Grounds for Appeal

EIGHTEEN

Samuel Jackson was in fact not dead at the scene, but he died an hour later in the Casualty Department of Hereford County Hospital.

He had only been admitted a few minutes earlier and the junior doctor who saw him had time only to administer oxygen and give a few last-hope injections to try to bolster the feeble, irregular heartbeat. Then the SHO had sent urgently for his registrar, but it was too late and after talking to the distraught widow and her fellow passenger, both doctors were in a quandary as to the cause of death.

Over a hasty cup of tea in the sister’s office, they discussed what they should do.

‘Do the police know about it, Tim?’ asked the registrar.

‘There were two constables who came behind the ambulance,’ replied the young doctor. ‘They were talking to the driver of the van outside, then they came in to see the wife and sister, who were carrying on about manslaughter!’

The registrar rolled his eyes heavenward. ‘Let’s keep out of that! He didn’t have any injuries, did he?’

The SHO shook his head. ‘Nothing worth talking about. A few trivial scratches on his back, that’s all. The wife said that he had been struck in the chest and fell back against the car, then fell to the ground.’

‘Nothing on his chest?’

‘A bit of reddening over his sternum, but no bruises.’

The registrar looked at his watch anxiously. ‘I’ve got to be off. I’ve told Mrs Jackson that we think the cause of death was a heart attack, but that in view of the circumstances, we have to report it to the coroner.’

As he made for the door, the sister hurried in and grabbed the harassed younger doctor and hustled him out to see another emergency, a farm worker who had cut his wrist half-through with a billhook.

That evening, Richard Pryor was in Angela’s upstairs sitting-room, watching their newest acquisition, a Bush TV-53 with a fourteen-inch screen in a wooden cabinet. He had decided to treat themselves to a Christmas present and only that day a dealer from Chepstow had installed the device and erected an aerial on a long pole attached to a chimney. He warned that reception in the Wye Valley was ‘a bit dodgy’ due to the hills on either side, but to a novice like Richard, the slightly blurred black-and-white images were enthralling. Angela’s family home in flatter Berkshire boasted much better reception, but she kept it to herself, not wanting to spoil her partner’s obvious pleasure.

However, someone else soon spoiled his enjoyment of the end of Panorama, as the telephone extension in her room began ringing. It was the Hereford coroner’s officer wanting to speak to Richard about the death of Samuel Jackson.

‘Both the coroner and the police feel that we should have a Home Office pathologist on this one, doctor,’ he explained. ‘The relatives are screaming blue murder — or at least manslaughter, as the chap collapsed after a scuffle. And the hospital would prefer an outside opinion, as he died on their premises and the wife is hinting at their failure to save him.’

It was common after any death in a hospital where there was even a possibility of an allegation of negligence, for the post-mortem not to be performed by their own pathologist, to avoid any accusation of prejudice.

Richard agreed to come up the next day, after he had dealt with a couple of cases in Monmouth, then went back to the start of the Benny Hill Show.

When he arrived at Hereford next morning, he found the coroner’s officer waiting for him, together with a detective inspector and a police photographer.

They stood in the little office as the DI explained the position.

‘The wife and two sons, one of whom is a solicitor in Worcester, are raising a stink about this, sir. There’s no doubt that Frederick Holmes, the Post Office driver, pushed the deceased, as both the wife and her cousin are solid witnesses and Holmes doesn’t deny it, though he says he was provoked by Jackson throwing his bunch of keys away.’

‘But it was nothing more than a push in the chest, not an actual heavy blow?’ asked Richard.

The inspector shrugged. ‘Well, the wife is making the most of it, quite naturally. But the hospital doctor says there was nothing significant in the way of injuries.’

‘And he died within an hour of this incident?’ persisted the pathologist.

‘Yes, he was alive when the ambulance reached him. It got there about thirty minutes after the incident. A passing AA man on his yellow bike and sidecar had stopped to see what was going on and he drove off to phone from the nearest box.’

‘Do we know if Mr Jackson was conscious after the collapse?’

