by Valerie Laws
She was thrilled with the ginger marmalade.
‘Eee thanks pet, there’s nothing like it for keeping you regular.’ The jar looked too heavy for her delicate hands. ‘It’s like amber.’ Tily looked into the sunlit depths of the jar. ‘I had an amber brooch once. You’ve got bonny hair, flower,’ she added. ‘Lovely and long. I used to be able to sit on mine. Now I cannot even sit!’
She said this jokingly, rather than complainingly. She never asked why Erica was there, or even who she was. She had been in a long time - fracture, hip replacement which went wrong, deep seated infection in the joint, then a chest infection caused by being in bed for weeks leaving most of her lung capacity unused, and now she was almost institutionalised, her muscles atrophied, washed up on those white sheets. Erica noticed her call button had been put out of reach. As she moved it back near Tilly’s hand, she glanced round and saw that every old patient’s button was also out of their reach.
‘Some nurses do that, accidentally on purpose like,’ said Gill. ‘Saves them having to come in so often.’
‘But that’s terrible! What if they need a bedpan?’
‘Not all the nurses are like that,’ she excused, ‘and I can keep an eye on the old folk.’
Erica went round the bay moving all the buttons within reach, asking casually, ‘What are the doctors like then?’
‘Mr Rohan did my op,’ said Gill. ‘He’s very good. Such a gentleman...’
‘Yes, I’ve met him. Charming man. I expect you knew Mr Kingston?’
"Oh, terrible that was. Yes, some of these were his patients, most of his have gone home by now though. They don’t keep hips in long these days unless summat goes wrong like. Oh, you should have seen him doing his round, those students of his shaking in their shoes bless them. But he could do his job alright. He did Tilly’s hip.’
‘The one that went wrong?’ Erica scented negligence. But she knew that the replacement joints did go wrong sometimes. All surgery was risky.
‘Took good care of me,’ said Tilly. ‘He’s dead now, you know. Who’d have thought he’d go before me! He was a bit hoity toity, but I just did as I was told. Doctor knows best.’
‘Course he does. And there’s a few others - anaesthetists, what have you - and the young Chinese doctor, the one they all call Jamie. Even the nurses use his first name. I suppose he’s still in training.’
‘He’s a lovely lad, for all he’s Chinese,’ said Tilly.
‘He is that,’ said Gill. ‘Mr Kingston used to tease him, like. When he did his rounds and Doctor Lau was with him, he’d say things like, ‘I expect you’d stick a lot of needles in her, Jamie. Or give her a bit of ground up tiger bone.’ And all the students would laugh though they looked dead embarrassed. I didn’t think that was right, mind. Because the lad couldn’t very well answer back, could he?’
That bastard Kingston. How much unexpressed resentment was the young doctor harbouring?
‘I bet he felt like sticking needles in Mr Kingston,’ Erica said as if jokingly, though the image was horribly like her memory of the death scene.
‘Well I wouldn’t go that far. He never said anything, but I saw him look daggers at Mr Kingston when he thought no one could see. They say the Chinese are inscrutable, but he wasn’t then! You’ll see Doctor Lau any minute, he’s coming down to check on Mrs Hilton’s painkillers a bit later. He’s always on duty somewhere it seems.’
Erica stuck around a while, chatting and getting to know any other patients who seemed conscious. She wanted to see more of Jamie Lau. He was definitely a suspect. Not only had Kingston humiliated and baited him in front of everyone, but referring to acupuncture, he had used the actual words about sticking needles in people. Could that have led to nails, pins, like big needles, being hammered into the hated head? Young doctors worked long hours. He must be under great stress - sleep deprivation was a torture, after all. People could be made to confess to terrible crimes that way - perhaps they could be brought to commit them too.
Just then Jamie Lau came in with a nurse. He went straight over to Mrs Hilton. Erica noticed the nurse was very familiar and informal with him, and behaved as if she was indulging him when, after a quiet consultation with Mrs Hilton, he gave fresh instructions for her meds. He turned and gave a general smile and nod of greeting to the ward, pausing as his eyes rested on Erica. She did stand out rather with her lycra and bare arms, not to mention her hair. He gave a half-smile of recognition and headed out of the bay.
