Click, Double-Click

by James Calum Campbell

  The rest of the surgery was perfectly routine. Mr Uprichard liked to work in an atmosphere of calm, to the accompaniment of piped classical music. We closed up to the slow movement of a Mozart Piano Concerto. I couldn’t bear it. I wonder if Mr Uprichard sensed my discomfort.

  ‘What sort of music do you like, Mr Cameron-Strange?’

  ‘Arnold Schoenberg.’

  ‘Indeed!’

  Tonality … atonality … it’s all the same to me.

  ‘Verklärte Nacht is beautiful I grant, but didn’t he go off the rails? What about Erwartung? What about the violin concerto?’

  I shrugged. ‘It’s a path of wonder.’

  ‘You have very good hands, Mr Cameron-Strange.’

  It was only then that I realised I was being interviewed for a job.

  I said no.

  IV

  The swirls of rain caught in the floodlit arc of the department entrance made a drizzle look like a deluge. The place still stank like a brewery. I turned up my collar, and started walking north-east fast along Old Dalkeith Road, keeping an eye on the lanes, the doorways, the passing cars. The haar clung to my skin like radioactive fallout. It had been midnight by the time we had settled our patient in ICU, and the head of the unit had detained me for ten minutes in his office to drink a shot of single Islay malt, Laphroaig, from a paper cup, while he entertained me with crazy anecdotes in colourful language. It was a little ritual we enacted from time to time, as much as anything an act of rebellion against the management who had pronounced the harbouring of alcohol on the hospital premises – let alone the drinking of it – a felony punishable by automatic, and summary, dismissal. It had been a good night. Penetrating trauma arrest, salvaged. I was a bit wired.

  Back at Thirlestane I was met with the acrid smell of burnt tealeaves. Caitlin was smoking a joint. I know I ought to have taken it off her, flushed it down the toilet, and confiscated her stash. I am ashamed to say I shared it with her. As with the head of ICU and the Laphroaig, it was really just an act of solidarity. Ill advised, ill conceived I know. I just wanted Caitlin to know that whatever bad place she was inhabiting, I was there with her. (Did I say that to her? How nauseating.) I didn’t even like the stuff. It didn’t agree with me. I hated that unpredictable flipping between an altered mental state and normality, the sense that one might never ‘get back’, the struggle with numeracy, the elasticity of time, the munchies … I thought I’d left it all behind one night on a deck on Coopers Beach, overlooking Doubtless Bay. But here I was. Idiot. Quite apart from anything else, if I got caught I’d be struck off.

  After that it gets a bit fuzzy. Scotch and spliff. A bad mix. Caitlin had disappeared off to bed. I don’t remember her going. I was sitting in my front room in a reverie. I hadn’t even bothered to take my coat off. It was still wet. Time to lock up and hunker down. I felt in my coat pocket for the house keys.

  And there was the crumpled sheet of Alan Bletchley’s ED record. I felt a sharp stab of guilt and self-recrimination. I opened it out and smoothed away the wrinkles and stared at it. Apart from the demographics it was a blank sheet. How the hell had I managed that? After that chaotic night shift across the Forth I had sat down in the morning and laboriously written up a log, longhand, of all the patients I had seen. The computers had still been down. Bletchley’s had been the only record I had actually taken to the patient, so it wasn’t in the pile I had mustered at the reception desk. It just got missed out.

  Did it matter? It had been a pretty nebulous presentation and maybe that off-hand psychiatrist at the other end of the line had been right. Was it even worth a cold referral? I glanced again at the crumpled sheet and at the patient’s demographics. The patient had filled in his own details in neat, carefully printed capital letters; no sticky label – the computers must have been down even when he had shown up at the desk.

  Alan Turing Bletchley dob 23/6/12 …

  I had to laugh. It was a pseudonym. He had given us an alias. Alan Turing – as everybody now knows – was the mathematical genius who had worked at Bletchley Park in Buckinghamshire during the war deciphering the coded messages the Germans generated with their enigma machine. He had created a primitive computer the size of a warehouse, and he laid down some of the theoretical foundations that would lead to the science of artificial intelligence. And Alan Bletchley – I had no other name to call him – had given a Buckinghamshire address and postcode; I had no doubt if I punched it into my satnav and drove south I would be taken to Bletchley Park. I tried to conjure an image of the man I had briefly and so monosyllabically interviewed in the Gloom Room, but the picture was already fading, like an old sepia photograph. If I went back to the hospital and tried to trace him, nobody would remember him. There was hardly any point in referring him to the community mental health team because he would be untraceable. Lost to follow up.

