by Sarah Ward
Catherine went hot and stared at her feet. ‘I wanted to see if Mina knew. I mean, if her mum had told anyone what happened. She didn’t know at all. She walked up and down the path looking confused.’
‘Of course Hilary never mentioned it. She wasn’t stupid. Now, however, Mina is down there doing her own digging into the past.’
‘She won’t find anything, though, will she?’
The woman leant forward. ‘Catherine. It’s really important that Mina doesn’t find out anything more about what happened down the Cutting. Do you see? Do you want the truth to come out?’
Catherine shook her head. ‘Of course not,’ she whispered.
The woman dropped her voice to the same level. ‘Catherine, will you help me?’
21
At the sight of Dr Jake Parsons, all Connie’s suspicions disintegrated. He was young. Very young, perhaps in his late twenties, but he exuded calm confidence. Wearing a checked shirt and black trousers, he would be a reassuringly casual presence for people worried about their array of ailments. He had a boyish face that still held the hint of a tan. He’d fitted them in straight away, the surgery allocating the rest of the morning patients around the other GPs.
‘There are quite robust procedures in place for GPs to sign off death certificates. We are, however, still often the first port of call for patients with chronic illnesses who die in their homes.’
‘For some reason, I thought the dead would be taken by ambulance to hospital,’ said Dahl.
‘It’s one possibility but, if a patient is clearly dead, a hospital isn’t necessarily the place to take them. First, death has to be confirmed and a paramedic who may be familiar with the patient will call the GP. Take Nell Colley, for example. She was known to me and others in the practice as she was often here. The paramedics also knew her as she’d been admitted to hospital with regular arrhythmia attacks. So, we have a sick patient known to two medical services.’
‘But only a doctor can confirm that death has taken place.’
‘Exactly. Hospital is one option but the other is to call the GP practice as one of us is probably making our rounds.’
‘Can you give us the sequence of events leading to you seeing Nell Colley?’
‘From what I remember, I was out doing my rounds when I received a call from the surgery to say that the paramedics had discovered her unresponsive and that death had occurred sometime earlier in the day.’
‘You’d seen her that week in the surgery, I believe?’
‘And the week before that, I think. Look.’ He rotated the computer towards them so that they could see the patient’s records. Jake Parsons ran down the list of visits. Around ten visits to the practice over a three month period.
‘She was in virtually every week,’ commented Connie.
‘Well, she had become sick over the spring and was anxious about it. Miss Colley had a heart arrhythmia, which is a common cause of sudden cardiac death. She’d been well until fairly recently and then deteriorated.’
‘She was being medicated for it, though, wasn’t she?’ asked Connie.
‘For that and for high blood pressure and cholesterol.’
‘You were happy to sign off the certificate?’
‘Certainly. I’d seen her that week. She had an erratic pulse and I upped her medication but she was clearly sick.’
‘That’s enough to issue a certificate?’ asked Connie.
‘Yes, although if she’d come to the practice and seen any of us, I could have still signed off the death certificate. You just need to prove you’ve seen a doctor in the surgery in the previous two weeks and we, of course, have her records.’
‘She was feeling poorly?’ Dahl squinted at the screen to look for the correct entry.
‘She was suffering from thumping in her chest, which was making her feel breathless. I increased the dose of her beta blocker slightly.’ He looked at them both, concerned. ‘There’s not a problem, is there?’
‘You didn’t notice anything else?’ asked Connie.
The GP shook his head. ‘Like what?’
‘Did she mention a book she was writing?’ asked Dahl. Connie frowned but kept her eyes on her notepad.
‘She didn’t say anything about a book.’
‘Let’s come on to Ingrid Neale.’
‘That’s slightly longer ago but I do remember the big old house in Cold Eaton.’ Jake Parsons turned the computer screen back towards him and found the records of Ingrid Neale.
