Pulse

by Felix Francis

  He wrote it down.

  ‘Was there any indication of how the cocaine entered his system?’

  ‘If you mean were there obvious signs of him having injected it, then no, there weren’t. But the post-mortem should determine that too. Some addicts are very ingenious at disguising the fact by injecting themselves in difficult-to-see places.’

  ‘I didn’t see a syringe in the racecourse toilet.’

  ‘Shooting up is not the only method of taking cocaine, you know,’ I said. ‘Most users snort it up their noses and some smoke it. You can even take it orally.’

  ‘You seem to know a lot about it.’

  I’m sure I blushed.

  ‘A misspent youth,’ I said with a laugh.

  He wasn’t to know that I had recently tried anything and everything to try to alleviate my feelings of despair. Drink, drugs, cigarettes – all had been my bosom pals at some time or another during the previous twelve months. Some still were.

  ‘Is that all?’ I asked. ‘I should be getting back.’

  ‘All for the time being,’ PC Filippos replied. ‘But can I have your home address just in case?’

  Just in case of what? I wondered.

  I gave him my address and he wrote it down in his notebook, which he then snapped shut.

  ‘Thank you, Dr Rankin,’ he said, standing up. ‘Most helpful. I suspect the coroner’s office will be in touch in due course.’

  ‘What happens if you can’t find out who he was?’ I asked.

  ‘Oh, I’m sure we’ll do that. For a start, we’ll check his description against people reported missing. That usually turns up the identity of the deceased. Someone, somewhere, will miss him when he doesn’t return home, maybe not tonight but soon enough.’

  I shuddered at the thought of the man’s wife and family waiting for him to get back for his supper totally unaware that his body was already cooling in the hospital morgue.

  ‘Awful to die so alone,’ said PC Filippos, as if he had been reading my mind. He downed the rest of his coffee and looked at his watch. ‘Right, I must be getting along. I’ve got to get back to the racecourse. I need to check for evidence in the Gents where the man was found.’

  ‘What, now?’ I said. ‘Surely it will have been cleaned.’

  ‘It was the cleaner who found him – the poor woman was very upset. The man was in a locked lavatory cubicle and all she could see were his feet under the door. I have given instructions for the whole Gents to be left alone so I’d best go back tonight. They’ll need it available for the racing tomorrow.’

  He hurried away and I went back to caring for the sick and injured, all the while thinking about the unnamed man lying on a slab just along the corridor.

  I worried about my decision to administer the adenosine. Why did I do that before having the blood results back from the lab? That had been reckless of me. At best, it had hastened his death. At worst, perhaps he would have survived if I hadn’t been so foolish.

  I soon convinced myself that it had been my stupidity that had killed him.

  It was all my fault.

  My shift ended at 2 a.m. and I drove home afterwards like a maniac.

  It was a way to express the anger that was boiling within me.

  I was angry with the man for dying, and angry with myself for letting it happen. But, most of all, I was angry at what had become of me – angry at this wretched depression and the way it was ruining my life.

  I jumped a red light on the Evesham Road, passing straight through the junction without even braking.

  It was as if I didn’t care.

  And I didn’t.

  On this occasion, late at night, the roads were clear and I sailed through without incident. I did it without thinking rather than as a conscious effort to kill myself. I didn’t exactly think of myself as having a death wish but, if the Grim Reaper came along and hooked me with his scythe, it wouldn’t have bothered me too much.

  Maybe I was more suicidal than I realised.

  But then I thought about those in another car that I might hit. I knew all too well the horrific injuries that occurred in high-speed car crashes. I spent my working life saving people from them.

  I would never forgive myself if I seriously injured or killed someone else.

  I slowed a fraction.

  Perhaps I’d be better off just driving really fast into a nice big solid tree. That should do it.

  ‘Single-car accidents’, the police called them. ‘Tut-tut,’ they would say, ‘she must have gone to sleep after a long shift at the hospital. Such a shame. Such a waste.’

