by Liz Lawler
Throughout the day she had fought off the temptation to have a stiff drink, but at the last moment, with her coat on and ready to leave the flat, her resolve weakened and she took a swig of Absolut vodka to wash down 2mg of diazepam. If she wasn’t careful, this could easily become a habit. Since the night of her abduction she had drunk every day. A holiday was an excuse to drink, but this nip before work couldn’t happen again. She would put it down to Dutch courage. A one-off.
With a deep breath, as ready as she ever would be, she left the changing room and stepped out onto the floor of the department.
It was Friday night and it was heaving. No one gave her a second glance. On the large whiteboard covering ‘majors’ patients a name was written in every cubicle space. Down the corridor, ambulance crews were waiting to offload their patients. A quick check on the computer showed her that ‘minors’ was equally busy. She saw Nathan Bell through the long glass partition windows of the doctors’ office, eating Doritos and tapping the keyboard, and wandered in to see if he was ready to do a handover.
He was bone thin and overly tall, unable to stay still even when he was sitting. His right foot tapped the ground continuously, causing his knee and thigh to jerk, which was probably how all the junk food he consumed was burned off. He’d been in the department for a year and had proved to be a sound doctor, but patients shied away from him. The port wine stain covering the left side of his face was shocking. Alex had wondered if he had ever explored the possibility of having laser treatment to diminish the deep red colour.
‘Be with you in a minute, but there’s no rush. I’m staying on until midnight.’
‘Why?’ she asked. ‘Has someone gone off sick?’
He shook his head, his eyes staying on the monitor to read blood results. ‘No. Caroline thought that as it’s your first day back you could do with some support.’
He said it bluntly, though Caroline, she suspected, wouldn’t have wanted her to know this. In truth, she’d probably told Nathan to find a plausible reason for staying the extra hours. He could have said it was Friday night, the place was heaving and he could spare the time. But Nathan Bell didn’t do deception well. He was blunt and he was truthful.
She was about to tell him there was no need to stay when a high-pitched screech from the transceiver blasted the air.
‘I’m right behind you,’ he said. ‘Just give me two minutes.’
Fiona Woods was at the control base with the transceiver in one hand and a pen in the other as she prepared to take down the details from the paramedic. Her colleagues around her were hushed so that she could hear her caller more clearly, and some of the patients and visitors stopped in their tracks so that they, too, could listen in.
‘Emergency department receiving,’ Fiona said calmly and clearly. Her new hairstyle looked torturous; in a French braid too tightly woven, it pulled the skin at her temples. Her naturally frizzy hair was something she constantly battled with, and Alex could bet she’d have a headache at the end of the shift with this new attempt.
‘We have a young female, unresponsive at the scene. Glasgow Coma Score, now 12. Systolic pressure 85. Heart rate 110. Resps 26. Sats 99 per cent. She has a bleed through her jeans, either rectal or vaginal. Over.’
Fiona pressed the transmit button. ‘Do we know if she’s pregnant? Over.’
‘Undetermined. We have verbal response, but incoherent. We have no status on history. Over.’
‘What’s your ETA? Over.’
‘Four minutes. We’re in the hospital grounds. She made it this far.’
‘Thank you crew 534. Emergency department standing by.’
Alex headed straight to ‘resus’, with Fiona on her tail. As they entered the resuscitation area, Fiona briefed the nurses on what was coming in. Alex was glad she was on duty; Fiona was a brilliant practitioner and, after seven years in this area of nursing, there was very little she didn’t know about emergency medicine. Alex automatically gloved up, donned a green plastic apron and went into bay 2 to check the equipment. It was the nearest bay for an ambulance crew and consequently the most used. Therefore it was essential that before and after each patient the stock was checked.
On the wall behind the patient trolley there was a board holding equipment. At a glance she saw everything was in place, but she went through each item anyway. She did the checks in less than a minute and then moved on to other equipment: oxygen supply and resuscitator bag, used to assist ventilation, with a snugly fitted facemask. She pressed buttons and flipped switches, and cardiac monitor screens lit up with alarms beeping as they searched for a source.