‘Miss Neale I hadn’t seen before, but she was an asthmatic who had been hospitalised twice in the last month with breathing difficulties. She had been given doses of steroids on both occasions.’
‘But you referred her for a post mortem,’ said Dahl.
‘I rang my colleague here, Dr Fowley, for advice on both patients. He’s a partner and very experienced. He confirmed that there was no need for a PM in the case of Nell Colley but, in the case of Ingrid Neale—’
‘Yes?’ asked Connie. Alert.
‘I remember him making a comment about the location. Cold Eaton. He said it was a miserable place and not where anyone with chronic asthma should be living. Also, as we hadn’t seen Ingrid Neale recently, she’d need to be taken to hospital, which I informed the paramedics was the case and then left.’
‘Your procedures seem to be fairly robust.’
‘There are guidelines after Harold Shipman, and quite right too.’ Jake Parsons typed on his keyboard. ‘I’m trying to see how many sudden deaths I’ve attended in the last four months so you can see what normal looks like.’
He ran his finger down the screen. ‘One, two … five.’ He looked up at them. ‘Not that many but, as I said, it does happen. Why are you interested in those two in particular?’
‘They appear to have known each other. Nell Colley didn’t mention the other woman to you?’
‘Do you know what, she didn’t but she did mention asthma to me. I dismissed it because Miss Colley verged on the hypochondriac and she didn’t have asthma. But I’m sure she mentioned something.’
‘Can you remember what?’ asked Dahl.
‘I think she asked if it was common to die of it. I don’t really remember. No crime has been committed, has it?’
Connie looked at Dahl. ‘I don’t think so. We just needed to check up on the two deaths.’
Jake Parsons looked relieved. ‘You know what? I think I’ll bring this up at the team meeting tomorrow. One of my colleagues can attend the next sudden death.’
Dahl stood up. ‘Goes with the job, I suppose. We have that much in common.’
As they left the room, Connie searched in her handbag for a vape. ‘That’s that then.’
‘I suppose.’ Dahl looked deep in thought. He smiled across at her. ‘Time to move on, I think.’
22
‘They still won’t let me see her.’
Mina sighed and looked at her watch. After a fractured night, the work of the morning had dragged on interminably. She was desperate to see her mother and talk to her about the Cutting. If Hilary was in a lucid state, now was the time to catch her. Mina’s dreams had been infused with dark tunnels and bottomless voids. She had been so spooked that she had forgone her early paddle so that the morning’s work had felt painstaking and arduous. She needed to stretch her muscles and clear her head. Instead, she had to confront the decline of her mother after she’d got rid of this girl who was once more pestering her.
‘I really would like to see her.’ The pleading tone struck a false note. There was an otherness to the girl that would make her a magnet for bullies. Perhaps this was why she was spending so much time in the hospital away from her contemporaries.
‘My mother’s not up to seeing anyone. Didn’t I make myself clear?’ Catherine shrank from the harsh tone and Mina immediately felt ashamed. ‘Is there anything you want me to say to her?’
The girl opened her mouth to speak but was halted by a sharp ‘Catherine’ behind her. They both turned and a woman wit
h a clipboard was staring at them.
‘What are you doing here, Catherine? It’s not your shift today.’
‘I wanted to swap.’
‘You know that’s not allowed.’
Mina used the opportunity to slip away and left them arguing. The lift deposited her outside the oncology unit and, as she pressed the buzzer to be admitted, she saw through the glass a huddle of nurses, not around the station but at the entrance of her mother’s room. As the doors opened, she rushed towards them and one nurse broke away. Diane who had nursed Hilary on and off for nearly a year. She came towards Mina.
‘Oh I’m so sorry, Mina. We were just about to call you.’
Mina brushed past her and dashed towards her mother’s room. The group parted at her approach and she saw her mother in the bed, her face for the first time in months relaxed and serene. She looked from Hilary to the group in shock.
‘She’s gone?’
Diane nodded.
‘But she felt better.’
