Donor sd-1

by Ken McClure

  ‘Sounds awful.’

  ‘I’ve known better times,’ said Lisa.

  She said it matter-of-factly rather than with self-pity. She struck Dunbar as capable woman who was up against it but coping well.

  ‘Tell me about Amy Teasdale.’

  Lisa’s face relaxed into an extremely attractive, albeit distant, smile. Her eyes said that she was grateful for Dunbar glossing over what had happened. ‘Ah yes, Amy,’ she said, before pausing for a moment to compose her thoughts.

  ‘Amy was a perfectly ordinary little girl apart from the fact that her kidneys weren’t properly functional. Practically from the time she was born she’d been in and out of one hospital after another, so she was well used to them. Because of that she wasn’t the uncomplaining little heroine the press likes kids like her to be. In fact, she could be a right little madam at times, if things weren’t to her liking. I suppose that was because she’d been spoilt by parents and relatives because of her condition, but in spite of it we all liked her. She was one of ours, and we were delighted when word came through that a suitable kidney’d been found. She’d been waiting for years and within weeks of coming to us a kidney had been located and the word was that the match was good, something around eighty per cent compatible, if I remember rightly. It seemed like a dream come true.’

  ‘So you expected a good result?’

  ‘Of course. It was an excellent match and kidney-transplanting has become practically routine these days. There was no reason to expect anything else. We were looking forward to seeing Amy skipping down the ward and saying good-bye. She could look forward to a normal life.’

  ‘But that didn’t happen.’

  ‘No. She rejected the kidney and died soon after the operation.’

  ‘Who carried out the operation?’

  ‘Dr Hatfull, one of Dr Ross’s surgical team.’

  ‘What did you think of him?’

  Lisa looked shocked at the question. She said, ‘It’s hardly my place to pass comment on the medical staff.’

  ‘I’d still like to know what you thought of him. This is all confidential, remember. Nothing you say will be repeated outside this room.’

  ‘I thought Dr Hatfull was an excellent surgeon. In that unit they all were. It’s a very prestigious place to work, a good career move, as they say. There was always a waiting list for surgical and nursing appointments.’

  ‘But you still think something went wrong?’

  ‘I am convinced Amy was given the wrong kidney. Her reaction was so strong that it must have been due to the presence of radically foreign tissue inside her. The immunosuppressants she was given just couldn’t cope. She died in agony, poor mite.’

  ‘Have you any idea how she could possibly have been given the wrong kidney?’

  She shook her head. ‘I’ve been thinking about that ever since it happened and I know all the arguments against it. There was only one organ sent from the donor hospital, so how could there be a mix-up? The tissue type was tested both at the donor hospital and at Medic Ecosse and found to check out, but I know what I saw. I’ve seen rejection problems before and Amy was a classic case of a patient being given incompatible tissue. Nothing will convince me otherwise.’

  Dunbar found himself impressed by Lisa Fairfax. She wasn’t over-emotional or hysterical. She was a sensible, straightforward, down-to-earth woman with a lot of common sense.

  ‘What did you do about it at the time?’

  ‘I went to the director of nursing staff and told her what I felt. It went down like a cotton-wool sandwich. I was told to pull myself together, that I was emotionally overwrought and that I should think about the damage I could do to the hospital with such “wild allegations”.’

  ‘But you weren’t put off?’

  ‘No, although in my present circumstances I sometimes wonder if I should have kept my mouth shut,’ said Lisa with a strained attempt at a smile. ‘But no, I went to Dr Kinscherf and Mr Giordano and asked them to investigate the possibility that Amy had been given the wrong kidney.’

  ‘And got the same reaction?’

  ‘More or less. They said my concern for my patients did me credit but becoming emotionally involved with them could distort my judgement. Amy’s rejection of the donor kidney had been just one of those things, an unfortunate roll of the dice. There are still lots of immune responses that the medical profession doesn’t fully understand. They suggested I take some time off — in practice they suspended me from duty. They kept paying me but it was conditional on my seeing my GP and some old trout with a frontal lobotomy they called a counsellor. She was supposed to “help me through my trauma” i.e., make me see sense and keep my mouth shut. When I failed to play ball with the trout or take the GP’s Prozac highway to inner peace and contentment, they sacked me. Now here I am with no job, locked up twenty-four hours of the day with a doolally old person who used to be my mother, secure in the knowledge that things can only get worse.’ She threw the remains of her drink down her throat.

