Pestilence

Chapter Four

It was four days before Saracen saw Jill again when their duty stints coincided on Friday morning. He raised his eyes in question when she came into the crowded treatment room and she nodded briefly and self-consciously in reply. Saracen mouthed the word ‘lunch?’ to her and she nodded again.

They ate in the hospital staff canteen, a huge rambling barn of a place which reminded Saracen of a school assembly hall and where the acoustics were such that the air was constantly filled with the clatter of crockery and cutlery from the kitchens. The tiled walls were clean to shoulder height, where the agreement with the unions expired and then grew progressively filthier as they climbed to meet the vaulted ceiling some twenty feet above the lino clad floor. Proper cleaning would have required the erection of scaffolding and so was out of the question but, for the most part, poor lighting hid the dirt.

“You spoke to the nurse?” asked Saracen.

Jill Rawlings said that she had. “It was Mary Travers; she’s a friend of mine. She said that the patient was severely cyanosed when they got to her, almost navy blue in fact. They gave her oxygen on the way back to the General but then there was some discussion as to whether or not she should be taken on to the County Hospital.”

“Why?”

“Mary didn’t know. Dr Tang just told them all to stay on board while she spoke to Dr Garten. When she came back Dr Tang told Mary that the patient would be going to the County and, as she would be going with her, there was no need for Mary to stay on board. Mary was well over her duty period so she was quite glad. She returned to A amp;E and signed off.

“So as far as Nurse Travers was concerned the patient was being taken to the County Hospital?”

“Yes.”

“And she was alive when Nurse Travers left her?”

“Yes.”

“Did you ask about times?”

“Mary couldn’t remember. She suggests you check the ambulance log book.”

“I already did.”

“And?”

Saracen hesitated before replying. It had been his intention to involve Jill as little as possible in the affair for her own good but it was becoming too difficult and he did want to discuss it with someone so he decided to confide in her. “The record says that Myra Archer was dead on arrival at Skelmore General. There was no mention of a transfer to the County Hospital.”

“But why?” exclaimed Jill in astonishment.

“Why indeed,” said Saracen.

Jill asked what had made Saracen suspicious in the first place and he told her of his meeting with Timothy Archer.

“Poor man,” said Jill when he had finished.

Saracen confessed that, at first, he had been sceptical about Archer’s story and had put it down to the man being overwrought. But now there seemed to be grounds for believing that there had indeed been some kind of foul-up over his wife’s treatment and a subsequent cover-up.

“But why would Garten involve himself in the cover-up?” asked Jill. “Surely the blame was down to Dr Tang?”

“That puzzles me too,” Saracen agreed. “I can’t honestly see Garten putting his career on the line to save a junior doctor.”

“Or anyone else for that matter,” added Jill.

“Then he must be involved in some way.”

“Tricky,” said Jill.

Saracen agreed with his eyes.

“What are you going to do now?” asked Jill.

Saracen shook his head.

“Have you tackled Dr Tang?”

“I tried but when I mentioned the name Myra Archer she took fright and scurried off.”

“She might tell Garten,” said Jill.

“That thought had not escaped me,” replied Saracen ruefully, “But I broached the subject casually; there was no suggestion of an accusation so I think I might get away with it.”

“What happened when the ambulance reached the County Hospital?” asked Jill.

“As far as I can tell it never did. Timothy Archer told me that he had been sent to the County when he first tried to locate his wife but the staff there had no knowledge of her and sent him back to Skelmore General. That’s when Garten acknowledged that she had been admitted to A amp;E and told him that she had died of a heart attack.”

“But we know that the ambulance did leave for the County. It must have been recalled en route.”

“Or maybe Myra Archer died on the way?” said Saracen, thinking out loud.

“If that’s the case I can’t see what all the fuss is about. Can you?” asked Jill, “Presumably the decision to send the patient to the County was taken in good faith. If she was so ill that she died on the way it seems likely that she would have died anyway.”

Saracen tapped his forehead and said, “Then why the big cover-up over an extra five minutes or so in the ambulance?”

“It does seem a bit much,” agreed Jill.

Saracen stopped racking his brains for answers and smiled at Jill. “I’m grateful to you for asking around,” he said.

“Don’t mention it.”

“There is one more thing.”

“Yes?”

“Alan Tremaine has asked me to have dinner with him and his sister tomorrow evening; apparently she’s coming to stay for a bit. He suggested I bring a friend. Would you come?”