‘We hadn’t been able to stabilise her in the last few days. She likely succumbed to an infection. Her temperature was unsteady this morning too. Here’s Mr McQuaid now.’ The nurse stepped aside as a tall man with a stooped posture entered. He only glanced at her mother but picked up the notes at the bottom of the bed. Mina recognised him as the surgeon who had performed the most recent surgery on Hilary.
The group at the door dispersed at his arrival leaving Mina alone with the consultant. He looked tired. ‘It wasn’t unexpected although I was hoping to get her into a hospice before this happened. It’s a balancing act. The local one won’t take any patient until they’re in their final stages. It’s an art not a science.’
‘I don’t have any complaints about her treatment here.’
Mr McQuaid gently replaced the notes into the holder.
‘I really am sorry.’
‘Will there be a post mortem?’
‘Your mother had a CT scan this week and, given the metastasis of her cancer and the growth in particular of the tumour on her parietal lobe, we knew her life expectancy was weeks, even days. I don’t think a PM is necessary but I’ll talk to colleagues first.’
Mina nodded. ‘Did she say anything? Before she died, I mean.’
He frowned. ‘As I understand, your mother was found dead when the nurse came to administer medication. I can find out when someone last spoke to her if you wish.’ He checked the chart again. ‘Her temperature was taken this morning before breakfast and was high. I can ask one of the nurses who were on duty to have a chat with you.’
Mina sat down on the chair next to her mother’s bed. ‘But she was lucid yesterday. I don’t understand.’
‘Let me see if I can find a nurse for you.’
He left her for a moment and Mina found she couldn’t look at her mother’s shape in the bed. Instead she looked out of the picture window and watched a woman pushing a young boy in a wheelchair. She turned away from the little boy’s gaunt face. At least her mother had lived a full life on her own terms. So why had she a sense of something not completed?
Diane bustled into the room. ‘I’m so sorry, Mina.’
‘I can’t believe it.’
‘I saw her before breakfast and she said she was feeling all right but still very weak. And we couldn’t get the temperature down. She was sweating so I changed the sheets for her.’
‘Was it you who found her?’
Diane shook her head. ‘About an hour after, two nurses came to give her medication and she’d already passed away.
I called the doctor to confirm she’d gone. It does happen like that. I’m so sorry.’
Mina dug in her rucksack for a tissue and blew her nose. ‘She didn’t say anything this morning?’
‘Very little. I opened the curtains and it was still dark and changed her sheets as she’d soaked them. Later, when the nurses came in to give her medication, they realised she’d passed away.’
‘Without warning.’ Mina caught sight of the nurse’s face. ‘Sorry, I didn’t mean it in any way. It doesn’t matter.’
*
After Mina had left, Diane did the job that her colleagues hated but which always gave her a sense of conclusion with patients she’d nursed for a long time. She began the meticulous process of laying out. She washed Hilary’s frail body, pulling gently on the limbs where rigor had begun to set in. When she had finished, she pulled the sheet up over to Hilary’s neck and picked up a hairbrush. With light strokes, she arranged Hilary’s curls. As she stepped away towards the corner of the room where the drip had been moved to, she slipped slightly and had to hold on to the bed head to steady herself. She squinted at the floor and stooped down and brushed her fingers over the vinyl.
She went out to the ward and checked to see who was the supervisor on duty. Barbara. She breathed a sigh of relief. Barbara would know what to do.
A few minutes later, Barbara was also looking down at the floor. She unfastened the saline bag still draped from the hook and inspected it for a moment. ‘Leave this with me.’
23
‘Shit.’
Connie looked up in surprise as Matthews opened the door of Sadler’s office.
‘What’s the matter?’
‘We’ve had a call from St Bertram’s. Notification of a suspicious death on one of their wards. They’ve informed the coroner and want us to have a look at the body in situ before it’s moved. Can you attend? Dahl, you go with her.’
Connie got her things together, checking her vape was in her handbag. ‘Any other information?’