  Dunbar felt uncomfortable. Saying he was sorry seemed in adequate, so he just nodded.

  ‘I’m sorry,’ said Lisa. ‘I shouldn’t be saying these things to a total stranger.’

  ‘Total strangers are often the best people to say these sort of things to,’ he replied.

  She smiled slightly, as if happy at finding someone else who knew that.

  ‘You’ve given me a problem,’ said Dunbar.

  ‘How so?’

  ‘I came here expecting to find a nurse who had got too involved with her patient and who had made a hysterical allegation born of grief. You’re not the type. I find myself believing you, but perhaps you can see my difficulty?’

  ‘I know what I saw.’

  Dunbar’s look suggested to Lisa that her reply was inadequate. She said, ‘Oh, I accept that the right organ was sent and that it arrived safely and checked out, but nothing will convince me that it was transplanted into Amy.’

  ‘Does the name Sheila Barnes mean anything to you?’

  Lisa looked blank. ‘I don’t think so,’ she said.

  ‘Sister Sheila Barnes?’

  ‘A nurse? At Medic Ecosse?’

  ‘Yes.’

  ‘Doesn’t ring a bell. Should I know her?’

  ‘Not really,’ replied Dunbar, getting up out of his chair. ‘I just wondered. Thanks for seeing me. It’s been a big help. I really hope things get better for you.’

  ‘What’s coming for me won’t go past me,’ said Lisa.

  ‘Pardon?’

  ‘It’s a Scottish expression,’ said Lisa. ‘The equivalent of que sera sera.’

  Dunbar pulled up his collar and looked up at the stars as he stepped out into the street. It was nice to see a clear sky but the price for it was a temperature now dropping below zero. He was unsettled. Lisa Fairfax was absolutely sure that Amy Teasdale had been given the wrong organ at her transplant operation. From what he’d seen and heard of Lisa, he could not dismiss her as neurotic, nor as someone who had been too involved with her patient. But how could she be right? Where could this ‘wrong organ’ have come from? You didn’t find drawers marked DONOR ORGANS in hospitals. If the correct organ had been sent and received, surely that was the end of it. The rejection response must have been just one of those inexplicable things that sometimes happened. Fine, but in the case of Medic Ecosse it had been two of those things.

  The only thing he was sure of as he pulled out into the traffic on Dumbarton Road was that he was going to see Sheila Barnes at the hospice in Helensburgh. He was beginning to feel more than a little uneasy about the whole business.

  Dunbar spent the following morning at his desk in the hospital making notes from the figures on the computer disks and asking Ingrid to provide some more information about certain topics. He had identified a lack of information about catering costs at Medic Ecosse and thought that asking her to prepare a breakdown of meal costs over the past eighteen months should keep her busy while he concentrated on other th
ings. He was relieved not to have stumbled on anything that had been missed from the disks supplied by Giordano’s office. The information given to him was on the whole pretty comprehensive.

  Halfway through the morning he noticed something else. The patient records had at first seemed satisfactory in terms of listing treatment given and correlating this with itemized costing, enabling him to check billed sums against monies received but, in treating this as an academic exercise to fill in the time, he noticed an anomaly. The records of Omega patients’ bills were not itemized. There was no way of checking on their treatment.

  He could see why Giordano’s office had thought he might well be satisfied with only the final sum — it was many thousands of pounds in all cases — but it was something he could ask Ingrid about. In the meantime, he rang The Beeches Hospice on his mobile phone and asked if he might visit Sheila Barnes that afternoon.

  ‘Are you a relative?’ asked the female voice.

  Dunbar paused momentarily to reflect on how often that question was asked every day. ‘No, just an old friend,’ he lied.

