Trauma (16 page)

'I just hope for your sake that he included three thirty in the morning!' said the nurse.

The nurse had planted the seeds of doubt in Sarah's mind. Tyndall had meant, as soon as McKirrop came round, hadn't he? He hadn't meant, first thing in the morning . . . had he? She tapped her fingers on the phone while she considered whether or not she should make the call. 'Oh to hell with it,' she concluded and made it.

'Tyndall,' said the voice at the other end. He had a frog in his throat. Sarah knew that he had been asleep.

'Professor? It's Sarah Lasseter here at HTU. John McKirrop recovered consciousness ten minutes ago.'

'Did he indeed?' replied Tyndall, clearing his throat. 'Is he lucid?'

Sarah gave a silent prayer of thanks that Tyndall didn’t seem to think the call unnecessary. 'Yes sir. A bit groggy but I don't think there's any serious damage.’

'Does he remember anything about how he got his injuries?'

'No, but he remembers the incident in the cemetery a couple of weeks ago so there's no impairment to long term memory.'

'Really? What's he been saying about that?'

'He remembers being beaten up and the boy's coffin being empty.'

'What else?' asked Tyndall after a short pause.

'That's about it sir. He's very tired and I didn't want to press him. He's sleeping at the moment.'

'Good,' said Tyndall. 'Let him rest. You are to be congratulated Doctor.'

'Thank you sir. What should I do about the police and Father Lafferty?'

'What about them?'

'They wanted to speak to Mr McKirrop as soon as he came round.'

'I think we can leave calling them till the morning. It's not as if Mr McKirrop is going anywhere is he?'

'No sir.'

'Good night Doctor. Thank you for letting me know.'

Sarah replaced the receiver and felt well pleased. She did a quick check of the patients and told the night staff nurse she was going back to the residency. She left with a smile on her face ... and fifty pence in her pocket. When she got to her room she was torn between making herself some coffee and getting directly into bed, knowing that she would only have about three hours sleep at most. She opted for bed.

Sarah could feel the adrenaline surge of the last hour or so clearing from her veins and allowing tiredness to replace it. By the time she had laid out her clothes in order - just in case, she could feel her eyelids coming together. Her arm felt heavy as she reached out to turn off the bedside light. Within seconds she was asleep.

Sarah had an undisturbed three hours sleep before her alarm woke her and she complained out loud as she always did. She reached out and made several attempts to connect with the 'off' button before the room was restored to silence again. 'Not already,' she grumbled. 'It can't possibly be . . .' But it was, and she was up and getting washed after a few more minutes. She was pleased to find Paddy Duncan at breakfast in the dining room; she hadn't seen him since the Chinese meal.

'Rough night?' Paddy asked.

'Not really,' replied Sarah. 'Well, yes and no,' she added after reconsidering.

'What does that mean?' asked Paddy.

Sarah told him about the McKirrop case.

'Well done,' said Paddy enthusiastically. 'And you say Logan gave him up for lost?'

Sarah nodded and said, 'He saw him as a sort of organ supermarket.'

'That's a particular hobby horse of his,' said Paddy. 'He reckons that people should have to opt out rather than in when it comes to transplant permission. It's a view that's gaining popularity.'

'It's something I've not really considered,' said Sarah.

'Maybe you should,' said Paddy.

'Why?'

'If you're working in a place like HTU, it's a problem that's going to come up quite a lot.'

'Good point,' agreed Sarah.

'How are you getting on with dear Dr Logan anyway?' asked Paddy. Any better?'

'I don't think I could go that far,' replied Sarah. 'But I did let him know that I'm not his door mat and it seems to have improved matters.'

'Good for you,' said Paddy.

'How about you? Were you called out last night?'

'Twice,' replied Paddy. 'A patient we carried out a routine hernia operation on last Monday. He's developed a wound infection and it's been a bit slow to respond to treatment. I think it might be Pseudomonas so I changed him to PYOPEN last night when his temperature was pushing 103. We should get the result of the lab test some time this morning. They were going to do a direct oxidase test on the wound exudate. I just hope to God I was right.'

'I'll keep my fingers crossed,' said Sarah. She looked at her watch and wiped her mouth with her napkin before saying, 'Another day of work and play beckons. See you.'

'See you Sarah.'

Despite not having had much sleep, Sarah had a spring in her step as she climbed the stairs to HTU and walked in through the swing doors. Yesterday had been a good day and she thought that the effects were going to last for some time. Her father had once said that about medicine. 'Every now and then,' he said. 'You get a day that makes all the rotten ones worth while. Once you've tasted success it's like a drug. You just go on wanting to have that feeling again. It's like being allowed to play God for a few hours.'

Almost at once she could sense that something was wrong. Sister Roche crossed her field of view but failed to acknowledge her. Another of the nurses smiled as she passed but didn't seem anxious to talk. Sarah went into the duty room but found it empty. She came out again and walked through to Alpha 4 to take a look at John McKirrop. His bed was empty. The linen had been removed and the hi-tec equipment on both sides of the bay lay dark and silent.

Sarah stood there bewildered, unable to come terms with the empty bed. Why on earth would anyone move him? She looked around and saw Sister Roche coming out of Beta suite. This time Roche acknowledged her and came over to join her.

'Where is Mr McKirrop, Sister?' Sarah asked, feeling embarrassed because the question sounded ridiculous. It showed on her face as vulnerability.

'Mr McKirrop died two hours ago,' replied Roche quietly.

'But that's impossible!' exclaimed Sarah. 'He came round at three thirty this morning. He was fine.'

'Dr Logan seemed to think that Mr McKirrop's death was not unexpected,' replied Roche.

'Dr Logan?' exclaimed Sarah.

