‘Mr and Mrs Trevor Murrell were accepted by the clinic two months ago and treatment started at once. Mr Murrell suffers from oligozoospermia, which affects the quality of his sperm. Mrs Murrell took a course of fertility drugs and on’—he consulted his notes—‘March the fifth, eggs were collected from her ovaries by laparoscopy, for which she was given a general anaesthetic…Professor, you wanted to say something?’
‘I’m sorry to interrupt, but did you say her eggs were collected by laparoscopy?’
‘Yes, I did.’
‘Interesting. Ultrasound is usually used these days.’ He paused. ‘You didn’t mention an anaesthetist among the staff. They’d need one for laparoscopy, you know.’
‘Indeed. They use a retired consultant who lives nearby, a venerable old chap called Longstreet. This may have some significance, as you will see.’
He waited to see whether the Professor was going to say any more, then continued, ‘From the clinic’s point of view, everything proceeded normally. The eggs were passed to the laboratory, where they were fertilised with sperm from Mr Murrell using microinjection. They were then incubated for three days and monitored as they developed into embryos while Mrs Murrell remained at the clinic with her husband to await the eggs replacement in her womb.
‘However, before this could happen, she developed a fever and was put on a course of antibiotics. This, unfortunately, was to no avail and she died the same day of an overwhelming group A streptococcal infection.’
The short silence was broken by the Professor. ‘I’m rather surprised antibiotic therapy didn’t work.’
‘It was a highly toxogenic organism—the so-called flesh-eating strain. The antibiotics simply didn’t have time to work.’
‘Was there a post mortem?’ This, from Tom.
‘Yes, hut nothing untoward was discovered.’
‘You mentioned an enquiry?’ said the Professor.
‘Yes, we carried it out that week. The clinic’s aseptic and other procedures were all satisfactory, none of the staff were carriers and no source of the organism was found. We concluded that Mrs Murrell herself was the carrier.’
‘Didn’t Mr Murrell have anything to say at this time?’ Tom again.
‘No, he was still in a state of shock. It wasn’t until after we’d completed our enquiry and put her death down to misadventure that Mr Murrell came to us with his curious story.’
‘How long afterwards?’ the Professor asked.
‘Let me see…’ Again, Ashby consulted his notes. ‘March the nineteenth, to be exact. Just under two weeks.’
‘And what was this curious story, exactly?’
‘In essence, that despite the general anaesthetic, Mrs Murrell was conscious during the laparoscopy and overheard one of the staff saying that Mr Murrell would not be the father of the baby.’
‘I suppose it’s possible she was conscious,’ the Professor mused, ‘if the anaesthetist had forgotten the pre-med, or given the wrong dose of supplementary anaesthetic.’ He looked up at Ashby. ‘You don’t think it was vindictiveness, on Murrell’s part? Once the death of his wife had sunk in.’
Ashby shrugged his shoulders. ‘It could have been, of course.’ He glanced at Marcus. ‘It’s just that we don’t think it was.’
‘Do you know Mrs Murrell’s exact words?’ asked the Professor. ‘We do need that, really.’
‘You’ll appreciate that’s not very easy. Mr Murrell isn’t the brightest of men, and in the circumstances, his memory wasn’t of the best. However…’ he turned to Marcus again.
‘After Dr Ashby had told me about the case, I questioned Mr Murrell myself,’ Marcus said, ‘and took the precaution of taping the interview.’ He picked up a cassette, pushed it into the player on his desk and pressed a button. After a preliminary crackle, his voice came out of the speaker.
‘So can you tell me, please, Mr Murrell, what it was that your wife told you?’
‘‘S difficult, like I told the other guy.’ Mr Murrell was from the East End of London.
‘Just do the best you can.’
There was a sigh, then Murrell said, ‘She was woozy like, after the op. An’ they give ‘er seddytives to keep ‘er quiet.’
‘Yes?’