“I’d be delighted,” said Jill.

Social occasions were rare for A amp;E staff. When one member was off duty another would usually be on, however, it was sometimes possible, with a bit of duty swapping, for two to be off at the same time. Alan Tremaine had engineered his off duty to coincide with Saracen’s so he could give a small dinner party for his sister Claire who would be arriving on the following day.

In actual fact the limitations imposed on social life by work in A amp;E suited Saracen very well. He disliked parties, a legacy of his time with Marion when their life had grown to revolve around a seemingly endless circuit of social gatherings, outstanding only for their superficiality. Why so many people who so patently disliked each other should have continued to seek each others’ company had been beyond his comprehension. But Marion had seen it all as an exciting game, a competition for which she would plan like a military strategist, deciding in advance who to speak to, whom to avoid, what to wear, what to say. The end result had always been a flawless performance. Marion would arrive like a film star, shine brightly, stay long enough to capture the hearts of all the men, them leave before the proceedings had begun to flag.

“Time we were getting back,” said Jill.

Saracen snapped out of his preoccupation and gathered their used crockery to return to the kitchen hatch as was the regulation. “Pick you up at seven thirty tomorrow evening?”

“Fine.”

It was raining when Saracen turned into the narrow lane that led down to the Nurses’ Home at the General and the rain drops on the back window made it awkward for him to reverse the car in the small space available at the foot, a space made even smaller by illegally parked cars. When he finally did complete the manoeuvre he saw Jill sheltering under the long canopy that fronted the building. He leaned over and opened the passenger door.

“I saw you arrive from the window,” said Jill as she swung her stockinged legs into the car.

Saracen made an appreciative sound.

Jill smiled and said, ‘I thought I’d better make the effort; don’t know what the opposition is going to be like.’

‘I’ve never met her before,’ confessed Saracen. ‘She might be a twenty stone dumpling.’

‘With my luck she’ll be a Dior model,’ said Jill. “And there’s me with St Michael stuck all over me.’

‘You look great,’ said Saracen and meant it.

Jill’s prediction proved to be a good deal more accurate than Saracen’s, for Claire Tremaine was no dumpling. She turned out to be a slim, confident, elegant woman in her mid twenties who proved to be as witty and entertaining as she was attractive. She was not however slow to point out the failings of Skelmore as a place to live, a view that Saracen happened to agree with, although he did feel a little irritated that an outsider should be so forthright so quickly.

But such considerations had long since ceased to be important enough for him to take issue with. Throughout the course of the evening he smiled and laughed in all the right places. Jill might have been goaded into some kind of defence of her home town but she was kept fully occupied by Alan Tremaine who was having difficulty keeping his eyes off her cleavage and kept repeating — due to over-indulgence in Cotes du Rhone — that he hadn’t realised what delights had been lurking beneath the drab blue cotton of a Skelmore nurse’s uniform. Jill was well able to handle the situation for, at twenty seven, she had seen a lot of randy housemen come and go.

‘So why have you come to Skelmore Claire?’ asked Saracen.

‘My first job,’ replied Claire. ‘I’ve been doing a PhD at Oxford in archaeology and my supervisor is leading the search for the site of Skelmoris Abbey. He took me on despite the fact that I haven’t written up my thesis yet.’

‘Why the sudden interest in Skelmoris Abbey?’ asked Saracen. ‘No one has ever bothered to look for it before, have they?’

‘Not in recent times,’ agreed Clare but that was because no one really had any idea where the site was.’

‘And now?’

‘A few months ago a librarian in Oxford was leafing through the pages of some old books that had been bequeathed to the university and he found a map. It was very old and very yellow’

‘How exciting,’ said Jill.

‘Just like Treasure Island,’ added Tremaine.

‘It included a plan of Skelmoris Abbey and it contained information about the surrounding area. A lot has changed of course in six hundred years but we now think we have a reasonable chance of finding the actual site.

‘There was something about this in the local paper,’ said Saracen. ‘The abbey was supposed to have been destroyed by fire wasn’t it?’

‘The fire is fairly well documented,’ said Clare.

‘And the legend?’ smiled Saracen.

Clare smiled and said, ‘Legends are legends.’

‘So the curse doesn’t bother you?’

‘What curse?’ asked Jill.

Claire said, ‘According to the story, the abbey was entrusted with the safe-keeping of a chalice. Anyone attempting to remove the chalice would incur the wrath of God and pay with his life. Legend has it that a lot of people did.’

