The Dilemma

by Abbie Taylor

  Plenty of people would say I should go to the police. But I’ve said to myself, you’re the Matron. You must have had your reasons, and I respect that. So here’s what we’ll do. I’ll mind my own business and say nothing. And in return, you will send me something to ease my conscience. Shall we say £5,000 in cash? By the 17th, or I’ll assume you’re not interested.

  The e-mail went on to give a postal address in Essex.

  This is an accommodation address. Even the police would have trouble tracing it, though I suppose they could if they tried. But I don’t think either of us would want that.

  I would prefer not to communicate by e-mail. I look forward to hearing from you by post very soon.

  Sincerely,

  A well-wisher

  Dawn’s lips were numb. Five thousand pounds! Accommodation address! It took her several attempts to read the message all the way to the end because the words kept blurring into each other. She had to keep taking extra breaths; there wasn’t enough air in the normal ones to fill her chest. You killed Ivy Walker so discreetly. Her lungs emptied again. What was going on here? Who had written this?

  It came to her a second later.

  The post-mortem! The lab had found the potassium in Mrs Walker’s body. The pathologists had come up to the ward to ask some questions and … The syringe! They had searched the stock room and found the empty potassium syringe in the sharps bin. With her fingerprints all over it! What had she been thinking? Had she left her brain at home that morning?

  As she had today, it seemed. Because it was another few seconds before she remembered. There hadn’t been a post-mortem. Whoever had written this, it couldn’t be someone from the lab. Mrs Walker had gone straight from the ward to the mortuary. She had been cremated two days after her death; Dawn had seen with her own eyes the coffin go through the curtains.

  But if not the lab, then who? Who the hell had sent this? Dawn scrolled the screen back up to see the sender address. Well-wisher. The same name as the signature on the message. She didn’t know anyone who used that as their e-mail address. Almost certainly it was a fake, specially created to send this toxic little memo.

  Her chest was sucking at nothing again. Blackmail letters. Fake e-mail addresses. Here she was, sitting in her office on a perfectly normal Thursday afternoon, surrounded by her filing cabinet and her shelves and the poster on the back of her door advertising the International Research Conference, everything so ordinary and everyday, and yet this … this unspeakable message sitting on the screen in front of her. From outside the door of the office came a shuffling sound. Then a woman’s voice.

  ‘That’s right, Mrs Potterton.’ It was Trish, the ward physiotherapist. ‘Just a few more steps. Doing really, really well. Your niece will be delighted.’

  The voices and the shuffling passed on. But Dawn sat as if glued into place.

  Your niece.

  Mrs Walker’s niece! That was it. All along Dawn had thought there was something funny about her. She had wanted to speak to her at the funeral but at the last minute Heather Warmington hadn’t turned up. It had left Dawn feeling uneasy, and now, at last, she knew why. That time they had spoken on the phone … Dawn couldn’t remember exactly what had been said but … there’d been something, hadn’t there, about Mrs Walker being better off dead? And then afterwards, when Mrs Walker had died, Heather Warmington must have remembered the conversation and concluded there was something suspicious going on. She had gone to her lawyer who had said … Dawn leaned in again to read the e-mail. Why did she keep forgetting what was in it?

  But as she read the words again, her stomach settled in her like a stone. This was no lawyer’s letter. You killed Ivy Walker so discreetly. The implication was there right under her nose. Whoever had written this was telling her something: telling her that they had been there.

  Had been there and seen her kill Mrs Walker.

  The room went blotchy. Dawn put her forehead on her hands. God. Oh God. Her breathing echoed harshly from her palms. The blind. That stupid, broken blind. What was the point in her checking before she went in to the room that no one was about if anyone walking past afterwards could have looked through the window and got a ring-side view? How had she been so stupid? How could she ever have thought she could do something like that on a busy ward in the middle of the day and not be seen?

  She took her hands from her face and folded her arms around herself, rocking on her chair. Something was wrong. Something didn’t fit with that scenario. Even if someone had happened to look in, what would they have seen? A nurse tending to a patient. Fiddling with her drip, which nurses did with patients a hundred times a day. Mrs Walker’s body had not been discovered for almost an hour after her death; Dawn had been long gone from the room by then. Why would anyone jump to the conclusion that the death of a frail, elderly, terminally ill lady was due to her?