Erica went after him. The nurse had gone on to the nurses’ station where she was talking to a colleague.
‘Doctor Lau?’ She had overtaken and was blocking the way. He was taller than Erica, but then just about everyone was. He looked pale and drawn. Dead tired. But he was still cute. Cute as a facebook kitten.
‘Did you wish to see me about Mrs O’Rourke? Are you a relative?’ His voice was soft but clear, with a trace of some kind of accent.
‘Oh, no, just visiting... I really wanted to talk to you. I’m writing a feature on Mr Kingston for the local paper, kind of an extended obituary...’ She watched him for any reaction to the name of his persecutor and possible victim. Was it her imagination, or did he flinch at the name? It was hard to tell, because he put his hand up over his face to push his hair back in a weary gesture.
‘I saw you in Mr Rohan’s room,’ he said. ‘I can’t think why you want to talk to me; it’s not that I don’t want to help but I’m very busy. ‘
‘You look exhausted, I wouldn’t expect you to talk to me now when you’re on duty. Why don’t I take you out to dinner if you are allowed out of here for an evening? ‘
He looked a bit startled. She could see he was tempted, by her or the food she didn’t know, but unsure, perhaps about discussing the hospital with an outsider.
‘Well, thanks, that sounds great, but...’ he began.
She pressed home her advantage. She had no qualms about asking a guy out.
‘Come on, don’t tell me that’s not the best offer you’ve had all day! It’s just a chatty piece for the local rag health page; do I look like a paparazza? I’ll even feed you if you’re too tired to hold a fork.’
He laughed, reassured by her small, harmless appearance and her flirtatious manner. Just another girl who wants to play doctors and nurses, he thought maybe. Well, she could live with that for now.
They agreed to meet in a couple of evening’s time at a little restaurant right on the beach which served brilliant veggie and carnivore food in terrifying quantities. The wine and decor was Mediterranean, the menu cosmopolitan. He said he had never been there. Or anywhere much, he basically lived in the hospital.
‘Just think of it as care in the community,’ she advised him, and let him go.
When she got back to Tilly and Gill, they were grinning significantly.
‘I was just asking Doctor Lau to talk to me for the paper; you know, I write the Guardian health page.’
‘We believe you, thousands wouldn’t,’ said Tilly.
‘That lad could do with a break.’ Gill counted her stitches. ‘He was up in the night, and now he’s still here; and I’m sure he was on duty yesterday. He really cares about patients you know. He spends ages checking meds, and he’s so careful about lowering beds and so on to look at people in traction and so on. Some of them let the bed bounce off the floor, and that’s no fun when you’ve got broken bones or whatever. I think that’s why Mr Kingston got at him; thought he was too soft, needed to toughen up a bit. ‘
Cute and caring? What a killer combo. Killer? Could someone so compassionate drive nails into a living head? But then again, how sensitive could a surgeon afford to be? They did stuff like that all the time. What a mess. Hoping Tessa wasn’t guilty, and now Jamie. Someone had to have done it, for god’s sake.
The man on the table. You remembered the feeling of the rock hitting the pins into his head, the resistance of his skull transmitted up your arm, the give when they broke through into the softness of his brain. The way
his fingers curled inwards round the nails that held them helpless. Those hands, surgeon’s hands, so skilfully causing pain, carving people up like meat. That’s how they operate. Doctors. Surgeons. Making incisions and decisions, and nobody questions them. Until it’s too late, but even then, they all protect each other from their mistakes or misdeeds. All the clever-clever golf-playing back-slapping smug surgeons with money and status and the power of life or death. Or a life not much better than death. All in the same club. They’re all in it together. Yes, he wasn’t the only one. There are others. Someone should operate on them. It would be a public service. A crusade.
