The Dilemma

by Abbie Taylor

  Almost lunchtime. She still had to do a quick check on all her patients before the dinner trolleys came round. She started with Lewis in the side room.

  ‘Good news, I hear,’ she said as cheerfully as she could. ‘You’ve been given a date for your operation.’

  ‘Yeah. Friday.’

  Dawn nodded at the spiky metal cage on his calf. ‘I’m sure you can’t wait to be rid of that.’

  ‘Yeah, it’ll be great.’ Lewis was saying all the right things, but to Dawn’s mind there was something forced about his enthusiasm.

  ‘Nervous?’ she asked.

  Lewis picked at his blanket. ‘Not really. Just – you know. Worrying about what could go wrong.’

  ‘Wrong, like what?’ Dawn sat down on the chair beside his bed.

  Lewis shrugged, still picking at the blanket. ‘I don’t know. Complications. Reactions. You hear things.’

  ‘But you’ve already had one operation. To put the fixator on in the first place. And that went very well, didn’t it?’

  ‘Yeah, but this one’s going to be much bigger. I don’t know. I just keep thinking about it. If something happened … if I lost my leg … I don’t know what I’d do.’

  Dawn gave the fixator a light tap. ‘Don’t think like that,’ she said. ‘The surgeons here are very experienced. The chances of anything bad happening are very small.’

  ‘I know, I know. That’s what the docs said. But I can’t help it. I’ve just got this feeling.’ Lewis put his hands behind his head and puffed out his cheeks. ‘Stupid, I know.’

  ‘It’s not stupid at all,’ Dawn said. ‘It’s perfectly normal to worry. But think of it this way, by Friday afternoon, it’ll be all over. And I’ll be working here on Friday night so I’ll come in to check on you. You’ll be sitting here, listening to your earphones, wondering what on earth you were so worried about.’ She bent her head to catch his eye. ‘OK?’

  ‘Yeah, OK.’

  She left him looking a bit happier, fiddling with the buttons on his mobile phone.

  Danielle Jones was next. That morning she had gone ahead with the surgery for her Crohn’s Disease. She had been very drowsy when she had returned from theatre but was now awake.

  Dawn asked her softly, ‘How are you feeling?’

  ‘Very sore.’ Danielle lay in a weary, flattened-looking way, her hair spread around her on the pillow. Fluid dripped from a bag into her arm. More tubes drained blood and other body fluids into various containers under the bed. Between the buttons of her pyjamas, a long white bandage was visible all the way down her middle.

  ‘Do you need something for pain?’ Dawn asked.

  ‘Oh, yes. Please.’

  The jingling of keys announced Mandy’s arrival. ‘Already sorted, Dawn. I just gave her some morphine.’

  ‘It’s not working.’ Danielle gave a weak shake of her head. ‘I would have felt it by now.’

  ‘Just give it a chance,’ Mandy advised. ‘You’ve only had it a few minutes.’

  ‘There’s no point. It won’t work. I’m telling you it won’t.’ Danielle gave a little sob and put her arm over her face.

  Mandy rolled her eyes at Dawn. She showed her Danielle’s drug chart. ‘Ten milligrams, see?’ she whispered. ‘She couldn’t possibly need any more than that.’

  Dawn’s gaze was fixed a couple of inches below the chart, at the morphine keys on Mandy’s belt, clinking a little every time she moved.

  Slowly, she said, ‘Let’s give her the benefit of the doubt. She’s awake, she’s clearly uncomfortable, her pulse and BP are up. She’ll take another dose. I’ll come with you and sign it out.’

  Mandy sighed. ‘OK, Dawn. You’re the boss.’

  Dawn followed Mandy to the stock room. She couldn’t take her eyes off the keys. Her heart was beating faster. Had she really thought that Danielle was uncomfortable enough to need an extra dose? Or was it just an excuse for her to get near the morphine cupboard? If so, what did she think it was going to achieve? It wasn’t as if she could do anything with Mandy there watching. But just seeing the morphine, she thought, might spark an idea in her mind, help her to come up with some sort of plan.

