The Dilemma

by Abbie Taylor

  Dawn opened her mouth.

  ‘Sister Hartnett to ITU! Sister Hartnett to ITU!’ Francine’s pager was flashing red.

  ‘Oh, now what?’ Francine looked down and jabbed the Silence button. ‘Honestly. I’ve only been gone for five minutes.’ She looked up again. ‘Sorry, Dawn. What were you going to say?’

  ‘Nothing, nothing. You go ahead.’

  ‘You’re sure?’

  ‘Yes. It was just … I skipped breakfast.’ Dawn held up her coffee. The urge to confess was fading rapidly. What on earth had come over her? ‘This will sort me out.’

  ‘OK.’ Francine was already moving down the hall. ‘Call if you need anything. Otherwise – have a good night.’ She smiled at Dawn and waved. A moment later she was gone around the corner.

  In her office, Dawn closed the door and pulled down the blind. Then she switched on her computer. She brought up the details of all patients due to be admitted in the next few weeks. A long list appeared. St Iberius had nearly seven hundred beds. Name after name blipped up on the screen. All ages, specialities and dates.

  Dawn put her hands to her head and took a breath. She was going to have to try to narrow this down. Being admitted within a couple of weeks. How many weeks was ‘a couple’? Two? Three? Well, whichever it was, there couldn’t be that many male patients whose surnames began with F coming in to St Iberius in the near future. She’d make it three weeks. No – a month, to be sure. If only she knew which speciality. Endocrinology. Oncology. Gastroenterology. The e-mail again: Coming to St Iberius for an operation. An operation! That would put Mr F under one of the surgical teams rather than the medical.

  Now she was getting somewhere. She pulled a sheet of paper from the printer. Scrolling through the names on the computer, she began to write down the details of all those patients who fitted her criteria. Mr George Furby, aged fifty, coming in on the twelfth for a hernia repair. Mr Amr Farooqi, aged sixty-nine, having a gastrectomy in three weeks’ time. Mr Brian Foster booked for an arthroscopy as a Day case. Some of the names she recognized. Neil Foran, an elderly regular with bladder cancer. James Franks, aged thirty, a local drug dealer and frequent client of the St Iberius A&E department. Dawn scratched her forehead. So many names. So far she’d found at least forty and they were still coming. The next name appeared. Christopher Farthingale, due in next week for heart surgery. Aged nine months. Nine months! She closed her eyes. Surely Dr Coulton couldn’t want her to kill a baby. But she couldn’t rule him out. She couldn’t rule anyone out.

  Her neck ached from hunching over the keyboard. She tipped her head back to relieve the stiffness. Mr F. It wasn’t enough. She needed more. Who was he to Dr Coulton? Why would he want him killed? She’d heard somewhere that most murderers knew their victims personally. Could this Mr F be a family member? A neighbour? The ceiling tiles were patterned with hundreds of tiny holes. She should look up Dr Coulton’s address. HR would have it on file. It shouldn’t be hard to come up with some sort of excuse as to why she needed it. Maybe if she asked around, one of the staff would know something. Dr Coulton didn’t give much away about himself but there must be someone who knew about his background. People always knew things. There was always someone like Mandy who somehow managed to exhume all sorts of details and was happy to pass them along to anyone who asked. She looked at the list of names on her desk. What on earth did she plan to do with it when she’d finished? Phone all the patients up and ask if they knew of anyone who would want to kill them? ‘Good morning. This is Sister Torridge calling from St Iberius. I have reason to believe that your nine-month-old has an enemy.’

  But what alternative did she have? She sat forward again and took up her pen. If she had to rule out each and every patient, then that’s what she would do. Name number forty-eight popped up on the screen. She pulled a fresh sheet of paper from the printer and kept going. There was a knock at the office door.

  ‘Come in.’ Wearily, she threw the pen down again. She arched her back and placed her hands on her head. It would be Mandy, calling in for a chat or to ask where the incontinence pads were.

  But it wasn’t Mandy.

  ‘Good afternoon, Matron,’ a dry, deep voice said.

  Dawn spun in her seat, yanking her hands down.

  ‘Are you busy?’ Dr Coulton asked.