‘Well. I could’n’ get no sense from ‘er at first, then the nex’ day she says, “Trey, I’m scared, I don’ like it ‘ere.” Why not? I says. Seems all right to me. Then she says, “Trey. I was awake, y’ know, in the op.” What? I says. You mean when they cut you open…? “No, I didn’ feel nuffink,” she says, “but I ‘eard.” Eard what? I says. Then she says…’ Murrell, whose voice had become unsteady, gulped and swallowed.
‘Just take your time,’ Marcus said.
‘She says, “They was saying the baby wouldn’ be yours, Trev, I ‘eard ‘em.” I says somfink like, ‘oo the fuck’s is it then? Scuse me, Mr Evans.’
‘That’s all right,’ Marcus said gently.
We sat in silence as Murrell sniffed. Then, he said, ‘She didn’ say no more after that. The nurse had come in an’ gives ‘er a jab.’
‘So the nurse was in the room while she was telling you this?’ Marcus interrupted quickly.
‘Can’t remember. She coulda bin, I s’pose.’
‘Then what happened?’
‘She slept, an’ when she woke up, she was ‘ot like, all over. I tol’ the quacks, hut they couldn’…’
His voice disintegrated and Marcus shut the machine off. After a short silence.
Ashby said, ‘That’s pretty well exactly what he told me.’ Marcus looked at Professor Fulbourn. ‘Not the voice of vindictiveness. I’d have thought.’
‘No.’ Prof cleared his throat. ‘It’s still a great shame we don’t have Mrs Murrell’s exact words, though. As Mr Murrell so trenchantly observed himself, if it wasn’t his baby, whose was it?’
Ashby said, ‘There is one possibility. A man will pay a great deal of money to have a biological child of his own. Mr Murrell paid nearly four thousand pounds, although he’s far from wealthy. Suppose the clinic took the money, then simply used donor sperm instead.’
‘That thought had already occurred to me, as you know,’ said Marcus, re-asserting his control over the meeting. ‘But before we go into that, are we all agreed that Mr Murrell’s story is, to say the least, a cause for concern?’
‘Naturally,’ said Ashby.
‘Yes,’ said Tom. ‘Definitely.’
I nodded my agreement.
The Professor sighed. ‘Cause for concern, certainly, I’d have to agree with that. But what can we do about it?’
‘That’s what we’re here to decide,’ said Marcus. ‘I think it might be useful at this stage, Professor, if you, as the expert among us, could give us the background to what we’ve heard, and perhaps explain some of the terms.’ He looked down at his notepad. ‘Er…oligozoospermia, for instance. Laparoscopy, ultrasound. And microinjection of sperm.’
Prof smiled. ‘That’s rather like a person with no basic physics asking for an explanation of the quantum theory. However’—he looked round—‘those of you who already have some knowledge will have to bear with me.’
Assuming I was included in that category, I nodded, along with Ashby.
‘Forewarned by Evans,’ continued Prof, ‘I took the precaution of bringing along a visual aid.’ He opened his briefcase, took out and hung up the usual flattering portrayal of female internal plumbing. It always reminds me of a wildebeest’s skull: the tubes and ovaries forming the horns; the triangular womb, the head: and the cervix and vagina, the snout.
‘Pregnancy,’ said Prof, ‘is a miracle which occurs when a sperm deposited here, in the vagina, manages the epic journey up through the cervix and womb to the Fallopian tubes, here, where it fuses with an egg which has been released by an ovary. The fertilised egg is then carried back down to the womb, here, where it embeds and becomes an embryo. Clear so far?’
Nods from Tom and Marcus. I glanced at Tom, wondering if he was thinking of his own son
. Jealousy twisted at me for an instant and I thought: Must stop this…
‘One of the most common causes of infertility is blocked Fallopian tubes. Sometimes, they can be unblocked, hut all too often, sadly, they can’t. In these cases, in vitro fertilisation, IVF, is usually the couple’s only remaining hope.
‘IVF means exactly what it says: fertilisation of an egg by a sperm outside the body, literally, in glass. Although I suppose in plastic might be more accurate these days.’ He sighed. ‘I digress. The woman is given a course of fertility drugs so that she produces up to a dozen eggs, and when these have developed, they are collected from the ovaries either by laparoscopy, or ultrasound.