  Another sound from outside the office. A faint scratching noise, close to the bottom of the door. Dawn stopped rocking to listen.

  Scrttch. There it was again.

  Someone was out there. Listening.

  Dawn sat frozen, hunched over her desk, her gaze fixed on the door. Through the blind, a dark shape moved. The scratching noise had stopped now; there was silence on the other side, but the person, whoever it was, was still there. The dark shape moved again. Then someone gave a cough.

  ‘Nearly there, Mrs Potterton.’ Trish’s voice again. ‘Soon have you back in bed.’

  Another scrttch on the tiles as Mrs Potterton’s walking frame scraped past.

  Dawn waited for the blotchiness around her to settle. She had to get out of here, think about this properly. There was an explanation for this; she was missing something, she just couldn’t think clearly enough at the moment to work out what. Her computer screen glowed on her desk. She felt a sudden lurch of dread. How long had that e-mail been open? E-mails could be read by the hospital. Every time you logged on there was a warning. She almost lunged to press Delete. Then she stopped. She was going to need to read this again. She stabbed instead on the Print button. The page with Well-wisher’s message on it came spooling out from the machine under the desk.

  Plenty of people would say I should go to the police …

  The words wobbled. The computer enquired, ‘Are you sure you want to permanently delete this message?’ Dawn stamped her finger on the Return key. Yes.

  She folded the paper up into a square small enough to fit in her hand. Then she picked her bag up from where she’d dropped it on the floor. To reach the main entrance of the ward she was going to have to walk all the way up between the beds, past all the staff and the patients and whatever visitors happened to be around. Act normal, she told herself. Just leave the ward in a normal, unremarkable way, and go somewhere quiet and sort this out. She swung her bag over her shoulder. She had to fold her arms because of the way her hands were shaking.

  The normal working day was coming to a close. Paradoxically, this was one of the ward’s busiest times, when the doctors and other staff crowded in to finish their rounds and finalize their management plans for the night. Dieticians and pharmacists scribbled in charts. At the nurses’ desk, a group of junior doctors was clustered around a CT scan, arguing about the contents. ‘Look. That’s definitely fluid, you can see it right there.’ ‘I don’t agree. I think it looks more solid.’ Dawn was almost at the doors to the hall when Mandy appeared from nowhere.

  ‘Off now, Matron?’ she shouted in her cheerful, fog-horn voice. Everyone within a radius of ten feet promptly turned to look at the two of them.

  ‘Yes.’ Dawn tried to stretch her lips in a smile. ‘Thought I’d try to beat the traffic today.’

  ‘Any final instructions for the evening?’ Mandy was covering the late shift.

  ‘Final instructions … let’s see …’ The corners of the folded paper were digging into her palm. ‘Mr Hughes can move on to solids this evening. If he’s up to it.’

  ‘Righty-ho.’

  ‘And if Micro phones w
ith his results, just let the medics know.’

  ‘Ooh, let me get that down.’ Mandy unfolded her ward list. She spread the sheet of paper over her thigh and bent to scribble the details. ‘Oh hell,’ she said, standing up again and shaking her pen. ‘Bloody thing’s stopped working.’

  Hurry, Dawn thought. Please hurry. Her face was pounding in time with her pulse. Already she had an almost uncontrollable urge to open the note up and read it again. Check she hadn’t missed something, that there wasn’t some bit at the end she hadn’t registered that would explain everything. Waiting for Mandy to fix her pen, she felt an odd sensation: a hollowness at the back of her neck, as if the space behind it was too open and exposed. She swung around. Trish the physio was helping Mrs Potterton back to bed. At bed six, Elspeth was hanging a bag of antibiotic. The doctors were still at the desk, squabbling over their CT scan. Everyone was busy, absorbed in what they were doing. No one was looking at Dawn at all. All the same, she knew beyond a shadow of a doubt. Before she had turned, someone had been watching her. Somebody on the ward, right here, right now, had sent that e-mail! The faces tilted and curved. Suddenly there were eyes everywhere, swivelling to follow her as she moved. She had to get out. She had to get out now!

