The Dilemma

by Abbie Taylor

  I think you know. You’ve had a taste already.

  Dawn gripped the backs of her arms again. You could hardly get more explicit than that. It was completely different from Dr Coulton’s random comment about the blinds. Clive might as well have admitted it straight out. She’d had him cornered in that smelly little room; he’d had no choice but to come out with it. Hit her with what he knew.

  Her gaze moved sightlessly around the office. On the back of the door was the glossy poster for the International Research Conference. She’d never got around to taking it down. Something about it now struck her. Confused, she looked back at it, trying to focus. What was it? She must have seen that poster, or others like it, a hundred times in the past few weeks. The printed heading: Sponsored lunch for all staff. And below it, the list of lectures for the day. She was about to pass on when she saw it again. Perhaps it was because she had been thinking about him only moments ago that the name, previously hidden amongst the scores of others on the list, had jumped out and caught her eye:

  Dr Edward Coulton, Speaker, Lunchtime Lecture: The Role of the Macrophage. 1-2pm.

  Dawn couldn’t take her eyes from the poster.

  Mrs Walker had died at half past one.

  The office door opened, swinging the list of names out of view.

  ‘Dawn?’ It was Pam, back from ITU. ‘I’ve got you that morphine.’

  Dawn shook herself. She took the ampoule. ‘Thanks, Pam.’

  ‘No problem. I’ll get back to changing those urine bags, shall I?’

  ‘If you don’t mind, Pam. Thanks.’

  Then, as her colleague went to leave the office, Dawn said, ‘Pam?’

  Pam turned back. ‘Yes?’

  Dawn nodded at the poster. ‘Do you happen to know of anyone who went to that talk a couple of weeks ago? The one at lunchtime?’

  Pam peered around at the back of the door.

  ‘Dr Coulton’s talk?’

  ‘Yes.’

  ‘Indeed I do,’ Pam said. ‘As a matter of fact, I went to it myself.’

  ‘You did?’

  ‘Yes. I’d just done a morning shift on Ocean Ward and decided to go along for the lunch. Free three-course spread from the Bengali Star!’

  ‘And you saw Dr Coulton? You were at his talk?’

  ‘Indeed I was.’

  Dawn stared ahead, rolling the morphine ampoule between her fingers. So there it was. Dr Coulton was not the blackmailer. It was like doing a Sudoku puzzle that you had been stuck on for a long time, then suddenly having the right number light up in your head like a firework and finding that all the other numbers, bam bam bam, plopped into place, as plain as day.

  ‘Boring bugger, isn’t he?’ Pam was saying. ‘Likes his long words. I’ve never known anyone drone on so much. Half the audience was asleep by the end.’

  Dawn said absently, ‘Were they?’

  ‘Oh, yes. Even Professor Kneebone. Clive spotted him nodding off in the front row. Gave me a dig in the ribs to point him out.’

  Dawn’s head snapped up. ‘Clive?’

  ‘Yes.’

  ‘Clive was at the lunchtime talk?’

  ‘Yes, he was. A couple of us met him in the hall as we were going in. We told him about the free lunch and he came along with us for the bhajis.’

  ‘But …’ Dawn looked wildly at the poster. ‘But he couldn’t have …’ If Clive had been at Dr Coulton’s talk, he couldn’t have returned to the ward at the time Mrs Walker had died. Once again, the Sudoku number was wrong, the entire puzzle useless and destroyed. But how could it not be him? You’ve had a taste … What else could he have meant by that? What? What?

  ‘Wait a sec, though.’ Pam was holding a finger in the air. ‘Now I think of it, Clive never actually made it to the lunch. He made some excuse or other and walked out after the first few minutes.’

  Dawn was struggling to keep track of what was going on. ‘Clive walked out of Dr Coulton’s talk?’

  ‘That’s right. Said he’d left his pen on the ward. Like I say, purely an excuse. And he made the most dreadful fuss on the way out … trampling on people’s feet …’ Pam’s voice faded. ‘Dawn? You all right?’