  I smoothed out the crumpled paper of his record and scratched out a brief summary of our interaction, including the failed attempt at referral by telephone. Then I wrote, ‘DNW’. Did not wait. And signed it.

  For a moment I had the illusion that a corner of the sheet of paper was smouldering. Round its edges there was a heat shimmer of the sort that sits above the hose of a petrol pump in a filling station.

  Migraine. I whispered, ‘Dammit.’ I get about one a year – not frequently enough to take it seriously. I fished around the flat for analgesia, to try to abort, or at least, attenuate the attack. All I could find were a couple of time-expired DF118. Laphroaig then weed then dihydrocodeine. Explain that to the GMC.

  The heat shimmer spread out in the shape of a large letter C occupying the left periphery of my visual field. Behind it the world wobbled drunkenly like the tiled floor of a swimming pool. In some ways the aura was more distressing than the subsequent headache and nausea. I lay supine on my bed and patiently waited for it to go away. Twenty minutes later, and quite suddenly, my vision went back to normal. Sometimes I can get away with it, but this time I got the full package. I closed the curtains and undressed and went to bed properly and spent what seemed a few miserable hours trying to doze and intermittently vomiting into a basin. After there was no more to come up I jammed a tiny white tablet of buccal prochlorperazine between my gum and lip, and dozed off. I descended into the abysmal labyrinth of my cannabinoidal night. I got utterly lost. I was back in the dysfunctional emergency department over the bridge, back in the Gloom Room, crouched over the Formica tabletop, solving crossword clues.

  Owl specs inside hospital allowed (6) Awful pretty? Quite the opposite (6,5) Astute photo only disrupted tie break (7,8) Poser at Elsinore (2,2,2,3,2,2) First things first: that’s beyond excessive. Hot stuff! (6) Heat works out cheaper, for example … (9) … cooking ling by gas. Weird … but a winner! (7,7) New York City under attack? Take what refuge you can (3,4,2,1,5) Liam, I harp on about Beethoven’s Fifth Symphony (12) Winston Churchill could murder a pint (5).

  Mr Bletchley sat patiently on the plastic chair with his hands clasped on the table, staring unblinking at the opposite wall. His face was concealed behind a balaclava.

  I woke myself up with my own startled cry. And I remembered the terrible nightmares of my childhood. Night terrors. My mother would soothe me. ‘You’re all right now. It was only a dream. It wasn’t real.’ And I repeated her words to myself.

  That was a really bad trip.

  The room was completely dark. The digital clock said 03:00. How could it possibly only be 3 am? I had spent an age lying in this bed. My headache was gone, though. As a matter of fact, now my head, my mind, was completely clear. It was the only time I could be absolutely confident that I would not get a migraine – just after I’d had one. I flicked on the bedside lamp, got up, went into the kitchen and made myself a mug of chamomile tea. I said to myself, you are a fool. Never again. Don’t ever smoke another joint. Not ever.

  Why had Mr Bletchley put a balaclava on?

  I took the mug of tea back into my bedroom. I’d suddenly had an idea. Mr Bletchley ha
d said he was a crossword compiler, semiprofessional. So Bletchley was not merely an alias, it could be his nom de plume. Maybe I could trace him on the Internet. I was awake, but the laptop sitting on the table by the window was still asleep. I nudged the mouse into wakefulness. The screen icons illuminated obediently. I embarked on a search.

  ‘Crosswords. Bletchley.’

  The search engine proudly announced that she had scored about 6,500,000 hits in 0.2 seconds. Plenty about crosswords; lots of software packages for compilers. And plenty about Bletchley Park and Enigma, and the response to Enigma, codenamed Ultra. But very little about crosswords and Bletchley, apart from a piece of received wisdom that British Intelligence tried to recruit cruciverbalists because lateral thinkers might be good at cryptography. That struck me as a piece of folklore, akin to carrots aiding night vision.

  I typed in ‘Bletchley cruciverbalist’. I got more of the same. Lights, half lights, the lost mysteries of ancient stenography. I reran the tape in my head of the brief encounter in the Gloom Room but Mr Bletchley had said so little that there was barely anything else I could try. I gave it one last go.