‘He was according to the wife. Groaning on the ground and complaining of a pain in his chest, but then he slipped into a coma by the time the ambulance arrived.’

The coroner’s officer, a bluff police-officer nearing retirement, added a little more.

‘I spoke to the senior house officer and his registrar, sir. They had told the relatives that they felt that coronary artery disease was the cause of death, but the wife and sons were emphatic that the assault, as they called it, had led to the heart attack.’

Richard trod carefully here, as an incautious word, even to policemen, might come back to haunt him.

‘Well, it’s true that any stress, emotional or physical, can precipitate a sudden cardiac arrest in people with heart diseases, but it certainly can’t cause coronary artery disease. I think we should keep an open mind until the results of the post-mortem. Eventually, it may be a matter for the lawyers, rather than doctors.’

With this hopefully diplomatic remark, he hung up his jacket and went into the post-mortem room next door, to put on his boots and apron. He found Samuel Jackson to be a rather short, plump man of fifty, who looked as if his main form of exercise was going to good restaurants. The coroner’s officer said that he was a successful businessman from Worcester, owning a brewery and a chain of shops.

The only signs of injury were the slight scratches on the back of his neck and between the shoulder blades, consistent with sliding down the front of his Alvis, rather than significant evidence of impact. The reddening of the front of the chest seen by the Casualty Officer was no longer visible to Richard’s eye.

The internal examination revealed no injuries whatsoever and the only positive findings were an over-abundance of fatty tissue and generalized arteriosclerosis. Most significant of all was severe narrowing of all the coronary arteries, with thrombosis of the main branch of the left artery.

‘Could that have occurred in the hour between the incident and the death, doctor?’ asked the detective inspector, with a firm eye upon cause and effect.

‘I doubt it, as this looks firm and well established,’ replied Richard, cautiously. ‘But I’ll need to look at it under the microscope to make sure. That’ll take a few days, but I’ll try to get it done before Christmas.’

Mentally he kept his fingers crossed, as Sian would only have until Saturday to make the sections.

The last thing he did was to cut a number of incisions into the muscle of the heart itself, looking for evidence of infarction, but it looked normal, in spite of the blockage of the supplying artery.

The examination over, he stood at the sink to wash his hands and give a summary to the inspector and the coroner’s officer.

‘There’s no doubt that he had potentially fatal heart disease. This must have been developing for years and could have killed him at any time. But I’m well aware that he died within an hour of a stressful argument and a mild blow on the chest, which caused him to fall backwards.’

‘So did that lead to his death, doctor?’ demanded the CID man, with a terrier-like tenacity.

‘To be frank, I don’t know. I will have to do some tests to try to find out. If he has severe damage to his heart muscle which arose before the incident, then my opinion is that the argument and very slight physical trauma did not significantly contribute to death, which may have been inevitable. But I’m willing to bet that a lawyer might have a different view.’

‘So you don’t feel it’s justifiable to charge the van driver with causing the death?’

‘Let’s wait a few days until I do all that I can to clarify the situation,’ suggested Richard, not wanting to unnecessarily condemn a man to spending Christmas in police custody.

‘He’s presumably not going to flee the country over this, so if we hold our horses until we get all the evidence that’s available, it will be best for everyone concerned.’

As he drove home with his samples, including the complete heart in a large glass jar, he fervently hoped that some articles he had read recently in the specialist medical journals might help him to arrive at the most just solution.

That same Wednesday was proving a busy one for the usually placid Aberystwyth CID. Trevor Hartnell had arrived following a very early start from Birmingham and, after a late breakfast in the canteen, was going off with Meirion Thomas to seek the elusive Jaroslav Beran, now officially known as James Brown.

The local sergeant, Gwyn Parry, was detailed to accompany the pair that had arrived from the forensic laboratory in Cardiff to look at the old van in Comins Coch.