‘Creepy,’ said Jill.

‘What the story in the paper didn’t say was that the fire was deliberate,’ continued Claire. ‘After the deaths of the original Abbot and brothers the church tried several times to re-open the abbey. Although the new monks were God-fearing and had no intention of removing the chalice they met with the same fate as the others. In the end the church gave up and burned the place to the ground.

‘What an awful story,’ said Jill with a shiver. ‘I think if it was up to me I would let well alone.’

Claire smiled and said, ‘The plan is that I dig during the day and write up my thesis in the evenings.”

‘Sounds like a full life,’ said Saracen.

‘I think the idea is that there won’t be too many distractions up here in the sticks so here I am as an uninvited guest of little brother.’

“Consider yourself invited,” said Tremaine, leaning across and kissing his sister on the cheek.

“I wish I had a brother like that,” said Jill. “Keith and I fight like cat and dog whenever we are together!”

Tremaine made a rather unsteady attempt to kiss Jill on the cheek too. “I’ll be your brother,” he grinned.

Jill laughed it off and expertly avoided Tremaine’s advance. In another person his behaviour might have been considered offensive but, from Alan Tremaine it was accepted with good humour. If anyone was upset by it was his sister. Saracen noticed her occasionally betray her impatience with an unguarded look.

The party broke up around midnight for both Saracen and Jill were on duty in the morning but, before she left, Jill invited Claire to cal her whenever she got too bored with writing. They could arrange an evening out for girl talk.

Saracen passed his own apartment on the way back to the Nurses’ Home. “Nightcap?” he asked. Jill agreed.

“Brrr. The place is like a morgue,” said Saracen as he fumbled in the darkness for the light switch. He lit the gas fire, drew the curtains and put some music on before pouring the drinks. “Did you enjoy yourself tonight?” he asked Jill.

“It was a nice evening,” Jill replied.

“What did you think of Claire?”

“I hated her,” said Jill with disarming honesty that made Saracen splutter. “Why?”

“She is good looking, bright, self-assured, confident, totally at ease. Is that enough to be going on with?”

Saracen laughed and said, “You had nothing to worry about. You held your own beside her.”

“You’re too kind sir,” said Jill. “But I felt like a country bumkin beside Claire Tremaine. I could feel the straw falling out of my ears.”

“Nonsense,” insisted Saracen. “Besides you were a big hit with Alan.”

“Boys will be boys,” smiled Jill and returned to thoughts of Claire. “God, I wish I had that kind of confidence.” she said.

“Maybe it’s an act.”

“Do you think so?”

“It often is. Even the most outrageous extroverts insist on being basically shy.”

“They’re usually mistaken” argued Jill. “They misconstrue selfishness as sensitivity, ‘believe they’re ‘basically shy’ because they once managed to have a thought without telling the whole world.”

“That’s astute of you,” said Saracen quietly. “I came to the same conclusion many years ago.”

“Then maybe we both know people.”

“Maybe,” agreed Saracen.

They finished their drinks.

“I’d better get back,” said Jill looking at her watch.

“Of course, I’ll drive you.”

As they got to the door Jill turned and said, “Thank you James.”

“For what?”

“Not sticking your hand up my skirt.”

Saracen smiled and said, “I won’t say the thought didn’t occur to me.”

“Good. I would have felt insulted if it hadn’t. Incidentally…why didn’t you?”

“We don’t know each other well enough.”

Jill smiled and seemed pleased at Saracen’s reply.

Saracen looked at the green digits on the alarm clock and saw that it was thirteen minutes past four in the morning. It was third time he had looked at the clock in the past hour. Three hours of sleep was not much of a basis to begin a long period of duty on but that thought just made matters worse. There was no way that he was going to fall asleep again and it was all due to Myra Archer and the pricking of his own conscience.

The explanation that a short delay in deciding which hospital Myra Archer should go to as being all that was wrong in the case was attractive and convenient because it trivialised the incident and absolved him from further involvement. In fact, there was only one thing against it, thought Saracen as he lay in the dark; it was wrong. Of that he was certain. There had to be more to it to have warranted such a cover-up and falsification of records.

