Donor

ONE

‘Who can tell us where we get bread from?’ asked Kate Chapman. There were eighteen children sitting in front of her. She smiled as a forest of eager young hands went up and enthusiasm filled their faces. She loved teaching, especially at primary school. For her there was something magical about introducing children to the voyage of discovery she firmly believed education should be. She took her early navigational responsibility seriously. Not for her the cynicism that said these would be the surly teenagers of tomorrow, the bus-shelter vandals, the lager louts, that each new generation was more spoilt than the last. Kate simply could not see beyond the innocent little faces that currently vied for her attention.

‘Kerry?’

‘Please, Miss, a baker, Miss.’

‘Good, Kerry. Now, who’s going to tell us how the baker makes our bread?

No hands went up this time.

‘Come on, what does the baker use to make the bread?’ coaxed Kate.

A little boy, wearing glasses with one lens blanked off to encourage a lazy eye, put his hand up tentatively then withdrew it. He did this several times with furtive glances to the side as if afraid of making a fool of himself.

Kate sensed his dilemma. ‘Yes, Andrew,’ she said encouragingly. ‘Come on, have a try. What do you think the baker uses?’

‘Is it flour, Miss?’ asked the little boy, putting his head to one side and then putting the end of his pencil in his mouth.

‘Well done, Andrew. It’s flour.’

He flushed with pleasure.

‘Now, what kind of man makes the flour that goes to make the bread?’

Kate glanced behind her at the colourful pictures that lined the wall. She looked directly at the one showing a windmill with a red baker’s van standing outside it.

Several hands went up as excited children got the clue and made the connection.

‘Yes, Annie?’

‘A miller, Mrs Chapman.’

‘A miller,’ agreed Kate. ‘Well done, Annie. Now then, what does the miller need to make the flour?’ She looked along the rows of children as they struggled to come up with the answer. The expressions on their faces were such that she could almost hear their minds working. But she frowned when she came to a pretty little blonde girl in the second row. She felt a sudden wave of concern. Amanda clearly wasn’t concentrating on the question. Her eyes were dull and distant and her face was pale with a suggestion of moistness on her forehead.

‘Are you feeling all right, Amanda?’ she asked.

The child did not respond and the class murmured uneasily.

‘Amanda?’ repeated Kate.

The little girl turned her face towards her but still seemed distant.

Kate went over to her and put her arm round her shoulders. ‘What seems to be the trouble?’ she asked. She bent her knees, sat on her heels and smoothed the child’s hair back from her forehead. She let her hand rest there for a moment. Amanda was burning up.

‘Oh dear,’ Kate soothed. ‘You’re not very well at all, are you?’

Kate now had a problem. Amanda was not only one of her pupils; she was also her daughter. There was therefore no option but to pass the buck to a third party. Sandy, her husband, a medical lab technician, was on duty at the local hospital and there was no one else she could call on for something like this. They had only moved to Bardunnock a few months before and were still at the settling-in stage.

Kate stood up in front of the class and said, ‘I’d like you all to draw me a picture of what you think a miller might look like while I have a word with Mrs Jenkins. Any questions?’

‘What’s wrong with Amanda?’ asked Tracy Johnson, the local postman’s daughter.

‘She’s not feeling very well,’ replied Kate. ‘I think she’s got a bit of a cold coming on.’

Please God that’s all it is, thought Kate, as she picked up Amanda and hurried along the corridor to throw herself on the mercy of the head teacher, Isa Jenkins.

Isa Jenkins was teaching her own class. Kate looked through the one clear pane on the half-glass door and caught her attention. She saw Isa instruct her pupils to get on with something before coming outside into the corridor.

‘What’s up?’

‘It’s Amanda. She’s not well. I think she may be coming down with flu.’

Isa put her head on one side to look at Amanda, who was resting her head on her mother’s shoulder. ‘Poor wee mite,’ she said. ‘You don’t look well at all, do you?’

Amanda responded by putting her thumb in her mouth and nuzzling into her mother’s shoulder.