He sat in the front of their Morris Oxford estate, the rear luggage space filled with the paraphernalia needed at a scene of crime. When he piloted them to Ty Canol farm and led them into the weedy wilderness behind the cowsheds, the two men from Cardiff looked with distaste at the rusting van filled with mouldering agricultural devices.

‘What are we supposed to be doing with this?’ asked Larry McCoughlin, the liaison officer. ‘It’s full of junk.’

‘There’s a faint possibility it was used to move a dead body, maybe around ten years ago,’ explained Parry. ‘Can you find bloodstains after all this time?’

‘Depends on where they are,’ replied Philip Rees, the biologist. ‘Not much chance if they were exposed to the weather for all that time, but if some has seeped into protected cracks, we may get lucky.’

He was just going to ask if they were supposed to shift hundredweights of stakes and fencing wire, when the sound of a police Land Rover was heard coming into the yard and two uniformed constables appeared.

‘I thought that might be a problem,’ said the detective sergeant. ‘So I’ve organized some muscle for you.’

The back of the Ford van was soon cleared and the floor became visible, albeit cracked, dirty and covered with an assortment of debris.

‘Made of nine-ply board, that!’ growled Myrddin Evans. The farmer had come to watch the desecration of his vehicle and his scowl deepened as Philip Rees levered up the rotting floor with a case-opener.

‘I’ll be putting a claim for compensation, mind!’ he threatened. ‘Damaging my property like this.’

Gwyn Parry grinned at him. ‘You do that, Myrddin. About five bob should cover it!’

With McCoughlin holding the floor away from the battered side panels and the rusted bearers underneath, the forensic scientist scraped off sludge and debris from along the edges of the plywood. Then he dug a sharp probe into the cracks in several areas of the floor and removed more concealed material, which he put into some specimen tubes. With a few circles of filter paper which he pressed against suspect areas, he did some magic with fluids from bottles out of his case and then viewed the results with interest.

‘We’ve got a positive screening test for blood here. That’s by no means conclusive, and it might well be animal, but I’ll take this stuff back to Cardiff and get back to you tomorrow.’

The two uniformed constables found a tarpaulin in the back of their vehicle and spread it to protect the floor of the van before putting Myrddin’s fencing materials back inside.

‘We may need to have that bit of floor taken down to Cardiff, depending on what’s found,’ said the scientist. ‘Until then, it should be OK like this, given it’s already been sitting here for years.’

As they all drove away, leaving a bemused farmer wondering what all the fuss was about, a few miles away Meirion Thomas was pulling up in the CID Vauxhall outside a small cottage near Llancynfelyn. Trevor Hartnell got out the other side and was rather overawed by the surroundings, which contrasted so greatly with the seedier part of Birmingham where he spent his working life. Below the road, the ground sloped down to the great expanse of the bog, beyond which the sea sparkled in the sunshine. Looking the other way, the purple line of the hills formed the horizon, whilst near at hand, the whitewashed bwythyn of Gelli Derwen was like something from a Grimm’s fairy tale, against its background of trees.

They walked towards it and closer inspection took some of the romance from the scene, as the walls were stained with green mould and the window frames showed peeling paint over rotting wood. The front garden was overgrown and a rusty bicycle was on its side near the corner of the single-storey cottage. The door was set between the two small windows, inside which were yellowed net curtains.

There was no bell or knocker, so Meirion rapped on the upper panel. A dog began barking and was followed by a muffled curse and a yelp.

‘At least somebody’s home,’ said Hartnell, feeling in his breast pocket for his warrant card.

There was a rattle of a chain and then the door was pulled open, the bottom grinding against uneven floor tiles. A beery, unshaven face appeared, an unwelcoming scowl fixed in place.

‘Who are you? What you want?’

The heavy features, chin and cheeks part-hidden by several days’ growth of stubble, glowered at them. Trevor, accustomed to such meetings over many years, was certain that one glance had told the man that these were two police officers standing on his doorstep. They both flashed their proof of identity at him and his dark eyes under the beetling grey bows seized upon Hartnell’s card.

‘Birmingham? What you want coming from there?’