Over at the divider unit, which separated the bays, Nathan was pulling out syringes and placing them on the counter; some he filled with saline, others he kept ready for drawing blood. Fiona Woods and another nurse hung two one-litre bags of warmed fluids. On a priority 2 alert, X-ray and path lab were standing by. It was all in the preparation. Be ready, be waiting, and be prepared for the unexpected.
*
Her blood had seeped through the white blanket, turning a large patch a deep red. It had dripped down the side of the trolley, onto the wheels, and was now wetting the floor. Her face was a stark white beneath the oxygen mask. Her eyelids were flickering and she was making small murmuring cries. In the few minutes it had taken for them to get her here she had seriously deteriorated. She was bleeding out with every passing second.
Even while they were positioning her, Nathan Bell had hold of her left arm, had a tourniquet in place and was inserting a needle. The fluid was attached and a pressure bag put round the litre of fluid to rush it through faster.
‘Have we any history at all? A trauma? Anything?’ Alex asked quickly, while casting her eyes over the woman’s body for immediate assessments. The blood loss was great, and the ashen face and white fingers were alarming.
‘It was a 999 call,’ the paramedic replied. ‘She was found just inside the hospital grounds, clearly trying to find help. The couple who found her said she was groaning and then she slumped on them. Unresponsive initially with us, and then in the back of the ambulance we’ve had a few moaning sounds.’
‘Do we have a name?’
‘Haven’t checked pockets. She didn’t have a bag with her, but there might be something in her jacket.’
The woman was making sounds from the back of her throat, a deep humming, and Alex didn’t like it. It was too internal, and her Glasgow Coma Score, the tool for evaluating neurological function and patient’s level of consciousness, was dropping.
Fiona Woods pulled out her shears as the other nurse removed the blood-soaked blanket. The woman’s blue jeans were drenched at the groin and down to as far as the knees, and more blood was being soaked up by her pale green shirt.
With ease, Fiona cut away the clothing. ‘She’s flooding,’ she said urgently. ‘I’m not going to get a catheter in here. And there’re clots in her pants.’
Alex moved away from the head end of the trolley and inspected the find. Dark congealed blood was mixed with tendrils of white. ‘It looks like foetal matter. Put it in a kidney bowl. Put the trauma call out and state urgent need for obs and gynae.’ The call would also bring other doctors – an anaesthetist and a general surgeon. ‘We have a Class III moving rapidly to Class IV blood loss. I want more people in here now.’
Over the next twenty minutes fluids and blood were pumped into the young woman, and theatre was standing by. The urgently summoned help had arrived, and in a controlled rush of precise activity, everything possible was done to stabilise and to facilitate aggressive treatment.
The anaesthetist was preparing to put the woman to sleep. Every person attending the scene was tense with the need to get the woman out of A & E quickly so that the bleeding could be explored, vessels clamped, whatever was causing it stopped.
Alex was standing to one side at the head of the trolley getting the respiratory ventilator ready when she saw the woman’s lips moving beneath the oxygen mask. She leaned close to her patie
nt’s face and, over the hiss of oxygen, she spoke calmly, using similar words to the ones that Caroline had used with her. ‘Hello, sweetheart. My name is Alex and I’m a doctor. You’re in hospital and you’re safe. I’m going to help you now. Can you tell me your name?’
The woman’s eyelids fluttered and then her blue eyes stared. Alex saw a natural focus in them, an awareness, and she smiled warmly at the critically ill woman. ‘Hi, sweetheart, are you talking to me?’
The voice was weak, the breathing laboured, and Alex sensed in her heart that her patient wasn’t going to make it. This moment might be the last that this young woman ever had to speak, and Alex ignored the anaesthetist who was now indicating that she move away so that he could proceed. She was going to give her patient this time.
‘Tell mum I’m sorry. Tell her I love her. I’m so stupid . . . I . . .’
She was panting and Alex quickly replaced the oxygen mask.
