You Are Dead

22

Friday 12 December

Jacob Van Dam, seated behind his desk in his Harley Street consulting room, peered like a wise owl through small, round tortoiseshell spectacles. A diminutive figure, with large patches of liver spots across the top of his head and on the backs of his bony hands, the psychiatrist was dressed in a grey pin-striped suit that seemed a size too big for him, as if he had shrunk in the years since having it made, and his collar, knotted with a club tie of some kind, hung around the loose wrinkled flanges of his turkey-like neck.

During many years of practising forensic psychiatry, dealing with a wide range of violent criminals, he had been assaulted on a number of occasions, and these days preferred to keep the barrier of his desk in front of him, for safety.

At seventy-seven he was long past the age at which he could have retired, but he loved his work far too much to ever consider that. Besides, what the hell would he do if he did retire? He had no hobbies, his work had always been his life. He held an endless fascination with human nature — which he saw daily with his patients.

The walls around him were lined with books on medicine and on human behaviour, quite a few of them bearing his name on the spine. His published works, lined along one shelf, included a book on why the public had adored Princess Diana, and another which was considered the definitive analysis of the Yorkshire Ripper, Peter Sutcliffe, who had been convicted of murdering thirteen women. Further along were the three volumes of which he was most proud, which came out of his time working as a psychiatrist within the high-security psychiatric hospital Broadmoor, where one of the criteria to be an inmate was to be diagnosed criminally insane.

What had always intrigued him, from his earliest student days, was the whole notion of evil. Were some human beings born evil, or did something happen to turn them evil? And first, of course, you had to define evil. That was the topic he had explored in these three volumes, without coming to a conclusion.

In forty-seven years in psychiatry he had not yet found, definitively, any of these answers. He was still looking for them. Which was why he still came here every weekday morning and saw patients until the early evening, thanks in part to the understanding of his beloved wife, Rachel.

He was writing up his notes on the patient who had just departed from his office, an actor almost as old as himself who was unable to cope with the fact that women no longer threw themselves at him, when his secretary buzzed to announce that his next patient had arrived. Dr Harrison Hunter.

Hastily, he looked up the man’s name and the referral letter from his family GP, a Dr Edward Crisp in Brighton. The letter was short and terse and the first referral he’d ever had from this doctor. Harrison Hunter was suffering from anxiety, with frequent panic attacks, and Dr Crisp believed him to be delusional. Van Dam pressed his intercom button and asked his secretary to show him in.

Instantly, for reasons the psychiatrist could not immediately define, this new patient simultaneously both excited and intrigued him — but also sent a wintry chill through his bones.

Van Dam stood up to shake his hand then ushered him to sit on one of the two hard, leather-cushioned antique chairs in front of his desk. For a moment they were forced into silence as an emergency vehicle siren screeched by outside. As the siren faded the only sound for some moments was the hiss of the gas fire in the grate.

Harrison Hunter’s body language was extremely awkward. Fifty-five years old, according to the referral note, he looked pleasant enough, conservatively dressed in an off-the-peg business suit, dull shirt and clumsily knotted tie, tinted aviator glasses and sporting a mop of floppy blond hair rather like the style of the politician, Boris Johnson. The hair did not match the man’s eyebrows and he wondered if perhaps it was a wig.

His new patient moved his hands from his thighs to his knees, scratched both of his cheeks, then the tips of his ears, then patted his thighs and shrugged.

‘So, how are you hoping I can help you, Dr Hunter — may I call you Harrison?’ the psychiatrist asked. It was his customary opening line for his first consultation with any new patient. He glanced briefly down at his notes, then placing his elbows on his desk, he steepled his hands, rested his chin on them and leaned forward.

‘Harrison is fine.’

‘Good. Are you a doctor of medicine?’

‘I’m an anaesthetist. But a rather unusual one.’ Hunter smiled. He had a dry, slightly high-pitched voice that sounded distinctly neurotic.

They were both forced into silence as another siren screamed past, followed by a third. When it faded the psychiatrist asked, ‘Would you like to tell me in what way you consider yourself to be unusual?’

‘I like to kill people.’

Van Dam stared at him with an expressionless poker face. Anaesthetists could occasionally be quite spiky, believing their role was as important as the surgeon’s, yet they were getting paid less. He’d had one tell him that it was the anaesthetist who held the power of life over death in the operating theatre and who described surgeons dismissively as nothing more than butchers, plumbers and seamstresses. He had heard most things during his career, and patients often said things calculated to shock him. He remained silent, studying the man’s face and body language, then looked straight into the man’s eyes. Dead eyes that gave nothing away. He held his silence. Silence was always one of his strongest tactics for encouraging people to talk. It worked.

‘The thing is, you see,’ Harrison said, ‘I work in a busy teaching hospital, and I’m expected to lose an average of eight to nine patients a year through adverse reactions to the surgery or anaesthetics — from syndromes such as Malignant Hyperthermia. I’m sure you are well aware of the dangers of anaesthesia?’