  Dawn stared at him, her mouth open. Seeing him standing in her doorway … it was like chasing someone through a long, dark tunnel only to turn around and realize they had been right behind you all along. Dr Coulton’s marble gaze slid over the room, pausing as it reached Dawn’s lists of F names on her desk. Instinctively she lowered her arms to cover them. Dr Coulton’s expression did not change.

  ‘I have something to discuss with you,’ he said. ‘Something rather private.’

  ‘I see.’

  ‘May I?’ Dr Coulton came further in to the office and closed the door. The only other chair in the room was stacked with documents and journals. Even if Dawn had been inclined to clear them for him, she wouldn’t have been capable. He did it himself, picking the papers up and looking about for somewhere to put them.

  ‘Just leave them on the cabinet,’ Dawn said. She had to swallow between the words ‘the’ and ‘cabinet’. The harsh daylight from the window made Dr Coulton’s long face look more cadaverous than ever. Dr Death, Danielle had called him. The name was more apt than she could ever have realized.

  Dr Coulton sat down, rather fussily arranging his white coat around his trousers.

  ‘You might not be surprised,’ he said, ‘to hear what it is I want to discuss.’

  ‘No.’ Dawn’s voice was flat. Inwardly she wanted to shout, Hurry up. Please. Just get on with it. But she didn’t. Something inside her warned, Let him say it first. Don’t give anything away you don’t have to. She sat, straight-backed, her hands in her lap. The Matron, graciously granting a few minutes of her time to the rather irritating junior doctor.

  Dr Coulton said, ‘It’s about Mr Geen.’

  Dawn blinked.

  ‘Mr Geen?’

  ‘Yes, Clive Geen. One of the nurses working on your ward.’

  ‘I know who Clive is,’ Dawn said shortly. What was Dr Coulton on about? What did Clive have to do with any of this?

  Dr Coulton said, ‘Well, have you noticed anything odd about him recently?’

  ‘Odd?’

  ‘Yes,’ Dr Coulton said irritably, ‘odd.’

  Dawn knew she was just repeating everything he was saying. But she couldn’t help herself. Her brain wasn’t offering any other options. She was having a completely different conversation than the one she had anticipated and her brain was still stuck on the other track, speeding off in an entirely different direction.

  Now Dr Coulton seemed surprised. ‘You haven’t noticed.’

  Dawn pulled herself together.

  ‘I’m sorry,’ she said coldly, ‘but I seem to have completely lost track of where this is going. I would appreciate it if you could get to the point and tell me why you are here.’

  ‘If I have to spell it out,’ Dr Coulton said in an equally chilly tone. ‘Mr Geen has been involved in the care of several of my patients and I take their welfare very seriously. Once I became concerned, I made it my business to observe him closely. And I am now convinced. He shows many of the signs.’

  ‘Signs?’ Dawn was bewildered.

  He ticked them off on his fingers. ‘Irritability, alternating with lethargy. Poor hygiene. Pupils that are enlarged on some occasions, then pinpoint on others.’ When she didn’t answer, he said impatiently, ‘Surely that list rings a bell? They are the classic signs of opiate abuse. You are the ward sister, the Matron. I’m astonished you haven’t picked it up.’

  Dawn looked wildly around the tiny room. Of course she hadn’t picked it up. Clive could have grown three extra eyes lately and she wouldn’t have noticed.

  ‘That break-in the other night,’ Dr Coulton said, ‘when the morphine was stolen from your ward. That has confirmed to me once and for all tha
t Clive needs to be dealt with immediately.’

  Dawn stared. ‘You think Clive stole that morphine.’

  ‘Obviously he did. He’s an addict. An addict who has just recently started working at this hospital. Now drugs have gone missing. The police should be informed as a matter of urgency. I believe he was on your ward with a gun. He could have done someone a serious injury.’

  Dawn almost wanted to laugh. This was nonsense. Nonsense. She knew perfectly well that Clive had not stolen that morphine. And Dr Coulton must know it too. What was the point of this pathetic charade? But still something held her back from confronting him. She didn’t know why, but it had to be him who said it first. She gripped her thumb hard between her fingers to keep the words from pouring out.

