by Manda Scott
‘Yes. They were useless. They all tested sensitive to basic penicillin. As far as the microbiologists were concerned, they killed off all the bacteria in the first couple of hours after treatment.’
‘And the animals still died?’
‘Yes.’
‘And nobody thought that was curious?’
‘Only the microbiologists. Everyone else was too busy trying to keep the horses alive.’
‘And blaming the micro crowd for being useless.’
‘More or less.’
‘Sounds familiar.’ He made a steeple of his fingers, rested his chin on his thumbs and tugged at his upper lip. ‘What about your mare? When did she have surgery?’
‘She had a caesar Friday night. We took her home on Saturday to try and keep her clear of infection.’
‘And she started clinical signs of infection on Monday night. That’s seventy-two hours after surgery. I thought they all started at forty-eight hours post-op?’
‘So she was different.’
‘She was, wasn’t she?’ He drew a line, hard down the pad. Wrote at the head of it. ‘Did anyone else go near her after you took her home? Anyone from the vet school?’
‘Nina. She gave me a hand with morning treatments on Monday. Nobody else. Why? Does it matter?’
‘I don’t know.’ He scribbled Nina’s name in his new column. ‘This is pretty vicious stuff, Kells. You’d think your mare would show signs a lot sooner than Monday if she picked something up in theatre.’
‘Maybe. We hit her pretty hard with the antibiotics. I came home with half the vet school drug store in the back of the lorry. It could have delayed the onset.’
‘It might …’ he nodded slowly. ‘Or then again, it might have done just the opposite. If you think about it the other way round …’ The nod turned to a shake. He chewed his lip. Chewed the pen. ‘And that would be nasty. Very, very nasty …’
‘Eric? Try that in English?’
‘Just because it says penicillin on the bottle, doesn’t mean that’s what’s inside, Kellen.’
‘You can’t put E. coli in neat penicillin, Eric, however armour-plated it is. It would die off in seconds.’
‘True. But then maybe you don’t need the bugs …’ He drifted off, floating in some internal world.
‘Eric?’
‘Sorry.’ He smiled at me vaguely, as if he had forgotten for a moment that I was there. He stood up and pushed his pad back into his pocket. Nodded again. ‘Give me a minute, Kells. Just let me check I’m not telling fairy stories.’ He walked up the ward to the staff room at the end and made a brief, animated phone call.
I sat on the bed watching plasma drip into a vein and followed the rising graph of her temperature step up towards 40°. Tried to remember how high it can go before organs start to disintegrate. Tried to remember what we could do to bring it down if the antibiotics didn’t work. Symptomatic treatment. All you can do in the absence of a definitive diagnosis. When I was a student, it was iced-water enemas. No doubt there are better things now.
Eric came back. Sat down again on the end of the bed. ‘Right.’ There was something new in his voice. Urgent. With an undercurrent of excitement. Like the dog when she’s hunting. ‘How serious were you about someone else putting in her catheter, Kellen?’
‘Fairly.’
‘To make it look like suicide?’
‘Yes.’
‘OK. I’ve read her file from last time. As far as they were concerned, she cracked because she’d had a run of cases that died. As her therapist, would you say that was right?’
‘Yes. That and about a week on no sleep trying to keep the last one alive.’
‘Fine. Who else knows that?’
‘Me. Matt Hendon, probably—she told him most things. And Steff Foster. She worked it out for herself.’
‘So if we were working backwards, from a suicide that wasn’t a suicide, either one of those two could, potentially, have set up a series of deaths to follow the same pattern as before?’
‘Maybe.’
But if I’m right, Kellen, then we aren’t too far off a repeat prescription. I don’t think she’ll blow it a second time.
‘Make that definitely, Eric. How would they do it?’
He smiled. Tight-edged and hard. ‘Injectable endotoxins. Things have changed since we were in college, Kellen. I just called a friend in micro. If you have a valid research grant number, you can buy neat endotoxins off the shelf. They come dried. All you need to do is add water and inject.’
‘Without any bacteria?’