Saracen realised that this was the second time in as many weeks that he had lain awake in the early hours feeling troubled about things at the hospital. The first time had been after the affair at the mortuary when the explanation on offer had seemed too pat and convenient, just like now. Thoughts of that incident had been receding but now they surfaced to niggle at him again. He reached out for the lamp switch and abandoned all hope of sleep. Any remaining reluctance to get up was solely concerned with temperature. The flat did not have central heating and maintained at best an ambience between lukewarm and cold. At four thirty in the morning it was on the freezing side of cold.

Saracen turned on the gas fire and squatted down in front of it for a few moments, trying to cram as large an area of body as possible into the path of the radiant heat before making for the kitchen to switch on the electric kettle. He lifted the kettle first to make sure it had enough water in it. It had not. He breathed a single expletive and padded over the cold lino in his bare feet to the sink. In his haste to get back to the fire he wrenched on the cold tap too hard and overdid it. The mains pressure at that hour in the morning ensured that he received an icy spray all over his bare chest. Single expletives were no longer sufficient, he launched into an adjectival soliloquy.

As he sat nursing his coffee Saracen’s gaze fell on his text books arranged in neat rows in shelves by the fire. The group nearest to him were concerned with pathological technique. Their titles reminded him again of the horror of waking up on the post-mortem examination table. It made him think of how he had come to be there in the first place. He imagined his body being dragged across the courtyard and into the mortuary, his wrists scraping the stone floor, the coldness, the stillness, the sweet sickly smell and the forgotten fact that still eluded him, the connection between formaldehyde and ammonia. He withdrew a large tome on histology and looked up formaldehyde.

Saracen found only what he already knew. Formaldehyde was a gas that could be dissolved up to a concentration of forty percent in water. A ten percent solution, known as formalin, was commonly used as a general fixative for the preservation of dead tissue. The book went on to list appropriate occasions for the use of formalin fixation in preference to others. Saracen closed it and put it back on the shelf. He lay back and idly scanned the other titles on the shelves. His eyes stopped at Cruikshank’s Medical Microbiology and he sat up sharply. That was it! Formaldehyde did have another use. Ninety-nine times out of a hundred it would be used as a tissue fixative but it could also be used to kill bacteria. It was a powerful disinfectant!

Saracen thumbed quickly to the relevant section on sterilisation and methods of disinfection. He found what he was looking for. Paraformaldehyde tablets, when placed in a spirit lamp evaporator, gave off formaldehyde gas capable of disinfecting entire rooms. At the end of the process the toxic formaldehyde gas could be neutralised by throwing in rags soaked in…ammonia! He had found the connection. It made sense. He had been lying unconscious for many hours in a room next door to one that was being disinfected by formaldehyde gas.

One question had been answered but a much bigger one had loomed up. Why had it been deemed necessary to disinfect the entire mortuary in the first place and why all the lies about thieves in the night? Could it be that the affair at the mortuary and the cover-up over Myra Archer’s death were in some way connected? The flood gates to Saracen’s imagination opened up. Just how did Myra Archer die?

Skelmore General did not have a full time pathologist of its own. Post-mortems were carried out by a rota pathologist, one of two who covered the County Hospital as well as forensic work for the district. They were both based at an office in the County Hospital. Saracen phoned Dave Moss, his friend at the County to find out which one was on duty. It was an important consideration for one of the two was approachable while the other was a paranoid alcoholic who attempted to cover up his failing abilities with increasing pomposity. The latter would not take kindly to inquiries coming from someone of Saracen’s lowly status. He would almost certainly mention the matter to Garten.

“Dave? It’s James Saracen.”

“Saracen! If you are about to tell me that you are sending down a dozen patients knee deep in shit I’m going to put down the phone and pretend you never called.”

“Nothing like that…Actually it’s three nuns with gonorrhoea.”

When the banter had stopped Saracen asked who the duty pathologist was.

“Hang on, I’ll look.” After a few moments Moss returned and said, “It’s Peter Clyde. What’s the problem?”

“No problem. I just want to check up on something.”

“Uh huh,” said Moss knowingly. “I see, it’s cover up your mistakes time. Say no more.”

Saracen tried to laugh then asked, “Is he in the office this morning?”

“I think so. I saw him about half an hour ago come to think of it. His extension is 431…But I suspect it says that in your directory too…”

Saracen took the point Moss was making and said, “I’m sorry, I had to make sure it wasn’t Wylie today. The inquiry I have to make is rather delicate.”

“I understand,” said Moss. “I keep hoping that Wylie will retire soon and save us the continued embarrassment of pretending that he’s not pissed out of his mind all the time.”

“At least his patients are dead.”