  Mandy gave her pen a final, vigorous shake. Ink spattered over the nearest curtain.

  ‘There we go,’ she said. She wrote on her page with her tongue sticking out. ‘Micro … Hughes. Got it. Anything else?’

  ‘No, that’s it. Thanks, Mandy.’ Dawn was already moving away, heading for the doors. Not quite running, but very nearly. The hall was as busy as the ward. At the lift, a long queue waited. Dawn hurried past it to the fire escape and shouldered through the door. The cement stairwell was cool, blessedly empty. The heavy door clanged shut behind her. She leaned against it, resting her head back on the metal. Now she knew what some of her patients meant when they described a panic attack as feeling like something alive was trapped in their chests, fighting to escape. She closed her eyes and put her hand to her ribs, waiting for the sensation to pass, feeling the breeze on her face from the steep, snail-shell drop of the stairwell.

  Then she opened her eyes again and started down the steps. Down she went, around and around, the stairwell turning and circling on itself like her thoughts, the same questions repeating in her head over and over. Who had sent that message? Who? Once more her breaths were coming too fast. She stopped again, holding on to the wall, making herself breathe more slowly. Count, she told herself. Count between breaths. No point blacking out on the fire escape and being found here with this letter in her hand.

  By the time she reached Café Pio on Lavender Hill she had started to calm down. The café was a place she sometimes came to if the traffic was too heavy to catch the bus straight home. The warm, familiar smells of fresh-baked muffins and flapjacks enveloped her as soon as she opened the door.

  ‘Large cappuccino, please,’ she said to the waitress.

  She leaned on the top of the counter, still feeling as if her legs could do with the help. Next to her elbow were rows of plates piled with scones, biscuits and slices of cake. A cast-iron cauldron filled with soup bubbled on a tripod. Two women at a nearby table chatted over a pot of tea. It was all so cosy and peaceful and normal here. She had read that e-mail all wrong. She must have done. Things like this did not happen to people like her. Her, the Matron, at one of London’s top teaching hospitals! The sharp corners of the note had softened in her sweaty palm. She had completely overreacted just now on the ward. She’d get some coffee into her, sit at one of the quiet tables under the bookshelves and read the note through again. Properly this time.

  She took her cappuccino to a table at the back. At the next table, a woman sat by herself, reading a magazine. Dawn hung her bag from the back of the chair and sat down, feeling much more settled and in control.

  She was just opening the note out again when a high-pitched screech erupted from somewhere around her: BLEEE-BLEEE-BLEEEEE—

  Her nerves already operating at maximum voltage, Dawn almost knocked over her cappuccino. The noise sounded so exactly like a cardiac arrest alarm. The woman at the next table had jumped as well. She dragged her bag up from the floor and began to scrabble around in it. Keys and tissues and pens flew out all over her table. Sorry, sorry, the woman mouthed at Dawn. She pulled a phone from the bag and flipped it open. BLEEEEE – the high-pitched screeching stopped.

  ‘Hello?’ the woman said into her phone.

  Dawn sat, dry-lipped, in her chair.

  The high-pitched shriek of the phone. Like the high-pitched shriek of an ECG alarm.

  Mrs Walker’s ECG alarm.

  She leaned forward, putting her hands to her face. Now she saw it! Now she understood how this Well-wisher person knew what had happened. On the day Dawn had killed Mrs Walker, she had turned the ECG alarm in the side room to Silent and then forgotten all about it. And so, all the while she stood injecting the potassium into Mrs Walker’s drip, no alarm had gone off to remind her that the ECG above her head was changing – changing from a normal to a lethal rhythm. On the screen above Mrs Walker’s bed, in full view of the open blind on the door.

  Dawn wanted to lie down on the floor. To pull her knees up, cover her face, curl up into a ball. Stop this. Stop this. It’s too late now. You can think about this calmly, work out what to do. Or you can end up in prison. Lose your job. Be banned for ever from working in a hospital. It’s up to you.