His central European accent was still strong.

‘We want to talk to you, sir. You are James Brown, formerly Jaroslav Beran?’

‘Don’t use that name no more. James Brown is me.’

‘Can we come in and talk, Mr Brown?’ said Meirion, easily. ‘We’re hoping you can help us with our enquiries.’

That ominous phrase seemed familiar to the Czech and his scowl deepened even more.

‘Never let us go, do you, once we’ve been inside? But I done nothing, you ask my parole officer.’

‘We already have, sir,’ retorted the local DI. ‘Now can we come in and talk, please? Unless you want to come down to the police station instead.’

Reluctantly, Brown dragged the door open wider and without a word, turned away to lead the way into the room on the right of a short passage. As Hartnell followed him, he got a glimpse through the other door, where greyish sheets were tumbled on an unmade bed. A dog began whining somewhere in the back of the cottage as the two detectives went into a living room, where a small log fire smouldered in the hearth. Facing it was a sagging settee covered in American cloth and a couple of hard chairs stood by a table near the window, on which was a pre-war Marconi radio and a couple of half-empty bottles of whiskey and gin. The floor was covered in faded linoleum, worn right through near the fire and at the door. Both officers were large men and Brown was also over six feet and equally broad-shouldered, so the small room seemed full of bodies.

‘What you want with me?’ repeated the householder, not inviting them to be seated.

Meirion pulled a notebook and consulted it. ‘You used to own a Ford van, registration number EJ 2652?’

Surprise tinged with unease passed over Brown’s coarse-skinned face. He raised a hand to his head and scratched his cropped, bristly hair in a classical gesture of puzzlement.

‘Sure, years ago I did. What’s the problem, you just discovered I made parking offence?’

His attempt at levity or sarcasm fell flat.

‘What did you use it for?’ asked Hartnell.

Brown failed to see where this was leading and his beetle-brows came together like two hairy caterpillars above his eyes.

‘I had business in Aberystwyth, everybody knows that. I carried furnitures in it.’

‘Sometimes stolen furniture?’

James Brown made a sweeping gesture of annoyance.

‘Christ, why you bring that up again? Look, sure there were some misunderstandings; I got landed with hot stuff. But I paid twice in the prison for that, now for years I am clean!’

‘Did you carry anything else in that van apart from furniture?’ asked Meirion.

The man looked shiftily from one officer to the other.

‘It’s a long time ago. Sure, I used to move all sorts of stuff, sort of transport business for others when they wanted small things moved.’

‘Did you ever carry meat of any sort?’ persisted Hartnell.

This was a difficult one for their victim. Rationing in Britain had only finished very recently — ironically, long after it had been abolished in Germany. To admit to carrying meat was tantamount to owning up to black-market activities — or even rustling, a crime well established in West Wales.

‘No, I never carried no meat! Look, why you asking me all this?’

Ignoring this, Meirion went off on another tack.

‘You live within sight of Borth Bog. You must know about the body found there recently.’

Brown grabbed the back of one of the hard chairs and Hartnell tensed himself slightly — but the man was only leaning his weight on it.

‘Sure, I heard something about it.’

‘Come on, it’s almost on your doorstep!’ snapped Trevor. ‘You must have read or heard that he was man with a Batman tattoo on his shoulder?’

Brown shrugged. ‘I don’ recall, no.’

‘Who used to drive your van when you were in business?’ asked Trevor, smoothly.

Brown stared at him suspiciously. ‘I had a few guys, different times.’

‘And what was the name of the one with a Batman tattoo on his shoulder?’

The Czech stared blankly at Trevor Hartnell.

‘What the hell you talking about, mister?’ he demanded aggressively. ‘You come here, push into my house and talk bloody nonsense!’

‘You had an assistant — or more likely, an accomplice — about ten or eleven years ago,’ interposed Meirion. He drove for you and carried furniture for you, when you had the shop in Aber. We want to know his name.’

‘I don’ remember. I had plenty working for me then,’ replied Brown, stubbornly.

