The Dilemma

by Abbie Taylor

  Dawn left Mandy for the moment and moved on to the E on her piece of paper. She had left Elspeth to last because, in fact, she was a bit unsure about her. Elspeth was a junior nurse, a couple of years out of her nursing degree. There had never been any overt row or confrontation that Dawn could recall; Elspeth was a competent enough nurse, if not the type to do more than she had to. It was more a series of little things – like the time Dawn had asked her to help clean up a patient who had vomited and had heard her grumble to Mandy, ‘Who does she think she is? I didn’t do a degree to end up as a skivvy.’ Elspeth had a habit of calling in sick, often on a Monday or a Friday, leaving her colleagues to pick up the slack at the last minute. Recently Dawn had been forced to pull her up on it, warning her that the next time she called in sick she would have to produce a doctor’s cert. Later she had overheard Elspeth in the canteen, discussing her with another nurse.

  ‘She’s got no life,’ Elspeth had complained. ‘It’s pathetic. She’s in here at all hours, sneaking up on people long after her shift’s supposed to be finished.’

  ‘One of those spinster types, do you reckon?’ the other nurse had said. ‘Became a Matron so she could feel needed.’

  ‘Probably. Promise me one thing, though: if I’m still working here when I’m her age, shoot me.’

  Dawn’s lips tightened. Well, Elspeth needn’t worry. She was not Matron material. For a start, she was not reliable. She’d been on the ward with Clive, both of them sitting around in the coffee room, the day Jack Benson had almost died. And, Dawn remembered, Elspeth might have a degree but she was not good at ECGs. Only the other morning she’d had to call Clive over to explain to her what a funny rhythm on one of the monitors meant.

  Dawn stared at the crinkled page on the table.

  Clive.

  Of all the nurses on Forest, he was by far the most likely to do something like this. He was excellent at ECGs. He was good, in fact, at all the technical aspects of nursing, she had to give him that. Just unpleasant when it came to dealing with the actual patients. He would have spotted straight away that the ECG wasn’t right, would have found it strange that Dawn had continued to stand beside Mrs Walker and not pressed the emergency button over her bed or seemed to notice that anything was amiss. And there was no question that he disliked her. Particularly after their confrontation the other day in front of the ward. What a perfect, juicy revenge this would be for him.

  But he hadn’t been there. His shift had ended at lunchtime; he’d been gone from the ward half an hour before Dawn had given Mrs Walker the potassium. She had seen him herself, barging through the doors on his way out. Clive was not the sort to hang around the workplace on his afternoon off for a second longer than he had to. He might be the most likely person to do this. But it was not him.

  Dawn threw the pen down. This was useless. She was getting nowhere, sitting here scribbling things on bits of paper. Who was even to say that someone had seen her that day? She could be on completely the wrong track; the blackmailer could have found out about Mrs Walker some other way; it could be anything, something she hadn’t even begun to think of.

  The sweat-dampened paper had torn; the pen, in places, had poked right through. Dawn made a couple of half-hearted attempts to piece the writing back together. Then she took the page and ripped it in half. She folded the pieces over, tore them again. She stuffed the scraps into her cappuccino mug. Stirred them with the spoon, soaking them in the brown, creamy froth so that no one would ever be able to read them.

  At home, Milly flew to meet her, licking her hands, panting and yelping with excitement. Her ropy tail whacked off Dawn’s calves. Dawn patted the warm, stubby flanks. The dog’s simple, open pleasure brought a lump to her throat. She thought, She doesn’t know what I’ve done.

  In the kitchen, she prised open a tin of Milly’s favourite rabbit in gravy. But even as she spooned the chunks into Milly’s plastic bowl, her mind was still working.

  She had moved on for now from the question of ‘Who’. Even if the blackmailer was Elspeth or Trudy or Mandy, she had no way of knowing which. Ultimately, the question now was, ‘What was she going to do?’

