while to leaf through Trish Lyons’ notes. His concentration was interrupted at intervals by the commentary from passing Thames tourist boats as they ploughed their way up and down the river. ‘The building on your right is…’ Not that much concentration was required. It was clear from the notes that Trish had been a healthy baby who had grown into a healthy child. In fact, there was nothing at all out of the ordinary in the notes until she had gone to Pinetops school camp and had been exposed to a child there who had been diagnosed with pulmonary tuberculosis. She’d been given BCG vaccine as a precaution and ‘green-stickered’ to ensure that her future health and wellbeing was monitored.

Steven was puzzled and disappointed. He couldn’t see what all the fuss had been about or why it should have proved difficult to get access to these notes or why Scott Haldane had needed to discuss anything in them. What was there to discuss?

Well, there must have been something, Steven concluded, but he certainly wasn’t looking at it. That fact alone was enough to stop him drawing a line under the affair. He hated the idea of missing anything — a good investigator turned over all the stones and there must be one stone missing in this case. They might well be sensitive to outside interest but he would ask the green sticker people a few more questions just to see what happened.

Steven decided to focus on statistics. He would ask how many children were affected by the exposure and just for good measure… who they all were. He would also ask for details about the child who had caused the panic in the first place — name, address and current state of health. He called Jean Roberts with his request.

‘And if they should baulk at that and ask if this information is really necessary?’ she asked.

‘The answer’s yes.’

It took two days and another intervention by John Macmillan to get the information Steven had requested and even then, details about the child who had contracted tuberculosis were missing. ‘Sir John will explain,’ said Jean.

‘Her Majesty’s Government is only too well aware of the potential repercussions of revealing that a non-white immigrant child has exposed a number of British children to the scourge of tuberculosis,’ said Macmillan. ‘It has been decided that only a select few should have access to the child’s identity and whereabouts. A top level decision, I’m told.’

‘And we are not among that select few?’

Macmillan paused for a moment before saying, ‘I know it’s in your nature to dig in your heels and demand to know things. This is not a criticism; you’ve usually been right when you’ve smelled a rat but on this occasion I have to ask you formally if it is really necessary for you to know the identity of this child — if it is, I promise I will get it for you but first you have to assure me that it is.’

It was Steven’s turn to pause for thought. ‘No, it isn’t absolutely necessary,’ he admitted, although he added quickly, ‘at the moment.’

Later, Steven sat down in his favourite chair by the window in his apartment where he could see the river traffic pass by through a gap in the buildings opposite. A Sci-Med salary did not run to a riverside address. He had had to settle for one street back but it had everything he needed and afforded him views of the sky and the river. As he slumped back in the chair looking up at passing clouds, he wondered what Scott Haldane had been so upset about — not being given details of the child with TB? He doubted that. It could have no relevance. No, he concluded, he was still missing something here. Maybe he still hadn’t asked the right question.

Yet again, he looked down the list of children who had been green-stickered for follow-up, one hundred and eight from across the UK and all in the twelve-to thirteen-year-old age range. Was it something in the way they had been exposed to the danger that had alarmed Haldane? Maybe a lack of primary checks on immigrant pupils? Possibly something in the way the incident had been handled at Pinetops? Or afterwards? The continuing niggle that he was missing something made Steven decide to drive up to the Lake District in the morning.