‘We can find out, if you won’t tell us,’ said Meirion complacently. ‘Didn’t you keep records, paying their tax and National Insurance?’ He said this with his tongue in his cheek and was rewarded with a scornful laugh.

‘You making joke? This was in war still, nobody did those damn things. I just paid cash in the hand.’

The local DI nodded. ‘OK, have it your own way. Your shop was in Vulcan Street, wasn’t it? We can soon ask around that area, plenty of people can still remember ten years back.’

Brown shrugged and stayed silent.

‘How long have you lived here?’ asked Hartnell.

‘Since before end of war — except when I was on holiday in Swansea.’ Again the attempt at humour fell on deaf ears.

‘Where were you before that?’

‘In army, Czech battalion. I got invalided out, now live on little pension.’

Meirion seized on this straight away. ‘I looked up your Probation Service records. You left the military in 1942, but you didn’t come here until 1944. So where were you in between?’

James Brown looked from one to the other, in a troubled, hunted fashion.

‘I was here and there… travelling to get job.’

Trevor Hartnell took a chance.

‘You were in Birmingham, weren’t you? Ever heard of Mickey Doyle?’

‘I was in Midlands sometimes, yes. Who this Doyle fellow?’

From then on, the Czech stubbornly refused to admit anything, denying any knowledge of Birmingham gangs or any involvement in organized crime. Eventually, the two detectives decided they were wasting their time until they had better evidence and left the cottage, with a promise — or a threat — that they would be returning, probably the next day.

Their farewell from Brown was a final bellow at the whining dog, then the door was slammed behind them.

‘Nice chap!’ remarked Trevor, as they walked back to the car. ‘I’ll bet he was up to something back in my manor in Birmingham. I’ll get a check run on him now that we’ve got a name.’

As Meirion drove away, he looked down at the bog, where there was still a muddy scar where the body had been hoisted from the peat.

‘Too much of a coincidence for this fellow to be here, within spitting distance of where we found Batman,’ he said ruminatively. ‘And we still haven’t even got a name for him!’

‘You haven’t put the heart in formalin, doctor,’ admonished Sian. She was looking over his shoulder as he sat at the big table in the bay window of the laboratory, where the light was strongest.

He had a large stainless-steel tray in front of him and, wearing a pair of rubber gloves, was using a forceps and scalpel to cut small postage-stamp-size squares of heart muscle and coronary artery. These went into pots of formaldehyde-saline, to fix the proteins in the tissue, ready for Sian to process them into sections for viewing under his microscope.

‘No, and I’ll tell you why in minute, Sian. Meanwhile, can you get these blocks processed and give me fibrin stains, an acridine orange and a PTAH, as well as the usual H and E stains, please.’ These were special stains, intended to reveal different defects in the heart muscle.

‘What’s the problem with this case, doctor?’ said the technician, being as insatiable as usual in her search for knowledge.

‘There’s a thrombus in the descending branch of the left coronary artery and I’m anxious to know how long it’s been there. The family are claiming that the shove in the chest that this poor man suffered was the cause of his coronary episode and hence his death.’

‘And was it?’ she demanded, always ready to take the side of the downtrodden masses, even though this particular victim was a rich brewer with a very expensive Alvis motor car.

‘Well, his coronary artery disease certainly wasn’t, as it must have been there for years. And I don’t think the thrombus was either, as he died within an hour of the squabble. But I’d like to know if his heart muscle was already damaged from lack of blood supply, which is why I’ve got the heart in this tray.’

Sian looked at the organ phlegmatically, unlike Moira, who though she had got used to typing descriptions of unpleasant things, was not keen to view them in the flesh.

‘Why have you already sliced across it?’ she asked.

‘I want to try some new techniques that I’ve read about in the pathology journals, mainly from the other side of Europe,’ he explained. ‘The trouble with conventional histology is that it can’t show the very early stages of cell death in the heart muscle, just by staining fixed tissue.’

