Forty-one

The page had been photocopied from an operating theatre record dated 17 April, three years earlier. Cholecystectomy. Time operation began: 11.42 a.m. Time operation finished: 13.17 p.m. Surgeon’s name. Assistant surgeon’s name. Anesthetist. Scrub nurse. Circulating nurse. Nature of operation. There were others noted on the same page, but Patel was in little doubt this was the one he should be concerned with. Whatever the exact reason the sister had handed him the envelope containing the copy, he was certain it had to do with this particular operation.

Cholecystectomy: he’d have to look that up.

Bernard Salt’s signature at the end of the page; dashed off in no time at all, pitched between a scrawl and a flourish.

“Who usually fills in the record book?” Patel had asked, polite and always eager to learn. “Yes, after an operation.”

The answer was the circulating nurse and this particular one was still at the hospital, that day, that moment in the recovery ward, a broad-boned woman with skin like raw washing left too long in the wind.

“Oh yes,” she said, Midlands accent, uncertain. “Yes, that was me. You see, my handwriting, I’m afraid it’s not the best.”

“And this operation, a long time ago, I know, but I was wondering … perhaps there is something you remember?”

The look in her eyes told Patel that there was.

“I don’t know,” she said, casting her eyes about her already, concerned that she might be overheard. “We were asked, you see, not to talk about it.”

“Of course,” said Patel reassuringly. “I understand. But this is a police inquiry.”

“Into this?”

“No. Oh, no. Of course not. But we think, well there is a possibility, there might be some connection.”

The nurse sucked in her lower lip, distorting her face.

“If it might help to put a stop to what’s going on, you’d want us to know, wouldn’t you. I mean, you’d want to help put a stop to all this, these attacks?”

“But this was three years ago. More than that even. I can’t see …”

“Trust me,” Patel said. “If it isn’t relevant, nobody need ever know we’ve ever talked about it. I can promise you that.”

She sighed and he could see that she had made up her mind. “The patient … he was on his way out of the theater, being wheeled, you know, here to recovery, and I could see that he was crying, really crying, and I stopped, you know, the trolley and went to touch him, just on the shoulder, to touch him and he screamed. Screamed and screamed and screamed. Ever such a fuss and palaver we had calming him down. And then he told us-well, you don’t know, do you? — but what he said was, right through the operation, he knew everything that was going on. He’d been able to feel the whole thing.”

Once, back in Bradford, Patel’s paternal grandfather had been taken suddenly ill and rushed to hospital. Even as the old man lay there in the middle of a ward of strangers, palpably dying, it had been all but impossible to extract information from the doctors. Don’t worry. No need for anxiety. The best thing you can do is not get upset. Nothing more than an exploratory operation. Tests. Examination. Before the results had come through, his grandfather had been dead.

Trying to get information here had been little better: men and women, but mostly men, so used to obscuring the truth that it was second nature. Any question either ignored as by rote or weighed in the balance against any possible slur or taint of redress. Such records as existed were incomplete for the police’s purposes and jealously guarded. So they had gone off digging, never sure of what they were searching for, another member of staff with a professional or private grudge or family with grounds for retribution? One veil prized away only for another to fall into place.

Excited by Helen Minton’s gesture, Patel drove far too fast to the enquiry room and bullied his way on to the computer. Less than half an hour later he was knocking on the superintendent’s door.

Carew had shifted gears: the bursts of belligerence, the bravado were gone and now he was playing for time, a straight bat, content to sit there and give the same answers, short as possible, again and again and again. More than one eye on the clock.

“I was wondering, sir …?” Lynn Kellogg on her way across the CID room the moment Resnick appeared.

Resnick looked at her forlornly and shook his head.

“But the scalpel …”

“No way we can tie it in, nothing that puts him with the girl that lunchtime, any other time, nothing at all.”

“We’ve got his name in her diary, surely …?”

“Eighth most popular name, A and B group parents, kind of statistic Amanda Hooson would have loved. Medical school, university, probably full of them.”

“If it is somebody else, he must know who he is, why hasn’t he come forward?”

Resnick shrugged. “Who knows? But Naylor did come up with a student, positive he saw Carew sitting in the corner of the Buttery, watching the pool. Says he was on his own.”

Lynn Kellogg closed her eyes.

“His solicitor said it, I don’t like him. Neither do you. Sort that gets under your skin, blurs your judgment.”

“Karen Archer, sir, you have questioned him about her as well?”

“He swears not to have set eyes on her after he received his warning. Hasn’t heard from her, no idea where she is.”

“I don’t believe him.”

“Isn’t it what I just said? You don’t want to believe him.”

“I don’t think, where women are concerned, he’s the kind of man that ever gives up, lets go.”

“I hope you’re wrong,” Resnick said. “I hope to God you’re wrong. Meantime …”

“We’re releasing him.”

