“Were those fatal?”
“Only in a single instance.”
A young physician sitting next to me stood and asked, “What of the nausea and vomiting that at times accompanies even the smallest doses of quinine?”
Marburg and Moran looked up at the questioner before Joanna could completely conceal herself behind me. Moran continued to stare at me and I am certain he recognized my face. But whether he spotted Joanna was not clear.
“Some nausea and vomiting occurred, but it was not severe and brief in nature,” Marburg replied.
“That is surprising since nausea is quite common at the lower doses.”
I had to resist the urge to jerk the young intern down by his coat sleeve, for he continued to direct Moran’s attention to our position. Joanna was slouched behind me, but could not go lower or she would have slipped off the bench and surely caused a stir. I could only hope that Moran had not noticed her. The last thing we needed was for Moran to be on even higher alert.
Marburg was skillfully explaining that the nausea that often accompanied quinine ingestion was in part due to gastric irritation, which was avoided when the drug was given by injection.
Another questioner farther down inquired about the actual dose to be used.
Joanna asked in a low whisper, “Do you believe Moran recognized me in my nurse’s garb?”
“I think not, but I cannot be sure.”
“It would be unfortunate if he did.”
“Let us hope that was not the case,” I said softly from the side of my mouth. Now the doctors were examining a lesion on Cardogan’s face. “This would be a good moment for you to depart unless there is a compelling reason for you to remain.”
“I have what I came for,” Joanna said, and quietly slipped away.
The conference lasted for another half hour, with most of the questions and comments on dosage and side effects of quinine. A heart specialist in the audience offered advice on cardiac monitoring during the procedure, while an ophthalmologist warned of possible adverse effects on vision from large doses of quinine. Finally, the grand rounds ended and a sullen Derek Cardogan was wheeled away. As the audience filed out, I walked down to the podium carrying a copy of Stephen Marburg’s latest monograph on malaria and its various presentations. Moran watched my every step and made no effort to conceal his interest.
I approached Stephen Marburg and congratulated him, “Very nicely done, Stephen.”
“Thank you, John,” he said, and extended his hand to shake mine. We sat together on several committees at St. Bartholomew’s and thus were familiar with each other. “I have not heard recently from your dear father. Does all go well with him?”
“For the most part. Of course he suffers from some of the infirmities that accompany the aging process.”
“There is no avoiding those.”
“True enough. But his mind remains sharp and he maintains a keen interest in malaria.”
“I recall our discussions and his vivid recollections of malaria during his Afghan days. I am delighted that he is keeping up on the subject.”
“Oh, it is more than simply keeping up. He reads every new advance and has an extensive file on malaria that he continually adds to. As a matter of fact, he has recently purchased your latest monograph on the subject and requests that you be so kind as to autograph it.”
“It would be my pleasure,” Marburg said. “And I shall insert a bit of a note as well.”
I handed him the monograph and turned to Christopher Moran. “I trust things have finally calmed down on Curzon Street.”
“They have, but of course there are people who continue to make needless inquiries,” Moran said blatantly.
“That will soon end,” I said. “For I have heard that Scotland Yard has officially closed the case of Charles Harrelston.”
“And well they should have. The poor Harrelston family has suffered enough.”
“I agree.”
“And some people are meddling in the accidental death of Benjamin Levy as well.”
“The newspapers say there are questions remaining that need to be answered.”
“The death was accidental and now that Levy is gone and buried, no one can dispute that.”
We exchanged knowing glances, both quite aware where each of us stood. He knew we were close on his trail, and I made no effort to hide it. As Joanna had predicted, Derek Cardogan would tell Moran every detail of our visit to his home yesterday. Joanna had also predicted that Moran’s arrogance would not allow him to shy away from the accusations leveled against him. He considered himself too clever to be caught. And Scotland Yard was stymied as usual, and too amateurish to be concerned about the crimes in front of their eyes. Thus, Moran would not alter his plan to kill Derek Cardogan.
“Here you are,” Marburg said, and handed the signed monograph back to me. “Please give your father my fondest regards.”
“I shall.”
As I climbed the steps I could feel Moran’s stare at my back. Had my back been more sensitive, I might have also felt the hatred that accompanied the stare. For a brief moment, I wondered if we had miscalculated the cunning of this very clever killer. He seemed so confident and so unconcerned about those who opposed him. Did he have some plan that we had not yet considered? Was he in fact playing us rather than we playing him? Shaking my head, I quickly dismissed these negative thoughts and hurried along to the departments of cardiology and dermatology. Those two specialties had no idea how important their roles would be in placing a noose around Moran’s neck.
21
The Players
Mrs. Helen Hughes was a short, stout, no-nonsense nurse who was in charge of the special care unit at St. Bartholomew’s Hospital. She and Joanna had been close colleagues at the hospital and had remained friends after Joanna’s departure from the nursing profession. We invited Mrs. Hughes to 221b Baker Street under the pretext that my father was chronicling yet another Sherlock Holmes adventure and needed her expertise to assure that all descriptions of St. Bartholomew’s were accurate. She was more than willing to assist, for she, like most Londoners, was an avid fan of Sherlock Holmes.