Fiona appeared at her side, smiling at the patient, her tone gentle but firm. ‘She needs to be out of here now, Alex.’
Alex stroked the woman’s forehead.
‘I’ll tell her, sweetheart, but you’re going to get better and you can tell her yourself.’
‘Alex!’ Fiona commanded through gritted teeth.
‘Dr Taylor, you need to let the anaesthetist get to her.’ Maggie Fielding stated calmly, her voice finally conveying to Alex the urgency of the situation.
Alex stared at the medical team surrounding her, impatience stamped on all of their faces.
‘Dr Taylor, we need to help her!’ Maggie spoke for all of them.
The eyelids suddenly lifted higher and the woman’s eyes were filled with fear. ‘You said you’d help me. You, you . . .’ Her eyes rolled back. And then a whisper of final words: ‘I should have said yes . . .’
Chapter seven
She had yet to be seen by her family, but in a purse in her leather jacket a NatWest debit card and a Barclaycard identified her as Amy Abbott.
She had been declared dead two hours ago and had yet to be moved from resus. Amy Abbott was not going to be wheeled down the corridors to the mortuary. Instead, the coroner’s private black ambulance was standing by, ready to take her away. Her clothes had been bagged, her medical notes photocopied, her body briefly inspected. A police officer stood near the trolley guarding her until the time came for her to be collected.
Alex wanted to brush her dark hair, wash her blood-stained hands and remove the hideous airway tube protruding from her mouth, but she didn’t. Amy Abbott was no longer her patient. She was now in the care of the coroner. She would be cut open, her organs lifted from her body, each dissected and microscopically examined until an answer to her death was found.
Alex was rooted to the spot she had been standing on for the last hour. She was out of the way of the police, but close enough to see Amy’s face. There was no peace written in her features. Her eyes were wide open in fixed surprise and her lips were prised apart with rigid plastic.
A plain-clothes police officer arrived and Alex watched him talking to Nathan Bell, Maggie Fielding and the anaesthetist over in a corner. He looked her way and nodded briefly, suggesting he was aware who she was. The anaesthetist did most of the talking, and from his gesticulating hands, aimed twice in her direction, and the tight expression on his face it looked like he was blaming Alex for the situation.
Immediately following Amy Abbott’s final words, the anaesthetist had none too gently pushed Alex aside and taken over. He had tried to resuscitate the woman for a further thirty minutes, with him ventilating and Nathan Bell giving chest compressions. When Alex said they needed to call the coroner, he had quietly agreed. Any sudden death from an unknown cause had to be reported, but when Alex declared she believed Amy had been murdered, his eyebrows rose in astonishment and she distinctly heard him say through gritted teeth, ‘Oh God. So you’re the one.’ Leaving Alex little doubt that she had been widely discussed, that he had heard about her abduction, and from his tone, was sceptical.
Fiona Woods and the other nurses had glanced away in embarrassment. Nathan Bell had tapped the floor with his foot and fiddled with the equipment over on the counter. But Maggie Fielding had surprised her. On the pretext of turning off the oxygen behind Alex’s back she had squeezed Alex’s shoulder comfortingly and offered words of support. ‘You did everything you could,’ she’d said.
The grey-suited officer walked towards her.
‘Dr Taylor? My name’s Greg Turner. Detective Inspector. Can we find somewhere quiet to talk?’
Alex noticed a shiny patch staining his dark-patterned tie, and the collar of his white shirt curling up at the ends. He was probably no older than his early thirties, but grey was running through his dark wavy hair and lines fanned his tired green eyes.
Peeling off her rubber gloves and shoving them into her pocket, Alex led the way to the relatives’ quiet room. She sank down on one of the low, boxy armchairs and he followed suit, leaving only inches between their knees.
He rested his hands in his lap. ‘Why did you decide to call us? Was it because you knew she had gone missing? That she was Amy Abbott? A nurse who worked at this hospital?’
Alex cleared her throat, her mind searching for the right words so that she came across as a professional trying to help. ‘I didn’t know who she was until after she died. Until after I made the call. I’ve heard that she worked here, but I’ve never met her. It was what she said that made me call you.’