“Maybe soon,” Resnick said. “Not yet.”

Salt had screamed at the scrub nurse in theatre, fumbling with a clamp instead of slapping it down into his hand and the poor bugger on the table into a bleed that had his kidneys bobbing around like a coxless pair catching a crab. Of course, he’d apologized to her afterwards, no excuse for snapping like that and she’d said, no, it had been her fault, her fault entirely, but it had been her eyes that had told the truth.

Interesting, the way they were polarizing, attitudes towards him inside the hospital. Well, not interesting at all, really, take that back, more what you’d expect. Most of the nurses, female ones, the secretarial staff, social workers, their sympathies were with Helen, the other woman, used and then abused. Whereas the men-some of them it was nudge, nudge, wink, wink, sly old goose keeping a bit going on the side and pretty much getting away with it; others who’d found themselves on the receiving end of Helen’s tongue, they thought he was well shot of her. All brimstone and spare the treacle.

There was a message on his desk-he’d swear his secretary’s handwriting had become more crabbed since this had come out into the open-would he please get in touch with a Superintendent Skelton as soon as possible?

Soon as he felt up to it: later.

Right now what he needed was a brisk walk, fresh air. He knew some surgeons who kept a silver flask topped up with one form of spirits or another, a quick tipple between jobs to keep the hands steady. Or so they claimed. One of his former colleagues, now gone to meet the great consultant in the sky, hadn’t been above grabbing the mask when no one was looking and having a furtive go at the ether. Nine operations a day, that man, matter of routine. Of course, it had killed him. Heart. Four years short of fifty. Wife had remarried within six months, junior surgeon. New blood. Probably something going on there beforehand as well. Truth were known, they were all at it. Most of them. Human nature. What was that play? Restoration. Damn. English teacher had them read it at school. One that got the sack. Way of the World, that was it. True enough.

Bernard Salt stopped at the slip road to the car park and for only the second or third time since it had happened, he was thinking about the incident that evening after talking to Helen. A sound like a footstep, a movement, definitely a movement, and close, close to him. But then someone he knew had come along and after that, nothing. Which was in all probability what it had been.

Except …

That houseman, Fletcher, then Dougherty, it hadn’t seemed anything that concerned him, that might impinge on his life, touch him at all. And then that young girl, the one who’d been an ODA. He had never wanted to admit to himself that there might be a connection.

Then he turned back towards the hospital and saw the two men standing close to the entrance, neither of them men that he recognized as such, but the way they stood and waited, you didn’t need to know their name.

“Superintendent Skelton,” said the taller man, showing his card. “This is Detective Constable Patel. We appreciate that you have a busy schedule, but we were wondering if you could find time to talk to us. It may not take very long.”

Salt made a brief nodding motion, almost imperceptible. “I have a cholecystectomy scheduled, which I should imagine, barring complications, will take an hour to an hour and a half. After that …”

“Will be fine,” said Skelton. “There are other matters we can be checking into while we’re here.”

Salt didn’t ask what these might be; some of them he thought he might guess.

“Cholecystectomy,” said Patel, “an operation to remove the gallbladder, is that right?”

“Yes,” said Salt, “it is. Absolutely.”

“What did you get your degree in?” Skelton asked as they were walking into the hospital.

“Mechanical engineering, sir,” Patel said, holding the door to let the superintendent step through.


“Rightly or wrongly,” Bernard Salt was saying, “the impulse is always to calm the patient down, give something to deal with the residue of the pain, basically ensure as little agitation as possible. Last thing you want them to do, dwell upon what happened. Difficult enough to forget, I should have thought, without willingly reliving it all the time. No, you can apologize, you can try to explain.”

“Smooth it over,” suggested Skelton.

“Absolutely.”

They were in the consultant’s office, Skelton and Salt facing one another from the two comfortable chairs, Patel off to one side on a straight-backed chair with a leather seat. Among the questions he wanted to ask, why wait until someone else gave us this information, why not come forward with it yourself? The sister who did point them in this direction, what were her motives? Another of a different kind, what was Skelton’s degree in? But he remembered somebody saying, the superintendent was not a graduate at all. When Skelton had entered the Force, relatively few recruits had been graduates; even fewer had been Asian, black.

“There is always, I suppose,” Skelton was saying, “the danger of legal action in cases such as this?”

Salt tapped his fingers together, brought his heavy head forward once.

“And so to do anything which might seem to be accepting liability …”

“Quite.”

Skelton let his glance stray towards the window. After the brave showing of sunshine, today’s skies had reverted to an all-over anonymous gray. “I believe there was an instance, four years ago. An … er … laparotomy, if I have the term correctly.”

“An exploratory examination of the abdomen,” said Patel.

Salt glared at him with something close to hatred.

“The patient claimed to have been awake throughout the operation,” Skelton continued. “Damages were sought from the health authority, who settled out of court for an undisclosed sum. You were the surgeon in charge of that operation.”