  On the bus home, she had passed a police station with its familiar blue and white lantern on a pole outside. It had occurred to her that she could get off the bus and just march on in there. Blackmail was a crime. The police could track the person through that address they had given in Essex. Dawn had looked up the term ‘accommodation address’ on her laptop. An accommodation address, it turned out, was a place to where people could have their mail sent, from where it would be forwarded to their real address. All sorts of people used them: businesses who wanted to pretend that their firm was in a posher area, women who didn’t want an abusive ex to know where they lived. And now, it seemed, blackmailers. The companies who handled the mail promised security and discretion. Even the police, they claimed, would never be able to discover the client’s real address. But surely when a crime was involved they would be forced to hand over the details?

  Yes – and then what? Blackmail was a crime. But murder was worse. One look at the contents of that e-mail and the police would be far more interested in her than in any blackmailer.

  No. The police were not an option.

  While Milly gobbled up her rabbit chunks, Dawn went around and around the kitchen with a cloth, restlessly wiping the already spotless taps, surfaces and doors.

  So then, what should she do? Ignore the note?

  Of all the alternatives, this was the one she kept returning to. It seemed by far the most sensible. Blackmailers should not be given in to. Everyone knew that. Once this person had her in their power, what else might they want from her? On the other hand, if she refused to pay up, what could they do? What proof did they have to back up their ridiculous accusations? Mrs Walker had been cremated. There were no remains on which a drug test could be performed. No matter what the blackmailer thought they might know or have seen, it would end up being their word against hers.

  As the evening wore on, she became more and more convinced that this was the right thing to do. Ignoring the message might give her a few sleepless nights, but in the end the blackmailer would have to back off. They might even start to assume they’d been mistaken. It was a big jump, from seeing a nurse happening to stand near a patient to assuming that she had actually murdered her. This person was testing her, sizing her up to see how she would respond. Well, if that was the case, they weren’t going to get very far.

  For almost the first time since she had received the message, the tight band constricting Dawn’s chest seemed to loosen. She even brewed herself some coffee and drank it on the couch in front of the television – although afterwards, to save her life, she couldn’t have told anyone which programme had been on. At bedtime, however, her confidence collapsed all over again.

  Why couldn’t she get it into her head? The e-mail was not a guess. You killed Ivy Walker so discreetly. This person had seen! Otherwise how would they have known to write to her in the first place? And something else had occurred to her. Even if Well-wisher had no proof, the suddenness of Mrs Walker’s death had not gone unnoticed. Professor Kneebone had commented on how unexpected it was. Dr Coulton, that day in the canteen, had seemed astonished to hear that she had died. Who else might think it was odd if anyone asked them to look back? People would ask, ‘Why didn’t she have a post-mortem?’ Geoffrey Kneebone would recall how Dawn had talked him out of doing one. And she had gone to that funeral, even though she had admitted to Celia Dartson that she hadn’t known Mrs Walker at all. Not that there was anything wrong with going to a patient’s funeral. But when you added it in with everything else …

  The tight band was back around her chest. Hospitals loathed publicity. Particularly with St Iberius currently attempting to stamp itself on the map as an international Centre of Excellence. But a matter like this … no matter how vague the evidence was, they would have to investigate it thoroughly. The public would have to be assured that
St Iberius considered patient safety to be of paramount importance.

  A Matron accused of killing a patient. Dawn’s stomach retracted.

  In bed, she lay twisting her fingers around each other. The light from the street stained the walls with a grim, orange glow.

  The bottom line here was that she could lose her job. Whether there was enough evidence actually to send her to prison was another matter. But one thing she knew for certain. If there was a shadow of doubt as to whether the patients were safe in her care, the hospital would not keep her working there.

  She dug her nails into her fingers.

  Could she pay the blackmailer? Supposing she had to? Five thousand pounds! Dawn was far from rich. Three years of home care for Dora, alterations to the downstairs bathroom and a wheelchair ramp for the front porch had not come cheap. Dora and Dawn had not been entitled to any help. Everything had come out of their own pockets and in the end they’d had to remortgage the house. Dawn was paying back the mortgage now but there was very little of her salary left at the end of each month. But she did have the money. It would be a huge chunk from her savings, but if it came right down to it, she could pay it.