  ‘Bletchley the bottom line’.

  And there it was. I clicked on and highlighted ‘The Bottom Line by Bletchley’. I double-clicked and there was the 12 by 12 square grid with its pleasing symmetrical array of bold barricades and below it, clues across, and clues down. I clicked on the tiny print icon and after a pause the printer jumped to attention and began to churn out a single sheet of paper. Then a new window opened on the screen.

  Windows has unexpectedly encountered a problem and needs to close …

  I clicked my tongue in annoyance and clicked on the ‘Don’t send’ box and the window abruptly vanished along with the crossword and I was peremptorily disconnected and left staring at the Cuillin ridge at dusk, my screensaver. Then it too vanished and my laptop went to sleep.

  I couldn’t be bothered to reboot. I made myself another mug of chamomile, picked up the single sheet that had issued from the printer, sat up on my bed and read the rubric of The Bottom Line.

  Twelve clues are ‘two in one’ and code for twin solutions. One solution may be converted to its twin by dropping a letter. The shorter twin should be entered into the grid. The twelve redundant letters, when unjumbled, form The Bottom Line which is thematically related to and also predicted by four (unclued) lights.

  The legend contained one further line, but it had been redacted, as if by a censor’s heavy pencil. Well, I said I was something of an addict myself. In the half-lit, half-conscious other world of the migraineur it was therapeutic to pick up a pen and see if I could fill in some of the lights.

  These designer crosswords are so bloody difficult. You read the legend and it doesn’t mean a thing. All you can do is solve what clues you can, and hope for a hint from the evolving pattern. I wondered if ‘The Bottom Line’ referred, literally, to the bottom line of the grid. 41 across. But there was no clue provided for 41 across. The last clue across was 40:

  Shrive Elena back (5)

  Elena back is ‘anele’. What’s that Hamlet quote?

  Unhousel’d, disappointed, unaneled.

  Something to do with confession, or ‘extreme unction’.

  I wrote ‘ANELE’ into the grid. One done, 40 to go! Plus the four ‘unclued’ solutions, plus, presumably ‘the bottom line’. That would be a word, or words, of twelve letters, made up of twelve ‘redundant’ letters from the ‘twinned’ clues, whatever that was about. 41 across was heavily barricaded off, quarantined. Only five of its twelve letters were deducible from other clues. It could not be solved by serendipity. I would have to identify its twelve letters, and unjumble them. And at the moment nothing gave me a hint as to the nature of the four other unclued solutions and their thematic link. I would just have to fill in as many solutions as possible and hope that the sum of the parts might suggest the whole.

  When you start solving a crossword puzzle, the first clue is always the most difficult, because you are operating in limbo. After that, you have a kind of nidus from which to expand. I now knew, for example, that the second last letter of 27 down, Peacekeepers’ turn to disclose gradually (6), had to be L.

  Peacekeepers … the United Nations … UN. It’s a jaded crossword convention. To turn is to roll. Disclose gradually … UNROLL. It’s kind of managerial-speak. Anyway it fits. It even gives me the second last letter of the bottom line. L.

  Next? 21 down: Ends up in drab mini, topless panto girl; toe curling! (8)

  Haven’t a clue.

  I began to discern that there were a host of clues of the sort that you would come across in any standard daily newspaper cryptic crossword. They were relatively straightforward. But there were a dozen or so clues that seemed absolutely impenetrable. Periodically I would take a step back and look at the half-completed puzzle and take a stab at the unclued lights.

  H _ D _ _ E _ T

  _ _ _ B _ _ _ E

  C _ _ __ _B _ _ E

  A _ A _ _ A _ _

  I hadn’t the ghost of an idea. For the first one, I got it into my head that I was looking for a superlative adjective. Haddiest heddiest hiddiest hoddiest huddiest hyddiest? Nothing seemed to fit. I didn’t fare any better with numbers two and three. Maybe they were proper names. The fourth one looked weirdest of all.

  This is ridiculous! It’s four o’clock in the morning! Pack it in. You’ve got to be at work in four hours.

  Haddlest heddlest hiddlest hoddlest huddlest hyddlest …

  V

  Now here’s the thing about designer crosswords: they are impossibly obscure until you discover the key.

  17ac: Muddle sly Lily, and break up first love? Yes, maybe (4)

  What on earth is all that about?