“The patient,” Patel said, less than comfortable with both of the older men staring at him, “was in a ward on which Karl Dougherty was working as a nurse.”

Salt shook his head. “I can only take your word for that.”

“It is true,” said Patel. “Dougherty himself remembers the incident and, as far as we have been able, we have checked the records.”

“I’m sure you have,” said Salt, a tone neither quite accusation nor patronization. “And I am sure you have discovered that in November of last year, during an appendicectomy, the anesthetic was found not to be functioning correctly and the operation was abandoned.”

Skelton looked across at Patel and Patel, who had come across no such information, nodded wisely.

“Only a few months before the operation to remove the gallbladder,” Skelton said, “there was considerable adverse publicity around a woman who claimed to have been conscious while giving birth by Caesarian section.”

“Certain newspapers,” Salt said, “I am sure sold a great many extra copies.”

“Not only were the health authority sued, but also the surgeon in charge and the anesthetist. I think that is correct?”

“In the light of that,” Skelton went on, “it’s reasonable to imagine the authority, the hospital managers, would be very loath to attract similar publicity so soon again. Quite apart from the financial loss, what might seem to the general public like a falling away of professional standards, that would be something to be avoided at all costs.”

“Not at all costs, Superintendent. There is no sense of anything having been covered up. And as for this hospital, I can assure you that, cheek by jowl, our record in these cases compares very favorably with others of a similar size.”

“I’m sure it does.”

“The number of operations that are carried out …”

“Please”-Skelton spread his hands-“Mr. Salt, even if such issues were my concern, you would not have to convince me that what you say is true.”

Salt cleared his throat and stretched out his legs, drawing them back up again towards his chair.

Skelton glanced over at Patel and nodded.

“The operation to remove Mr. Ridgemount’s gallbladder, sir, the anesthetist was Alan Imrie and his assistant was Amanda Hooson.”

“Correct.”

“At the time of the operation, Tim Fletcher was attached to you as a junior houseman?”

“I believe … I should need to check to be … Yes, yes. I suppose it’s possible.”

“The surgical ward in which Mr. Ridgemount was a patient, Karl Dougherty was a staff nurse on that ward.”

“He may have been. I’m sure you know that better than I.”

“Dougherty, Fletcher, Hooson-after the last of these, at least, why didn’t you come forward?” Skelton asked.

“I had never drawn the connection you are suggesting.”

“Never?”

“Superintendent, Dougherty may have been one of the nurses who cared for Mr. Ridgemount. During his time at the hospital, so would a good many others. And as for Fletcher, I can’t imagine that his contact would have been more than peripheral.”

“So you never thought it might be relevant-what happened to Ridgemount?”

“What he alleges happened.”

Skelton looked at the consultant keenly. “He made it up?”

“An operation, Superintendent, it’s a traumatic thing. It has been known for patients to hallucinate, for their imaginations to distort what actually happened under the anesthetic.”

“And you’re saying that’s what happened in Ridgemount’s case?”

“I’m saying it’s a possibility.”

“It’s also a possibility that he was telling the truth.”

“Yes.”

“Ridgemount,” said Patel, “he was threatening legal action also.”

Bernard Salt nodded. “At one time.”

“Against yourself, the senior anesthetist, and the health authority?”

“So I believe.”

“You’ve no idea, sir,” asked Patel, “why the action was dropped?”

“None. Although, my supposition at the time was that whoever had been advising him didn’t consider his case strong enough to take to court. Either that, or he changed his own mind about what actually happened.” Salt made a point of looking at his watch. “Gentlemen,” he said, rising to his feet, “I am in danger of being late for theater.”

“The anesthetist in charge that day,” Patel said as they were passing through the door, “Imrie, wasn’t he also involved in the cesarean section? The case that was settled out of court?”

“I believe he was.”

“If we wanted to speak to him?” Patel said. “He no longer appears to be on the staff of the hospital.”

“Eight months after the Ridgemount operation,” replied Salt, turning in the corridor to face the two policemen, “when legal action was still threatened, Alan Imrie committed suicide.”

Instead of going directly to the operating theater, Bernard Salt went to Helen Minton’s ward, where she was just finishing hand-over.

“I assume this is more of your dried-up spite. Dragging this wretched Ridgemount affair back into the open.”

Helen Minton arched her back and stood her ground. “I thought telling people of your inadequacies as a man was not enough. I thought they should understand how far the same inability to face the truth or to accept your responsibilities is present in your professional life as well.”

While this confrontation was taking place, a zoology student named Ian Bean, fresh back from a field trip to Robin Hood’s Bay, walked into Skelton’s station and asked to speak to whoever was in charge of the Amanda Hooson murder inquiry.

Less than an hour later, Ian Carew was released from police custody without charge, thirty-two hours after he had been arrested.

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