  Out of the corner of her eye, she saw a movement. A stirring near the wall, a darkness gathering from the shadows behind. Then the shape detached itself; rose up into the room.

  Dawn’s heart began to pound. Something told her to stay lying on her back, to keep staring ahead, not to turn and look at it directly. The feeling was very strong, that she wasn’t alone, that someone else was here in the room with her. The shape coalesced. Now it was a person. A tall woman in a dark dress, floating above the floor. The figure moved closer. Now it was beside her locker. Beside her bed. Jesus! Dawn jerked her head off the pillow. The shape fled at once, shrinking back to the shadows. When Dawn, her fingers shaking, managed to turn her lamp on and looked to where it had vanished, all she saw was her navy uniform, hanging from its hanger on the wardrobe door.

  Her head fell back on to the pillow.

  It’s only me, she had said when she had entered Mrs Walker’s room. And Mrs Walker had relaxed again, knowing that everything was all right. The Matron was here. The one person above all others that she could trust with her life, to guard her and protect her and keep her safe.

  Dawn lay rigid under the grim orange light.

  She thought to herself, You deserve this.

  ‘Bed six didn’t sleep until two,’ Pam, the night nurse, reported. ‘So I gave her a Temazepam and she settled in twenty minutes.’

  The day staff scribbled down the information. Dawn sat with her chair pushed back so that she could watch the semicircle of staff around the desk without being observed. Was Elspeth glancing towards her more often? Did Trudy seem more jumpy and anxious?

  She hadn’t slept at all. She had seriously considered calling in sick this morning. The thought of having to face this person, whoever they were, knowing that they would be watching her behind her back, hugging their nasty little secret to themselves, was intolerable. But by the time her alarm went off, even the thought of that was better than having to endure more sleepless hours in her silent house. She’d be better off at work. She could distract herself there, tire herself out. She didn’t have to face anyone she didn’t want to; she could keep her head down, avoid interacting with anyone unless it was absolutely necessary.

  After the handover, she went straight to her office and shut the door. She spread some papers out on her desk, but sat without reading them, staring at the ward through the little pane of glass, watching the staff as they went about their work.

  Something had occurred to her during the handover. It was a risk, the blackmailer sending her a message like this. If Dawn did decide to go to the police and the person was caught, the least that would happen to them was that they would lose their job. Five thousand pounds was a lot of money but it wouldn’t get you very far if you were out of work. Either the blackmailer was very confident of not getting caught or they needed the money urgently enough for it to be worth the risk. Which of her three suspects might need five thousand pounds that badly?

  A few feet from the office, Mandy was busy admitting a woman with varicose veins. She was showing something to the patient – from the look of it, a photo of Jason, her nine-year-old, covered in mud and holding up his football medal. Mandy showed that picture to everyone. She was the sort of person who was happy to share the details of her private life with any stranger who walked through the door. A mother like Mandy would do a lot for her child. Five thousand pounds would pay for a lot of school trips and football lessons and new boots. Dawn watched her sitting on the patient’s bed – again! – the two of them chatting as if they had known each other for years. How did Mandy do that? Become so friendly with someone in such a short space of time? Dawn had had many conversations with patients over the years, some of them very intimate and profound, but never this easy banter with a total stranger after only a few minutes. Would Mandy be able to chatter on like that if she was blackmailing her own boss, sitting just a few feet away from her?

