by Andrew Smyth
The professor steepled his fingers. If there’s one thing I like less than a short man with a goatee beard, it’s a short man with a goatee beard who steepled his fingers. It was a sign that I was about to receive a lecture, but to be fair, that’s why I was there. ‘As far as I was concerned it was straightforward. The removal of a lesion by laparoscopy, I’ve done it hundreds of times.’
‘And there was nothing about this that made it any different?’
‘Nothing. It was entirely straightforward. After the procedure, he was kept in ICU for a few hours. Intensive care is a precaution in case there are reactions to the procedure or the drugs. But in Mr Satchwell’s case there were none.’
Afterwards, I went in to see him when his daughter, Greta, arrived and I explained that everything had gone well and the sample had been sent off for a biopsy, although I doubted that this was really necessary, but it was a precaution we always take in these circumstances. I checked his notes with the night nurse and they indicated nothing out of the ordinary.’
‘You didn’t go back again later?’
He looked surprised. ‘No. There was no reason to. Everything looked normal.’
‘When did you realise that there were complications?’
‘I’m not sure I would describe them as “complications”,’ he replied, rather pedantically. ‘I don’t think there was any relationship between my procedure and what happened next.’
You would say that, wouldn’t you? I thought. ‘But when did you hear that he had relapsed?’ I repeated.
‘I got a call from the duty doctor early the next morning. He asked me if there was anything about the operation that he should know – it was as though he was accusing me. I told him there wasn’t. He told me that they were trying an emergency bypass, but he said he wasn’t hopeful.’ West paused. ‘In the end I suppose his prognosis was right. It appeared that Mr Satchwell never regained consciousness.’
‘So what do you think happened?’
‘I’ve given this some thought,’ the professor replied guardedly. ‘It could have been related to the anticoagulant we used. There’s always a trade-off for patients who take anti-coagulants for their heart condition balanced against the need for blood clotting during an operation.’
‘And was Mr Satchwell taking anticoagulants? Did he have a heart condition prior to this?’
‘I think it was more of a precaution than a condition. We’d changed his prescription some days before the operation, to minimise the time between stopping it for the laparoscopy, and then starting it again afterwards. When carrying out surgery, you don’t want uncontrolled bleeding so we stop the anticoagulants beforehand. All this is perfectly routine,’ he added, as though I was questioning his clinical judgement.
‘But clotting is a risk? I understand that if he had previously diagnosed coronary disease, anything that promoted clotting could be dangerous.’ I mentally thanked my Internet session on Wikipedia for providing me with a rudimentary medical knowledge.
‘Theoretically, yes. But most unlikely to have any effect in such a short timescale.’
‘But you’re sure that the ultimate cause of death was a heart attack?’ So far he had not committed himself.
The professor was silent for a few moments. ‘The duty doctor said there was no doubt, but that doesn’t explain the cause. It could have been a natural event, that his time was up, if you like.’
‘But you don’t think so? Had he had an ECG beforehand, or any blood tests for cardiac markers?’ This time it was my ex-wife I thanked for her input.
‘No, we didn’t see the need. I told you his heart condition appeared only very minor.’
‘Enough to kill him.’ I couldn’t help myself but I was getting annoyed by the professor’s rather smug evasions.
As though sensing my frustration, the professor suddenly seemed to change tack. ‘You must understand, I wasn’t there when he had the seizure that killed him. As I told you, when I left him late the previous night he seemed fine. I didn’t get back to the hospital until after he’d died, so there was nothing I could do. I was told it was a heart attack, so I had to accept it.’
‘So you did go back that morning?’
‘Yes, of course, he was my patient.’ West turned and looked out of the window for quite a long time before speaking again. ‘I don’t want you to get the wrong idea. The hospital is always going to say that it was natural causes. They don’t want to admit that anything could have gone wrong, but it’s different for me. I have a professional responsibility, but I have a personal one as well and I think that something’s not right here. I’ve had some concerns about this hospital and had been thinking of changing.’
‘Concerns about the hospital? What sort of concerns?’
‘It’s got a big multinational behind it which means they have almost unlimited resources. If there’s any possibility of someone making a mistake – even a minor one that’s obvious to everyone, they clam up and go into denial. It’s not the right way to run a hospital – you have to be aware of the risks and be open about them. It took them years before they even recognised that infections could be carried by their own medical staff.’
I thought the professor was being remarkably complacent. ‘You put up with this? You work with these people even though you knew about their cover-ups?’
‘I didn’t know for sure,’ he said defensively. ‘It was part of their culture.’
‘A culture that allows a university professor – a public figure – to be employed to treat patients privately for a healthy fee?’
‘I’m not going to argue with you. These are the conditions we have to work under. I didn’t make the rules.’
‘From what you say there don’t appear to be many rules. Who benefits most from your relationship with IHG? Them, for having a professor on their notepaper, or you for the fees you can charge?’
‘I don’t have to put up with this,’ he snapped. ‘Who are you, anyway? Coming in here and making accusations?’
‘I thought it was you who was making accusations, Professor. I’m just asking questions and you’ve already said enough for me to report you to the BMA. Tell me what else you know about this hospital.’