  Dr Coulton was saying, ‘I could go straight to the Medical Director. But that would look bad for you, so I’m giving you the chance to deal with it yourself. I’m new here, but you have a good reputation amongst the doctors. Your ward is well run; the consensus is that the patients are in good hands. So I am surprised that you appear to have completely dropped the ball on this. Unless …’ He paused. ‘Unless, perhaps, you’ve got something else on your mind at the moment?’

  He watched her, his cold, unblinking, snake eyes filled with meaning. Dawn straightened. At last. At last they were getting to the point. She fixed Dr Coulton’s stare with a cool gaze of her own. ‘And if I do?’

  ‘Well, then for the sake of your patients I suggest that you sort it out.’

  ‘Oh really?’ She twisted her mouth. ‘And how do you suggest I do that?’

  Dr Coulton’s eyebrows rose. His chin retracted, dipping and tucking in to his neck. His whole expression said, I beg your pardon? Suddenly Dawn couldn’t stand it any more. The game-playing, the skulking, the hiding. He was taunting her. He knew that she knew, and that she knew that he knew. Well, enough of this. She wasn’t going to put up with it for a minute longer. Yet even as she blurted it out she knew that it was as much because she was desperate to tell someone and couldn’t keep it to herself any more.

  ‘I’m being blackmailed.’

  It was as if a catch inside her had been released. A trapdoor had burst open; the pressurized contents behind were pouring out, gushing down all over the desk and the papers between them. No going back. No going back now.

  Dr Coulton’s eyebrows rose even higher. His chin dipped further until it looked as if it was growing straight out of his neck.

  He said, ‘Blackmailed!’

  ‘Yes.’

  ‘Have you gone to the police?’

  ‘No.’

  ‘Why not?’

  She wanted to scream, ‘You know why not.’ But her tongue stuck to her palate, refusing to form the words. Dr Coulton did seem so surprised. In those glacial eyes there was no spark of glee, no cunning flash of pleasure. Yet again, she felt herself backtracking. Be careful. Be careful here.

  She said, ‘It’s a … a private matter.’

  ‘I see.’

  Dr Coulton was looking away from her now, seemingly fascinated by the pile of journals on the filing cabinet. Dawn wanted to fling them into his face. The way his nostrils flared, so prissy and fastidious, like a pair of umbrellas opening. He made it sound as if she was referring to some sordid sex issue. The unmarried Matron, gone and landed herself in something unsavoury. Christ. How had she got herself into this mess?

  Dr Coulton, still studying the filing cabinet, said, ‘I can understand why you might not want to say. But if you have no one else to tell, then I would advise that you go to the police. Your ward is suffering. You need to sort your staff out and you can’t do that if you are distracted.’

  So calm and rational. The male voice of Reason, rising above the female mess of disorganization and indecision and weird sex scandal. He seemed so earnest, so logical. So concerned about the patients. Could he really be faking it? Was it possible that he really did think Clive had stolen that morphine? But that meant … if that was true …

  Despair filled her. If it was true. If it wasn’t him. Whatever had made her so sure that it was? A random, throwaway comment about a window blind. That had been her sole basis for suspecting Dr Coulton above all the many other people who could have come on to the ward that day. She had leaped on his comment and seized it and twisted all the other evidence around to fit it because she had been so desperate to think that she could manage the situation, that she was in control. She had struggled and fought to outsmart him and had actually thought that she was getting somewhere. Only to find that not only had she got nowhere, but now she was in a far worse position than when all of this had started. Dr Coulton was right. Whatever his motive for saying it, he was right.

  Her shoulders sagged.

  ‘All right,’ she said, ‘I’ll do it. I’ll go to the police.’

  Dr Coulton said earnestly, ‘I think you’re doing the right thing. Blackmail is a crime. You can’t deal with this on your own.’

  ‘No. No, I know.’ She did know. It had been an enormous weight off her shoulders even to tell Dr Coulton as much as she had. Telling the whole story to someone in authority, handing over the problem to someone who would know what to do, would be a relief worth anything that might happen afterwards.

  ‘The police see this sort of thing all the time,’ Dr Coulton was saying. ‘No matter what you’ve done, I’m sure it won’t be as bad as you think.’ He was standing up now, preparing to leave, straightening his white coat, brushing down his trousers.

  At the door, he paused and turned.

  ‘After all,’ he said, ‘it’s not as if you’ve killed anyone.’