‘I’m awfully sorry about this-’ began Kate but Isa stopped her. ‘Nonsense,’ she said. ‘I’m sure we can work this out together. What do you want to do? Take her home or over to the medical centre in Colbrax?’

‘I think maybe home,’ said Kate. ‘I’ll put her to bed and keep an eye on her for a while. She’s got a bit of a temperature but it could subside as quickly as it came on. You know what kids are like.’

‘I should by now,’ Isa smiled. She had been a teacher for thirty-two years.

‘I really hate doing this to you,’ said Kate, ‘but-’

‘Nonsense,’ insisted Isa. ‘I’ll commute between classrooms until the bell.’ She looked at her watch. ‘It’s only another hour and a half. No problem. What are your lot doing?’

‘They’re drawing a miller.’

‘Right, off you go.’

‘Thanks, Isa, I’m indebted to you,’ said Kate, finding another reason for liking the life in Bardunnock.

At six o’clock Kate was in the kitchen when she heard Sandy’s car come round the bend at the foot of the hill and labour up to the tight right-hand turn into the drive of the cottage. The car was a green, eight-year-old Ford Escort they had named Esmeralda.

‘Where’s my princess?’ Sandy Chapman called out as he opened the door. He paused to wipe his feet on the coarse mat before stepping inside. For once his call was not answered by the sound of running feet and laughter. Kate emerged from the kitchen, drying her hands. ‘Your princess isn’t very well, I’m afraid. I had to bring her home from school this afternoon.’

Sandy stooped to kiss Kate on the forehead and put his arm round her shoulder before asking, ‘What’s the matter?’

‘I thought it was just a cold but now I’m not so sure. I thought I’d wait till you came home before I called the doctor.’

Sandy nodded, now looking worried. He climbed the stairs to Amanda’s room and pushed open the door. Amanda’s head didn’t move on the pillow but her eyes looked up at him.

‘Hello, Princess,’ said Sandy softly.

Amanda didn’t reply. Her gaze drifted off to the window but her focal point was miles beyond.

Sandy’s head nearly touched the ceiling in the upstairs rooms of the old cottage and his shoulders almost filled the doorway. He sat down on the floor beside Amanda and rested his elbow on the bed. ‘Poor Princess,’ he said. ‘Have you picked up some nasty bug?’

He ran his fingers lightly along his daughter’s forehead and felt the film of moisture on her pallid skin.

‘I think we are going to call Dr Telford to give you some medicine to make you well again.’ He looked at Kate meaningfully and she got the message. She left to telephone while Sandy continued to talk to Amanda.

‘Tell Daddy where it hurts. Is it your tummy?’

Amanda shook her head slowly.

‘All over?’

A nod.

‘Have you been to the bathroom today?’

‘Can’t remember.’

‘Can you remember what you had for lunch?’

A blank look.

‘The same as the other children?’

A nod.

‘You didn’t eat any of the berries off the bushes in the garden did you, Princess?’

A slow shake of the head.

‘Well you cuddle in now. The doctor will be here soon and he’ll make you all better.’ Sandy put Amanda’s teddy bear beside her and tucked in the covers.

‘What do you think?’ asked Kate when he came downstairs.

Sandy shrugged. ‘Same as you, I guess. I want to believe it’s just a cold or flu but I think it’d be as well to get a qualified opinion.’

Kate put her head against his chest and he wrapped his arms round her.

‘Oh God, I hope it’s nothing serious,’ she said.

‘We’re probably worrying unnecessarily,’ said Sandy, but he glanced at his watch and asked, ‘Did you get any idea how long the doctor would be?’

‘The receptionist thought about half an hour. He still has a couple of patients to see at evening surgery.’

There wasn’t enough room in Amanda’s bedroom for all three of them to crowd in, so Sandy stayed downstairs while their GP examined Amanda and her mother provided reassurance by holding her hand. Sandy stood looking out at the garden while he waited. There was no escaping the unease he felt, despite knowing that nine times out of ten a parent’s fears were unfounded. The chances were that the doctor would come downstairs joking with Kate, tell them that there was nothing to worry about and accept their apologies for calling him out unnecessarily.