“But Dr. Watson,” she said to me while sipping from a glass of fine Madeira, “surely you and Joanna have the experience to supply the information your father requires.”
I had a rehearsed response ready. “But for the most part, I am locked away in the department of pathology and Joanna has been absent for several years, so we may not be up to date on any recent changes at St. Bart’s.”
After a moment’s hesitation, she said, “There have been some modifications to the special care unit.”
“Which is precisely where Sherlock Holmes was a patient,” my father joined in.
“Oh, goodness! What disease was he stricken with?” Mrs. Hughes inquired, genuinely concerned.
“A feigned illness,” my father said evasively. “But pray tell, what are the modifications you spoke of?”
“The special care unit is now sealed off from the remainder of the hospital, with strict requirements for entry. There is a clerk stationed at the door whose job it is to make certain only doctors, nurses, and hospital personnel can gain entry.”
“A wise precaution,” Joanna said. “As I recall there is only a single door into the unit, which, I assume, still consists of one large room.”
“Yes and no,” Mrs. Hughes said, and held her glass out for a refill of Madeira. “There is only one door in, but a side room was constructed for supplies and additional equipment.”
“Could you please describe the equipment?” Joanna requested.
“It is mainly the cardiac monitoring machines that instantly produce electrocardiograms. These are of course needed in the event the patient’s heart is adversely affected. There is also a respirator to assist breathing, and several wheelchairs and gurneys.”
“To the best of my recollection, the unit has a single, large window.”
“Which is always securely locked.”
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“As it should be.”
My father asked, “Is the monitoring of patients done exclusively by nurses?”
“With only rare exceptions,” Mrs. Hughes replied. “We are of course trained to take and record the patient’s vital signs, and to quickly set up the electrocardiogram and respiratory-assist machines.”
“But doctors periodically check on their patients, do they not?” Joanna asked.
“They do indeed. And in most high-risk cases, their visits are far more frequent.”
“Say, every five or ten minutes?”
Mrs. Hughes shook her head. “Every half hour or so, but again only in the most difficult cases.”
“This is most helpful,” my father complimented while jotting down notes. “In the story, I have the nurses attired in their usual uniforms. Does that hold true for the special care unit?”
“The nurses always wear their highly starched uniforms, which is a requirement. But in the event the patient is plagued by vomiting or diarrhea, the nurses protect themselves with aprons and gloves.”
“I would think the gloves could interfere with the nurses’ giving injections,” Joanna said.
“It is always the doctors who give the injection in the special care unit.”
“For what reason?”
“To avoid any possible error, so they say.”
“Do the doctors measure out the dose of the drug to be given as well?”
Mrs. Hughes nodded, with a grin. “Although we look over their shoulders while they are measuring.”
“Oh, I forgot to ask,” my father said. “Is there any type of alarm system in case someone attempts illegal entry?”
“None that I know of. But that would be quite unnecessary, for the clerk at the front desk is most vigilant.”
“And I suspect he will be very vigilant tomorrow, when Mr. Cardogan undergoes quinine-by-injection therapy,” Joanna said.
Mrs. Hughes narrowed her eyelids. “How did you learn of this?”
“We attended grand rounds this morning where the case of drug-resistant malaria was discussed,” Joanna answered.
“A treacherous disease,” Mrs. Hughes commented. “With a treatment that is nearly as treacherous. We will all have to be on our toes tomorrow.”
“Has the nursing schedule already been established for this case?”
Mrs. Hughes nodded. “For the entire twenty-four hours he will be in the special care unit. This will require the use of three nurses, each working eight-hour shifts.”
“And those will be very experienced nurses, I would assume,” my father said.
“Our most experienced nurses,” Mrs. Hughes said.
My father wrote down a final note, then said, “You have been of considerable help and you have been most generous with your time, but I have another great favor to ask of you.”
“I shall try my best.”
“Excellent.” My father offered her more Madeira, which she declined. “As you must be aware, in my stories I must have absolute accuracy or they lose believability. Thus, I need to know the staff’s expressions, voice tones, and gestures while they go about their professional duties. Would it be possible for Joanna and my son to carefully observe the proceedings on Mr. Cardogan tomorrow morning? They could take notes that they could later transmit back to me.”
Mrs. Hughes hesitated. “I am afraid that would be most unusual, Dr. Watson.”
“But my son is on staff at St. Bartholomew’s and Joanna is a qualified nurse,” my father persisted. “And their conduct would be in every way professional.”
Mrs. Hughes sipped more Madeira as she reconsidered my father’s request. “It could be allowed, but you will require the consent of Dr. Marburg, who will be the physician in charge tomorrow.”
“He has already given his consent,” Joanna said. “However, he clearly stated that we need your permission as well, for the moment-to-moment activities will be under your supervision.”
Mrs. Hughes slowly nodded. “Of course you will have to stand outside the unit itself so as not to disturb the patient.”
“Agreed,” Joanna said promptly.