  ‘I see. Well, I don’t see any problem there. We encourage our patients to live as normal a life as possible up to the very end. Shall we say three o’clock? I have to suggest a time so that we can adjust Mrs Barnes’s medication accordingly. It would be a wasted journey if she was asleep when you arrived. On the other hand, we have to keep her as comfortable as possible. It’s sometimes a fine line.’

  ‘I understand,’ said Dunbar, starting to feel guilty about what he was doing, though not guilty enough to call the whole thing off. ‘I’ll be there at three.’

  Ingrid returned shortly before lunch-time with facts and figures about how much patient meals cost to prepare, what the clients were charged and what the profit margins were. ‘I’m sure you’ll find we haven’t been undercharging.’ She spoke pleasantly but managed to convey that she thought she’d been sent on a fool’s errand.

  ‘It’s as well to have all the figures to hand,’ said Dunbar, hoping he sounded like an accountant.

  ‘Is there anything else you’d like me to do?’ asked Ingrid.

  ‘As a matter of fact there is. I’m a bit puzzled about the information given to me on the Omega patients.’

  Ingrid’s expression became serious. ‘Really? Why?’ she asked.

  ‘Well, basically there isn’t any.’

  Ingrid looked puzzled. She came over to stand behind Dunbar and peered down at the screen. ‘I was sure I saw figures for them when I copied the disk for you.’ She leaned over and tapped computer keys until patients’ records came up, then kept one elegant finger on the down-key to scroll through them.

  ‘There,’ she announced, removing her finger and pointing at the screen. ‘There’s one. A ten-day stay, netting seventeen thousand pounds. Not bad, eh?’

  ‘But for what?’ asked Dunbar.

  Ingrid looked at Dunbar in a way he found hard to interpret. She was either puzzled or seeing him as some kind of mental defective. ‘Forgive me, Doctor,’ she said. ‘I thought your interest lay in establishing that we were maximizing our income from clients and getting the best possible return for the investment of taxpayers’ money?’

  ‘That’s broadly true,’ agreed Dunbar.

  Ingrid appeared to have difficulty in controlling her impulses which Dunbar, reading her body language, guessed were to throw her hands in the air, shake her head and shout, ‘Then why in God’s name do you want to know anything as irrelevant as that?’ Instead she said, ‘I suppose we thought that a profit of seventeen thousand pounds for a ten-day stay would be enough to satisfy you without itemizing the patient’s treatment.’

  Dunbar mutely agreed that this was the case. He wondered for a moment just how far he should press this point. On the one hand, he wanted to establish that he had the right to ask for any information he wanted. On the other, he didn’t want to push his credentials as the village idiot when all he was doing was thinking up things to keep Ingrid busy. ‘It doesn’t even say what the patient was in here for,’ he said.

  ‘I’m sorry,’ said Ingrid. ‘It’s this confidentiality thing we have. I suppose we thought you’d be happy with the final income figures. If it’s any help, I can tell you that this particular Omega patient had a baby here. It was feared that there might be complications but in the end everything was fine. In fact, if I remember rightly, all three Omega patients we’ve had were in for obstetrics care. Very rich men are always anxious that their wives have the best of care during pregnancy when problems are thought possible. Would you still like me to organize an itemized costing of their stay?’

  Dunbar shook his head. ‘No, I don’t think that’ll be necessary.’

  ‘Is there anything else I can help with?’

  ‘Not for the moment,’ smiled Dunbar. ‘I’m going to take the afternoon off, see the delights of Glasgow.’

  ‘Don’t hold your breath,’ said Ingrid.

  Why was a sneer considered by so many to be the basis of sophistication? he wondered idly as he watched the door close.

  He set off for Helensburgh just after one o’clock after checking the route in the AA road maps thoughtfully provided with the car. It seemed straightforward enough, just a matter of following the northern shore of the Clyde down to where Helensburgh sat at the foot of the Gare Loch. As he drove along the Clydebank expressway and out along the Dumbarton Road he passed the turn-off to Lisa Fairfax’s place. He couldn’t help but think of her sitting there in the flat with her demented mother. It made him reflect on how people’s lives could be ruined by notions of filial duty.