He recognized that the nature of his job at the hospital tended to distort his view of how much serious illness there was around. Was it the same for policemen? he wondered. Did they see crime and potential criminals everywhere they looked? He heard Amanda’s door open and turned round to look up the stairs. Dr Telford came down first, with Kate behind. They were not joking.

Sandy knew George Telford through his job. General practitioners in the area were encouraged to participate in the care of their patients while they were in the district hospital.

‘What do you think?’ asked Sandy.

‘I’m not happy with her,’ replied Telford, looking concerned. ‘I think we should take her into hospital overnight and run some tests.’

‘Have you any idea at all what’s wrong?’

‘I’ve an idea her kidneys aren’t working properly,’ replied Telford. ‘I could be wrong but I think we ought to run some biochemistry on her. Can’t do any harm.’

‘I suppose not,’ said Sandy. Kate had come over to stand beside him and he had his arm round her shoulders.

‘Has she shown any sign of having trouble with her waterworks in the past few days?’ asked Telford.

Sandy looked to Kate, who shook her head. ‘None at all,’ she said. ‘She’s been as right as rain.’

‘Well, a thorough examination at the hospital should put our minds at rest.’

‘What hospital were you thinking of?’ asked Sandy.

Telford looked thoughtful. He said, ‘I’m trying to decide whether to take her in to the district hospital for overnight observation or maybe have her taken directly up to the Sick Children’s Hospital in Glasgow.’

‘She doesn’t seem to be in too much discomfort,’ said Kate, hoping to influence the decision in favour of the local hospital. That would be more reassuring than having Amanda taken off to Glasgow.

‘True,’ agreed Telford. ‘That’s what we’ll do, then. We’ll take her over to the district hospital and have some preliminary tests done.’ He looked at his watch and said, ‘I suppose at this time it’ll mean calling out the duty technician in the lab. That’s not you this evening, is it?’

‘Not tonight,’ replied Sandy.

‘I’ll stay at the hospital tonight,’ said Kate. She knew from Sandy that on occasion the parents of young children were permitted to stay over in a guest room at the hospital.

‘Good idea,’ replied Telford.

It was just after eight thirty when Kate turned to Sandy and said, ‘You must be starving. You haven’t had anything to eat.’ They were waiting in the small side room outside the ward while Amanda was settled by the nurses.

‘I’m not hungry,’ replied Sandy.

‘Me neither.’

‘What do you think?’ she asked anxiously.

There was no need to ask what she meant. Sandy said, ‘I think she’s got worse in the last hour.’

‘It could just be the upset at coming into hospital.’

‘Maybe,’ conceded Sandy, but he sounded far from convinced.

‘Why don’t you go on home?’ Kate suggested. ‘There’s nothing you can do here. I’ll be here for her if she wakes in the night.’

Sandy nodded as if only half considering the suggestion. ‘I think I’m going to pop along to the lab first to see if Charlie got the specimens okay,’ he said. ‘Maybe I’ll hang around until he’s got the results. If they seem okay I’ll go on home. You will call me if anything changes?’

‘Of course,’ replied Kate. ‘And don’t stand over Charlie. You’re an interested party, remember.’

Sandy nodded; he kissed Kate on the forehead and turned to go.

The district hospital lab was situated in a small brick building, separate from the main building and hidden behind a row of conifers that bent in the wind as Sandy left the warmth of the hospital and walked down the path towards it. He got intermittent glimpses of the lights on in the building as the lower branches of the trees separated. Icy raindrops started to pepper his face as he turned into the shelter of the ivy-covered porch outside the lab. The door was locked. He fumbled in his pocket for his key but discovered that he’d left it at home. He rang the night bell and a few moments later the door was opened by a short, dark-haired, studious-looking man wearing a white lab coat with a green plastic apron over it. His dark-rimmed glasses seemed too large for his round face, giving him the look of a wise old owl.

