George Barnabas - 04 - Fourth Attempt (2 page)

Her knife slid down the belly, from xiphysternum to symphysis pubis, cutting a wake that lay open the whole of the belly from the lowest ribs to just above the smudge of dark pubic hair. She pulled the flaps apart and began to investigate the abdominal contents, dictating continuously as she went. Danny took the various pieces of viscera, weighed them and gave her the details, which she dictated into her mike too before carrying on, checking the stomach for its contents, which she emptied into a stoppered flask that Danny held for her, then the gut, the kidneys, liver … and her puzzlement grew. This had been a healthy young woman. There was no hint of disease anywhere that she could see with the naked eye, though of course there was still the microscope work to be done. The liver, in particular, she thought, had the pristine look of one belonging to someone who had never tasted alcohol in her life.

But that was a fanciful notion. She set it aside as unworthy of a practitioner who was supposed to have a scientific mind as she set to work on the pelvic contents. Ovaries and fallopian tubes: normal and, to the naked eye, healthy. The uterus: here her gaze sharpened and she looked even more carefully.

Bulky, she thought. Moving even more carefully now, she lifted it over the bony pelvis and set it on the slab where she could do a further dissection. Danny watched her in his usual imperturbable fashion, his lips pursed as though he were whistling, though he never emitted a sound as her knife slid over the membrane and then bit into the thick strong muscle of the uterine wall.

She wasn’t unduly surprised when she finally had the uterus open. She had expected it, but all the same it deepened the pity she felt; standing there looking down on the twelve-week foetus that lay curled up and very dead inside its equally dead mother. She could almost have wept for it.

*

It took her some time to regain her equilibrium. She finished the PM, finding the cause of death without any difficulty: the lungs were full of water, and there were other signs which made it clear Pam Frean had drowned. Since she had been discovered in her bath under the water, that had been the most likely explanation anyway; but George had deliberately given no thought to that fact when making her examination. It would not be the first time she had found that a corpse which had been recovered from under water had been dead before it entered it. But in this case, it was a true bill; death by drowning. Later, however, the blood-chemistry tests added another dimension: the girl had taken a large dose of diazepam.

But try as George might to stop thinking about the case, she couldn’t. She did all she could to keep the facts about the PM quiet, but of course she failed. Sheila had them wormed out of Danny immediately; she might regard him as one of the lower orders, but when she wanted something from him she could turn on the charm to great effect and without shame. So in no time everyone around the hospital was talking of the three deaths — and still calling all three of them suicides. And though George tried not to let the gossip get to her, she found herself wanting more information than she had, certainly about the last case. Because with this one the gossips were almost certainly right.

That was why she went over to A & E to see her old friend Hattie Clements. There had been something in the notes which suggested that Hattie might be able to give her more information about Pam Frean. And that was something George badly wanted.

‘I know people are overreacting a bit,’ Hattie, the senior sister on Accident and Emergency said as she gave George a beaker full of the department’s famous bitter black coffee. ‘But it’s understandable. I mean, one suicide a day for three days! No wonder people are uneasy.’

‘But there weren’t three suicides!’ George said. ‘It’s people
like Sheila whipping them up, that’s all. And it wasn’t one a day. That was just the way people heard about it.’

‘You’re wrong, George,’ Hattie said. ‘And I don’t often think that, you know I don’t. But right now Sheila’s irritating you so much you’d blame her for the war in Bosnia if you could. But truly, she’s not the only one talking. Now, just listen!’ She raised her voice to override George’s attempt to interrupt. ‘On the Monday they found Lally Lamark dead on the floor of her office, stiff as a board and —’

‘Which shows she didn’t die on Monday,’ George said. ‘Goddamn it, Hattie, who’s the pathologist around here, me or you? She’d been dead since the Friday. Rigor mortis had —’

‘They found her on Monday.’ Hattie was stubborn. ‘And that caused enough drama, the way it happened. And then on Tuesday, there was Tony Mendez collapsing in the middle of a case and frightening the crap out of Gerald Mayer-France so much that he had to hand over the gall-bag he was doing to his registrar.’

‘Any excuse to cut short his NHS sessions are balm in Gilead to Mayer-France,’ George retorted. ‘He’s the sort of consultant who gives the NHS an even worse name than it’s got. He was probably cuddling up to one of his private patients in Wimpole Street before the poor sap of a registrar had the skin clips in —’

‘And then,’ Hattie said, riding over George magnificently, ‘yesterday, there was Pam Frean. Is it any wonder they’re all looking over their shoulders to see who’ll be the fourth one?’

