by Mairi Chong
Euan looked sulky. ‘Well I didn’t have anything to do with it,’ he said. ‘How was I meant to know he was going to die?’
‘The police…’ Cathy began, but she was interrupted.
‘Police? I’m not talking to the police,’ Euan said.
Cathy clenched her hand around the handle of her doctors’ bag. Her nails dug into the stitching, leaving a line. ‘The police,’ she went on, trying to control her voice, ‘seem to think that he might have swallowed something. It might have been accidental, or perhaps deliberate.’
‘What, and you think I did it because we fell out? Is that why you’ve come here? To accuse me?’
Cathy shifted and the sofa creaked in protest. ‘No. I’m here because you were the last patient he saw, and I wanted to know …’
The man’s voice was now raised, and his partner shook her head as if she had seen it all before. ‘I didn’t kill the bast–’ he started to say, but Cathy couldn’t stand this anymore.
‘Listen to me and shut up!’ she shouted angrily.
She felt a cold sweat between her shoulder blades and tucked a strand of hair behind her ear.
‘Jesus,’ she said under her breath.
Deliberately slowing her words, she continued. ‘I need to know what he was like and what he said during that consultation. It might be extremely important.’
It seemed that her rudeness had shocked Euan into talking civilly, at least for now.
‘I couldn’t get an appointment with that young doctor, the girl I usually see. She always deals with my back. So, I had to get one with him. The other doctor knows me. She knows about all my problems. I haven’t been able to work for months now. She’s the first one who’s listened. Tried me with a different painkiller, di-hypro-something.’
‘Dihydrocodeine,’ Cathy said. ‘It’s a highly addictive opiate-based drug.’
‘Yes, yes we talked about that,’ said the man, now warming to his cause. ‘Me and the girl doctor, we spoke about it and I said no, I would only use it as and when I needed it, and just when things got really bad.’ He looked at her self-indulgently. ‘And things have been bad recently. I’ve maybe allowed them to run a bit low.’ His breath was unpleasant and sour, even from this distance.
‘And you’ve been on them for how long now?’ Cathy asked.
‘Six.’
‘Months?’ Cathy asked, barely about to hide her incredulity. Surely Linda couldn’t have been so stupid. It was practice policy not to continue someone on an opiate-based drug for this amount of time, and especially for something like chronic back pain.
‘So, the appointment that day?’ Cathy asked, but she already knew the answer.
‘Well, I finished the tablets a bit early and needed some more.’
Cathy sighed. Drug seeker was a fair description then, but the only person to blame for it was Linda. Deciding to ignore this for now, Cathy continued. She still needed answers and she’d have to deal with Linda later. ‘OK, so how did Dr Hope seem when you were in?’
The man leaned across the sofa to her, as if he was going to confide something of great importance. Cathy saw the pock-marked skin now close-up, and his yellowed teeth smirked at her through thin lips. ‘A bloody jumped-up bastard,’ he said slowly and deliberately, letting the words fall heavily.
Cathy got up sharply, but he kept on talking, and rose too, following her to the door. The dog began to bark again.
‘Listen, Doctor, I’m happy to tell you everything I know, but how about you give me an apology for the way your friend behaved and then write me a nice prescription for my pain killers?’
She slammed the door behind her, and as she ran down the steps, she heard laughter drifting down the disgusting stairway.
26
When Cathy returned to the practice following her house visit, she found it was twelve-thirty already and most of the staff had either drifted upstairs or home for lunch. By now, the carpark looked nearly empty, and there was no sign of the news reporters, thank goodness. She hesitated a moment outside the practice to look at the brass sign, with all the doctor’s names listed on it. Dr J. Longmuir, Dr M. A. Hope, Dr C. Moreland. The graffiti that had been scrawled next to Dr Hope’s name had been removed, presumably by Bert. Glancing around her, she ran her fingers across the engraving. They would need a new sign now. She had to get to the bottom of this. The practice waiting room was deserted. The glass automatic doors closed behind her. The whole place felt abandoned.
