The Patient Killer (A DCI Morton Crime Novel Book 4) (30 page)

‘You don’t think it’s bad luck now?’

‘I can’t say. I found some consistencies between Yacobi’s death and that of Niall Stapleton that made me reconsider, but the Yacobi case was a long time ago. I’d forgotten all about it until recently.’

‘Tell me about Primrose Kennard,’ Kieran said.

‘She was the first of the recent victims. She was drugged with sodium thiopental. We found a needle tip embedded in her collarbone and a small puncture to the skin above.’

‘What is sodium thiopental?’

‘It’s an anaesthetic. It would have knocked her out cold about thirty seconds after being injected.’

‘Would she have been awake for those thirty seconds?’

‘She would have been conscious,’ Chiswick said. ‘To an outsider she’d have appeared drunk and disoriented.’

‘And what happened to her after she was knocked out?’

‘The killer cut out her lung. The one he’ – Chiswick gestured at the defendant – ‘donated to her.’

‘And that killed her?’

‘Yes. She never regained consciousness.’

‘Who was the next victim?’ Kieran asked.

‘Mr Niall Stapleton. He too had his throat slit.’

‘Like Mr Yacobi, the earliest victim?’

‘Exactly like him,’ Chiswick said. ‘The throat was slit with something exceptionally sharp.’

‘Such as?’

‘Such as a scalpel.’

‘And did Mr Stapleton have a medical link to the other victims?’

‘I understand that he had a blood transfusion which came from Mr Carruthers, just like Mr Yacobi.’

‘So, all three of them were recipients of Mr Carruthers’ donations?’

‘Yes.’

‘What about the fourth victim?’

‘I can’t tell you.’

‘Why not?’

‘Because she received a bone marrow transplant, and the killer removed her bones. But I’m told the defendant admitted giving her an illegal bone marrow transplant.’

‘Objection!’ Carruthers roared.

‘Sustained. Watch yourself, Doctor Chiswick,’ Quinn said. ‘You know the rules.’

‘Nothing further.’ Kieran sat down. The jury had been nodding along with everything the coroner had to say. They were angry and righteously so. They now knew that Carruthers had given life, and Carruthers had taken it away.

Out of the corner of his eye, Kieran saw Carruthers stand up. Kieran hadn’t expected Carruthers to try to cross-examine the coroner. It was a risky move.

‘Doctor Chiswick, can you conclusively link Amoy Yacobi and Niall Stapleton?’

‘They are consistent. Both were cut. Both were hung upside down after death.’

‘But that’s not a unique method of killing someone, surely?’ Carruthers said.

‘No, I cannot conclusively link them.’

‘So, Amoy Yacobi could have nothing to do with Niall Stapleton?’

‘It’s possible.’

‘Doctor, how many times a year can one donate blood?’

‘The minimum interval permitted is twelve weeks.’

‘Four times a year. How many units do you collect each time?’ Carruthers asked.

‘I don’t personally collect any.’

‘How many units can an adult male donate each time?’

‘Four.’

‘So, sixteen units a year. I donated for the better part of a decade. How many units would that be?’

‘Over a hundred.’

‘So, it’s possible that it could be a coincidence,’ Carruthers said.

‘I suppose so.’

‘Tell me about these cuts. Were they left to right or right to left?’

‘They were cut left to right.’

‘What does that tell you?’ Carruthers asked.

‘It would indicate the killer is right-handed,’ Chiswick said with a twinge of reluctance.

‘Nothing further.’ Carruthers waved to the jury with his left hand.

W
ednesday July 15th 11:00

The next day at trial, Carruthers pulled a rabbit out of his hat. Like Kieran, he must have noticed that the mood of the jury was against him.

‘My Lord,’ he began. ‘Before I begin my defence, I’d like to introduce medical evidence that I am not fit for trial.’

Kieran thumped his fist down on his desk. ‘My Lord, we’ve been over this. Mr Carruthers has attended every day so far without issue. He wants to delay the verdict. Justice delayed is justice denied.’

‘With respect to Mr O’Connor,’ Carruthers said, ‘this is a new issue. As the police detective pointed out, I have an exceptionally poor memory. I had the opportunity to seek a medical opinion while I was on bail, and it would appear that I’m suffering from dementia.’

‘Bullshit!’ Kieran cried. ‘My apologies, my Lord.’