  But Grant would have known otherwise. What would he say to the boys?

  The boys!

  Oh God, I couldn’t do it to them.

  I slowed a bit more.

  I made it home in one piece.

  Home was a modern four-bedroom detached house on a new estate on the outskirts of Gotherington, a village five miles to the north of Cheltenham.

  I’d had to drive past Cheltenham Racecourse on my way.

  I knew it well. I regularly acted as one of the racecourse medical officers, following the horses in a Land Rover, ready to leap out and treat any jockey injured as a result of a fall.

  But my mind tonight wasn’t on the track, the horses and the medical requirements; it was on the gentlemen’s toilet under the main grandstand.

  I imagined the unfortunate cleaner finding the man unconscious in one of the cubicles. It must have given her quite a shock. But at least the man was then still alive.

  When I’d been at medical school there had been a story going around about a man who had died while sitting on the loo. In the macabre humour of all medical students, we had laughed at the revelation that, by the time he was found, rigor mortis had set in and the ambulance crew couldn’t lay him down flat on a stretcher. He’d had to be carried to the morgue on a chair.

  I pulled into the driveway and parked my little Mini Cooper next to Grant’s Audi.

  That was a good sign, I thought. He’s still here.

  I had an intense fear that Grant would leave me – that he would have had enough of my erratic behaviour and, one day, I would come home to find him packed and gone. I didn’t have any hard evidence to make me think that way – no unexplained telephone calls or cryptic emails – but I still worried. Sex between us had become a distant memory and I’d have probably left me by now if I’d been him.

  He repeatedly tried to reassure me that he wouldn’t go but I knew that he was fed up treading around me on eggshells, saying nothing at all rather than risk uttering some throwaway line to which I would take exception.

  I realised that I took even the slightest criticism straight to my heart; every cross word was a dagger in my side.

  Didn’t everyone?

  No, they didn’t.

  I had tried hard to let things pass, to laugh them off as nothing more than mere banter between husband and wife, but God had wired my brain wrongly. I couldn’t leave things be or let them go. I would demand to know what he meant and refuse to believe his answer of ‘nothing’. It would end in tears, his or mine, and we wouldn’t speak for hours.

  I quietly let myself in through the front door. The light was on in the hall but the house was quiet. I imagined Grant had allowed the boys to stay up late to watch Match of the Day but they would be asleep by now, dead to the world as only teenagers could be.

  I went through to the kitchen and, even at this late hour, I put out the breakfast things. It was like a ritual. Cereal packets, bowls, spoons, mugs, plates, knives, butter dish and marmalade – all had to be put in exactly the right place on the table.

  I stood back and checked.

  I’d always had a bit of OCD – obsessive-compulsive disorder – but the depression had made it much worse. I knew that it was irrational to arrange everything just so, but I couldn’t help it. The house might burn down in the night if I didn’t, or my mother would die in her sleep, or any number of other awful outcomes would occur simply
because I hadn’t put the spoons properly in line with the bowls.

  I believed it. Totally.

  I went upstairs and put my head round the door of each of the boys’ rooms.

  As I’d expected, they were fast asleep, the sound of their breathing like music to my ears. They were my raison d’être. My all, my life.

  I took my pills, potions and patches in the bathroom and then slipped between the sheets next to Grant. He grunted, which I took to mean, ‘Welcome home,’ and then he went straight back to sleep, snoring gently.

  It had been my first ‘late’ shift of three in a row and I’d been up since six, almost twenty-one hours on the go and most of it on my feet. I was exhausted but, even so, I couldn’t nod off.

  I lay in the darkness listening to the sounds of the house cooling, as I did almost every night. My psychiatrist had given me pills to help me sleep but they didn’t seem to work. Perhaps I should double the dose.