  Mandy unclipped her keys and opened the padlock on the safe. Dawn found herself scrutinizing every inch of the interior in a way she never had before. On the metal shelf was a stack of cardboard boxes filled with morphine ampoules. The flap on the top box was open. Still grumbling, Mandy lifted it out.

  ‘Mark my words, Dawn, we’ll be pandering to Miss Drama Queen for the rest of the week. I know she’s just had surgery, but you see if I’m—’

  She stopped. She had taken an ampoule from the box and snapped it open without paying attention to what she was doing. A long sliver of glass had driven into her finger.

  ‘Shit,’ Mandy said. Already, a shiny red bead was starting to swell on her fingertip.

  ‘Here, quick.’ Dawn yanked a sheet of tissue paper from the roll on the wall. Mandy pressed the paper to her finger but the blood still came soaking through.

  ‘Try holding it under the tap,’ Dawn said. ‘The cold might stop the bleeding.’

  Mandy went to the sink and turned the tap on full force. She sloshed her finger about under the water. Crimson streaks ran down the sides of the basin. Dawn, watching from a few feet away, turned her head a couple of degrees and found herself looking straight at the boxes of morphine. The sink was directly behind the door of the safe. With Mandy standing where she was, the open door blocked her view of the shelf.

  Dawn’s heart rate sped up further.

  ‘Still haemorrhaging,’ Mandy called from the sink.

  ‘Just give it a minute,’ Dawn called back. Her eyes were still glued to the boxes. Ten ampoules, the e-mail had said. The exact number of ampoules in each box.

  Before she could think any more about it, she snatched one of the lower boxes out from under the stack. Under the sound of the running water, she ripped the cardboard flap open. In almost the same movement, she tipped the ampoules into her hand and crammed them into the pocket of her dress. The glass containers clinked off each other. Dawn gripped her pocket, whipping her head towards the sink. Mandy was still rinsing her finger. Dawn shoved the empty box back at the bottom of the stack.

  ‘Any chance of a band-aid?’ Mandy called.

  ‘Coming up.’

  How normal her voice sounded! She wiped her hands on her uniform and took a band-aid from a box on the shelf. She couldn’t quite believe what had just happened. All that plotting and planning and worrying, and now here she was with the morphine in her pocket, just like that. But it wasn’t over yet. The thing now was to get out of here as soon as possible, before Mandy had a chance to start poking around. She passed the band-aid around the door. While Mandy was occupied with peeling the back off the sticky part, Dawn threw the bloodstained morphine ampoule into the bin and took a fresh one from the top box. By the time Mandy appeared, smoothing the band-aid around her finger, Dawn had broken open the new ampoule and drawn the morphine into a syringe.

  ‘Oh, thanks,’ Mandy said. ‘Save me chopping another one of my fingers off. How many’s that left now?’

  ‘We’ve taken two,’ Dawn said. ‘This one and the one you bled on. That leaves four in the top box.’ She paused.

  Mandy said, ‘And ten in each of the others.’

  Dawn said nothing. Staff were supposed to check all the boxes, not just the one on top. If Mandy opened the other boxes … But she didn’t. She clicked the top of her pen and wrote the numbers into the pink-paged ledger.

  ‘Forty-four left in total,’ she said.

  Dawn could have thrown her arms around her. Sloppy, careless, wonderful Mandy. Mandy slammed the ledger shut and tossed it into the safe. Then she closed the door and snapped on the padlock.

  ‘Here’s the syringe for Danielle.’ Dawn held it out, praying that Mandy’s finger wasn’t too sore to prevent her from taking it. She had to get her out of the stock room. She couldn’t move properly until Mandy had lef
t; she was trying to keep as still as she could, one hand clamped over her bulging pocket. All she needed now was for the ampoules to clink against each other – or worse, for some of them to fall out and smash on the floor.

  Thankfully, Mandy took the syringe.

  ‘I’ll give this to Miss Lawyer,’ she said. ‘Get her off our backs.’

  She went out, still fiddling with her bandage. Dawn stayed where she was, locked in the same stiff, clenched position, clasping the knobbly heap in her pocket until well after Mandy’s footsteps and the jangle of her keys had faded.