  She made herself drink some of her coffee. The mug shook so violently that it banged off her tooth. Beside her, the woman was still talking into her phone. The waitress was at the counter, mopping the floor. Everything was fine. Everything was going on just as normal. No one had noticed that anything was wrong.

  Dawn rattled the mug back on to its saucer. Then she took the crumpled page with the e-mail on it and opened it out on the table.

  OK. She flattened the creases out with her fist. OK. This had happened. She’d been seen. She’d been caught. And now she had to deal with the consequences. The first thing, the most important thing, was to work out who this person was. Then at least she would know who she was dealing with. Just now on the ward she’d had the sensation that someone was watching her while her back was turned. One of those people there had written this note. But who? There’d been dozens of people about. She’d been in such a panic that she’d run out of the ward without registering more than half of them.

  Well, whoever it was, they had also been on the ward the day Dawn had … the day Mrs Walker had died. If she could find out who had been there on both days, she might have a chance of narrowing things down. Her mind was clearer now. She was thinking better. The day of Mrs Walker’s death had been the day of the International Research Conference. Dawn remembered because it had struck her how very quiet the ward was. In fact – her hands tightened on the page – the only staff present had been the nurses on duty that afternoon. And she could find out quite easily who they were. She was the one who drew up all the rotas. It would take her less than a minute to check the off-duty folder in her office.

  But even as she thought this, she realized something else. She already knew which nurses had been there, because before going in to Mrs Walker’s room she remembered pausing to check on the whereabouts of each of them.

  Suddenly she was reaching behind her, rummaging in her bag for a pen.

  Mandy. Elspeth. And Trudy Dawes, the new student.

  Those three. She could swear to it.

  Dawn hauled the pen from her bag. On the back of the crumpled page, she printed the initials, one below the other: M, E, T.

  Then she sat back.

  All right. Which of them?

  The truth was, she couldn’t see any of them doing it. These were her colleagues, her team. They had worked some tough shifts together, had helped and supported each other through some difficult cases. The thought of one of them betraying her in this way was horrible. But like it or not, the facts were there. Someone had sent this e-mail. Someone
who had been on the ward that day – someone who, it now occurred to her, knew her work e-mail address, the one she used to circulate rotas and memos to the nursing staff.

  She wiped the sweat from her pen.

  Right then. Trudy first. She knew next to nothing about the girl. She had only started on the ward a few weeks ago. But surely she could discount Trudy? Nervous, rabbit-in-headlights Trudy who had almost passed out the other day while changing a dressing and had to be helped to the staff room to put her head between her knees. Would she have the guts to do something like this? And more to the point, how well could she read an ECG?

  Of the three of them, Mandy, the most senior, was the most likely to have spotted the changes in the ECG and to have put two and two together. She had been covering the Day Ward that day, directly across the floor from the side room. She’d had her back to Dawn, but Dawn hadn’t been watching her all the time. Mandy could have turned her head at any minute without her noticing. And this sort of scandal would be right up her street. Mandy loved gossip, the juicier the better. And she wasn’t above a touch of maliciousness if she thought it would add to the excitement.

  But Mandy had been on Forest Ward for nearly three years. She was good with the patients, friendly and interested, if occasionally sloppy with details. She and Dawn had always worked well together. Hadn’t they? A memory surfaced: Dawn, a couple of months ago, asking Mandy not to sit on a patient’s bed while she took her blood pressure. Mandy, normally easygoing, had blown up in a burst of unexpected temper.

  ‘Don’t patronize me, Dawn. If I didn’t have a child to take care of, I could be in charge of my own ward by now. So keep your superior tone to yourself and don’t treat me like a half-wit.’

  Dawn had been astonished by the outburst. She hadn’t meant to sound patronizing. As the Matron, it was her job to make sure that infections didn’t spread from one bed to another. Surely Mandy understood that? As it happened, Mandy’s anger had seemed to fade quickly enough. The following day she had behaved towards Dawn in her usual cheery way. But had the resentment still been there, festering underneath? Was there enough dislike there to make her want to do something like this?