Sian was already ahead of him. ‘You’re into histochemistry, then. But we haven’t got the equipment. You need frozen sections and all sorts of fancy reagents.’

He nodded, pleased at her quick mind and wide knowledge of what was going on in the technical world.

‘There are some cut-price methods being tried, where a large slice of tissue, as opposed to little bits for the microscope, can be processed for enzyme content.’

She settled on a stool next to him and put her chin in her hand, prepared to listen to his explanation.

‘We’re doing enzymes now in my biochemistry course. But how can that help you with this problem?’

Richard settled back to give a lecture, always ready to impart knowledge to those who wanted to hear it.

‘Muscles need energy and they get this through turning carbohydrates and other nutrients in the blood into carbon dioxide and water, using enzymes, especially the dehydrogenases.’

Sian nodded, in a slightly superior manner. ‘Yes, the Krebs cycle and all that!’

‘Well, those enzymes are inside the muscle cells, but if those get killed or injured by cutting off their blood supply, as with a coronary thrombosis, then the enzymes leak out through the damaged cell walls.’

Again his technician was ahead of him. ‘That’s the basis of the SGOT tests we used to do in the hospital. The enzymes became raised in the serum, because they were leaking out of the heart.’

Richard gave one of his impish grins. ‘I don’t need to tell you anything, do I, Einstein? So you’ll appreciate that if the enzymes increase in the blood, they must decrease in the muscle — and that’s where these tests are useful.’

At this point, Angela came in from the office clutching a sheaf of papers, but she diverted to the window area to hear what was going on.

‘I’m getting taught some biochemistry by Sian here,’ said Richard. ‘Damned good she is, too!’

The young blonde made a face at him, but she flushed with pleasure at his praise.

‘How’s it done, then?’ demanded Angela.

As she joined the audience, he explained. ‘As you said, it can be done now on a microscopic scale using live tissue in frozen sections, but we haven’t got the equipment. The same can be done using the same reagents on big slices like these, but it’s prohibitively expensive to use large volumes of stuff like nitro-BT. However, recently there have been attempts to use cheaper chemicals, which is what I’m going to try.’

Intrigued, Angela wanted to know what they were.

‘According to some chaps in Czechoslovakia and Germany, potassium tellurite and TTC can react with dehydrogenase enzymes and show up deficiencies. I messed about with tellurite a bit just before I left Singapore, but it was too unreliable to be of much use, so I turned to TTC. That’s why we’ve got some here. I brought it back with me.’

‘What’s TTC?’ demanded Sian, determined to be able to show off the next time she went to her biochemistry session.

‘Triphenyl-tetrazolium chloride,’ he replied. ‘A long name, but relatively cheap stuff.’ He reached across the table and picked up a small bottle containing white powder and placed it in front of Sian.

‘If you would be kind enough to make up a one per cent solution in a slightly alkaline phosphate buffer and — if we can borrow space in Angela’s incubator for half an hour — we’ll see what happens.’

As soon as Trevor Hartnell got back to the police headquarters in Aberystwyth, he sat in an empty office offered by Meirion Thomas and did some urgent telephoning. First, he rang his wife to say he wouldn’t be home that night, but would be staying in a bed and breakfast place on the seafront, organized by the local CID. He wanted to be on hand if the forensic report, promised by next morning, added any weight to their enquiries, so it was not worth trekking back to Birmingham, only to have to return. After assuring his wife that he would do all he could to be back home before Christmas Eve, to go shopping for presents for their two kids, he spoke at length to his Chief Inspector in Winson Green. He brought him up to date with the visit to the derelict van and the interview with the former Czech soldier, then asked for some digging into the antecedents of ‘James Brown’.

‘I’ve got a suspicion that he may have been on our patch towards the end of the war,’ he explained. ‘Can you organize a search to see if a Jaroslav Beran shows up anywhere in the records for that time, especially if there’s any connection with Mickey Doyle?’

His DCI promised to get some men on to it straight away, and with nothing more he could do that day, decided to go for a bracing walk along the promenade in the chill December wind.