  The morphine ampoules were bulkier than the cash had been. Dawn was going to need a larger envelope to post them. With some kind of padding to protect the glass. At the post-office in the Georgian terrace of shops at Silham Vale, she bought an A3-sized envelope with bubble wrap on the inside. Also plenty of stamps – far more than she probably needed, but she wasn’t taking any chances.

  Walking down the patchwork pavement of Crocus Road, past the parked cars with their windscreens shimmering in the sun, she felt herself lifted by a sense of control. She’d done it. She’d got the morphine! Once she had posted it, the blackmailer would be in her power. For the twentieth time, she thought it: Thank God Mandy had been so careless. A more thorough nurse might have insisted on opening each and every box. How long, Dawn wondered, before the missing morphine was discovered? Anything from a day to a couple of weeks, depending on whether anyone ever actually did check all the boxes or whether the theft only came to light when the upper boxes were empty and the bottom one was reached.

  And that was when it hit her. She stopped.

  If whoever took the keys from Mandy this evening did a proper count and discovered the empty box, Mandy would be blamed. She would have been the last one to hold the keys. Pharmacy would go into meltdown. Even one ampoule going accidentally astray was a matter for all kinds of meetings, explanations, overhaul of policy. But ten! And the empty box still in the safe, carefully closed over and placed at the bottom. A deliberate attempt to mislead. Mandy would find herself at the centre of a massive investigation, surrounded by pointing fingers. When did this happen? When did you last check all the boxes? At the very least, she would be hauled before a disciplinary panel for negligence. At worst, accused outright of the theft.

  Dawn sank on to a nearby wall. Shit, shit, shit. Now what?

  Mandy might not be the best nurse Dawn had ever worked with. But she was a long way from being the worst either. The patients liked and trusted her, and her interest was warm and genuine. Mandy might forget to chart a patient’s temperature, but she would happily spend twenty minutes nattering with them about their womanizing husbands or the latest episode of Coronation Street – a practice which, in Dawn’s opinion, could often reveal at least as much about a person’s condition as taking their temperature ever could. She pictured Mandy sitting white-faced in the HR office, worried sick about what might happen to her son if she lost her job. Mandy was part of Dawn’s team. Her responsibility. She could not let that happen.

  Dawn sighed, slumping her shoulders. No sooner had she solved one problem than another took its place. Was this ever going to end?

  ‘It’s the padlock on my shed,’ Dawn told the cashier. ‘I seem to have lost the key.’

  The hardware shop smelled of paint and cardboard and oil. Along the counter was a row of plastic containers filled with screws, bolts and various other small, unidentifiable metal objects. The teenage cashier wore a set of overalls with the name ‘Alan’ stitched in red over the pocket.

  ‘What you need,’ he said, ‘is a pair of bolt-cutters.’

  He led Dawn down an aisle, between shelves stacked with paint brushes and pots of turpentine. At a stand hung with long plastic packages, he stopped.

  ‘Here we are.’ He flipped the edges of the packages. ‘What kind do you need? Angled? Clipper cut?’

  ‘I don’t know.’ Dawn stared at the profusion of blades and handles. ‘It’s just an ordinary padlock.’

  ‘What size?’

  ‘Well … around so …?’ She held up her finger and thumb an inch apart.

  Alan pulled a package off the stand. ‘This one’s quite good,’ he said. Through the plastic Dawn saw a pair of shiny red handles. ‘It’s our most popular brand.’

  ‘How does it work?’

  The teenager explained. ‘You put the shackle of the lock – the thin part – between the blades. Then you squeeze the handles and …’ He brought his knuckles together and made a regurgitative noise in his throat, presumably to indicate the shattering of solid metal.

  Dawn studied the curved blades. A bit like a clip-cutter, then. Breaking a padlock didn’t seem a million miles away from removing a stitch.

  ‘And this is a popular brand?’ she said. ‘You could buy it just about anywhere? In any shop?’

  Alan shrugged. ‘Pretty much.’

  ‘OK then. I’ll take it.’