  My mind was racing too much for sleep, worrying about the dead unnamed man, about the still living girl I’d sent to Bristol, about whether I had put the marmalade in the correct place downstairs and if I should go and check, about how I would pay the mortgage if Grant left me, about famine in Africa and about nuclear missiles raining down on us from North Korea. I worried about anything and everything, most of which I had no control over anyway. But that didn’t stop me worrying about it.

  I turned over and tried unsuccessfully to switch off my brain.

  I was tired of worrying.

  I was also tired of being angry all the time, tired of feeling worthless and tired of the emptiness I felt inside.

  I was tired of being depressed while pretending I was fine.

  But, most of all, I was just tired of being tired.

  I must have fallen asleep eventually because it was light when I woke. And I was alone in the bed. I rolled over and looked at the clock on my bedside table. Eight-thirty. Not bad for me, I thought. I was usually awake at five.

  Grant will have gone on his regular Sunday morning run, I said to myself. He’d put on a few pounds after leaving the military but he still liked to keep himself in reasonable shape. He wouldn’t be back until nine-thirty at the earliest.

  He was welcome to it. The last thing I felt like doing was exercise. I simply didn’t have the energy to do anything I didn’t absolutely have to.

  I rolled over again and stuck my head deep into the pillow. A little longer wouldn’t do any harm, surely, and I would be back at work at six that evening for another eight hours of picking up the broken pieces of other people’s lives.

  I just wished I could pick up those of my own.

  ‘Mum, are you awake?’ one of the twins shouted from the landing. Even after fourteen years I found it difficult to tell their voices apart, especially when they were shouting.

  ‘I am now,’ I shouted back.

  ‘I need my football kit. I have a practice at nine.’

  Toby, I thought. The eldest by two minutes. Mad keen on football and now in the village boys’ team. ‘It’s in the airing cupboard,’ I called back. ‘And your boots are under the stairs.’

  ‘Thanks.’

  ‘Do you want any breakfast?’

  ‘No time,’ Toby shouted back. ‘I’ll have it after.’

  Oliver, the younger twin, meanwhile, would still be sound asleep. He hated football and only said he wanted to watch Match of the Day so he could stay up late. The twins might look identical, but they had very differing opinions. Oliver maintained, often at great length, that footballers were all overpaid prima donnas who should get a real job rather than playing a stupid game all the time.

  But I thought we were all playing a stupid game, the game of life, and, when the referee’s whistle blew, we would shuffle off this mortal coil and out of the floodlights only to be replaced by a new signing with an unpronounceable name from Real Madrid or Juventus. The never-ending match would go on, but without us on the pitch. And no one would notice.

  The front door slammed shut as Toby left and I went back to trying to catch a few more winks.

  The quiet before the storm.

  4

  It started raining heavily as I drove to the hospital on Sunday evening at a time when most sane people would be going home for the night.

  The day had seemed to drag on interminably.

  I’d failed miserably to get back to sleep and had finally dragged myself out of bed and into the shower just before Grant returned from his run, all hot and sweaty, demanding access.

  There had been a time when we would have squeezed into the shower cubicle together, relishing our wet bodies being in such close contact. Things would have invariably progressed to another form of steamy action in the bedroom.

  But not any more.

  It was as much as I could do to be naked and visible in the same room as my husband, let alone within his touching distance.

  I hated my body and I felt sure he must too, in spite of him continually telling me he loved it. My once firm, fulsome and prominent breasts now sagged alarmingly towards my waist and, in spite of nightly applications of expensive anti-cellulite creams, the skin on my thighs was already giving a good impression of orange peel.

  That alone was enough to make me depressed.

  ‘What do you expect?’ Grant would say. ‘You’re in your forties having had two children. It’s nothing to worry about.’

  But, of course, I did worry about it. And I was constantly desperate that he might trade me in for a younger model, just as he did every three or four years with his car.

  I had finally made it downstairs just before ten and, of course, the marmalade had been in the right place on the table all the time. If it hadn’t, then I would surely have known about it. The house would have burned down, or the boys infected with some debilitating disease, or we would be involved in a worldwide nuclear Armageddon with only minutes left to live.