  The sun was shining when he drove into Helensburgh and parked down by the sea front. The matron of The Beeches had told him to follow the signs directing tourists to Charles Rennie Mackintosh’s famous Hill House; the hospice was located in Harlaw Road, the street running parallel to and a little behind Hill House, but he had time in hand so he decided to stretch his legs first and also find something to eat. He had given lunch a miss in Glasgow because he hadn’t been sure how long the journey down would take him. In the event it had taken under an hour. He watched the waves for a bit until the wind chilled him, then he went in search of a bar or cafe. He found an outlet of the Pierre Victoire chain, where he had a mushroom omelette and a glass of wine. He followed this with two cups of good coffee and a consideration of what he was going to ask Sheila Barnes — if, indeed, she was in any position to answer.

  The Beeches was a large, stone-built Victorian villa with ivy clinging to its walls on the two sides Dunbar could see as he approached. In another setting it might have been forbidding but here, above the town and with views over the water, it seemed pleasantly neutral in the pale yellow, wintery afternoon sunshine. Dunbar rang the bell, and was led along to the matron’s office by a woman orderly dressed in a pink uniform and thick brown stockings. Her shoulders sloped dramatically from left to right. As he followed her he had to fight a conscious urge to emulate her posture. He was very aware of the warmth of the building and suspected that they must keep the heating full on.

  ‘Dr Dunbar, please come in,’ said a pleasant woman in her late forties in response to the orderly’s announcement of his arrival. She had prematurely white hair, suggesting that she had been blonde in her youth, and wore the kind of professional half-smile affected by senior nursing staff to put strangers at their ease.

  ‘Mrs Barnes is awake, although I have to say that she couldn’t recall you when I told her you were coming.’ The smile didn’t waver but her eyes asked the question.

  Dunbar felt a pang of guilt. ‘It’s been a very long time, Matron. Many years.’

  ‘Well, I’m sure it’ll all come back to her when she sees you, and you can have a nice chat. We like old friends to call, and Sheila doesn’t have much longer to go, I’m afraid.’

  ‘Is she comfortable?’ asked Dunbar.

  ‘She has her moments of discomfort, but on the whole we’ve got her pain under control. You may find her a little sleepy.
She’s on morphine.’

  ‘Someone told me her husband has cancer too,’ said Dunbar.

  ‘It’s true, I’m afraid. They both contracted it at almost exactly the same time. Very strange. I can’t ever recall that happening before. Cyril has the room next door to Sheila. Would you like to see him too?’

  Dunbar shook his head and said, ‘I never knew Cyril.’

  ‘I’ll have Morag take you up now.’

  The orderly was summoned back and she led Dunbar along the carpeted corridor and up the stairs to a pleasant bay-windowed room on the first floor.

  ‘Mrs Barnes, your visitor is here,’ said the orderly as she entered. Dunbar entered and the orderly backed out and closed the door. He approached the bed, where a painfully thin woman lay. Dunbar knew her to be forty-seven, but she looked twenty years older. Her face was etched with pain lines and her eyes seemed unnaturally large because of the hollowing of her cheeks.

  ‘Mrs Barnes, I’m Steven Dunbar.’

  ‘I don’t know you,’ said Sheila Barnes in a voice that didn’t rise above a whisper.

  ‘No, I’m afraid you don’t,’ he agreed, ‘but I had to ask you about an allegation you made while you were a nursing sister at the Medic Ecosse Hospital.’

  Sheila Barnes gave the tiniest snort of derision. ‘After all this time?’

  ‘Yes. I’m sorry, but something happened recently that makes these questions necessary. You maintained that a patient had been given the wrong organ in a transplant operation. Is that right?’

  ‘There was no other explanation.’

  ‘Was it a patient you were particularly fond of?’ asked Dunbar.

  Sheila Barnes shook her head slowly. ‘No,’ she said. ‘He was a little shit, as I remember. Why are you asking me this now?’

  Dunbar saw no point in telling her anything but the truth. He said, ‘Because another nurse working there has made exactly the same allegation.’

  Dunbar imagined he saw a sharpness appear in the big eyes. ‘Has she now?’ she said thoughtfully.