  On her way home, Dawn went through her plan again. It was very straightforward. Tonight she was going to sneak back to the ward and break open the padlock on the morphine safe. That way, the missing morphine would look like an outside job and Mandy would not be blamed. It was as simple as that.

  The plan, when she had first thought of it, had seemed preposterous, but the more she thought about it, the more she saw that with a few basic precautions there was no reason why it shouldn’t work. It was the recent break-ins at the hospital that had given her the idea. If anyone saw her in the hospital tonight, all she’d have to say was that she had returned to fetch something she had forgotten. Of course, if that happened she would have to turn around and leave again and think of something else. But it was worth a try.

  At home, in her kitchen, she cut the plastic packaging away from the bolt-cutters. The blades were slate-grey, heavy and greasy-looking. Dawn avoided touching any part of the cutters with her fingers. She wrapped them in a sheet of newspaper and stashed them in her navy bag. They just about fit.

  The trickiest part of the plan was the timing. The most obvious thing would be to wait until after nine when the night shift started and there would be fewer people about to see her. But if she waited too long, the new shift might discover the empty morphine box. Dawn checked the rota to see who was on. Elspeth and an agency nurse called Lucy whom Dawn had never met. Elspeth, being the ‘home’ nurse, would probably be the one to take the morphine keys. Dawn seriously doubted that Elspeth would bother to check all the boxes. So unless the agency nurse turned out to be exceptionally conscientious, the missing morphine was unlikely to be discovered tonight. On balance, it was a chance worth taking.

  Dawn forced down some food: a banana and a slice of toast. Then she packed her stolen morphine ampoules carefully into the A3-sized envelope. She wrote another letter to the blackmailer and added it in with the ampoules:

  This is the last ‘favour’ I will do for you. I think we both have enough information about each other now to call it quits.

  At ten o’clock she went upstairs and changed into a pair of jeans and a dark top.

  ‘Sorry, Milly,’ she said to the dog, faithfully plodding behind her to the front door. ‘No walk for you this evening, I’m afraid. But wish me luck.’

  She took the envelope with her up to the green. The night was fresh, with a brisk, rising breeze. To fit the parcel through the post box she had to squeeze it and compress it right down. There was a muffled thud as it landed on the pile of letters inside. There. Everything Well-wisher had asked, she had done to the best of her ability. Now, no more. No more.

  It was almost eleven when she reached St Iberius. The tower block was patched with lights, pocked by tiny black shapes moving about inside. The air was cool; the sounds of the breeze in the trees and the bus as it pulled away were very close and clear. Dawn felt alert, energized, ready for anything. Through the glass sliding doors she saw the empty main hall, the WRVS shop closed and shuttered, the fountain switched off. Arnold, the night porter was sitting in his cubicle just i
nside the entrance. From her position in a dark corner of the car park, Dawn watched him talking on the phone, pushing his hand up under his navy-brimmed cap to scratch his head.

  Then, carrying her bag with the bolt-cutters, she went around the side of the tower block. In a high, concrete wall, a door led to a yard filled with large, plastic bins. The yard was filled with the sweetish smell of rotting food. At the far end, a heavy metal door led directly into the building. There was no handle on the door, just a keypad set into the wall beside it. Dawn tapped in the code. Inside was a narrow, unlit hallway. Through a set of grey, floppy doors were the kitchens, mopped and silent, ready for the next day. Beside the kitchens was the service lift. This also required a code but Dawn knew this as well. There was nothing about this hospital that she didn’t know. Every doorway, every crevice, every pipe and leak and gurgle – all were as familiar to her as the body of any long-term patient she had ever cared for and watched over.

  The lift took her to the second floor of the tower block. From there, a glass-walled link tunnel led to the old Victorian wing. At this time of night, the link was empty. At the far end, Dawn used the fire escape to climb the remaining flights to the fifth floor. The corridor leading to Forest Ward was deserted as well. There was only Dawn, her soft-soled trainers squeaking on the moonlit floor. How many nights had she walked this corridor, floating with the euphoria that always hit in the earliest part of the morning, after twenty hours with no sleep? How often had she stood at this window, looking out at the rows of darkened houses, calm in the knowledge that the hospital was here for them if they needed it, guarding them while they slept?