  Elspeth hove into view, pushing the drugs trolley. She wore her usual impassive expression; impossible to tell whether she was thinking anything out of the ordinary. Elspeth was by far the most attractive nurse on Forest, dark and graceful, with high cheekbones and very small teeth, like a cat’s. The one thing that Dawn thought detracted from her looks was that she always looked completely bored. She handed each patient their little container of pills and moved on to the next bed without a word. Not for Elspeth the easy Mandy banter. Nothing wrong with that, necessarily; gregariousness was not for everyone. Part of the job of a ward sister was to match the staff with the type of patient that suited them best. Elspeth was good at quick, technical tasks: preparing a run of young, fit patients for theatre, getting each one promptly through the doors. Mandy was better with the slower, frailer patients who needed someone to chat to. But capable though Elspeth was, it was clear that her main interest and preoccupation lay elsewhere. She did the work in a mechanical, emotionless way, utterly lacking in warmth or empathy, that Dawn knew the patients found off-putting. Many of them were too intimidated to ask Elspeth for help with things like washing or the commode and would wait instead until Dawn or Mandy came around. If Elspeth had no plans to stay on long-term at St Iberius, did that mean she wanted to leave nursing altogether? How much would five thousand pounds help with that?

  Trudy, the student, crouched by bed eighteen, fumbling to change a urine bag. She seemed to be having difficulty separating the stiff catheter tubing from the bag. All that could be seen of the patient was his grey, curly hair sticking up over the top of his Telegraph. Trudy gave the bag a couple of tentative tugs, then pulled again, more forcefully. The Telegraph gave a convulsive jerk. The patient’s face, lavender in colour, shot out from behind it. He clutched at his groin, glaring at Trudy, his lips moving at speed. Trudy flushed dark red, fumbling even more. Dawn didn’t need to hear her to know that she was babbling, almost in tears. Sorry. Sorry. I’m so sorry.

  Student nurses were paid very little. Who knew what Trudy might need with five thousand pounds? A holiday? Loan repayment? Food? But she was so diffident, so terrified of everything. Daphne from Orthopaedics had reported that when Trudy was doing her placement there she had upset the relatives of one patient, a teenage girl with a spinal tumour, by bursting into tears every time she treated her.

  ‘She won’t last,’ Daphne had scoffed. ‘Much too soft to be a nurse.’

  Being soft, in Dawn’s opinion, didn’t make you a bad nurse. But you did need to be able to hold it together enough to get on with things and give the patient the treatment they needed. Trudy seemed to go to pieces in any situation where a patient deteriorated. Surely if she had witnessed what Dawn had done, she would have spoken to someone about it? Mandy perhaps, or one of her student friends – or even the police? Or said nothing at all, out of fear? But this ruthless, hard-nosed cunning – setting up a fake address, demanding th
ousands of pounds. No. Dawn could not see it in her.

  The office door opened, banging off the edge of the desk.

  ‘Coffee?’ Mandy stood planted in the middle of the doorway.

  ‘No. No, thanks. I’m all right.’

  Mandy stayed where she was.

  ‘You’re up to something,’ she said.

  ‘Am I?’

  ‘Yes. You’ve been hiding in here all morning. Spying on us through your little window. Not like you.’

  ‘Oh. No, it’s just … I’ve got a lot to catch up on.’

  ‘Oh, right.’ Mandy came on into the office. ‘Thought there might be something on your mind.’ She settled her bottom on the desk, shoving the keyboard and a container of paperclips to one side. ‘Warm today, isn’t it?’ she said, fanning herself with her ward sheet. ‘Muggy.’ She was very chatty, even for her. ‘Hope the new ward’s got air-con when we move to it. I’ve been thinking where to bring Jace on his holidays when his school breaks up.’

  Dawn wanted nothing more than for Mandy to go away and leave her alone. But she kept the smile on her face, listening to Mandy bang on about her plans for a week-long trip to Euro Disney in July. She thought with a shiver, I can’t antagonize anyone now.

  It was when Mandy finally left the office that it hit her.

  She could not stay on Forest Ward. Even if she sorted things out with the blackmailer, even if they agreed never to tell anyone, how could she go on working here, knowing that one of her nurses knew something like this about her? She couldn’t do her job properly, be a proper ward sister if she was always wondering and fearful, walking on eggshells, afraid to antagonize anyone. No matter what happened, she would have to leave St Iberius.

  That’s if she was still allowed to work as a nurse at all.