‘That you back then?’ said Michelle, suddenly appearing from behind the reception desk. ‘They’ve all packed up for lunch and left me to it. Police have been in again though.’
‘Oh?’ Cathy transferred the doctor’s bag to her other hand and crossed the hall, her heels clipping on the polished floor, sending echoes like ricocheting bullets.
‘Spent an age with Brenda and then Bert again,’ said Michelle conspiratorially. ‘No idea what they were asking him, but Brenda … Oh, well she can tell you herself.’
Brenda had obviously heard voices and had come through from the doctors’ corridor.
‘Bit quiet Brenda,’ Cathy said. ‘It’s not usually like this at lunchtime. Did you let them all off early?’
Brenda laughed. ‘Hardly. No, we do have normal surgeries this afternoon, but it was Linda’s idea really. They’ve gone to the new café down the street. Linda said she was buying cake to cheer them all up, and Irene and Tracy, oh and Julie, went along. Bert’s still skulking about. I think he’s taken this business very badly.’
‘I think we all have,’ replied Cathy shortly.
‘How was the house visit?’ Brenda asked.
‘Fine. Listen, Brenda, Michelle was saying that the police had been back. What were they wanting this time? It wasn’t anything to do with James, was it?’
‘That was the strange bit,’ the practice manager said. ‘They were asking about Maureen, his poor wife. Goodness knows why. I couldn’t tell them a thing. Anyway, he’s just phoned to say he’ll be in later.’
‘So, do they know the cause of death yet?’
‘Yes. Although I felt I had to drag it out of them. They came in and asked me about cleaning products and paint stripper for the practice. Of course, I didn’t know a thing about that and pointed them in Bert’s direction, but that’s what they think it was, something called hydrocarbon? Fraser mentioned them in his talk.’
‘Hydrocarbon?’ Cathy asked, feeling sick.
‘Yes, I’m afraid. They seem to think it wasn’t an accident either. Cathy, it’s too dreadful to even imagine.’
Michelle leaned in.
‘Patients have all been talking today. Apparently, the newspapers got a photograph of poor Dr Longmuir getting into a police car.’
‘Oh God,’ sighed Cathy.
‘But I thought you were onto something earlier? You chased out of here with a bee in your bonnet about something. Did you get anywhere?’ asked Michelle.
Cathy blushed. True enough, she had marched out of the place, only calling to the girls at the desk that she had her mobile on her but not to call unless it was an emergency.
‘Not really,’ she said, rather embarrassed. ‘I thought Mark’s last patient might have been able to tell me something, but it turns out that he was behaving quite normally before he died and didn’t show any sign of being unwell. His last few patients all seemed pretty standard.’
Cathy thought it likely that Mark had not felt so good during his final consultation. As she had driven back to the practice, she had considered that this was probably the reason for him only recording two words to describe the patient. If it had been a hydrocarbon poison, Cathy wondered if he had starting to feel tingling in his mouth, or pain when he typed in the notes. Perhaps he had done well to even manage those two words.
Cathy went to her room. Leaning back in her chair, she sighed and rubbed the back of her neck, trying to make sense of it all. Hydrocarbon. It couldn’t have been worse. She had seen a case once before, a long time ago. The ma
n had left a note and had downed a bottle of furniture polish. Cathy still remembered going into the side room to tell his wife after they had failed to revive him. It had been her first time at breaking bad news to someone, and she felt afterwards that she could have done the job better. She had been too matter-of-fact. She supposed that it had been because of the nerves. Cathy still didn’t know why her consultant had asked her to do that one. She watched a woman crumple, almost dispassionately. Time seemed to stop. Cathy had spoken briefly. ‘If there was anything they could do …’ but the words were empty. She had left a nurse with the woman. It still plagued her, that one encounter with hydrocarbon poisoning. She had even mentioned it at the practice meeting the other night, when Fraser had given his talk. At the time, he had asked if anyone had come across any commonly-used poisons. In fact, Fraser had said that accidental poisonings were rarely found nowadays other than in children.