‘Evening, Charlie,’ said Sandy as he stepped inside and closed the door behind him.

Charlie Rimington smiled and said, ‘I had a feeling I might be seeing you when I read the label on the specimens. How is she?’

‘Not good, but it’s always hard to tell with kids. How are the tests coming along?’

‘Up and running. I take it you’re going to wait?’

‘If you don’t mind.’

‘I’ve got kids too, remember.’

The insistent bleep of an electric timer distracted them and Sandy turned off the machine he was standing beside. He’d done this a thousand times before for other people’s children’s samples. It had never felt like this.

Feeling awkward because it was Rimington’s duty shift and not his, he stood back to allow Rimington to open the loading cage and extract the specimen tube. He saw the ward label on the side of the glass: ‘Amanda Chapman’. It made the hollow feeling in his stomach worse.

Rimington tore off the print-out from the machine and sat down, pencil in hand, at his desk to read it, using the pool of light from an anglepoise lamp. Sandy stood at his shoulder feeling impatient but fighting hard to hide it. After thirty seconds of silence he could stand it no longer.

‘Well?’ he asked.

‘No signs of infection and no toxic substance present,’ said Rimington.

‘But?’ said Sandy anxiously.

‘All the signs… suggest sudden renal failure.’

‘Jesus,’ said Sandy, gripping the bench and letting his head fall forward. He remained like that for a few moments before asking, ‘What are we talking here? Mild?’ He took the analysis sheet from Rimington’s hand and read the results for himself. ‘Jesus,’ he repeated. ‘We’re talking dialysis.’

‘’Fraid so,’ agreed Rimington.

Sandy stood by while Rimington phoned the result through to the ward. There was no question about it: Amanda would have to be transferred to a hospital with a dialysis unit, and the sooner the better. The district hospital did not have this facility. It would have to be Glasgow after all.

A knot of fear formed in the hollow space in Sandy’s stomach. He was worried sick about Amanda but he had to be strong for Kate’s sake. Then there were the logistics of the transfer to be worked out. Kate could go in the ambulance with Amanda, while he drove up to Glasgow in Esmeralda so that he and Kate could get back, whenever that would be. He couldn’t see that far ahead.

Charlie Rimington said, ‘Don’t worry about the lab. Andrew and I can cover for you. Take as much time as you need.’

‘Thanks,’ said Sandy, turning to leave. ‘I appreciate it.’

Outside, it was now raining heavily. Sandy was soaked by the time he got back up to the hospital. He paused just inside the door to wipe the water from his face and push his wet hair back from his forehead before entering the ward.

Kate was talking to George Telford, who was telling her the results of the tests. There was anguish on her face. She saw Sandy arrive and came towards him.

‘Oh, Sandy,’ she sobbed.

Sandy took her in his arms and held her tight. ‘Come on now, Kate,’ he encouraged her. ‘She’s going to be okay. We just have to get her to the right place.’

‘Dr Telford says she has to be transferred tonight,’ said Kate.

‘It’s for the best,’ said Sandy.

‘But how will we-’

Sandy put his finger on her lips. He said, ‘Let’s just take everything one step at a time. You travel in the ambulance with Amanda. I’ll drive up. Then, when we’ve heard what the doctors in Glasgow have to say, we’ll decide what’s best.’

Kate nodded and wiped away her tears.

‘Come on now,’ soothed Sandy. ‘Let’s be strong for Amanda.’

Sandy had to fight against recurrent feelings of disorientation as he followed the ambulance on the road to Glasgow. He was having difficulty in coming to terms with just how quickly everything in their lives had been turned upside down. Only a few hours before he had expected to be watching television with Kate in front of the fire in their cottage while Amanda slept safely upstairs in her room. Now here he was heading north through driving rain on a dark night, with Amanda seriously ill in the vehicle in front and Kate in a terrible state. He wanted it to be a bad dream. In a moment he would wake up and find he was in bed at home with absolutely nothing amiss. Ahead, the ambulance pulled out to overtake a heavily laden lorry in the nearside lane of the dual carriageway. Sandy did the same and hit the wall of spray coming from the lorry’s wheels. He turned the wipers up to maximum speed. This was no dream. It was a nightmare.