“Then I believe we can arrange something suitable.”
“Excellent!”
“I am most grateful,” my father said. “And as a way to repay you for your generous help, I propose to include your real name in the Sherlock Holmes adventure, which is something I rarely do. Of course, I will only do so with your permission!”
“Oh, sir! I am flattered,” Mrs. Hughes said.
“So you have no objection to your name being included?”
“None whatsoever.”
“There is a condition,” my father told her. “You must not breathe a word of this to any staff, for the word will spread and they may begin to act unnaturally, which is exactly what I wish to avoid. They must proceed with the same professional behavior that they always demonstrate.”
“I shall not utter a word,” Mrs. Hughes vowed. “Not even to my husband.”
“Then we are agreed,” Joanna said. “We shall see you first thing tomorrow morning.”
“Oh, how exciting!”
“Indeed.”
At the door, the women hugged each other farewell. Once the nurse was safely in her carriage, we gathered around a cheery fire and toasted our success with another glass of Madeira. Our first move was now in place, but it was simple and easy to perform. Subsequent moves would be far more difficult.
My father asked Joanna, “Have you truly spoken to Stephen Marburg?”
“No,” Joanna replied. “But I shall.”
“He may resist,” I cautioned. “He is a stickler for exactness and protocol, which makes him a very fine physician.”
“I know a person of authority who can convince him.”
“And if he continues to resist?”
“Then he places Derek Cardogan’s life in the direst of dangers.”
As I was about to pour another Madeira, my stomach growled audibly, for it was mid-evening and I had skipped lunch to prepare a medical school lecture. “Shall we call on Miss Hudson to prepare one of her sumptuous meals?”
“It is her evening out,” my father said. “I suggest we walk down to Gennaro’s for a relaxing dinner.”
“Is it Italian?” Joanna asked.
“It is, and the food and service are equally superb,” my father replied.
We bundled up in topcoats and shawls for outside the dark evening had turned very cold. The chill was exaggerated by a heavy fog that shrouded everything and even dimmed the streetlights. We strolled half a block down Baker Street before deciding to cross. On the other side of the street we could barely make out the illuminated window of the small Italian restaurant.
“Careful now,” my father warned as we stepped off the curb. “There is some unevenness in the cobblestones which one can trip over.”
I took Joanna’s hand in mine and gave it a gentle squeeze. Her return squeeze was gentler yet, and caused a wave of affection to sweep through every fiber of my being. At that moment I considered myself to be the luckiest of men, for beside me was the most enchanting woman I had ever encountered. And despite the strange set of circumstances that brought us together, we were a perfect match. It was a certainty I would love her forever, and that was sealed in my heart and mind.
“I do hope that one day you will be mine,” I whispered to her.
“There is no need to hope, dearest John, for I am already yours,” she whispered back.
We heard the sound before we saw its source. There were hoofbeats thundering against the cobblestones, which were combined with the distinctive noise of fast-turning wheels. In the dense fog we could not see the rapidly approaching carriage. Acting on pure instinct, my father pushed Joanna and me off the road onto the sidewalk, then fell upon us just as the carriage passed, no doubt saving us from serious injury or even death.
Catching our breaths and swallowing back our fright, we listened as the sounds of the horse and carriage faded
into the night.
“That was no accident,” Joanna said, her voice surprisingly strong.
“It had to be Moran,” I agreed. “This would be the style of a backstabber.”
“He is worried,” Joanna said. “He knows we are closing in on him. He feels us nipping at his heels.”
“So he tries to kill us.”
“Or injure us badly, for either would serve his purpose. He needs us dead or, at minimum, incapacitated.”
“Which is a sure sign that he plans to act tomorrow,” I concluded, then thought further. “Or perhaps he will attempt to kill Derek Cardogan tonight.”
“Tomorrow,” Joanna said with certainty. “The special care unit at St. Bartholomew’s gives him the perfect cover and will remove all suspicion.”
We turned our attention to my father who was leaning against the brick wall, gathering himself.
“Are you all right, Father?” I asked.
“Quite so,” my father replied, and pushed himself off the wall. “My body is intact and so is my brain, for it now recalls an attempt on my life, as well as the life of Sherlock Holmes, that occurred so many years ago.”
“It was a horse and carriage then?”
“It was, and the name of the murdering scoundrel behind it was none other than Sebastian Moran.” My father shook his head and sighed deeply. “How could I have forgotten such a monstrous deed, for it all seems so clear now. It occurred on a fog-shrouded street at a time when my hair was only beginning to turn gray. A horse and carriage driven by a nameless driver came straight at us and only missed by a bare whisker. We were fortunate to escape with our lives. And I also remember Sherlock’s vow after the incident. He calmly said, ‘We shall repay Moran back in spades, Watson.’ And, as God is my witness, we jolly well did.”
“And we shall again,” Joanna promised.
I went to my father and gave his shoulder a congratulatory hug. “So the old brain is working quite nicely after all.”
“When the appropriate jolt is applied, it seems to come to life,” my father said.
The Daughter of Sherlock Holmes Page 23