‘You need to go to the oncology department. The death was only this morning. I don’t have any more details. Can you call me when you’re done?’
‘We can take my car, if you like. I know a good place to park.’ Dahl waved his car keys at her.
The road to St Bertram’s was clear and Dahl sped through the town keeping an eye on the speed limit.
‘What do you think it is?’ Connie was impatient to get going. ‘Suspicious death? You don’t think it’s anything to do with the two we’ve been looking at?’
Dahl kept his eyes on the road. ‘I think we agreed they weren’t suspicious. This one, though, must be more serious. They’re calling us in straight away.’
‘Suspicious in what way? I don’t like the sound of that. Hospitals are bad enough places without having a killer in them.’
Dahl glanced at her. ‘I heard you had a spell in St Bertram’s last year.’
She didn’t return his stare but looked down and fiddled with her vape. ‘I couldn’t wait to get out of there, to be honest. I felt so helpless and now I’m worried what we’re going to face.’
‘Could be anything. Suspicious could be in terms of medical treatment given, an action by another patient, an external influence. We’re not going to be able to guess until we get there.’
‘It’s got a good reputation. The problem is I only enter the hospital these days when I’m attending a PM. I don’t get to see the alive bit, if you see what I mean.’
Dahl grimaced. ‘I don’t think “the alive bit” is going to be the term to describe what we’re about to see.’
*
Bill Shields nodded at Connie as she entered the room. The pathologist appeared to have got even larger than when she’d seen him last.
‘Well, I didn’t have to go far for this one, did I?’
Still the gallows humour and Connie could feel the disapproval emanating off Dahl. ‘This is DC Dahl. He’s just joined us from Glossop.’
‘Glossop.’ Bill’s voice was full of meaning. ‘Hope you weren’t wanting a quiet life around here. Bampton has a habit of throwing up its secrets in a nasty way.’
‘I’m well aware of what Bampton’s like.’
Bill took the hint and turned back to the body. ‘We have a seventy-five-year-old cancer patient who was found dead this morning. Cause of death was initially prescribed as a respiratory infection with metastatic cancer of the spleen the secondary cause.�
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‘How long had she been in hospital?’ asked Connie.
‘Just over a month, although she’s been having treatment in this unit for about a year. Arrangements were being made to transfer her to a nursing home, a rehabilitation unit so that she could return home for a period, but she took a turn for the worse this week.’
‘But there’s a problem?’ asked Dahl.
‘Come and see.’ They both moved towards the bed. A woman with an emaciated body lay on the bed. Connie, feeling nauseous, took a slight step back but bumped into Dahl who was leaning forward.
‘I can’t see anything.’
‘It’s not the body that’s the problem. At least, that’s not what’s brought me here.’
Connie looked around. ‘What am I supposed to be seeing?’
Dahl was looking at the floor. ‘There’s something on the tiles.’
Connie realised that Bill was standing to one side of the bed where a pool of thin liquid seeped towards the corner of the room. She moved closer. ‘What is it?’
Bill pointed to the drip. ‘It’s from the bag. A leaking saline drip.’
‘Doesn’t that happen often?’
‘Anything with liquid in is liable to leak. Take a closer look at the bag, though.’
Dahl gloved up his hand and reached out to touch the drip.
‘Puncture marks,’ he said.
Bill turned, a look of respect on his face. ‘Well done. They’re only faint but clearly visible.’
Connie looked forward. Two incisions could be seen in the clear plastic almost invisible to the naked eye, tiny tears puckering the bottom of the bag.
Dahl leant closer. ‘It was supposed to be saline?’
‘And it might yet be. The hospital, however, is on alert for this type of thing after the incident at Stepping Hill.’
‘I remember.’ Connie looked at the floor again. ‘Insulin was injected into some of the drip bags.’
‘It can cause a massive hypoglycaemic episode and when a patient is very ill it’s often fatal.’