‘You’ve got it. The bacteria were a blind, a red herring for the micro team. Your horses weren’t infected in theatre, Kellen; it’s probably the safest place in the clinic. I think they got it afterwards. By injection. You can kill mice in hours if you get the dose right. Horses won’t be any different. You just decide how fast you want them to go and then you slip the right amount of junk into a vein when nobody’s looking …’ he leant forward and wrapped one big bear paw over both of my hands, ‘… which is exactly what they’ve done with Nina.’
His face was different. Grim. Hard. Like gritstone. The house officers might see him like this. Possibly his registrar. I never have. ‘She’s got about four hours, Kellen,’ he said. ‘If we don’t get some anti-endotoxin into her by then, she’s finished.’
And we just gave it all away.
I stood up. Headed for the staff room. ‘I’ll call Steff. She might not have put it into Rain yet.’
He caught me. ‘No you won’t, Kellen Stewart. That woman’s just run off with the only thing we had that would work. If you’re calling anyone, it’s the police. I’ll start ringing round the other units. Someone else will have some.’
They might not.
I pulled free. Kept going. ‘The vet school’s closer than anywhere else, Eric. And it might not be her.’
He followed me in through the door. ‘Who else has been alone with her, Kellen?’
‘Matt Hendon. And he has a reason.’
‘And you think your blonde friend hasn’t?’
‘Of course she hasn’t. Why should she?’
We were both in the staff room by then, beside the phone. He caught my arm. Not hard. But enough to stop me reaching for the receiver. ‘Try watching her sometime, Kellen. She looks at Nina the same way you do. I’d say she has as much of a motive as he does.’
‘That’s unnecessary, Eric’
‘Maybe, but it’s true. The only person who hasn’t seen it is you.’
‘Bullshit.’
My bag was beside us, my mobile somewhere in the bottom. It rang, loud in the space we left.
I reached for it on instinct. ‘Hello?’
‘Kellen? It’s Steff. I’ve got some bad news.’
So what’s new? ‘It’s Rain. Rain’s dead, isn’t she?’
Dead because I injected her. With drugs Steff Foster helped to pack.
‘Yes. I’m really sorry. She’d gone by the time I got back.’
Just now, this is not the worst news I could have.
‘So you haven’t given her the stuff?’
I put a thumb up for Eric and tilted the phone his way. He leant over and put his ear beside mine.
‘No,’ she said, ‘I didn’t. There was no point. But that’s not the problem. It’s the foal.’
‘He’s got the E. coli too?’
Beside me, Eric made eyes. Big, wide I-told-you-so eyes.
The voice carried on in my ear. Smooth Chicago with three years of Glasgow overlaid. ‘No. At least, I don’t think so. You remember he was straining to pass dung this morning?’
‘Vaguely.’ At this moment, I can’t remember past the last half-hour. Nor do I care.
‘Well, he wasn’t straining to dung, he was straining to urinate. He can’t. He’s got a ruptured bladder.’
‘So?’ Do I really need to know this?
‘So we need to cut him, Kells. Now. Matt’s here. He called in on his way home and he’s offered
to stay and help. He can gas him, I can cut. I just need your consent.’
Eric shook his head. Mimed a cut to the throat and shook his head again.
‘No … Not yet. Hang on for ten minutes. I want to see him first …’
Eric’s head swivelled through a single, emphatic 180 degree arc. He mimed a shot to the temple.
‘Kellen, we haven’t got …’ She sounded frustrated. ‘OK. Just don’t hang about. I’ll get everything ready to drop him.’
‘I’m on my way.’
Eric stood blocking the doorway.
‘You’re not going, Kellen. It’s madness. One of those two has just tried twice to kill Nina. They’re not playing games.’
‘Or both of them together.’ At this stage, anything is possible. ‘But we need the anti-endotoxin. I’ll go in. I’ll get it. I’ll come back. I won’t take any risks.’ I gave him a squeeze round the waist. ‘Just keep her going till I get back, huh?’
‘All I can do is keep her cool, Kells.’
‘I know. It’s three miles. I’ll be back in under an hour.’