‘I am sorry I couldn’t bring it up sooner. I only received the diagnosis yesterday. I have a report here stating as such.’ Carruthers motioned once more for the bailiff, and copies soon landed in front of the prosecutor and the judge.

‘This doesn’t say he’s unfit for trial, My Lord,’ Kieran said after skimming it for a moment. ‘It says he has grey spots on his brain.’ He saw the jurors looking confused by the sudden interruption to the proceedings, and added, ‘My Lord, perhaps we could we excuse the jury while we discuss the matter?’

‘Very well. Bailiff!’

The bailiff dutifully opened the door to the jury box and waited while the jurors decamped to the jury room before parking himself by the door to guard it.

‘Approach, gentlemen.’

Kieran and Carruthers moved around their tables and proceeded up to the bench. Kieran had to crane his neck to see the judge towering way up above him.

‘Mr Carruthers,’ Mr Justice Quinn began, ‘I am going to give you the benefit of the doubt here. You cannot raise the issue of fitness to plead in the middle of a trial. Do I understand you when I say you wish to change your plea to that of not guilty by reason of mental disease or defect?’

‘I do, My Lord,’ Carruthers said.

‘Then I must warn you that short periods of absent-mindedness and forgetfulness fall far short of the required standard to establish a defect of reason. If you will forgive my informality, you seem sharp from where I am sitting.’

‘My Lord, I suffer from sundowning. I am more lucid earlier in the day. The prosecution allege that Primrose Kennard and Olivia Hogge were murdered late at night. I have no recollection pertaining to those nights.’

‘There are two further criteria you must pass. Firstly, it must be medically induced–’

‘It is. I’d know. I am a doctor.’

‘And it must render you unfit to know what you were doing.’

‘I cannot possibly say whether I knew what I was doing if I cannot remember doing it,’ Carruthers said.

‘My Lord,’ Kieran said, ‘this is yet another desperate tactic from a defendant who has consistently shown his ability to reason. He is no more insane than you or I. The presumption of sanity must win the day.’

‘Enough. Mr Carruthers has raised a prima facie case. Call your expert witnesses. Let the jury decide.’

***

T
he case was delayed while the prosecution rushed to find an expert witness who was available to examine Carruthers. Kieran was back in court after a long weekend adjournment, ready to deal with whichever quack Carruthers put on the stand to say he was crazy.

‘The defence calls Doctor Marco Naruda.’

Naruda was a Hispanic-looking man with a bald head, a double chin and thick, fluffy eyebrows which made him look much too serious. He placed an enlarged MRI scan printout on an easel by the witness box before being sworn in.

‘What are we looking at, here?’ Carruthers asked.

‘This is an MRI scan of your brain. It shows that you have a number of grey spots visible on your frontotemporal cortex. This is because of a build-up of proteins on your brain. It is an indicator of dementia, specifically Pick’s Disease.’

‘And what does Pick’s Disease do?’

‘It causes the sufferer to lose empathy. They become disinhibited and may be prone to wandering.’

‘What about memory?’

‘It can cause memory loss, including sundowning; that is to say that lucidity earlier in the day gives way to confusion and loss of sense of self in the evening. Pick’s Disease sufferers can appear almost normal in everyday life. They’re high-functioning in the early years.’

‘And what impact does that have on a sufferer’s propensity to commit crimes?’ Carruthers asked.

‘They’re much more likely to commit a crime. They’re disinhibited and don’t have the required empathy to understand that what they’re doing is wrong.’

‘Thank you, Doctor Naruda. Nothing further.’

Carruthers sat down.

Kieran shot to his feet. ‘What you’re saying is that those grey spots can be an indicator of Pick’s Disease?’

‘Yes.’

‘Does everyone who has grey spots suffer from Pick’s Disease?’

‘No.’

‘And does everyone who has Pick’s Disease commit murder?’ Kieran asked.

‘Not to my knowledge.’

Kieran sat back down. His other questions could wait for the afternoon session, when his own witness would show just how convenient it was that Carruthers claimed to be suffering from Pick’s Disease.

***

T
he witness for the prosecution was Doctor Marcus Jensen, a forensic psychiatrist with a long history of testifying both for and against defendants. He was scrupulously honest and thoroughly unimpeachable as a witness. Kieran had chosen him because Carruthers would have a hard time damaging his reputation on cross-examination.

‘Tell me, Doctor Jensen, how is Pick’s Disease diagnosed?’