George put down her cup with a little clatter. ‘Oh, Hattie, really, listen to yourself, will you? This is sheer nonsense! Those first two were accidents! Lally Lamark had been having trouble with her diabetic control ever since they’d changed her to the new sort of insulin. And Mendez, well, they thought he’d kicked the booze and was OK, but he hadn’t. And when he took a drink he just overestimated how much he could safely take and poisoned himself.
Accidentally.
I did the PMs on them both myself, goddamn it! If they’d
killed themselves I’d have spotted something to prove it. And they left no notes or —’

‘But Pam Frean did!’ Hattie cried. ‘She definitely did, didn’t she? And as for the other two being accidents, everyone says that Lally got her insulin right and people who knew Tony well swear he was well and truly in control. I have no trouble believing they were all suicides, no matter what you say!’

‘Don’t confuse me with facts, is that it?’ George said dryly. ‘Because guessing is so much more fun? Come on, Hattie, I expected better of you.’

‘Fiddle-de-dee,’ Hattie said, refilling George’s cup. ‘You wait and see. You’ll come and apologize to me yet. I know a suicide when I see one.’

‘Well, you didn’t see Lamark and Mendez,’ George said. ‘So you’re guessing as wildly as Sheila and everyone else are.’

‘Not wildly.’ Hattie insisted. ‘Informed opinion based on experience.’

‘It’s your experience of Frean that I want.’ George felt that the argument was getting sharper and the last thing she wanted to do was fight with Hattie. The whole fuss would die down in a few days, the way hospital fusses usually did, and George and Hattie would slip back happily into their old comfortable friendliness. No need to upset her over something so transitory, George thought, leaning forwards to bring her head closer to Hattie in a manner designed to disarm her. ‘Tell me what happened when you saw her.’

‘Hmm,’ Hattie said, only a little appeased. Then she shrugged slightly. ‘So you know about that?’

‘It was in the notes,’ George said.

‘Oh, fair enough. OK then. Well, she was brought down here by one of the other nurses on Laburnum Ward —’

‘Neurology.’

‘Uh-huh. Well, more neuro-research now, since Laurence Bulpitt died and the new chap came. What’s his name? Zacharius? Polish, I think he is.’

‘Hungarian,’ George said. ‘Go on about what happened with Frean. When was this?’

‘Um, last month. Let me check my notes.’ Hattie turned to her computer and began to click keys. ‘Here it is. The third of May. Wednesday, May third. Four-fifteen p.m. She passed out, really passed out cold. Not just a fleeting fainting episode but deeply out for several seconds. The nurse she was working with at the time was very sensible, saw it was an unusually prolonged syncope and once she came round insisted on putting her in a wheelchair and bringing her down here. I checked the girl and her blood pressure was … let me see.’

Again she clicked keys and, as the screen rolled, reassembled its data and then settled, nodded. ‘Here we are. Look over my shoulder. It’s all here.’

George obeyed, squinting at the bluish-white expanse, reading off the information. ‘Blood pressure low but not too bad. Pulse rate fast — that figures. Normal temperature, normal reflexes, normal — yeah, I see. Looks like a vaso-vagal episode of some sort.’

‘That’s what I thought, but then the other nurse went off back to the ward because they were bleeping her and I could talk to Frean on her own. So I asked her, could she be pregnant? Well, you always have to ask, don’t you? And she went as white as a sheet. I thought she was going to go out again, and I had to hang on to her because she’d have fallen off the couch. She didn’t flake out but she started to cry like a fountain and after that it was all pretty much run of the mill. From the story she gave’ — she squinted again at the screen — ‘last menstrual period and all that, she was about eight weeks pregnant. Give or take. She denied it all at first but then I got it out of her. She was just at the point of missing her second period. She was frantic about it.’

George raised her brows. ‘Wanted an abortion?’

‘No, that was the … Well, I asked her how she felt about the pregnancy to see if she wanted to terminate. I could have referred her to the right people then, you see? But I don’t
refer girls unless I know they’ve made up their minds about the issue. Some of the abortion clinic people are, well, a bit enthusiastic, you know? These girls need time to think. She said she didn’t know, she’d never thought about such a possibility, and I told her that if she was having unprotected sex it was a very high one and even then she didn’t seem to know what I was talking about. Very naïve, I thought. At first. But then I found out why …’

‘She can hardly have been uneducated in these matters, surely? You don’t get to be a senior staff nurse without learning something about the physiology of reproduction.’

‘Maybe so. But you can block it out of your thinking if you want to. Her family, you see, are religious. No, not just religious. Barking mad fanatic. The sort who come knocking on your door on Sunday afternoon and preach at you until you have to slam the door in their faces to get rid of them.’