  Hang on. 17ac is only a three letter word on the grid.

  Same goes for 18ac. Princess’ rubbish Frisbee record (4)

  It’s a cock-up.

  Or maybe not. They must be examples of the ‘two in one’ clues with twin solutions. There will be twelve of them. How very considerate of Mr Bletchley to identify them for us in this way.

  Odd though. Mr Bletchley is anxious that we solve his puzzle.

  Caitlin looked up from her muesli. ‘What you doing?’

  ‘Crossword puzzle.’

  ‘Gimme a clue.’

  ‘OK. 19 ac – Mash an ugli, tongue of tongues, with Lagavulin distilled outwith the V & A. Seven letters. Or maybe six. Something I something G something something. Or maybe an extra something.’

  ‘Let me just make sure I’ve got this straight. You want some drunk weirdo loitering outside a museum to assault some ugly person and do something revolting with his tongue.’

  ‘You’ve got it exactly.’

  ‘Leave it with me.’

  Back at ELSCOMF, the flamboyant peacock Eugene Gawkrodger was flying another outrageous kite. He wanted to reduce the emergency department patient population by 40%. ‘An ambitious target I know, but it can be done.’ There it was on the PowerPoint spreadsheet. Eugene had done his arithmetic. He had divided up the patients into two groups, deemed ‘appropriate’ and ‘inappropriate’. Rest assured, those deemed ‘inappropriate’ would not be cast into outer darkness. They would be triaged to a clearing house, run by on site GPs.

  I had a sudden vision of a uniformed officer in a greatcoat standing under a wrought iron gate at the end of a railway line, watching the huddled masses getting off the trucks clutching their pitiful possessions. He was directing them into the ‘appropriate’ and ‘inappropriate’ groups, with a curt nod of the head. His breath was visible in the freezing air. There were dogs barking in the background.

  I didn’t want anything to do with it.

  But I must keep calm. What was it Forbes had said? You must learn to be political. It wasn’t enough to badmouth a lunatic idea. You had to argue a case.

  ‘The reason why your model is flawed, Eugene, is that it is based on diagnostic criteria. There, for example, you have deemed pa
tients with “mechanical back pain” as “inappropriate”. But how do you know somebody has mechanical back pain unless you afford them the courtesy of a medical consultation? The trouble is, the patients don’t come into the department with a diagnostic label printed on their forehead. Some people think they do, but I can assure you, they do not.’

  ‘Is that not the purpose of triage, to wheedle these people out?’ This from MacTaggart.

  ‘Triage is a system of patient prioritisation. We don’t triage people out. Granted they did so in the Napoleonic wars, but we’ve moved on a little since then.’

  ‘Nevertheless, we need to get the patient numbers down.’

  ‘Why? If we were in private business, we would welcome customers with open arms. Why do you want to curtail a demand?’ Even as I asked, I could tell the committee wasn’t interested. Cutting down patient numbers was a given. I was always going to be out of step. I really ought not to be on this committee. I was a spoiler.

  ‘But we are not in private business, Alastair.’ MacTaggart was being patient, as if explaining something to a child. ‘The NHS is not an inexhaustible well of resource. There are other departments, other specialties. The cake is not infinite. And, to be frank, we can’t squander a big slice on an unproven business model.’

  MacTaggart had a knack of being simultaneously charming and obnoxious. And I was naïve and ingenuous. I tended only to register an insult retrospectively. It was only later, after we had adjourned, that I twigged, in a slow-witted way, that ‘unproven business model’ meant the same thing as – what was that comment he had made to me in the medical corridor? – ‘peremptory medicine practised by peremptory doctors.’

  Peremptory medicine practised by peremptory doctors. Was that what MacTaggart had said to me previously? Something like that but not quite that. Another word like peremptory. More dismissive.

  I chided myself that I had not reacted to such a remark. Was MacTaggart just a phenomenally rude man or was he too stupid to notice? I should have punched him on the nose. Peremptory medicine practised by peremptory doctors. My blood boiled. Both rude and stupid. MacTaggart was a very clever man, he was nobody’s fool, but he was quite capable of being stupid. Foolishness and stupidity are not the same thing. Fools are ten a penny, but it takes a certain talent to be stupid. And the cleverer you are, the more spectacular your lapses into stupidity are likely to be.