“Just as well,” said Moss. “A hamster with a hacksaw could have made a better job of the last PM I saw him do.”

They made their usual assertions about having to get together for a drink and Saracen put down the phone. He lifted it again and dialled 431. Peter Clyde answered. After an initial exchange of pleasantries Saracen came to the point and asked about the Post-Mortem report on Myra Archer.

“The name doesn’t mean much,” said Clyde. “Hang on a moment.”

Saracen could hear the sound of paper being shuffled at the other end of the phone while he waited then Clyde’s voice said, “Not one of mine I’m afraid. I’ve only had one at the General in the past four weeks and that…was a man…Robert Nolan, aged sixty nine, done on the eighth.”

“Damn,” said Saracen softly. “I suppose that means that Cyril Wylie must have done it.”

“He’ll be here tomorrow. You can give him a ring.”

Saracen gave a non-committal grunt that Clyde took up on. “Is there some problem?” he asked quietly.

“It’s rather awkward. I’d rather not ask Dr Wylie.”

“I see,” said Clyde thoughtfully, assuming that Saracen’s reluctance had something to do with Wylie’s drink problem. Saracen saw no reason to disillusion him. “One moment.” said Clyde.

Saracen was left holding the phone again. He hoped that Clyde had gone to check through Wylie’s records.

Clyde returned. “No joy I’m afraid. I thought that Cyril might have left his filing cabinet unlocked but no such luck. You’ll have to approach him yourself tomorrow.”

“Thanks anyway,” said Saracen. He put down the phone and rubbed his forehead with the heel of his hand.

“Problems?” asked one of the nurses.

“You could say that,” said Saracen with a wan smile but let it go at that.

All thoughts of Myra Archer were dispelled from Saracen’s head with the arrival in A amp;E of a badly injured thirteen year old girl who had been involved in a road accident with her bicycle. Both legs had been badly damaged where the car had hit her side on and she had lost a lot of blood.

“Have you alerted the theatre Sister?” Saracen asked.

“Yes Doctor.”

“Permission forms?”

“There’s a problem.”

“Can’t contact the parents?”

“No, it’s not that. They are here…but they won’t give permission for a blood transfusion. Religious reasons. They are Jehovah’s Witnesses.”

Saracen’s head dropped and he massaged his left temple with the fingertips of his left hand. It was his way of counting to ten.

“Where are they?” he asked.

“The small waiting room.”

“Put them in the office will you. I’ll talk to them.”

Saracen took a deep breath and entered the room to find a middle aged couple sitting there with their arms around each other. The woman was sobbing quietly into a handkerchief. Saracen said who he was and came straight to the point. “Let me be perfectly frank with you,” he said, “If your daughter does not have a blood transfusion soon she will die. There is no other possible outcome. Do you understand?”

The man nodded silently. The woman continued to sob.

“Will you please give me your permission?”

The woman sobbed harder. The man squeezed her shoulder and said, “I am afraid our beliefs forbid such a thing Doctor. We cannot give our permission.”

Anger simmered inside Saracen and he remained silent for a moment until he had regained his composure. He was about to say something else when they couple looked up at him and his anger was replaced by frustration. Instead of the smug self righteousness he thought that he might find in their faces he could see only pain and torment. The couple were suffering doubly, firstly because their daughter had been so badly injured and secondly because they felt compelled to block the one thing that could save her.

Saracen said, “I will now apply to have your child made a ward of court for the duration of her treatment. Do you have any questions?”

The couple remained silent but as Saracen got to the door the woman asked, “How long will that take Doctor?”

“One hour maybe two.”

“Will she…” The words died on the woman’s lips as she realised that it was a question she should not be asking.

Saracen left the room with the impression that the couple were really quite glad to have had the onus removed from them although he also suspected that they would never admit as much to anyone, not even themselves. The games people play, thought Saracen as he returned to the treatment room to check on the girl’s condition before entering Nigel Garten’s office to find the card that held the telephone numbers and instructions for instigating ward of court proceedings.

The number was engaged and Saracen cursed under his breath. When he still got the engaged tone after the third attempt he slapped down his fist on the desk in frustration and caused some ink to jump out of its silver pot and splash on to the leather desk top. He searched quickly through the desk drawers for blotting paper and found some, but there, just below it, was an open letter. Saracen’s eye caught the underlined name near the top of the page. It was Myra Archer.