Cathy logged onto her computer and began to type in the notes. She sat wondering what to say about the encounter and finally recorded: HV – nil of note. Drug-seeking for DHC. DO NOT PRESCRIBE DHC FOR THIS PATIENT *** She would have to discuss it with Linda later.
Having done this, she leaned back in her chair. She thought that she was getting another headache. Perhaps if she ran upstairs for a quick coffee before starting her afternoon surgery, it might settle her. Opening the door, she came face to face with Bert and jumped.
‘You scared the life out of me Bert,’ she said, clutching her throat.
‘Just checking the buzzer system, Dr Moreland, no need to concern yourself,’ the old man said.
‘I was just getting a coffee,’ she said, not sure why she had felt the need to explain.
‘Sorry to make you jump. We’re all a bit that way inclined at the moment though.’
‘We are,’ said Cathy considering. ‘Bert, Brenda said you had the police in asking you questions today.’
The handyman smiled, and his face wrinkled into a thousand creases. ‘Ah,’ he chuckled, ‘they were indeed and a whole lot of daft questions at that.’
‘Bert,’ said Cathy, her headache now forgotten. ‘Did they ask if you heard anything from his room?’
‘No,’ he said simply, and then as an afterthought: ‘Thought I was deaf most likely, though.’
Cathy smiled. ‘So, did you, then? Did you hear anything? You came out of your cupboard didn’t you when Tracy screamed? I saw that bit. Did you hear anything earlier in the morning though?’
The old man’s brow crumpled like linen. ‘Maybe a shout,’ he said thoughtfully, ‘but not so as I knew it was from his room. Could have easily been from your room, or Dr Longmuir’s, for that matter.’
Cathy felt confused now. ‘So that was about when, Bert?’
But the old man shook his head scornfully. ‘No, I’ve no idea on time. I was busy. Not sitting looking at my watch all day.’
‘But it was after the coffee break, am I right?’
‘Perhaps,’ he said non-committedly.
The old handyman shrugged and turned slowly ‘Need to get on,’ he said and began to walk leisurely down the corridor away from her.
27
Cathy had never attended an inquest and wasn’t quite sure what was expected of her. She did remember one of her colleagues, a GP at a practice she had locumed for years ago, who had been called as a witness following a patient suicide. A young girl had jumped in front of a train and the GP had only seen her the day before and judged her as being mentally stable. Her colleague had been very upset by the whole business and had felt guilty for not spotting how desperate the girl must have been.
Cathy had done a fair amount of psychiatric training, and recalled the words of one of the consultant psychiatrists when she had first started working for him. He had said that unfortunately, in this line of medicine, you would meet some very disturbed people, some of whom would make repeated attempts to kill themselves. He warned her that a ‘cry-for-help’ with a seemingly poorly planned, failed-attempt at suicide should never been taken lightly. Eventually, the more ‘cries-for-help,’ the more likely a disturbed patient would be to go through with it, and ultimately succeed. He did follow this up with one important reminder though. Never feel the need to take on the guilt and responsibility for someone else’s death. As a doctor, you clearly try to assist people, you offer them support, you refer them to get the help they need, but at the end of the day, it was impossible to watch over people twenty-four hours a day. Ultimately, he said that if a person was determined enough to commit suicide, then they would find a way. Cathy had felt uncomfortable when he had said this, and seeing her unease, he had continued. ‘Never take it as a personal failing, if you have done your best for them,’ he had said. She could still hear his voice now. Cathy had repeated those words, saying it to her distressed colleague at the time, but she never did hear what happened at that inquest.
The room wasn’t as Cathy had imagined it would be. For some reason, she assumed that it would be like the courtrooms you see on television. But it was more like a boardroom, informal with a large circular table in the middle and along the sides of the room, rows of chairs. It was all very modern and soft compared with her expectations. Brenda and Cathy had driven together to the court. Brenda apparently knew this area of the city and had offered. There was no reason to come separately. Irene and Tracy had arrived shortly after them, and Cathy saw at the far side of the room, an elderly couple who she assumed were distant relatives.