‘I’ll try and explain both these terms. A laparoscope is a surgical probe with a tiny camera on the end. A small abdominal incision is made, the laparoscope inserted and the eggs collected from the ovaries by remote control using a TV screen. Naturally, this is performed under general anaesthetic. Clear?’
More nods.
‘Ultrasound is also what it says. Sound waves are directed through the body like radar, and the returning echoes are used to build up a picture, also on a TV screen. Mr Jones,’—he turned to Tom—‘I couldn’t help overhearing that you’d recently become a father—did your wife have a scan?’
‘She did, yes,’ said Tom. ‘It was incredible. You could actually see the baby’s features on the screen.’
Prof nodded and smiled. ‘Incredible, yes, I suppose it is rather. Anyway, you use this same technique for collecting eggs. A fine needle is passed either through the abdomen or the vaginal wall to the ovaries and, guided by the ultrasound, picks up the eggs. It’s quicker than laparoscopy and, since it requires only local anaesthesia, safer.’
‘So why did they use laparoscopy at Catcott Manor?’ I asked.
‘A good question. Any ideas. Dr Ashby?’
‘I did ask Dr Kent, the director, about this, since they do have state-of-the-art ultrasound equipment and usually use it. She told me that she sometimes uses laparoscopy when the eggs are in a difficult position on the ovaries and she wants to collect them all.’
‘Is it important?’ asked Marcus. ‘I mean, is there any reason they shouldn’t have used laparoscopy?’
‘Not really, no,’ replied Prof, ‘although I avoid using it myself these days, because it involves the use of a general anaesthetic.’
I said. ‘Well, it’s certainly something I’d like to know about. I mean, it does rather affect—’
‘Indeed,’ said Marcus, overriding me, ‘but we’ll consider it later, if you don’t mind. Professor, you were telling us about IVF.’
‘Yes. The eggs have now been collected, by whatever method. They’re taken to the laboratory, examined, then sperm from the husband is added—in a Petri dish rather than a test tube. Although I suppose Petri Dish Baby doesn’t have quite the same ring about it.’ he added reflectively. ‘The eggs are then incubated for two or three days and periodically examined to check their development. I usually replace them in the woman’s womb when they are at the four-cell stage.’
‘How is that done?’ asked Marcus.
‘The embryos are taken up into a fine tube, which is then passed up through the woman’s cervical canal into her womb, where they are gently expelled.’
‘You make it sound simple.’
‘It is, compared with egg collection.’
‘What’s the success rate?’
‘If you replace four embryos, about thirty-five per cent.’ He smiled. ‘There’s also a chance of multiple births, which is why I never replace more than four.’
‘How soon d’you know whether you’ve been successful?’
‘About two weeks, perhaps a shade under. By blood tests.’ Marcus nodded, made a few notes, then said, ‘Which brings us to microinjection of sperm.’
‘Er—any more coffee in that pot, Mr Evans? This talking has made me rather dry.’
‘Yes, Anyone else?’
We all gratefully accepted refills.
Prof meanwhile had gathered his thoughts.
‘I said earlier that blocked Fallopian tubes was one of the most common causes of infertility, but it’s far from being the only one. Poor sperm quality is probably the next most common, either because there aren’t enough of them, which we call oligozoospermia, or because they can’t swim fast enough, which we call asthenozoospermia.’ He gave one of his wry smiles. ‘It seems that Western man isn’t the man he once was. For some reason, as yet unknown, our sperm quality has been steadily declining, at least for the last fifty years or so, since records have been kept. Perhaps we’re doomed to extinction, which is maybe no more than we deserve…However, IVF can help in these situations, because the spermatozoa are excused their arduous journey. They’re delivered direct to the doorstep, so to speak.
‘There are variations on this theme, for instance—Gamete Intra Fallopian Transfer—GIFT—a rather apt and lovely acronym. Sperm and eggs are delivered together to the tubes before fertilisation has taken place. Sometimes this works where IVF has failed, although it’s not clear why. Sometimes, even when sperm is placed directly on the egg, the spermatozoa are simply too weak to penetrate it.