  The sky was navy-blue, the horizon a deep orange flame. Out on the ward, trolleys rattled, collecting the remains of the evening meal. There was a smell of carrots and braised lamb. One by one the ward lights came on, making Dawn’s office seem even darker. The F names on her sheets of paper were a mottled, fuzzy blur.

  She had been so stupid. So stupid! How had she ever thought she could find Mr F on her own? The trouble was, she wasn’t thinking straight any more. The more she had tried to pick her way out of the knot in her head the tighter it had twisted, until now it was a tangled mess with her trapped at the centre. She needed help. Not right now – her shift was just about to start. But tomorrow morning, first thing, she would go to the police station on Latchmere Road just a couple of streets away. Ask to speak to someone there in private. She would sit down and tell them everything. Leave nothing out. And afterwards, whatever the consequences, she would deal with them.

  But her job. Her career.

  And Will. Will finding out. That look fading from his eyes.

  Dawn put her head in her hands.

  Chapter Fifteen

  At ten to nine, Dawn switched off her computer. She rinsed her hands at the little basin in the corner and smoothed her hair in front of the mirror. Then she stepped out of her office. At the nurses’ desk, Pam, one of their regular agency staff, was flicking through a copy of the Daily Mail.

  ‘Another drug shooting in Bermondsey last night,’ she was saying to Mandy with relish. ‘I don’t know how on earth they—Oh hiya, Dawn. Didn’t see you there. Are you on with us tonight?’

  ‘Yes, I am.’

  ‘Lovely.’ Pam turned another page. ‘Oh, look! Yet another gullible woman conned out of all her life savings. Listen to this: “Dave seemed so lovely when we first started dating. I believed him utterly when he said he’d never met anyone like me. I felt so sorry for him when he said he needed money for his mother’s life-saving transplant.” Can you imagine? She actually ended up remortgaging her house to raise the cash.’ Pam tutted with satisfaction. ‘Don’t these women have any brains?’

  Clive appeared, clutching his backpack, wearing a tatty denim jacket over his uniform.

  ‘Evening, Clive,’ Pam said. ‘All sorted for tonight?’

  Clive muttered something. He looked terrible. His stubble was back, worse than ever, ringing his mouth like a fungus. A scaly rash fla
ked around the sides of his nose. He looked as if he hadn’t washed in a week. Clearly he hadn’t expected to be working with Dawn this evening.

  Mandy, her shift over, was getting ready to leave. She pulled a pink cardigan on over her tunic.

  ‘Should be a quiet one tonight,’ she said, handing the morphine keys to Clive. ‘They’re all pretty settled. Oh – except for Lewis in the side room.’

  ‘What’s wrong with Lewis?’ Dawn asked.

  ‘He had his surgery this morning and he’s been complaining all day of pain. But I’ve just given him another dose of morphine so hopefully that should settle him.’

  ‘OK.’

  ‘Funny how they all seem to be so sore lately,’ Mandy said. ‘That Danielle’s been acting up all day as well. Though the last dose I gave her seems to have finally kicked in. And now Lewis has started up. Odd, because he’s not normally one to grumble. Anyway …’ She flipped her hair out over the back of her cardigan. ‘Hope it’s a quiet one. See you all tomorrow.’

  She left, carrying her grey slouchy bag over her shoulder. The doors swung and settled behind her. Dawn divided the patients up between the three night staff for obs and monitoring.

  ‘Pam, can you take the top end? Clive, take the middle eight. I’ll take the ones down this end, and the side room.’

  ‘Right you are.’ Pam folded up her Daily Mail and climbed to her feet. Clive took his list of patients and went off without a word.

  Dawn did a quick round. Danielle Jones was asleep, curled up on her side, her blanket pulled right up so that just her hair was sticking out. Dawn examined the chart at the end of her bed. Danielle’s vital signs were stable, the urine output for the past hour satisfactory. Dawn replaced the chart and moved on without disturbing her.

  In the side room, Lewis was wide awake, sitting up with his light on. The cage-like metal fixator had been removed from his calf. The entire leg was now encased from thigh to foot in a giant white cast. Lewis was shifting in the bed, lifting himself up on his hands, then wincing and sinking back on to the mattress.