‘There are five markers which are used to diagnose Pick’s. Tick three boxes, and you’re eligible for a diagnosis.’

‘What are the markers?’ Kieran asked.

Jensen began to tick them off on his hand. ‘One, it happens before age 65. Two, the sufferer undergoes a personality change. Three, they lose control. Four, they lack inhibition. Five, they exhibit roaming behaviour and may wander off.’

‘That sounds vague. Which of these did Doctor Carruthers exhibit?’

‘It’s hard to say. He is under sixty-five. He claims to have lost control, though no one was there to witness it. Likewise, he claims to feel disinhibited, though in the short session during which I examined him he was perfectly lucid and in control. He has not exhibited any roaming behaviour. At most Doctor Carruthers meets three of the five criteria.’

‘Do you agree that such a diagnosis is consistent with an increased predisposition to criminality?’ Kieran asked.

‘It would if it were accurate. I found no signs of sundowning in Mr Carruthers. In examining his work history, I found numerous occasions on which he worked at late hours as an anaesthetist without issue.’

‘What’s your overall assessment?’

‘The diagnosis is convenient. As a doctor, Carruthers would know how to select a condition which would explain his actions and be consistent with the perceived symptoms on display.’

‘So, he could be faking it?’

‘It’s possible.’

‘Thank you, Doctor Jensen.’

Kieran sat back down. Carruthers declined to cross-examine the prosecution expert. In Kieran’s opinion, he was wise to be wary of going toe-to-toe with a real expert. It was now down to the jury to decide, on the balance of probabilities, whether they thought Carruthers insane. From their expressions during the expert testimony, it could go either way.

T
hursday July 16th 10:00

‘The defence calls
me
to the stand.’ Carruthers stood and beckoned for the bailiff to escort him to the witness box.

It was a ballsy move. Kieran had to hand it to Carruthers: the doctor was willing to take a gamble. By testifying, he opened himself up to cross-examination, and Kieran fully intended to make him pay for that recklessness.

‘Doctor Carruthers,’ Carruthers said to himself in a strange, hoarse tone. ‘Why did you do it?’

‘I didn’t intend to kill any of those people. I wanted to take back my gifts.’

Kieran felt his jaw drop. The doctor was doing his own examination-in-chief in two alternating voices. The jury looked just as bewildered.

‘What do you mean, “take back your gifts”?’

‘I gave them life. I saved them, and they squandered it. They didn’t deserve to live.’

‘How did you determine that?’ Carruthers said in the deep voice.

‘I followed them. I gave them time,’ he replied in his normal tone. ‘I weighed up their actions and rendered my decision. Those who deserved to live, lived. Those who didn’t, didn’t.’

‘So, you killed them?’

‘Natural causes killed them. ,’ Carruthers said in his normal voice. ‘I just put them back where they were before I saved their miserable souls.’

Kieran couldn’t believe his ears. The doctor was not only admitting to having killed them all... but he was bragging about it! Kieran glanced up at the judge, who gave the slightest shake of his head but remained remarkably stoic. The jury seemed much more alarmed. They were looking at each other as if to ask:
did he just say that?

‘Nothing further for this witness,’ Carruthers said, tendering himself for cross-examination.

Kieran took his time getting to his feet. His preparation for the trial had included some time spent thinking about how he might cross-examine Carruthers, though not as much time as he would like to have spent in retrospect. He had not countenanced the possibility that the doctor might try to cross-examine himself in two voices. The insanity defence was on solid footing after that performance.

Kieran rounded on Carruthers. ‘Did they all receive body parts from you personally?’

‘They did. I took
me
back. They didn’t deserve me. The others...’

‘What others?’ Kieran asked, straining to keep his voice as level as he could.

‘The ones that lived because of bribes and cajoling. I didn’t touch them.’

‘Why not?’ Carruthers asked himself in a hoarse whisper.

‘They were not my gifts to take back.’

‘I thought you’d forgotten everything that happened,’ Kieran said. ‘Are you saying you remember it all now?’

‘No. I remember what they tell me.’ Carruthers pointed towards Kieran. ‘I simply wish to explain why I would have done what they say I did.’

Bloody hell. He was changing his tune faster than a DJ at a dodgy nightclub. First he had been proud, and now it was, once more, a hypothetical admission. Worse yet, the jury seemed to be nodding along with him as if he was making sense.