Sisters of Mercy

SISTERS OF MERCY

Andrew Puckett

© Andrew Puckett 2014

Andrew Puckett has asserted his rights under the Copyright, Design and Patents Act, 1988, to be identified as the author of this work.

First published 1994 by Collins Crime an imprint of HarperCollins Publishers.

This edition published by Endeavour Press Ltd
in 2014.

For
the siblings,

Harriette
Mullins

and

Christopher Puckett

Table of Contents

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Extract from
Death Before Time
by Andrew Puckett

1

‘
It’s Mr Peters — I think he’s dead …’ Student Nurse Armitage looked breathlessly from myself to Mary … then we were moving across the ward as fast as we could without actually running.

‘
Screens,’ Mary said to Armitage as she hit the alarm at the end of the bed, and Armitage drew the curtains around us.

Mary
had stripped away his pyjama jacket and I reconnected him to the monitors, although I already knew we were too late. There’s something about a dead person’s face; not just the slackness of mouth and jaw, but the way the eyes are focused on to something not of this world …

I
started external massage on his heart, putting all my weight on to the heels of my hands on his chest … I was briefly aware of the arrival of the crash team, then felt hands on my shoulders and a voice said in my ear, ‘I’ll take over now, Jo.’ Stephen Wall, our senior registrar.

I
stepped back.

The
other members of the team were crowded round the foot of the bed with their equipment: James and Emma, staff nurses, and Graham Wood, the anaesthetist.

Stephen
looked up at the cardiac monitor. ‘Ventricular fibrillation,’ he said. ‘Intubate and oxygen, please, Graham,’ then, ‘Jump leads, please,’ to Emma, who bought them forwards.

Jump
leads is an example of the rather black humour we have to adopt in the Intensive Therapy Unit if we’re to stay sane. Their proper name is defibrillator paddles and they’re electric terminals which, applied to the chest over the patient’s heart, causes them to jerk and, with luck, restarts the heart.

I
knew that that wasn’t going to happen this time, though. And it wasn’t just a sense of the macabre that sent a frisson through me as I watched Peters’s body forlornly twitching. Peters shouldn’t have died.

He
made the seventh patient to die of heart failure when they shouldn’t, and now I was going to have to do something about it …

Mary
said in my ear, ‘You’re wanted on the phone, Jo. We’re OK here if you want to answer it.’

I
thanked her and hurried back to the nurses’ station where Armitage was holding it out for me.

‘
Sister Farewell, ITU.’

‘
Good morning, Sister. Miss Whittington here.’ Miss Ann Whittington, nursing officer and my boss.

‘
Good morning, Miss Whittington.’

‘
I’d like to speak to you some time this morning, Sister, if that’s possible.’

‘
Er — yes.’ I glanced up at the clock. ‘Would twelve o’clock be all right? There was something I wanted to speak to you about as well,’ I added before I could change my mind.

‘
Very well, Sister. Twelve o’clock.’

I
put the phone down slowly, aware that I’d committed myself to an action I dreaded.

Better
prepare for it.

I
de-gowned in the air-lock before going back through the Duty Room to my office and closing the door. I took a breath, tapped my password into the computer and found Peters’s record.

Frederick
Peters
,
age
49
,
married
,
two
children
…
Address
…
Religion
:
Agnostic
.
Donor
card
:
Yes
.
Tissue
type
…

My
eyes flicked down …

Admitted
on Monday with myocardial infarction but had responded well to isosorbide mononitrate therapy, and had had no further heart attacks. He’d been due to transfer to the Coronary Care ward tomorrow …

In
other words, he shouldn’t have died, not of heart failure. It was why he’d been taken off the monitors, because he’d recovered so well … which is why we now didn’t know exactly when he
had
died …

I
printed out copies for Stephen and myself, then noted down the pertinent facts and added them to the six files I already had. I was still analysing them statistically with the calculator half an hour later when there was a tap on my door. I covered them with the second Peters printout as Mary came in. She shook her head briefly, then looked down at the printout on my desk.

‘
Anticipating events slightly, weren’t you, Jo?’

For
a moment, as I looked at her classically moulded face with its cornflower-blue eyes and tawny blonde hair, I was overwhelmingly tempted to confide in her … then I remembered that although she was my deputy and we got on well, I’d only known her for a few months and she did have a slightly over-loose tongue …

‘
Not really. It was pretty obvious.’

‘
I suppose so,’ she said, still looking at me.

I
said, ‘What time are you going to lunch today?’

‘
One.’

‘
Good. I’ve been summoned to the presence at twelve, so you can keep shop for me.’

‘
What does the Witless want you for this time? Done something you shouldn’t?’

‘
That, I shall discover at twelve.’