  It was true, and all because of the position of the marmalade.

  Toby returned from his football practice caked in mud and with a bloodied knee after being accidentally kicked by one of the other boys. But he wasn’t about to let his emergency-doctor mother do anything about it.

  ‘Leave it out, Mum,’ he said sharply when I tried to see exactly how deep was the cut. ‘It’s fine.’

  ‘It might get infected.’

  ‘I said it’s fine,’ he insisted.

  Fourteen-year-old boys. Not yet men but so eager to be manly. A bleeding knee was a badge of honour, a war wound.

  ‘Go and have a shower and put some of this on it.’ I tossed him a tube of antiseptic cream from my first-aid cupboard in the kitchen.

  He rolled his eyes in irritation but he caught the tube and took it upstairs with him to the bathroom.

  Lunch had then come and gone without any great fanfare, Grant and the boys mostly grazing on what leftovers they could find in the back corners of the refrigerator.

  Only a year or so previously, I would have eagerly produced a proper Sunday lunch – maybe a roast chicken or a joint of beef with all the trimmings.

  I had prided myself on my Sunday lunches, taking great pleasure in having the family sitting down at the dining-room table for one meal in the week with no TV, video games or mobile phones allowed to interrupt the conversation.

  Now, I simply didn’t have the energy or the inclination.

  Meals in the Rankin household had mostly become either ready or takeaway, with Grant now on first-name terms with the managers at both the local Indian and Chinese restaurants, even if they did rather embarrassingly call him Mr Wankin.

  I, meanwhile, had decided to stop eating altogether, existing on a meagre diet of vegetable soup plus the occasional sliver of plain grilled fish. Not that it seemed to be doing much good. Even though our bathroom scales showed that I’d lost another seven pounds in the last month, I was yet to feel any thinner. I regularly spent far too much time looking at myself in a full-length mirror. Not that I liked what I saw. It was far too
stressful.

  I parked my Mini in a space in the staff car park.

  It was ten to six in the evening but it might as well have been the middle of the night. The sun had gone down at quarter past four and it had been pitch-black for over an hour. The intense rain had also cleared the streets of all but the most hardy.

  I hated the prospect of the coming winter. The ever-dwindling length of daylight reflected the lowering of my own mood. Just five weeks, I thought, until the winter solstice and then the days would start getting longer again.

  Surely I could last out five weeks.

  But then it would be Christmas.

  The very thought made my toes curl inside my shoes.

  How could I get through all that eating, drinking and bonhomie?

  I was not ready for any form of socialising. All I really wanted to do was hide myself from everyone except my immediate family. Yet, perversely, here I was about to delve into the darker recesses of humanity, dealing with people at their most vulnerable, when they would be relying on me to make them better.

  But they were strangers.

  I don’t know why it made a difference, but it did.

  I would be more anxious about joining close girlfriends for a drink than of swimming in piranha-infested waters. But I felt able to deal quite easily with a waiting room full of prospective patients.

  Not that I found myself dealing with any patients on that particular night.

  There were two men and a woman waiting for me when I went in from the car to change. I could tell immediately that it didn’t signify good news.

  ‘Ah, Chris, there you are,’ one of the men said when he saw me. I knew him well. He was the Medical Director for the Gloucestershire Hospitals. My clinical boss. What was he doing here on a Sunday evening? And in a suit too.

  ‘Can we have a word?’ He was clearly uncomfortable.

  I looked at the three of them.

  ‘Of course,’ I said. ‘Here?’

  There were other hospital staff milling around, some arriving, some leaving.

  ‘Let’s go somewhere more private,’ said the woman.

  The four of us walked together down a long stark hospital corridor, brightly lit only by the cool glow of overhead fluorescent tubes. ‘On my way to the condemned cell’ was the only thought that floated into my head.