Van Dam continued to fixate on him. ‘Yes, very aware.’

The anaesthetist finally cast his eyes down for some moments. ‘Every now and then I kill an extra one, and sometimes two, each year, for fun.’

‘For fun?’

‘Yes.’

‘How does this make you feel?’

‘Happy. Satisfied. Fulfilled. And it is fun.’

‘Would you like to tell me about the kind of fun you experience when you kill someone?’

Harrison Hunter balled his fists and raised them in the air. ‘Power, Dr Van Dam! It’s my power over them. It’s an incredible feeling. There isn’t any greater power a human being can have than taking the life of another, is there?’

‘Not such fun for your patients, though.’

‘People get what they deserve, don’t they? Karma?’

‘Some of your patients deserve to be killed?’

‘This is what I need to talk to you about — it’s why I’m here. Are you a religious man, Dr Van Dam, or a Darwinian?’

The psychiatrist stared back at him in silence for some moments, blinking. Another emergency service siren dopplered past. Heading to a crime scene? One of this strange man’s victims? He picked up his pen and held it with the forefinger and thumb of each hand, focusing on the black barrel and silver cap for some moments. ‘This consultation is about you, Harrison, not about me and the views I hold. I’m here for you. And before we go any further, I must remind you that I am bound by the requirements of the General Medical Council. I’m not bound to protect a patient’s confidentiality if I believe him or her to be a danger to society, these days. The reverse is in fact the case, I am duty bound to report that person. So from what you are telling me, I am duty bound to inform the police about you.’

‘But first, Dr Van Dam, you would have to get out of your office alive, yes?’

Van Dam smiled back at him. He tried not to show his discomfort, but there was something intensely creepy about this man — although at the same time, fascinating. He exuded a deeply troubled darkness. On occasions in his past, working at Broadmoor, he had encountered similarly disturbing people. But he could not remember the last time he had felt himself in the presence of such feral evil. Dr Crisp had written that his patient was delusional. Was this one of his delusions?

‘True, Harrison,’ he replied, with a half-hearted laugh. ‘Oh yes. Yes, of course.’

‘You are not going to go to the police, Dr Van Dam. Firstly, I think you would hate to lose me as a patient. And secondly, I sense that although the law has changed, you don’t agree with the change. You’re a pretty old-fashioned guy, with old-fashioned views about the sacrosanct right of confidentiality between a doctor and patient. I read a paper you published in the Lancet over a decade ago. You put forward a very cogent argument for maintaining it.’

‘I wrote that a doctor should not be under a legal obligation, only a moral one. But let’s talk more about you. Why are you here, what are you expecting from me? How are you hoping I might be able to help you?’

His patient looked at him with a curious expression. It felt to the psychiatrist that the man was staring right through his soul. ‘I need to cope with my guilt.’

A number of thoughts went through the psychiatrist’s mind. People did die every year from allergic reactions to anaesthetics — a tiny percentage of all those who had operations. It was a tragic fact that every anaesthetist would lose a few patients over the course of his career. Was this simply Harrison Hunter’s way of coping with his guilt, to confess to killing them deliberately? Or was Hunter a fantasist?

Or was he, as he said, really a killer?

The psychiatrist decided to humour him. ‘I’m not sure I believe what you told me about you killing people deliberately,’ Van Dam said. ‘When you qualified as a doctor of medicine, surely you agreed to be bound by the basic ethics of medicine, Do no harm. So tell me why you are really here?’

‘I’ve just told you.’ He was silent for some moments, then he said, ‘There’s a local newspaper published in the Brighton area called the Argus. Take a look online, later. You’ll see a story about skeletal remains of a woman discovered yesterday in a small park close to the seafront, called Hove Lagoon.’

‘Why do you want me to look at this story?’

‘Because I know who killed her, and why.’

The psychiatrist studied him for some moments, watching his chaotic body language. Then he said, ‘Have you told the police?’

‘No, I haven’t.’

‘Why not?’

‘Because, Dr Van Dam, you and I need each other.’

‘Do we? Can you explain that to me?’

‘There’s another story in the Argus today. It didn’t make the printed edition this morning, but you’ll be able to read it online. You have a niece, Logan Somerville?’

Van Dam stiffened, visibly. ‘What about her?’

‘Are you very fond of her?’

‘I don’t discuss my private life with my patients. What does my niece have to do with this?’

‘You haven’t heard, have you?’

‘Heard what?’

‘About Logan. She disappeared last night.’

Van Dam blanched. ‘Disappeared?’

‘There’s a manhunt going on all over Brighton for her. For your niece. Logan Somerville. You need me very badly.’

‘Why is that?’

‘Because I’m the only person who may be able to save her life.’