When he had finally got through to the authorities and set things in motion Saracen returned to the drawer where the letter was lying and drew it out. He overcame his feelings of guilt at what he was about to do and read it. The letter came from British Airways and referred to a request made by Nigel Garten that all passengers and crew on the flight that had brought Myra Archer to the United Kingdom be contacted and treated as recommended. The letter confirmed that this had been done.

“What the hell for?” said Saracen softly as he stared at the letter. If the woman had died of a heart attack. What was all this nonsense about treatment for fellow passengers? Did this mean that Myra Archer had not died of cardiac failure? To find out the answer Saracen knew that he would have to find Garten’s original to British Airways. He started searching through the files.

After a few minutes which seemed like hours he found what he was looking for and read the letter still crouching down beside the filing cabinet. It advised the airline that Mrs Myra Archer, a passenger on their flight BA 3114 to London Heathrow had been shown to be suffering from a Salmonella infection. As a precaution it was deemed advisable for all persons on the flight to undergo a course of preventative antibiotic therapy as there was a possibility that food served on the aircraft might have been responsible.

“Food poisoning?” said Saracen out loud. Myra Archer had been suffering from food poisoning? He shook his head in puzzlement but did not have time to consider the matter further before Chenhui came through the door and said anxiously, “Dr Saracen, I need your help. You come please.”

Saracen followed Chenhui back to the side room where the teenage girl lay.

“I not happy,” said Chenhui.

Saracen examined the girl and checked the monitors. He agreed with Chenhui. “We can’t wait any longer,” he said. “We’ll have to give her blood right now. Has it come up from the bank?”

Sister Lindeman said that it had.

“Cross-matched?”

“Yes. How about the paperwork?”

“We can’t wait.”

“If you say so.” Sister Lindeman enunciated the words very clearly and Saracen recognised that she was inviting him to take responsibility publicly. “I say so,” he said with a barely perceptible smile.

Saracen had set up the transfusion and was washing his hands when Chenhui came up beside him and said, “I puzzled. Why parents say no blood?”

“A religious objection to transfusion,” replied Saracen, pushing off the taps with his elbows.

“I no understand.”

“Frankly Chenhui, neither do I,” said Saracen, baulking at the thought of attempting to explain something he had no heart for. “It’s all part of God’s little obstacle course.”

Chenhui looked more puzzled than ever.

“Let’s go have a cup of tea.”

As they walked across the floor towards the duty room a trolley came through the swing doors bearing a tear stained young boy holding his left arm gingerly. “He fell off a swing,” said the attendant.

“I will do,” announced Chenhui and Saracen nodded. He went to have his tea and found Jill Rawlings had beaten him to it. She was sitting on a corner of the desk holding cup and saucer. “I hear you gave blood to the JW,” she said.

“No option.”

“The authorities might disagree.”

“Sod ‘em.”

“My hero,” grinned Jill.

Saracen ignored the remark and asked, “Did Mary Travers say anything about Myra Archer having had a Salmonella infection?”

“Yes she did, come to think of it. Some days after the Archer case she and the ambulance crew were given a course of antibiotics as a precaution. It didn’t seem to be relevant to what you were asking at the time.”

“I suppose not,” said Saracen deep in thought.

“You’re not dropping the matter?”

Saracen screwed up his face. “So many things are bothering me. For instance how did they know the woman had a Salmonella infection if it was a treble nine call to a heart attack?”

“Presumably it was something they discovered afterwards at Post-Mortem,” said Jill.

“A Salmonella infection is hardly something the pathologist would be looking for in this woman’s case,” said Saracen.

“What are you getting at?”

Saracen shrugged his shoulders and sighed. “To be quite frank,” he said, “I’m not at all sure myself.”

Jill smiled and touched him on the forearm.

“I have another favour to ask,” said Saracen.

“Go on.”

“Would you ask Mary Travers what day she was given the antibiotic cover on?”

“All right,” sighed Jill, “If it will make you happy.” Then, as an afterthought she said, “If they did know that Myra Archer had food poisoning at the time of the call that would explain why they decided to send her on to the County Hospital wouldn’t it?”

“It would,” agreed Saracen. “But I don’t see how Chenhui could have made that diagnosis in the circumstances and that’s what’s niggling me.”

Saracen was in the bath when the phone rang. His first thought, as always when the phone rang in early evening, was that it was Nigel Garten trying to unload his duty stint on some pretext or other so he was relieved to hear Jill’s voice.