17
It was warm outside. A low cloud layer caught the fuzzed glare of the sodium lights in Bearsden and reflected it down through the trees of Garscube so that the shadows were sharp-edged and the ground was full-moon bright. The wind came from the south. Warm and damp and clinging. The air smelt of rhododendron and the slow-moving river and exhaust fumes from the traffic on the switchback.
I stopped the car at the top of the drive, just outside the cattle grid and called MacDonald on the mobile for the second time in half an hour. The duty clerk was less cordial the second time around. Repeated the fact that Inspector MacDonald was out and unavailable but that my message, my urgent and personal message, would be passed on and that she had no doubt that he would call me as soon as he could. She hung up before I could thank her.
The car rolled on down the hill. I switched off the lights as I crossed the cattle grid. Switched off the engine halfway down. Coasted silently to the space behind the unloading ramp. Invisible from anywhere but the back of the ward. To my left, a hound yodelled a greeting from the small animal ward. Somewhere down in the medicine byres, a cow lowed. No sound of a foal. Or a surgeon. I pushed the mobile into my hip pocket and followed it with the cigarette lighter from the glove box. Left the car door unlocked behind me.
Inside, the ward smelt of death. Death and disinfectant. As if there had never been anything else. I slid in through the upper doorway. The way we had brought Rain in. As far from the calf pens as possible. Rain lay in her box. Flat out. Rigid. At peace. The drip lines were gone. And the spider’s-web leads of the ECG. Someone had brushed her mane and tail into smooth sheets of dark silk. If there were new scars on the wood of the walls, I couldn’t see them. Perhaps it was peaceful after all. A note on the door read: ‘Await permission for PM.’
Maybe.
But then again, why bother?
The door to the drug store hung open. The lighter flickered, shielded by my palm. Shadows loomed, leering across the walls. Bottles glinted on the shelves. Antibiotics, anti-inflammatories, steroids. Cardboard boxes packed with drip sets and fluids sat squat in the cupboards. Plastic bottles of liquid paraffin ranged along the floor, sharing space with the bandages, VetWrap, cotton wool, gamgee. I moved them all, quietly, furtively, searching. Listened to the sound of my own breathing, too loud in the hollow darkness. An audible counterpoint to the incontinent flame of the lighter. I don’t have the stamina for this. Not now.
I found no vials of anti-toxin.
The door squeaked behind me as I left.
There were lights in the calf pens. Lights and noise and people. A combined assault on the senses that hit me as I turned the corner. Sandy was waiting for me at the bend in the corridor. Sandy, leaning half-asleep against the wall, with a black woollen cap pulled down over his bald head and a good two-day growth of stubble showing speckled white against the wind-blown brown of his skin. I tapped him on the shoulder. ‘Hi. I’m here.’
‘Kellen …’ His eyes were yellow for lack of sleep. The relief was raw in his voice. ‘It’s Cracker. He’s—’
‘I know. I heard. Shall we go and see?’
‘They said they could fix him. As soon as you came—’
‘I know. Let’s have a look first.’ He shuffled after me, lame from too long spent on his feet. I reached the doorway to the calf pens before he was halfway down the corridor.
The ringwormed calf lay asleep in the centre of its pen, directly under the heat lamp, nose under tail and eyes tight shut to keep out the noise and the light. The goat leaned sleepily over the door and made a half-hearted grab for my fleece as I walked past. The foal lay flat out in the straw, straining and swatting his tail to the floor like a bad-tempered cat. A urinary catheter stuck out like a thin, white straw from the end of his urethra. A drip line already ran into his jugular. A route-way for toxins.
I could already be too late. For him. Not for Nina.
Steff knelt at his head, her hand on his mandible, counting a pulse. Matt leant on the wall outside the pen, just out of range of the goat, filling a twenty ml syringe with something the colour of skimmed milk.
‘Kellen.’ He put down the syringe. Put a hand on my shoulder. Smiled welcome. Fatigue had etched new lines on his face. Fatigue and emotional burn-out. The smile looked real enough. ‘You made good time,’ he said.
‘No traffic,’ I said.
I looked at Steff. ‘How is he?’