‘Ah!’ George said, and let her shoulders relax. She had been right to come to Hattie with her questions. She had no right to dig around in the girl’s history, of course; her job had been just the post-mortem. But George being George, her curiosity was, as ever, uncontrollable. And now it was beginning to be assuaged. The puzzle had been why a pregnant girl should kill herself for such a reason in 1995. In 1895 it would have been understandable, but for a sophisticated nurse today, it was surely excessive. An unwanted pregnancy was a problem — even a major problem — but it was not an insuperable one, unless the girl was subject to pressures most modern young women were not. Strict religious parents could be just such a pressure.

‘That makes sense of her note, then,’ she said now.

‘I thought so as soon as I heard about it,’ Hattie said. ‘People said they couldn’t understand it, but I knew at once.’

George shook her head irritably. ‘Then everyone’s talking about the note too?’

‘Of course they are! This is Old East, remember? The mere
concept of a secret is unknown here.’ Hattie was amused. ‘I told you I knew Frean had left a note. How could I have known if everyone else hadn’t?’

‘I don’t know,’ George said. ‘You heard where it was found, too?’

Hattie nodded. ‘On the screen on the computer in Neuro? Yup.’

‘You don’t think that’s a bit odd?’ George said, trying to be casual.

Hattie was not deceived. ‘Do you?’ she said sharply.

‘Well … maybe a little. I mean, to sit down at a computer to leave a note rather than grab a piece of paper and a pen seems a bit calculated, don’t you think? And the ward computer at that.’

‘Calculated?’ Hattie said. ‘The whole business of suicide is calculated! As for where people leave notes, I had a patient in here once who had written in lipstick on her belly that she was sorry and it was her husband’s fault she’d done it.
That
was calculated. For people today to use computers isn’t. They’re as common at work as pens and paper, aren’t they? More common, really. And anyway, what other computer could she use? Unless she had one of her own, and though I know a few of the live-in staff do, they’re not all that common. People on NHS pay can’t afford ’em. I certainly hadn’t heard she had one.’

‘You no doubt heard what sort of toothpaste she used!’ George permitted herself to be sardonic. ‘Ye Gods, is there anything that isn’t a resource for chatter in this place?’

‘Nope,’ Hattie said cheerfully. ‘And you be glad of it. If we weren’t that way, you wouldn’t be here now finding out whatever it is you’re trying to find out. You use gossip the same way the rest of us do.’

‘Oh, shit!’ George went a little pink.

There was a silence and then Hattie said. ‘It was a weird note, wasn’t it?’

‘Not now you’ve told me about the family.’ George
reached into her pocket and pulled out a piece of paper. ‘I copied it.’ And she began to read aloud.

‘“I broke the fifth commandment. I cannot go on. It is a wicked thing I have done. I have to pay for the wicked thing I have done. Pamela Frean, her days are as grass, as a flower of the field so she flourisheth. For the wind passeth over it and it is gone; and the place thereof shall know it no more. The world shall know Pamela Frean no more. Amen.”’

Hattie gave a little shiver. ‘Poor creature.’

‘Yes,’ George said. ‘Poor creature.’

There was a little silence, and then George spoke again. ‘Did she tell you more? More than you’ve told me already?’

‘Oh, yes,’ Hattie said. ‘Lots.’

‘Can you tell me?’

‘Why not?’ Hattie shrugged. ‘She’s dead now, so the confidential bit is null and void really. She told me that her parents were very strict members of a fundamentalist group called … the Enclosed Brethren, I think. You know, no Christmas or birthday celebrations, no TV, no radio, no newspapers — and certainly no romantic entanglements. That was the phrase she used, and I thought it was rather sweet. It certainly made a change from the way everyone blathers on about relationships and “significant others” these days. Romantic entanglements …’ Hattie sighed. ‘I talked to her for a long time. They really are as hard as nails, those parents. Not that she complained about them, the opposite in fact. You’d think they were angels incarnate the way she talked, but they sounded so mean, so pinched, so … They forced her into nursing so she could go and be a missionary in Africa or somewhere — those people like to go to meddle and make trouble — even though she just wanted to be a musician. They told her that was a sinful way to think and prayed it out of her, she said.’ Hattie gave a little shudder. ‘It sounded a dreadful life, yet here she was, in a “romantic entanglement” and terrified of what her parents would say. That was when I put it to her directly: did she want to go ahead and have the
baby? She stared at me and said, “What choice do I have?” I opened my mouth to say a termination and d’you know, I couldn’t? Obviously with that background she’d have been appalled at the mere suggestion, so I just said, well, she’d better tell the father of the baby and make their plans, and sign into an antenatal clinic as soon as possible to get proper care. I told her not to come here for it.’ She hesitated. ‘I think it’s grim for staff to be patients in their own hospitals. You’re so bloody vulnerable to talk.’