'He was here when Mr McKirrop lost all brain function. He and Professor Tyndall agreed that there was no chance of recovery so the patient was allowed to pass away peacefully. That's why you weren't called out Doctor,' said Roche, anticipating Sarah's next question.

'Where does Dr Logan come into it?' asked Sarah, quite bemused by events.

'I understand Professor Tyndall called him in on the case,' replied Roche.

Sarah rubbed her forehead anxiously. 'Is Dr Logan here at the moment?' she asked.

'He's in the ivory tower,' replied Roche.

Sarah marched through to the doctors' room and entered without knocking. 'What the hell is going on?' she demanded. Her only concession to ethics was the fact that she kept her voice down when she said it. It came out as an angry whisper.

'I beg your pardon,' said Logan angrily.

'What's all this about McKirrop having no brain function? I was talking to him at three thirty this morning!'

'Calm down Doctor, calm down. You thought you were talking to him but it could only have been random disjointed function with the kind of damage that McKirrop had.'

'But he didn't have massive damage at all,' said Sarah.

'What are you saying?' demanded Logan. 'What did you think that was in the centre of his head? A birthmark?'

'I know it looked bad,' said Sarah. 'But McKirrop had an abnormal forehead. The unusual angle of his skull protected his frontal lobe which was recessed. It showed up on his X-rays.'

'I didn't see that,' said Logan.

'You didn't see the other X-rays. The X-ray department sent up two more films yesterday morning. You didn't bother to look at them.'

Logan paused for a moment to consider the implications of what Sarah had said. Deciding that he might be on shaky ground in an argument he ignored the implied criticism and said, 'All this is academic anyway. He had an EEG like the Utah salt flats.'

'Nonsense! His brain function tests were very encouraging yesterday.'

'If you saw that, you must have had the settings wrong on the monitors,' said Logan.

'How dare you!'

'I dare because I'm a senior registrar and you are a wet-behind-the-ears HO,' said Logan getting up angrily. 'You screwed up, Lasseter and if you're thinking about a second chance I suggest an immediate change in attitude!'

Sarah ran all the way back to the residency, not seeing the way clearly because of the tears that had welled up in her eyes. Not even she was sure whether they were born of anger or of self pity. 'I can't believe it,' she muttered as she sat on her bed. 'I do not believe it. McKirrop was going to be fine. He was going to pull through. I know it.' She had just blown her nose when her bleeper went off.

'Professor Tyndall would like to see you, Dr Lasseter,' said the nurse at the other end of the phone. 'Right now if you please.'

Sarah washed her face at the hand-basin in her room and held the towel to it for a good thirty seconds afterwards while she attempted to regain her composure. The last thing in the world she wanted to do was burst into tears in front of Tyndall. When she felt calmer, she took several deep breaths, dealt with some rogue strands of hair and set out for HTU. The spring in her step had gone. It had been replaced by lead.

'Dr Lasseter, do come in,' said Tyndall when Sarah knocked on the door and opened it slightly to look round. 'Please sit down.'

Sarah did as she was bid and smoothed her skirt. She had been unsure of what to expect in terms of Tyndall's mood. Even now, she was uncertain. Tyndall was urbane and smiling as usual but he didn't wear his heart on his sleeve as Logan did.

'Dr Logan tells me you were rather upset about Mr McKirrop? Perfectly understandable, I like my doctors to remember their patients are people first and patients second. Any death is always a matter of profound regret.'

'I just don't understand it!' said Sarah animatedly. 'I was so sure that he was going to be all right. His scans agreed and when he came round this morning ...'

'How often have you carried out full range of scans?' asked Tyndall. He was still smiling but Sarah knew that the first torpedo had been fired. 'On your own I mean,' he added. The torpedo was fully armed.

'Yesterday was the first time,' conceded Sarah. 'But I have seen a great many done and I feel sure there was no problem.'

'I understand Nurse Barnes assisted you?'

'Yes sir.'

'Sister Roche tells me that this was a first time for Nurse Barnes too.'

Sarah stayed silent. She hadn't known that.

'You didn't think to ask Dr Logan to check your findings?' asked Tyndall.

Sarah bit her lip. It went against the grain to drop even Logan in it. 'Dr Logan made me responsible for Mr McKirrop's tests sir and I felt happy with the way the scans went. There were no problems at any stage.'

'I see,' said Tyndall. 'You may of course, be right. It's possible that Mr McKirrop's brain was able, for a very short period of time, to give indications of activity but it's also possible that some kind of amplification error was made in the settings of the equipment.'

'I'm certain that they were all right,' said Sarah.

Tyndall shrugged his shoulders and said, 'Well, we can't turn back the clock Doctor but I must say that when I examined Mr McKirrop's head injury myself, I did feel that any restoration to normal activity would be extremely unlikely.'

'But the X-rays sir! The angle of Mr McKirrop's skull at the front afforded his brain a good deal of protection. I explained that on the phone to you.'

'Ah yes, the X-rays. Do you have them to hand?'

Sarah excused herself for a moment and went to fetch McKirrop's films. She didn't think the light box would be necessary to make her point. She held up the films, one by one, against the light coming in from the window until she found the one she wanted and then brought it back to the ivory tower for Tyndall to examine.

Tyndall held up the film in his left hand and traced the angle of the patient's skull with the pen he held in the other.

'The angle is quite unusual,' prompted Sarah.

'I see what you mean,' said Tyndall thoughtfully. 'But I suspect that the protection afforded was not enough. The PM will tell us for sure.'

'Yes sir,' said Sarah, feeling deflated at Tyndall's dismissive attitude. 'He did regain consciousness.' she said, surprising even herself at her unwillingness to concede an inch.