Her silence prompted him to ask the obvious. ‘Which was?’
‘She didn’t get to say much. We were getting ready to anaesthetise her when I saw that she was trying to talk. She asked me to tell her mum she was sorry, that she was stupid. And then she said, “I should have said yes”.’
Greg Turner’s expression was difficult to read. His eyes didn’t give away what he thought, nor did his next question. ‘And you felt this was reason enough to call us?’
‘Yes.’
‘Why?’
Alex pressed back against the chair, wishing the room was bigger so she could get up and pace about. It would be easier for her to talk on her feet and not be so close to the man.
‘Two weeks ago something happened to me, something that I don’t think your officer believed. I was meeting my boyfriend, Patrick, in the car park. I’d just finished a late shift. I got knocked out, and when I came to I found myself in the hands of this man. I was . . . Look, it might be better if you talk to Detective Best. She’ll have all the details. I er . . . it’s not that it’s difficult to talk about. It’s just . . . Well, frankly, I’m not sure you’ll believe it.’
Unexpectedly, tears rolled down her face.
Greg Turner pulled some tissues from a nearby box and gave them to her. ‘Well, it’s obvious you believe it. If you don’t mind, I’d rather hear about it from you first.’
Over the next half hour Alex told him everything, even down to the CT scan and the holiday in Barbados.
‘And this is your first shift back?’ was his first response.
‘Yes.’
‘Do you think perhaps it was too soon?’
Alex shut her eyes in frustration and sighed resignedly.
‘Dr Taylor, whether or not this did indeed occur, you’re a doctor. Would you recommend anyone else going back to work so soon? You’ve been through an extremely unsettling experience.’
Alex sat upright, her shoulders pulled back and her chin lifted higher. ‘It was what she said. He said the same to me.’
‘Her words could have meant anything, Dr Taylor. Her “yes” could have meant any number of things. Her post-mortem is in the morning. At this stage it’s best we await the outcome. Amy Abbott’s parents will have enough to deal with when they learn about the death of their daughter. Telling them she could have been murdered is out of the question. When I get back to the station I’ll go through the statement you gave to DC Best and I’ll check on how things are going so far. I’ll give you a
call when I know. In the meantime I would like to suggest that you don’t spread any rumours regarding tonight. It won’t do Amy’s parents any good, and if I’m being frank, it won’t do you any good either’
‘Do you believe me?’ Alex felt brave enough to ask.
He stood up. He straightened his suit jacket and did up the second button. ‘You’ve had a stressful time, Dr Taylor. Maybe you’ve come back to work too soon. I’m sure your colleagues would understand if you needed more time.’ He smiled at her politely. ‘Yours is a difficult job. I’m sure it takes it out of you, seeing so much pain. Give yourself a little more time, why don’t you?’
Chapter eight
The skin on her hands had turned red, and her fingers looked heavy and swollen. She had been sitting on the shower tray, knees drawn up, arms wrapped round them, since arriving home. Her work clothes were saturated, clinging to her shaking body, and her eyes were stinging from the tears that still fell.
Over the sound of the heavy spray of water she heard the telephone ring several times and knew it was either Fiona or Caroline, because by now Caroline would indeed know what had happened in her department. She wasn’t ready to talk to them yet. They wouldn’t believe her, so what was the point? Nathan Bell had tried to stop her rushing off into the night, but Alex had been determined to get out of the place. Everywhere she looked she had seen concern and confusion in the faces of staff. Fiona Woods had given her a hard hug, but even she, after her initial concern, had rolled her eyes in exasperation as Alex tried to explain, and any confidence Alex had left just shrivelled and died.
They were best friends, not just colleagues; each had been there for the other in times of stress, and each had lent a shoulder to cry on when the need arose. They had cried together over the worst cases, particularly young deaths, drowned their sorrows and got drunk. Fiona was one of the few people who were aware of what she had gone through thirteen months ago. But it seemed that Fiona had forgotten all this. And who could blame her?