CHAPTER SEVENTEEN
As Erica ran up the Ivy Lodge steps, she suddenly felt light-headed and there was a buzzing sensation in her hands and feet. Hungry and dehydrated. In her room, she poured a big glass of cold water, adding the juice of a lime from the fruit bowl, and had a couple of rice cakes spread with low-fat hummus from her emergency rations before her first appointment Laura Gibson arrived. She was one of those who’d suddenly asked for an appointment ‘urgently’ after the report of Kingston’s death, and Erica finding the body, had hit the media. But Erica assumed that was a coincidence. Laura was a smartly dressed, intelligent business woman, hardly the kind to seek shoulder-rubbing time with a corpse finder.
Today she was wearing a milky coffee-coloured tailored jacket, a cream shirt and a turquoise scarf, with black trousers which were well-cut but somewhat looser and longer than fashion dictated, to hide her deformed right leg and built up shoe. She was dark, almost Spanish or Italian looking, with black hair pulled back into a tortoiseshell clip and dark eyes. She walked with a swinging limp and a slim black walking stick and sat down with a small sigh. Erica recalled she had had the kind of tibia and fibula fractures, many years ago, which Kingston had worked on, and a fizz of anticipation ran through her. Was she about to hear something significant, or just another paean of praise to the great knifeman of Wydsand?
‘Hi Laura, haven’t seen you in ages, how’ve you been?’ Casual.
‘I’m fine.’ Always that insistence on the positive, with a hint of defensiveness. ‘Business isn’t great, but hey, we’re ‘all in this together’, allegedly.’
‘Yeah, right. So is it leg problems, or lower back, or that neck trouble? All of it related to your shorter right leg of course, referring stress and pain upwards as your body strives to correct itself.’
‘Yes I know, the zigzag thing.’ Laura zigzagged her hand in a gesture sweeping up her own body, from short right lower leg to left lower back (sacro-iliac joint) to right neck and shoulder area to left temple migraines. ‘Well all the usual aches and pains, I’m used to it. It’s like my weather, I live with it.’
‘I know you got good results from Ruta Grav in the past...’
‘I want to be sure anything I say here is confidential.’ Laura interrupted her in a sudden burst.
‘Absolutely.’
‘I want to speak to you partly as my homeopath, and partly as a reporter. I saw your appeal for information about Kingston.’
‘Confidential on both counts, as patient and source.’
‘I need to tell you. Tell somebody. Kingston was a sick son of a bitch, and he got what he deserved. Only whoever did it was too good to him, by all accounts they knocked him out with a rock first. I’d have happily helped bash in the nails.’ She was trembling slightly and a sheen of sweat was on her upper lip but she looked triumphant. ‘It feels horribly good to say that aloud!’
‘I suppose you’d rather I didn’t quote you, even anonymously?’
‘Actually I’d love it... but I don’t know... he may have relatives who’d be hurt by it.’
‘So how do you know? Did he treat you at all?’
‘No, and yes. The original tib and fib fractures were many years ago, as you’ll know, it was treated with an external fixator of the old fashioned kind. But not by Kingston.’
The old-fashioned kind using pins like Kingston’s souvenirs that ended up buried in his brain, Erica thought. She kept herself still and calm. Mustn’t push it.
‘Anyway, months later, pins out, plaster on, fracture clinics, all the usual. In the end, my tibia just didn’t heal. Didn’t unite. I hate that. I need to be independent, in charge. I used to be. That injury, somebody else’s incompetent driving, took that away from me. Instead I got not just pain, permanent disability, a leg shortened by over an inch, but the feeling of helplessness, my worst fear.’
Mine too, thought Erica. Then realised what had been said. Laura’s leg was now considerably shorter than that. She frowned, and Laura picked it up at once.
‘That’s right, that’s what the difference WAS. So I just got on with my life and my business, working hard, struggling a bit, walking with pain and difficulty, biting the humiliating bullet of disability, as you know I had a bad ankle fracture as well.’
‘Not a good place to make new bone, the tibia, lower down.’
‘Yes I know, bad blood supply. I’m an expert on this injury believe me. So fast forward fifteen years or so, about four years ago, I had a fall. Consultant checked me out, discovered the old tib fracture still hadn’t united, and told me incidentally that nowadays I could have an artificial ankle joint because of the damage there. But of course, I needed a solid leg bone to fix it to. So the leg would have to be fixed first. Well all those years it was out of alignment, painful as the broken ends were able to move slightly, but I’d got used to it. But now I was being offered new treatment for that too. Previously, they’d just written me off as soon as the plaster was in the bin. I was excited. The consultant was Robert Kingston.’