‘Until very recently, Artificial Insemination by Donor, AID, was the only hope for these couples, but then microinjection was developed. In this technique, the egg is held on a suction tube under a microscope while a spermatozoa is injected directly into it using a very thin glass needle. It’s tricky, to say the least, hut it can, and does sometimes work.’ He paused. ‘I think I’ll it leave it there, before you start dropping off to sleep.’
‘That’s not very likely, Professor,’ Marcus said with a smile. ‘What’s the success rate of microinjection?’
‘Very difficult to say. The technique’s so new, the few figures we have can’t really be relied upon.’
‘Is Catcott Manor successful?’
‘They have some success, certainly. I can’t remember the exact figures.’
‘I see. Thank you, Professor, you’ve certainly made things much clearer for us.’ He looked round at us all. ‘The thing is, what are we going to do about it? Miles, what do you think? You have the advantage of us, you’ve been there, we haven’t.’
Ashby took a deep breath and released it. ‘I think it should be investigated. The thing that bothers me most of all—apart from the Murrell case, obviously—is their, in my view, unnecessarily high level of security.’
Tom looked up. ‘What kind of security?’
‘A very sophisticated alarm system, including close-circuit cameras and invisible light beams. They also employ two full-time security guards, one of whom lives on the premises and is positively Neanderthal.’
‘Have you ever asked them the reason?’ said Marcus.
‘Yes, I have. Dr Kent justifies it partly on the grounds of threats she says she’s received from extremist pro-life groups—’
‘But that’s ridiculous,’ said Tom, ‘Surely, she’s bringing about life, not destroying it.’
‘Embryos are sometimes discarded. Don’t you remember all the fuss about embryo research? And many people find the methods by which the embryos have been brought into existence abhorrent.’
‘You said partly on those grounds.’ said Marcus.
‘Indeed. Her other justification is the expensive equipment she has on the premises.’
Marcus nodded. ‘But you nevertheless regard the level of security as unnecessary?’
‘I do.’ He hesitated, then went on, ‘And the whole place has an oppressive atmosphere, as though it’s hiding something…I know that sounds fanciful. but I do feel strongly it should be investigated.’
‘Unnecessary security, oppressive atmosphere,’ rumbled the Professor. ‘Hardly relevant if you’ve only noticed them now.’
‘I had noticed them earlier.’ Ashby said defensively. ‘but their relevance didn’t strike me until the Murrell case.’
‘Professor,’ said Marcus, ‘you can see that the rest of us here fee
l that there’s a—a case to be answered. Don’t you feel the same way?’
Prof looked up. ‘Rather depends on what you propose doing about it.’
‘I propose sending Mr Jones and Miss Farewell into Catcott Manor posing as a couple with fertility problems.’
Prof paused for a moment, his eyes on his hands. Then, he said, ‘Don’t know why you’re asking me, since you’re obviously going to go ahead whatever I say.’
‘Because we need your help, Professor. Your professional help.’
Again, the wry smile. ‘Oh, I see. What kind of help?’
‘Miss Farewell and Mr Jones will need a cover story. A verifiable medical history and referral from a bona fide clinic such as yours.’
‘I see,’ he said again. ‘I can foresee one problem straight away. Supposing I were to do as you ask, but that Miss Farewell and Mr Jones were to find nothing, as is quite possible. That could place me in an awkward position, having falsified medical evidence.’
‘No.’ Marcus shook his head vigorously. ‘My department has the authority to ask you to do this; it also has complete responsibility for its actions. In other words. I carry the can.’
Prof paused, his eyes flicking round us. ‘I’m uneasy about what I’ve heard, naturally. But I’m not convinced that such a cloak and dagger approach is necessary. You’ll have to let me think about it.’
Marcus swallowed. ‘I was hoping we’d come to some form of agreement today. Miss Farewell has to go back, and—’
‘Won’t take me all day.’ He glanced up at the clock. ‘It’s just gone twelve. I’ll let you know by two.’
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