‘Where’s James?’ whispered Cathy to Brenda.
‘Coming. He had a late call and said it was going to be tight.’
James walked in then and looking around, saw them. Cathy waved.
‘Here he is,’ she said.
He sat down next to her, awkwardly shuffling his arms free of his jacket. Glancing over his shoulder, Cathy turned to see DCI Rodgers and DS Milne, who were in the doorway talking.
‘James, how are you?’ asked Cathy, touching his sleeve. They still hadn’t spoken properly since he had returned to the practice the previous day following his encounter with the police. Cathy had hoped to catch him before, but both had been run off their feet.
‘Worn out,’ James replied. ‘This is an awful business,’ he went on. ‘They’ve found out it was some toxic household cleaner. Did they tell you? Hydrocarbon showed up on the postmortem. Can’t believe this is happening.’
‘We heard. They told Brenda. James, you look dreadful,’ Cathy stated.
The police came into the room and sat at the table along with another man they didn’t know. Then the coroner walked in, accompanied by another woman. The police stood up, and they all followed suit, as the woman walked to the front of the room and sat at the other side of the large table with presumably her assistant next to her.
‘Good morning everyone. Thank you for coming. Please sit,’ the coroner said. ‘I believe we are missing the usher today, so I’ll go through a few minor preliminaries on courtroom etiquette.’ She smiled around the table. ‘We understand that most relatives and witnesses have no experience in court so please don't worry about finding the right words. Any respectful comments or questions are welcome. I also have some practical requests. Please switch off mobile phones, do not eat, drink or chew gum.’
James reached into his pocket and fishing for his mobile, switched it off. The coroner waited and then went on.
‘Right, initially, I will explain why, in general terms, this inquest is being held and I will then discuss the issues we will cover today. If anyone has any hearing difficulties, we have a loop hearing aid system and as you can see, the courtroom is designed for those with mobility issues. Today I will not ask anyone to stand as they give evidence or statements.’
Cathy was surprised at the informality of the situation. The coroner was very reassuring. She explained that everyone who spoke that day would be asked to take a non-religious affirmation rather than swearing on the bible. She then told them that the reason the inquest was being held was not to attribute bl
ame to anyone, but as in the case of Dr Mark Alexander Hope’s death, the police had informed the court that there was reasonable cause to suspect that a death was unnatural, due to violence, neglect, or that it may have occurred in suspicious circumstances.
The coroner read out each witness statement in turn, and allowed each of them to add to, change or confirm what they had said to the police. She read out the postmortem statement, and as it turned out, the unidentified man who had come in just before the coroner was in fact, the police pathologist. He had clearly attended many inquests before and sounded both eloquent and succinct. Mark had died of respiratory arrest due to pulmonary oedema, but was going into multi-organ failure with liver and kidneys also affected. It seemed that coffee had been found in the stomach, along with a very small trace of a hydrocarbon-based oil-like substance.
‘And the small amount of hydrocarbon that you describe as being found in the stomach; would this have been enough to result in death?’ the coroner asked.
The expert witness bowed. ‘Indeed. Merely a tablespoon would have been ample,’ he replied.
‘May we move onto timing, doctor?’
The pathologist consulted his notes. ‘Of course. There is a range of variability in what might be possible, but within an hour of ingestion, would seem likely,’ he said. ‘I would add, that although not inconsistent with my experience, the oral mucosa in this case, was quite extensively damaged in comparison with the stomach lining. I only say this as a matter of note.’
‘Would this be caused by any particular circumstance in your opinion? Would the timing of ingestion alter because of this finding?’ the coroner asked.
‘I can only be clear that the time from ingestion to death was within one hour,’ he reiterated, and the coroner thanked him.
Tracy was then asked to confirm that it was she who had found Mark. She was unable to say much more than that though and disturbed the proceedings considerably by repeatedly blowing her nose.