Kate and Sandy sat on a bench in the hospital corridor while Amanda underwent further tests. They stood up when the doctor who had been dealing with her came out and introduced himself.

‘Mr and Mrs Chapman? I’m Dr Turner.’

‘How is she, Doctor?’ asked Kate.

‘She’s pretty low at the moment but I should stress that she’s not in any danger. There’s just been a build-up of toxic substances in her blood because of the kidney problem. Once we clear these away she’s going to feel a whole lot better, I promise you.’

‘Any idea why she went into renal failure?’ asked Sandy.

‘Impossible to say at this stage,’ replied Turner. ‘But there are a lot of tests we still have to do over the next few days.’

‘Is there a chance that this was just a one-off problem?’ asked Kate.

Turner displayed the unease of a man being asked to provide an encouraging answer he knew he couldn’t give. ‘I… I don’t really feel that’s likely,’ he said.

‘So you think she’ll need further dialysis?’ said Sandy.

‘It’s early days yet, but in all honesty I fear so. That’s usually the case.’

Sandy felt his spirits sink and his limbs become heavy. The chances were that Amanda was going to need regular dialysis from now on unless… He shut out thoughts of what might lie ahead and tried to confine himself to what was going to happen tonight.

‘Is it okay if we stay?’ he asked.

‘Of course,’ replied Turner. ‘But if you’ll take my advice you’ll go home and get some rest. She’s in good hands.’

‘But what if she should need us in the-’

Turner shook his head. ‘We’re going to keep her well sedated. Come back tomorrow. We’ll be able to tell you much more after we’ve carried out some more tests.’

Reluctantly, because all Kate’s instincts said that she should stay near Amanda, Sandy and Kate took Turner’s advice. It was a thirty-mile drive back to Ayrshire but the roads would be quiet in the early hours of the morning and the rain had settled down to a drizzle rather than the earlier downpour. They didn’t speak much as they walked to the car down the wet cobbled lane at the side of the hospital. They were both preoccupied with their own thoughts and could think of nothing encouraging to say to each other. A black cat that scurried off among the dustbins seemed to be the only other living creature in the darkness of the night.

The house was cold when they got in; the heating had switched itself off some hours ago. The coldness added to the feeling of quiet and emptiness that met them.

‘Are you hungry?’ Kate asked as Sandy knelt down to light the gas fire in the living room.

‘Not really. But I could use a drink.’

Kate poured them both a whisky. They sat on opposite sides of the fire. They hadn’t yet taken their coats off.

‘Everything’s been going too well,’ said Kate. ‘Something like this was bound to happen.’

Sandy looked at her questioningly.

‘You get your job, then I get mine. We find the cottage in the perfect village. Everything has been going just too smoothly. It had to stop.’

‘Nonsense,’ said Sandy softly. ‘That’s a very Scottish thing to say.’

‘We’re very Scottish people,’ replied Kate.

‘That doesn’t mean we have to subscribe to the “Weary Willie, we’ll pay for this somehow” philosophy.’

‘I suppose not,’ agreed Kate with a wan attempt at a smile.

‘Anyone found enjoying themselves will be dealt with severely,’ mimicked Sandy in severe Presbyterian minister tones.

Kate’s smile grew broader. She got up from her chair and said, ‘I’ll make us some toast. We’ve got to eat something.’

Neither of them managed much sleep. Both were relieved when it was time to get up and busy themselves. They phoned the hospital and were told that Amanda had had a comfortable night and that it would be best if they waited till early afternoon before going in. By then the doctors would have the results of the tests they planned for Amanda and should have something concrete to tell them.

Kate phoned Isa Jenkins to tell her what had happened and that she would not be at school today.