He looked down at his phone and I could tell he was debating whether to call security to have me thrown out but he hesitated. He looked back up at me. ‘You should be aware that they swim in a murky pool. The largest hospital group in the US was forced to pay a record fine – nearly a billion dollars, which they settled for falsifying invoices. They also paid doctors backhanders for referring their patients to their hospitals.’
‘Are you suggesting that they might have had a hand in Greg Satchwell’s death?’
‘Not directly, no…’ He hesitated and I waited for him to steeple his fingers again, but the fight seemed to have left him. ‘I’m saying that things aren’t always as they appear.’
‘And that seems to apply to you as well, Professor.’ I stood up. ‘Thank you for your time.’
As I navigated my way through the corridors out to fresh air, I thought things hadn’t turned out quite as I expected. Perhaps I was naïve but it hadn’t occurred to me that private hospitals could operate fraudulently. Equally, I hadn’t realised how big these organisations were, given that they also owned scores of hospitals throughout America where most were private. Perhaps there was an internal conspiracy within IHG to cover up all unexplained deaths? Before speaking to Professor West I would have thought such a thing impossible, but now I was not so sure. Private healthcare was a massive business, even in the UK and, as Professor West had said, where there’s money there’s often corruption.
It seemed even more likely that Greta’s suspicions might be based upon reality, which made me look at things in a different light. If even his doctor was concerned about the sudden death then this didn’t look like the waste of time I thought it was. I decided that since I was quite close by, I would go across to the Tribune offices and see if Paul had taken up station yet. Despite
his apparent waywardness, he was fairly reliable.
I worried about the “fairly” but I needn’t have. In fact it was difficult to miss him. He’s tall and gangling, and was wearing threadbare jeans and a leather flying jacket that looked as though it had been through a world war and ended up on the losing side. But it wasn’t that that attracted attention, more the fact that he was standing two doors down from the Tribune front door and making no effort to look occupied. He saw me coming and I signalled to him. ‘You’re supposed to look unobtrusive,’ I said. ‘You look like an overgrown kid waiting to see if Santa Claus is going to come down the chimney. Have you seen anything yet?’
Paul started to pout and I had to stop myself from laughing. Clearly he’d rather fancied his role as a super-sleuth. ‘Give me a chance,’ he said plaintively. ‘I’ve only been here an hour.’
I realised I had a decision to make. Either I could go back and wait on the boat on the off chance that Paul could identify the suspect, or I could barge in and wave the photograph at the reception desk and see if anyone was prepared to talk to me. Action against inaction? I hadn’t spent all those years in army intelligence for nothing. Their motto was: if in doubt, don’t. Wait until your intel has built up a picture of the situation before doing anything. Was this why I was no longer serving? Waiting wasn’t really my style and anyway, what did I have to lose? If they threw me out, I could still come back if Paul discovered anything. I decided to chance it. Directing Paul to wait in a slightly less obvious place, I checked that I still had the photographs in my pocket and headed up the steps to brandish it.
They buzzed me through the front door into a large reception area. There was no hint of blandness here. Quite the opposite – it looked as though I was walking through some of the pages of my books on design. Among the artwork on the walls, a large, bright Lichtenstein print dominated the room, at least I assume it was a print otherwise it would have been worth as much as the building. The furniture, what there was of it, was minimalist Bauhaus, pieces that I coveted but had no hope of affording. Someone clearly had taste, taste backed up by deep pockets. If this was a front, it was a damned impressive one. The receptionist, who would rate as employee of the year if she was as efficient as she was attractive, was looking at me expectantly and I decided to start at the top. ‘I wanted to see Mr Rogers. Is he free?’ She asked if I had an appointment, knowing full well that I didn’t. She was about to give me the brush off and she was clearly as practised at giving it as I was at taking it, although generally it’s been from women more in my league. I interrupted her before she could get into her stride. ‘If he’s here, tell him it’s about Greg Satchwell. I’m investigating his death.’
That almost penetrated her poise – obviously the name meant something to her because instead of calling security, she asked me to take a seat. I watched as instead of phoning she turned to her computer and typed a message on her keyboard, that way I wouldn’t know what she was saying about me, although I could probably guess.
After several minutes, it seemed that she had got her answer. ‘Mr Rogers says he can give you five minutes. If you’ll come this way?’
I followed her upstairs in the lift and she led me to what must have been the piano nobile, the main first-floor reception room when the house was first built in the late seventeenth century. Again, the décor was contemporary, with matching Eames chairs and ottomans in front of the fireplace. There were more pictures on the wall, and a huge pair of Warhol screen prints of flowers faced the full-height windows looking onto the street.
Brendan Rogers was sitting at a large rosewood conference table, with papers scattered around him. He looked up and nodded at the receptionist. ‘Thank you, Moira,’ he said, dismissing her. Turning to me he said, ‘Mr Hennessey, is it?’ He indicated one of the cane chairs across the table which looked like an original Marcel Breuer. ‘Have a seat. You said it was about Greg Satchwell?’
