Death's Door

Twelve

To Maggie Rose Steele, Mr Aldred Fine was a caricature, with his tall, cadaverous frame, his round spectacles, his pencil moustache and his slicked-back hair. But no run-of-the-mill caricature: she had spent weeks after their first meeting, early in her pregnancy, trying to work out which face from her past he called to mind.

It was halfway through their second and, up to that point, last consultation that she had realised that she was gazing at a double of Ron Mael, one half of the 1970s pop band Sparks. This had given her something of a start, since that visage, part scarecrow, part vampire, had scared the five-year-old Maggie witless, and sent her scurrying behind the sofa, every time he had appeared on Top of the Pops.

When she had told Stevie that evening, he had dredged from his encyclopedic knowledge of modern music the fact that the brothers were still out there, somewhere, little changed in the thirty years since their heyday. ‘Are you trying to tell me,’ she had chortled, ‘that I might have had the real Ron Mael looking up me this afternoon?’

‘I’d like to think not,’ he had replied, ‘but if there’s one thing we learn on the job, it’s that you never know.’

There was no laughter in her heart as she looked at her consultant, across the desk in his office in the Royal Infirmary, in Little France. It was said that the district had taken its name from the servants of Mary, Queen of Scots, located there on their mistress’s return to claim her crown; Edinburgh being Edinburgh, there was a rival school of thought.

‘What’s so urgent, Mr Fine?’ she demanded.

He removed the spectacles, and tucked them into a pocket of his lab coat. His hair was less well groomed than it had been at their earlier meetings and she was grateful for that also. If he’d only shave off that fucking moustache, she thought.

‘There’s something I have to talk to you about,’ he began, ‘something to do with your pregnancy.’

She felt all her strength and much of her self-control drain away. ‘Is she dead? My baby? Is she dead? She can’t be: she kicked me just this morning.’

‘Calm yourself, Mrs Steele. Your baby isn’t dead.’

‘Is she deformed? Is it spina bifida? Down’s syndrome? I know that can happen to first-time mothers my age.’

Aldred Fine swung round in his chair and leaned forward. His eyes held hers, and Ron Mael was gone, gone for good. His gaze was kind, comforting, reassuring, and although his face was still serious, she felt her panic subside, her breathing steady and her heartbeat slow to its normal steady rate.

‘At this stage of the pregnancy, your baby couldn’t be better,’ the consultant said. ‘She’s not too big, but that’s not a problem. No, my concern is with you.’

‘Me?’ Maggie laughed spontaneously. ‘Mr Fine, I’ve never felt better in my life.’

‘I don’t doubt that for a moment. However, as I said, there is something that’s arisen from your most recent scan. You’ll recall my explaining that a second scan isn’t usual but that we sometimes do it in the case of ladies who were once somewhat indelicately categorised by my profession as “elderly primagravida”. “Special mums” is the currently fashionable term. When we did yours, I’m afraid that it revealed a shadow on your right ovary.’

The butterflies returned. ‘What sort of a shadow?’

‘That we do not know. Ultrasound only shows up abnormalities; it doesn’t usually define them, not in the mother at any rate.’

‘Did it show in my first scan?’ Maggie asked.

‘No, but that doesn’t tell me categorically that it wasn’t there.’

She steeled herself to ask the question. ‘What could it be? Be straight with me, please.’

The consultant’s eyes fixed on hers again. ‘It could be, and I am sure that it is, an ovarian cyst; on the other hand, there is a chance that it could be something more problematical.’

She felt a cold wave break over her; she waited until it subsided. ‘If it’s not a cyst, then what? Do you mean cancer?’

‘That’s one possibility.’

‘How can we find out?’

‘The best way would be a CT scan, but we can’t do that, since it uses X-rays and would be harmful for the baby. So I propose that we give you an MRI scan. . That’s an acronym for magnetic resonance imaging.’

‘I know that,’ she snapped. ‘Sorry,’ she added quickly. ‘How does it work?’

‘The process is much the same as a CT scan; different technology, that’s all. We put you in a tunnel and take a cross-sectional picture of the abdominal area. Magnetic resonance should give us a decent image, and help us to make a diagnosis.’

‘An unequivocal diagnosis?’

Fine shook his head. ‘In your situation, probably not. It’ll give us an indication, that’s all. However, I should say that the ultrasound only showed an abnormality in that one ovary, nowhere else.’

‘Where else might it have been?’

‘In the other ovary, and in the uterus. Mind you, your womb has a tenant at the moment, and the ultrasound can’t see behind her. Mrs Steele, can I ask, is there a history of ovarian cancer in your family?’

‘No,’ she replied. ‘My mother died of breast cancer, and my sister’s perfectly healthy, as far as I know. She’s in Australia; I haven’t seen her in years.’

‘How about grandmothers, aunts?’

‘My father’s mother was Portuguese; I never met her and I’ve no idea what happened to her, but as far as I know, he was an only child. My other granny died when I was seven, and my aunt Fay, my mother’s older sister, she died when I was fifteen, of stomach cancer, I believe.’ She paused, then went on. ‘The MRI scan: is there any danger for the baby in that procedure?’

‘None at all.’

‘When do you want to do it?’

‘I’ve booked you in for tomorrow afternoon.’

She looked at him. ‘You were sure of yourself.’

‘Not really,’ he told her. ‘I was sure of you. I must stress that this is purely precautionary, so please don’t go fearing the worst, but on the infrequent occasions that I have this type of conversation, I’ve never encountered a patient who didn’t want to rush straight into the scanning tunnel afterwards.’