“I’ve spoken to Mary Travers. She started her course of treatment on the thirteenth. Is that what you wanted to know?”

“Thanks. You’re an angel.”

Saracen felt a weakness creep into his knees. He sat down as the blood began to pound in his temples. Myra Archer had died on the twelfth; the post-mortem would not have been done until the thirteenth at the earliest, more likely the fourteenth or fifteenth. To determine that Myra Archer had been suffering from a Salmonella infection would have required a lab examination of specimens taken from her body. The result could not have possibly been known until the fifteenth or sixteenth. Whatever reason Garten had had for putting Mary Travers and the others on treatment on the thirteenth it had nothing to do with anything discovered at post-mortem. He must have known beforehand.

The bath water had gone cold. Saracen dried himself and put on a towelling robe. He sat down to wonder how Chenhui and Garten could possible have made the diagnosis. From all accounts Myra Archer had been unconscious when the ambulance was called and had not regained consciousness. She had told them nothing and died of cardiac failure yet they had known that she also had a serious infection. It didn’t make sense. Not only had they been able to diagnose Salmonella but they had been able to determine that it was one of the more serious strains if Garten had deemed it necessary to contact the airline and to disinfect the mortuary. Could it have been typhoid? the ‘top’ of the Salmonella range. But if so why the secrecy? There were one or two cases every year. If only he could see a copy of the PM report, thought Saracen, perhaps he could work backwards from the exact cause of death and figure out how they knew. Wylie or no Wylie he would have to get his hands on that report.

Saracen rested his neck on the back of the chair and looked up at the ceiling for inspiration. He was tracing the path of a thin crack that radiated out from the light fitting when the telephone rang; it was Dave Moss.

“I’ve just had your Dr Tang on the phone,” said Moss.

“Oh yes.”

“She seemed to be in a bit of a state, ‘trouble is, I don’t really know what about. I only managed to pick up every fourth or fifth word. I think she wanted me to take a patient, maybe two, she kept saying ‘two’ then the line went dead.”

“I see,” said Saracen feeling anger rise within him, “And you are phoning to find out why a doctor who can barely speak English has been left in charge of A amp;E at Skelmore General?”

“More or less.”

“Well I’d like to know the answer to that too,” said Saracen getting out of the chair and gathering his clothes. “Give me fifteen minutes. I’ll get back to you.”

Saracen was furious. How could Garten do such a thing? How could he be so irresponsible? His toes got stuck in the heel of a sock in his haste and he cursed out loud as he disentangled himself then he lost a shoe which led to more cursing. He slammed the door behind him and ran downstairs to the car, making a conscious effort to control his temper and prevent its translation into sheer bad driving. With only partial success in that direction the front tyres squealed as he swung the wheel over to enter the hospital gates. In truth, this was due more to the fact that he had wrenched the wheel over sharply than to any excess of speed but it made the duty porter lift his eyes from his newspaper and half get out of his chair to glance out of the gate-house window. When he saw that it was Saracen he slumped back into inertia.

Saracen burst in through the swing doors of A amp;E and looked around for Chenhui, ignoring the smile of a junior nurse in his preoccupation. Sister Turner, the night sister, came out of the sluice room and looked surprised when she saw Saracen.

“I didn’t realise that Dr Garten had called you,” she said.

“He didn’t,” replied Saracen.

“Oh, I thought when I saw you there that he must have called you out to cover for Dr Tang…”

Saracen was puzzled. “Why should he? What’s wrong with Dr Tang?” he asked.

“She’s had some kind of nervous breakdown. She’s been admitted to the wards.”

Seeing that he had read the situation all wrong Saracen calmed down and felt rather foolish. “And Dr Garten?” he asked.

“He is with her right now.”

“So she wasn’t left on her own in A amp;E?”

“Good heavens no, she can hardly speak a word of…”

“Yes Sister,” interrupted Saracen. “What did you mean some kind of nervous breakdown?”

Sister Turner, a spinster clinging to late middle age and fond of tittle tattle, warmed to her task and said conspiratorially, “I’ve never seen anything like it. She was shouting and raving, ‘practically attacked Dr Garten when he tried to calm her down.”

“But why? What happened to upset her?”

The night sister looked perplexed. She said “The ridiculous thing is, we don’t know. She was raving in her own language.”

“But something must have triggered it off?”

“Not really. It’s not as if she hadn’t seen a dead body before.”

“Go on.”