When
she’d gone, I locked the files away and sat for a few minutes thinking about them. Then Stephen came into the Duty Room and I went out to meet him.

‘
It’s no good,’ he said tiredly.

‘
Are you putting him on life support?’ I asked.

‘
Yes. James is setting it up now. Did he have a donor card?’

‘
Yes.’ I handed him the printout.

‘
Hmm. Well, I’d better go and contact the next of kin, I suppose.’ He heaved a sigh. It was not a job any of us relished. It was bad enough informing someone of a loved one’s death, let alone having to ask for their organs, but Stephen was the most scrupulous registrar I’d ever worked with so far as organ transplant was concerned. He was also a dish: an athletic six feet with russet hair and blue eyes in a strongly sculpted, somehow very English face.

Many
doctors found excuses for not asking for the organs, but not Stephen. As he would say himself, it can sometimes be a comfort to relatives, knowing that another life can be saved. But not always …

*

At exactly twelve o’clock, I walked into the anteroom of Miss Whittington’s office. Her secretary said, ‘She’s expecting you, Sister, go straight in.’

I
tapped on the door though, before pushing it open. ‘Ah, Sister Farewell. Please have a seat.’

Her
desk was positioned so that her back was to the window — a psychological trick many people in positions of authority like to adopt.

‘
Now, I believe you said there was something you wanted to speak to me about?’ she said.

‘
Yes, but it’s a rather … delicate matter. Perhaps after you’ve … ?’

‘
Very well, although what I have to say concerns a matter of some delicacy as well. However …’ Her pale grey eyes met mine …

Pale
grey seemed to be her colour — her hair was pale grey, although in crisp, permed curls. Sometimes, she even wore pale grey. She was tall, slim, ageless; her unmade-up face was unlined, not unattractive, and yet somehow sexless. She was unemotional, firm, curiously formal.

‘
I have become concerned recently about a certain … lack of gravitas that has become apparent in ITU,’ she said in her clear, incisive voice.

‘
I’m sorry you should think that,’ I said slowly, then decided to call her bluff. ‘I’m not exactly sure I understand, Miss Whittington …’

‘
I think you do,’ she said. ‘It is not you who are giving me cause for concern, but your new deputy — Mary Tamworth.’ So that was it. I took a breath.

‘
I know Mary Tamworth can be high spirited sometimes, but she’s an excellent nurse and —’

‘
I’m sure she is, but on a ward like ITU, certain types of humour are unacceptable. I have had a number of complaints about her from the medical staff, which my own observations have confirmed. Yesterday, for instance, I heard her — in the presence of a student nurse — refer to the mortuary technician as the
bone
collector
: a clear and offensive allusion to this hospital’s transplant policy.’

I
remembered it myself. I’d noticed that she’d come in and was behind Mary when she’d said it, and hoped she hadn’t heard. The point Mary was making was that by the time all the useful organs had been taken from the body, there wasn’t much left but bones. A gross exaggeration, obviously, but …

‘
I’m very sorry this has happened, Miss Whittington, although I’m surprised that any of the medical staff should have complained, since she always seems to get on very well with them …’ I paused, hoping for some names, but when none were forthcoming, I continued, ‘However, I do take your point, and I’ll speak to her about it.’

‘
Good. I must add though, that I’d have hoped a nurse with your experience would have grasped this particular nettle a little sooner.’

That
irritated me.

‘
I think it’s only fair to say that Sister Tamworth has had overall a good effect on ITU since she’s been there. Her high spirits and her humour cheer up patients who have a lot to be worried about.’

Miss
Whittington’s lips tightened, although her voice remained light.

‘
Perhaps that is so, Sister, but you should know as well as anyone that a hospital depends on hierarchical respect for its efficiency: respect that is lacking in Sister Tamworth.’

So
the crack about the bone collector wasn’t all she’d heard.

‘
As I said, Miss Whittington, I do take your point and I will speak to her about it.’

‘
Good,’ she repeated. ‘That’s an end to the matter.’ She leaned back. ‘Now, what was it you wanted to speak to me about?’

I
hesitated, wondering whether to leave it after this worst of possible starts … No, it had to be done now …

‘
A delicate matter, you said,’ she prompted.

‘
Yes.’ I took a breath. ‘Mr Peters, the MI who came in on Monday, died this morning. Cardiac arrest. He was due to transfer to Coronary Care tomorrow and we’d taken him off the monitors.’

‘
You’re saying that you don’t know exactly when the fatal attack occurred?’

‘
Yes, but that’s not —’

‘
Potentially embarrassing, but it does happen. Write me a full report as soon as you can, please, Sister.’

‘
Of course, but that’s only part of the problem. He
shouldn’t
have died, Miss Whittington.’

‘
No, but patients sometimes do. I don’t think any blame will attach to you.’