Greta hadn’t told me much about Rogers but this was a man who exuded calm and authority in equal quantities – clearly a man accustomed to having his own way. He was quite heavyset, wearing a charcoal double-breasted suit. His complexion was dark but his heavy beard was smooth – his five o’clock shadow probably appeared sometime around midday, suggesting that he probably shaved more than once a day. All in all, I thought, a man careful of his appearance. I sat where he indicated. ‘Yes. His daughter, Greta, has asked me to look into it.’
‘Look into it?’ Rogers repeated. ‘So that’s your man who’s been waiting outside in the street watching our front door?’
Ouch! That was below the belt, I thought, but tried to pretend that it hadn’t hurt. ‘I understand that you were a partner in his latest development?’
‘My company was, yes. We’d done several projects together quite successfully.’
‘But this one wasn’t a success, was it?’
Rogers paused, as though anticipating where this was going. ‘We’ve learned to take these things in our stride,’ he said finally. ‘We can still come out ahead.’
‘Is it true that you had taken out insurance on Mr Satchwell’s life?’ I decided to go with the direct approach.
‘Key Man insurance? Yes. That was quite normal; we take it out on all our top staff and on the important people we work with. Key men in fact – the clue’s in the name. They are important to us and we need to look after them.’
‘And you are aware that Mr Satchwell died suddenly from an unknown cause?’
‘We knew he died suddenly, but we didn’t think the cause was unknown. I understood it was a heart attack.’
‘So you’ll collect on the insurance?’
Rogers laughed. ‘Ah, I see where this is going. You suspect we had something to do with his death?’ He shook his head. ‘You’re way off track. We wanted him alive more than most. Sure, we’ll get the insurance pay-out but that might not even cover the costs we’re facing getting his development back on its legs. It’s certainly not a motive for a killing. I’m not quite sure what kind of operation you think this is, though you have quite some nerve walking in here off the street and accusing us of murder.’
‘I’m not accusing anyone.’ I realised I was in danger of getting thrown out before I could learn anything. ‘I’m trying to find out what happened.’ I thought it time to shake his complacency and took out the photograph, smoothed it down and placed it in front of him. ‘This man was seen entering the hospital shortly before midnight. After going through reception, he put on a white coat pretending to be a doctor. He then went upstairs and into room 315 and a few hours later Greg Satchwell was dead when none of the doctors expected it. That’s what I mean about dying from an unknown cause.’ I waited a beat before delivering my coup de grâce. ‘Greta Satchwell says she’s seen this man here in your offices.’
Rogers continued looking at the photograph before raising his eyes to meet mine. He said nothing for a while and then picked up the phone and punched in a number. ‘Warren, could you come in here for a moment?’ He put down the phone and then turned to me. ‘Perhaps you should have done your homework before charging in here.’ He said nothing further and in a few moments the door was opened and the man in my photograph walked in. ‘Mr Hennessey, meet Warren Bidwell, our security consultant.’
I tried to remain impassive as though this sort of thing happened to me all the time, but it was like having your ace of spades trumped by the two of diamonds. After my interview with Professor West and now this, I was starting to feel way out of my depth, but just because Brendan Rogers was admitting that this Bidwell character worked for them, it didn’t mean that he wasn’t involved.
‘Mr Hennessey here thinks you had something to do with Greg Satchwell’s sudden death. He’s seen the video camera recording showing you went to his hospital room a few hours before Satchwell died.’
‘That’s what you pay me for, guv.’ My “suspect” didn’t seem in the least bothered at being found out. ‘I always keep tabs on the company’s partners, especially w
hen there’s a lot of money at stake.’
‘After eleven o’clock at night?’ I asked disbelievingly.
‘It’s the best time. No doctors around, only the night staff, while the security people are probably snoozing in front of their video displays. The nurses were happy to show me the patient’s records and talk about the operation. If it had been any other time they would have been too busy.’
‘Mr Hennessey,’ Brendan Rogers interrupted, ‘Greta has obviously not told you very much about our operation. We are very,’ he tapped the table to emphasise his point, ‘very careful. We don’t just insure our partners’ lives, we investigate them thoroughly and monitor them as long as we are working together. We don’t like surprises. If a partner goes into hospital for an operation, we like to check it out and make sure that we’ve been told the truth. Our Key Man insurance covers hospitalisation as well as death so we need to make sure of the facts before we put in a claim. It wouldn’t have been the first time that a partner tried to mislead us. Warren here was able to confirm that the operation was routine. As I told you, we take every precaution possible and so I can assure you that we had nothing whatsoever to do with Greg Satchwell’s premature death.’ He looked at me as though expecting a response, but I could think of nothing to say.
‘In fact,’ he went on, ‘I liked Greg; I liked him a lot. He was the same sort of man as I am. He was self-reliant and could see through problems clearly and didn’t like wasting time.’ Rogers said this looking at me pointedly. ‘Greg was on his way to turning his development around in spite of the problems they’d had. There was no way I wanted him dead – I wanted him very much alive.’ Rogers paused for a moment. ‘In fact,’ he continued, ‘perhaps I could spare Warren here to give you some help in looking into this.’