She stopped, took a deep breath.
Erica put the kettle on. ‘Why don’t I make us some tea? Or coffee? Like that fabulous jacket.’
‘Yes I look great from the waist up, don’t I?’ Laura laughed. Erica got busy making Laura’s choice of coffee, while she continued.
‘So, Kingston persuaded me to have another lot of pins and frames inserted. This time, the newer Ilizarov frame. First he explained he had to open up the fracture site, and saw the ends off the broken bones, as they were dead and he needed to get down to living bone. He said this would stimulate them to unite. While the frame was on, I had to turn the screws every day several times a day to force the bones to straighten and to stimulate the new bone to form, lengthening the leg. This was a huge decision for me to make. He was very keen to do it, a non-union that old was a challenge to his skill. I should have realised that was his priority, not my quality of life... but I take responsibility for agreeing to it. It meant at least eighteen months of limited life, worse disability, difficulty with everything, but I hoped it would be worth it in the end. So I went through with it, losing all the mobility I’d fought so hard to regain, gaining much worse pain, and now, ironically, the hospitals are dirtier and I got some foul infections, more pain, antibiotics, all that. This went on for two and a half years. My business suffered, my relationship broke down. And in the end it didn’t work. And it was my fault, not Kingston’s. I take responsibility for that. I have no trouble taking responsibility. It’s abdicating it I find hardest. You see there was a question I should have asked him, and I didn’t. So keen to believe it would work. To believe he could heal me. Him and technology. I’d lost sight of what you know to be true - that even surgery and technology rely on the body’s own healing power. If it doesn’t make new bone, it won’t heal.’
She sipped her coffee, holding the cup with both hands.
‘So what was the question you didn’t ask?’
‘Oh yes. ‘If my tibia didn’t form new bone and unite all those years ago, when I was much younger, why should it do so now?’ Well there was no reason, and it didn’t. But I blame myself for that. My leg, my responsibility to research fully before making a decision. So far Kingston’s just a typical alpha male surgeon drunk on his own skill, caring more about his career than my life. That’s not unusual, I’ve heard a hundred stories, we all have, doctors
who didn’t listen or believe until it was too late, doctors who said we, usually women, were imagining things, doctors who didn’t think about the whole person. Doctors who were callous, clumsy, tactless. Gave bad news badly. And to be fair, the op might have worked, has on some patients, he did nothing I could make any complaints about. Even though I later found out a different surgeon further south was doing the procedure much less invasively or drastically... even then, perhaps he was doing the best he knew how. And if his bedside manner was - disturbing, well that’s not uncommon either.’
‘Medics used to have all the empathy scorned and trained out of them. Things are better now with the new students, or so I’m assured. They even do poetry workshops.’
‘He was more than just tactless and callous and cold. He hurt me. His hands hurt wherever he touched me... and of course being me I had to hide it, stiff upper lip, but it wasn’t easy. He’d dig his fingers hard into the injury site... it made me feel sick... and somehow, under attack.’
‘There’s no excuse for that, when he’s in a position of power.’ Erica realised the man Tessa married was pretty much the same at work as at home, but his victims there already had broken bones. And he got kudos for fixing them, the clever bastard.
‘I know surgeons aren’t expected to be ‘kind’. Their field is the unconscious patient, the damaged area, the fixing, the skill, the success.’
‘I don’t think they’re all like that.’ Erica was thinking of Jamie Lau and his care for patients’ pain and suffering.
‘No, well... anyway, we’re getting to the monstrous bit, and I feel really - I don’t want to - so this horrible day, he gives me the bad news, my leg hasn’t healed. I’ve gone through all that for nothing. In fact worse than nothing, my leg is now even shorter, due to him cutting the ends off the bone. From a small orthotic in my shoe and a limp, I’ve now got a built up shoe and a worse limp. Well he just told me right out, and I was upset. Yes, I cried. In front of him and the nurse. Know what he said? ‘What are you crying for? We can just amputate your leg.’’