‘Grim.’ She kept her eyes on her watch until she’d finished the count. Of the three of them, she looked the most rested. And the most stressed. ‘Blood results are real crap. Urea’s up, potassium’s up, pH is down. He’s uraemic, hyperkalaemic and acidaemic. And his pressure’s falling. If we don’t cut him soon, he won’t stand the anaesthetic.’
Quite.
Sandy caught up with us. ‘But she’s here now. You can go ahead.’
‘Can we?’ Matt. Filling another syringe.
‘In a minute.’ I stepped over the door into the pen and knelt down by the foal. Cradled his head on my knee. Felt the soft velvet of his nostrils pushed against my hand, flaring tight with each breath.
‘How do you know it’s a rupture?’ I asked.
‘Signalment. History. Clinical signs.’ Steff. Frustrated. Very frustrated. Time ticks with the pulse of her patient. Both of them running out. She is, after all, a surgeon.
‘And what are they? The clinical signs?’
‘Oh, for God’s sake …’ She reined in. Pressed her lips to a hard white line. ‘He’s a three-day-old colt foal with a history of a prolonged foaling. As far as I know, no one has seen him urinate in a complete stream since he was born, certainly not since he came in here and he has an abdomen full of fluid. It’s classic, Kellen. What more do you want?’
Answers. I want answers to questions I can’t afford to ask. And I want three vials of anti-endotoxin. Now.
The foal’s skin was damp under my fingers. I leaned forward and felt the tight, round drum of his belly. Tapped fingers on one side, felt the ripple of fluid on the other. Watched his tail swat the straw.
I looked up at Steff. Hot, grey ice-eyes. ‘Have you tested the fluid?’ I asked. ‘Are you sure it’s urine?’
‘Kellen, what is this? Of course it’s urine. What else would it be? I’m not sticking needles in there blind unless I absolutely have to. I don’t want to spend half the night repairing a puncture wound in his small bowel on top of everything else.’
‘The lass is right, Kellen. The wee lad’s not fit for more than he’s got.’ Sandy stood outside, leaning on the top of the gate to take the weight off his hips. Worry and pain dug deep into the lines of his face. ‘You have to let them have a go.’
‘If you want confirmation, we could ultrasound his abdomen.’ Matt, from the other side of the pen wall. Leaning back with his hands in his pockets and his eyes half shut, tired beyond caring. ‘It’s fast and it’s non-invasive and it’ll giv
e you a positive diagnosis. Would that help?’ He is humouring me and it is obvious to all of us.
‘How long will it take?’
‘Minutes. Less than five.’
‘Right. Thank you.’
‘I don’t believe I’m hearing this.’ Steff pushed her way out of the pen, pulling a fistful of keys from her pocket. ‘What I don’t need in my life right now is an obstructive owner.’
We watched her go. Sandy played with the goat, ran his gnarled fingers along the top of the gate and then trapped its lip as it tried to eat his thumb. Matt laid out a row of neatly labelled syringes in a rectangular metal tray. Arranged them in order of size. Rearranged them in order of use. He sat down outside the pen, folding up his jacket inside out to make a cushion and then picked a piece of straw from an empty pen and began weaving knots.
I left the foal and sat opposite him, watching.
‘How is she?’ he asked finally.
‘She’s fine.’ I practised this lie all the way down from the hospital. I will tell it until someone else tells me differently. ‘She’s had some soup. She got halfway through writing a letter to Marjorie.’
She talked about it, anyway.
‘Did she, by God?’ Amusement lightened the dark thumbprints under his eyes. ‘Is there all-out war?’
‘I think if she sends it, she’ll be disinherited, but I gather that’s no loss.’
‘Hmm.’ He smiled a mirth-free smile, the closest he could come to a vermilion sneer. ‘Depends if you think a couple of hundred grand is no loss.’
I wouldn’t. But it’s not my inheritance.
He knows more of her finances than I do. To him, these things matter.
‘Is that why you said nothing this morning?’
‘No. Did you think I would?’
‘It crossed my mind.’
He made a loop of the straw, neatly tying off the ends and tossed it into the pen beside the sleeping calf. It fell against one flank, a lover’s knot, perfectly circling a round patch of ringworm. We watched it rise and fall to the rhythms of sleeping calf breath. Slow and restful.