“We had a ‘dead on arrival’ at around eight o’clock; Dr Tang was asked to certify the patient dead. When she came back she bust into Dr Garten’s office and started shouting and carrying on.”

“In Chinese?”

“Not at first.”

“Could you make out anything that was said?” asked Saracen.

“Not much. She has such a heavy accent but it sounded like, ‘six days, more then six days.’ But I couldn’t swear to it.”

“Then what happened?”

“She came rushing out of Dr Garten’s office and started telephoning. Dr Garten tried to reason with her but in the end he had to get the porters to restrain her while he sedated her.”

“And what did Dr Garten say about all this?”

“He said that Dr Tang had been under great strain recently and was suffering from nervous exhaustion. She would probably be as right as rain in a couple of days so it would be a kindness if none of us mentioned the incident outside A amp;E.”

Saracen nodded and said that he was going up to see Chenhui.

Away from A amp;E the corridors of Skelmore General had quietened as they always did around nine in the evening. The last visitors had gone and custody of the wards had been handed over to the night staff. Saracen had only the echo of his footsteps for company as he made his way along the entire length of the bottom corridor to reach ward eight. He disliked the hospital at night for it had a Dickensian dreamlike quality about it, an image intensified by the poor lighting in the corridors and the peeling green paint on the walls. To be admitted at night as a patient to Skelmore General, thought Saracen, must be an unnerving experience, being wheeled headfirst on a trolley with nothing but the cobwebs and dark shadows of the ceiling vaults to concentrate on while the trolley squeaked and echoed its way along a seemingly endless tunnel to an unknown destination Poor sods.

Saracen opened one of the two tall glass fronted doors to ward eight and went in. He winced as the door creaked loudly on its hinges but no one came out to investigate. He looked into the duty room and got a quizzical look from the staff nurse in charge. He said who he was and why he was there.

“She’s in the second side ward. Dr Garten is still with her.”

Saracen went in search of the side ward. He went inside and closed the door quietly behind him. Nigel Garten was sitting beside Chenhui who seemed fast asleep. He looked up as Saracen came in and looked startled but recovered his composure quickly. “I didn’t expect to see you here,” he said with a smile that seemed less than genuine.

“I had a telephone call,” said Saracen.

“Really? Who?”

Saracen was slightly taken aback at Garten’s directness but he answered anyway. “Dave Moss at the County.”

“Ah yes, Dr Tang’s phone call,” said Garten. He seemed relieved that it had not been one of the A amp;E staff who had phoned Saracen.

“And what did Dr Moss tell you?” probed Garten.

“He thought that Chenhui had been left on her own in charge of A amp;E,” said Saracen looking directly at Garten.

“Hardly,” said Garten slowly and quietly, his eyes holding Saracen’s gaze as if looking for a challenge. The strained smile on his face was maintained as if carved in rock.

“How is she?” asked Saracen.

“Out for the count. She’ll feel better after a good sleep.”

“What happened exactly?”

“A sudden emotional outburst, complete loss of control. I blame myself of course; I should have seen it coming. She’s just not up to the job. I should have said something to the board months ago but I was sorry for her, wanted to give her every chance.” Garten looked at the floor in a display of mock self condemnation.

Saracen was glad that Garten was looking at the floor otherwise he might have seen the look of distaste on his face. He had never disliked Garten as much before as he did at that moment. He looked at Chenhui, sleeping peacefully and moved over to the bed to feel her pulse; it was slow and regular. He noted the drip feed going into her other arm and asked Garten, “What are you giving her?”

“Heminevrin.”

“That’s a bit drastic isn’t it?”

“I deemed it necessary,” replied Garten with more than a hint of coldness in his voice.

Saracen felt the temperature drop and changed the subject. “Sister Turner said something about Chenhui dealing with a death in A amp;E when all this came on?”

“Nothing out of the ordinary. The man was dead on arrival.”

“I see, so it’s a complete mystery what triggered off Chenhui’s outburst?”

“Absolutely.”

“She does seem to have been under some kind of increased strain recently,” ventured Saracen.

“Really? I hadn’t noticed,” replied Garten.

Saracen got to his feet and said, “I’m here now, I’ll work Chenhui’s shift with you if you like.”.

“Wouldn’t hear of it old boy,” said Garten so quietly that Saracen thought he detected menace in it. ” You go on home.”

Saracen had to work hard to keep the astonishment off his face. “All right,” he said and left.