After Sian had made up a fresh solution of TTC and Richard had submerged a centimetre-thick slice of the heart in it, the shallow glass dish was placed in the body-heat incubator and left in peace for twenty minutes.

‘Leave it too long and there can be a non-specific deposition of the tetrazolium all over the tissue,’ cautioned Richard.

‘What’s the actual basis of the test?’ asked Angela, curious about something outside her usual expertise.

‘The dehydrogenase enzymes in the muscle convert the colourless TTC to a red dye which precipitates out on to the surface. If there’s no enzyme present — or a marked reduction — then nothing happens in that area and the tissue remains unstained.’

They watched the bench timer, bought in a kitchen sundries shop, and when the time was up, there was a feeling of anticipation, as even Moira, aware of something unusual going on, came to watch. Though earlier she had baulked at the fresh heart lying in the tray, the circle of muscle in its glass dish seemed much less repulsive as Richard laid it on the big table.

‘There’s a pale patch there!’ exclaimed Sian, proud that her efforts in making up the solution had contributed to success.

‘Yep, just where it should be,’ agreed Richard, pointing with forceps at one side of the thick circle of ventricle. ‘Blockage of the descending branch of the left coronary artery would cause an infarct of that part of the heart.’

‘So what’s the significance in this case, Doctor Pryor?’ asked Moira.

‘It takes some time for the death of the muscle to become apparent. How long depends on the way you look at it… just naked eye, with no fancy techniques like this would show nothing for many hours, even a day or two after the blockage. Using ordinary histology would shorten that time, but this is the most sensitive, together with the microscopic techniques that we can’t do here yet.’

‘So you feel that this rules out the possibility that the push on the chest caused the death?’ persisted Moira.

Richard shook his head. ‘I can’t go that far. But it shows that the infarct — the dead tissue — must have been present well before the incident at the side of the road. This was a man with severe coronary disease, who had already suffered an infarct, so that he was in danger of dropping dead at any time.’

Angela joined the discussion. ‘But you can’t rule out the possibility that the squabble pushed him over the edge, so to speak?’

‘No, I can’t. I’m pretty sure that the physical act of pushing him in the chest, which has not left any mark whatsoever, is not relevant. But anyone in a dispute gets an adrenalin release — the old “fight or flight” reaction. Their blood pressure goes up, their heart rate increases and this could well trigger an abnormality of its rhythm, which in a damaged heart, could cause it to stop altogether.’

‘So where does that leave the lorry driver — and the family?’ queried Moira, who was more interested in the legal liability than the pathology.

‘That’s a legal matter, not medical. On past experience, I would think that a criminal prosecution would be unlikely, as if it came to trial, the defence would have a field day with the fact that the deceased had already had a recent, potentially fatal myocardial infarct. Still, you never know, there’s another legal axiom, which is that “you have to take your victims as you find them”.’

Moira’s smooth brow wrinkled in puzzlement at this.

‘I don’t really follow that, doctor.’

Richard did his best to illustrate the point.

‘Look, if someone hits another on the head with a blow that normally would not be expected to kill him, but that person has an abnormally thin skull and dies of a brain haemorrhage, it’s not a valid excuse to claim that the attacker did not know of the thin skull. Actually, in practice, it’s a good point for the defence in mitigation, but the principle is the same as someone with a heart condition.’

Angela, also familiar with many legal dilemmas, pointed out to Moira the difference between criminal and civil actions.

‘The standard of proof in a criminal trial has to be “beyond reasonable doubt”, but in a civil action for damages, it only has to be a “balance of probabilities” which means that it only has to be proved that it was more likely than not that the outcome was due to the alleged cause. So if the police don’t take any action, maybe the family will sue the driver.’

Their secretary was looking bemused by now, but found it all fascinating. ‘I’ll have to go away and think about this,’ she said with a sigh. ‘I wish I knew a lot more about these things.’

As she went back to her typewriter, Richard went off to telephone the Hereford coroner to give him much the same opinion as he had offered to Moira.