‘Don’t worry about it,’ said Isa. ‘I rather thought that might be the case. The wee soul didn’t look well at all. I took the precaution of calling one of the supply teachers over in Ayr last night and warning her she might be needed today, so everything’s under control.’

Sandy called Charlie Rimington at home and was given similar assurances. ‘Nice people,’ he said when he put down the phone. Kate nodded.

‘Dr Grayson and Dr Turner will see you now,’ said the nurse who put her head round the door of the waiting room. Sandy and Kate followed her a short way along the corridor and were shown into a small, sunny room where the two men were sitting. Both got up when Kate and Sandy entered, and Grayson was introduced to them as the consultant in charge of the renal unit.

‘She’s looking better this morning,’ said Turner with a smile to Kate, who was looking anxious.

Kate nodded. ‘Yes, she is.’

‘She had a good night’s sleep, which I dare say is more than either of you two did.’

Sandy nodded his agreement.

With the pleasantries over, Grayson got down to business. He was a man in his mid-forties with thinning grey hair and a pepper-and-salt moustache. His dark suit looked expensive and appeared to have been made to measure with millimetric precision. The cuffs of his white shirt showed one centimetre on both sides and his gold cuff links seemed to rest at precisely the same angle on the table as he sat with his hands clasped in front of him. His shirt collar seemed to ride a little high and looked distinctly uncomfortable to Sandy’s way of thinking but it was the perfect foil for the dark university tie that hung below. The overall impression was of a man precise in all things.

‘Frankly, the news is not good.’

Sandy felt as if he had been hit by a train. He swallowed and looked at Kate, who seemed to be reeling too. He took her hand and squeezed it.

‘Amanda’s renal failure is quite severe, though we can see no reason for it. She has responded fairly positively to dialysis, although not as well as we expected. As regards prognosis, I think we should be looking at dialysis as a way of life well into the foreseeable future.’

Sandy rubbed his forehead. Grayson didn’t fool around with dressing up what he had to say. His worst fears were being confirmed at an alarming rate.

‘Can I ask what you do?’ continued Grayson.

‘I’m an MLSO at Dunnock District Hospital,’ said Sandy. He looked to Kate to see if she was going to reply for herself. She was looking down at her shoes. ‘Kate’s a teacher,’ he added.

‘Good,’ said Grayson. ‘Then, thinking ahead, I feel we should be considering a home dialysis unit for Amanda when one becomes available. You’re both obviously quite capable of dealing with its demands.’

Sandy raised his right hand slightly. It was a gesture designed to slow Grayson down. He was reeling from the onslaught. ‘You said, “foreseeable future”,’ he said. ‘What exactly does that mean?’

‘It means that Amanda will need dialysis until such time as a kidney transplant becomes available for her.’

The word ‘transplant’ seemed to have put Kate into shock. She sat with her eyes wide, staring at Grayson as he spoke.

‘A transplant,’ repeated Sandy slowly.

‘Yes.’

‘It’s that serious? But how? When? I mean, how long?’

‘Far too soon to start talking about that,’ replied Grayson. ‘We’ve lots more tests to do.’ He looked distracted, and almost before they could respond he had made his excuses and left, leaving them alone with Clive Turner.

Turner seemed more sensitive to their feelings and almost embarrassed at Grayson’s manner. ‘I know what you must be thinking,’ he said softly, ‘but these days kidney transplants are very common and very successful.’

‘But you need a suitable donor,’ said Sandy.

Turner nodded. ‘True, and that’s where the waiting comes in. Amanda will be tissue-typed and her details entered on an international register. As soon as a match comes up we can get the organ and do the surgery.’

‘How long?’ asked Kate. Sandy barely recognized her voice.

Turner shrugged uncomfortably. ‘It could be some time,’ he said.

‘Weeks? Months? Years?’ Kate persisted.

‘It could be a year or so,’ admitted Turner.

Sandy looked at Kate. He couldn’t remember ever having seen her look so unhappy. Her world was collapsing around her.