  ‘Sorry. Just thinking …’

  The Sudoku puzzle was complete after all, the missing number finally stamped in place. The picture now was so clear; she could see everything as precisely as if she had been with Clive at every step. Clive, incensed after the row with Dawn, storming off Forest Ward. Bumping into Pam and the others in the hall, allowing himself to be talked into attending the conference. Realizing too late his mistake as Dr Coulton droned on about cytokines and interleukins, sitting there trapped and seething, then remembering his pen and deciding to get the hell out of there. Shoving past the audience, furious at having to return to the ward, more than likely hoping to just grab his pen and leave without having to face Dawn again. He would have barged through the doors of Forest Ward, his stubbly face suffused with temper, and then … what? How far had he got before he had seen it? The ECG over Mrs Walker’s bed, flattening into the lethal rhythm that almost always meant imminent death. And Dawn, standing calmly beside her with the syringe in her hand. Perhaps he had known then and there what was going on. Perhaps it was only afterwards he had worked it out. Either way, she could imagine all too well his growing excitement, his malicious pleasure as he realized his chance for revenge.

  And more than revenge …

  Dawn’s gaze fell to her desk. On it, her lists of F names, lying beside the keyboard. Looking at them again, she noticed something. One of the names stood out, almost leaping up at her from the page. The writing on this name seemed larger than the others, the print darker and bolder. Funny, she hadn’t noticed at the time that she was doing that. Clearly, even as she had been copying the details from the computer, the name had meant something to her. She must have been struck by it for an instant – only without the information then that she had now, the true significance of it had passed her by.

  James Franks. Aged thirty. Coming to St Iberius next week for an operation on his hand.

  Nearly everyone working at St Iberius knew James Franks. A notorious local drug dealer and frequent Casualty attender, presenting regularly with various injuries: a fractured hand, a punctured lung due to a knife wound, a broken mandible. Once he had turned up with a whole crowd of injured gang members, escorted by a large group of armed police. One of the police, a girl who looked no more than eighteen, had sat on one of the plastic chairs outside a cubicle, cradling a rifle across her knee that was almost as big as she was. It had made Dawn uneasy. Did the police really think they were going to use those things in here, in a room full of patients and staff?

  But if James Franks was supplying Clive with drugs, why would Clive want him dead? Drug addicts, surely, didn’t go around killing their dealers. They depended on them remaining alive and well.

  But then Clive didn’t need a dealer any more, did he? Not now he had his own little supply set up at St Iberius. Perhaps James Franks had been hassling him, looking for money he was owed, insisting that Clive stay on as a customer. And so, when the opportunity had come along to get rid of him, Clive had jumped at it. It must have seemed so perfect. And now here was Dawn, threatening to ruin everything. Threatening to expose him, have him kicked out of St Iberius, cut off his supply. If she did that, Clive would have nothing to lose by telling the police everything he knew.

  The morphine ampoule was cold and hard, like a bullet between her fingers.

  Lewis, she thought suddenly. All day, sitting in that room, with a leg that had been freshly fractured and re-set, with screws and bolts driven into the bone. And the only medication he had been given was water. The pain must be appalling.

  In the stock room, she drew the morphine into a syringe and wrapped a blue opiate sticker around the side. Then she took the syringe to the side room. Lewis was clutching the side of his bed, his other hand held in the air over his leg, the fingers shaped into claws as if somehow to rip the pain f
rom under the plaster. His face was the same porridge-grey colour that Clive’s had been.

  ‘I thought you’d never come,’ he said.

  ‘I’m sorry.’ Dawn was pulling the cap off the needle. ‘I’m really sorry. But it’s going to be all right now.’

  ‘That stuff won’t help. It’s been tried already.’ Lewis’s pupils were black and dilated, so enormous you could almost see all the way into his head. Exactly the way Clive’s had been.

  ‘This time it will,’ Dawn said. ‘I promise. This time it’s different.’

  Lewis’s distress and Clive’s were due to different causes entirely but the remedy for both was the same. Dawn attached the syringe to Lewis’s drip and pressed the plunger. The syringe emptied. The vein beyond Lewis’s drip bulged as the morphine surged into his system.

  It took less than a minute. Lewis’s clawed hand relaxed, dropping away from his leg. He sighed and fell back against his pillows.

  Dawn said softly, ‘Better now?’

  Lewis nodded. Out there somewhere, Clive was stumbling along some pavement or side street in the night, coping with his agitation and withdrawal the best way he could. It would be a long time before he managed to find any relief. But for Lewis, at least, the torment was over. His pupils shrank to their normal size. His eyes lost their eerie, translucent appearance; the porridgy skin pinkened to a more human shade. Lying with his head back against the pillows, he even managed a dreamy smile.

  ‘Thank you, Sister,’ he said.

  Lewis slept soundly for the rest of the night. Dawn could only wish for such a luxury for herself. Several times she visited her office and sat staring at the drawer with the contaminated morphine ampoules wrapped in their envelope. The plan had been to take the ampoules to Claudia Lynch’s office in the morning. Now what was she going to do? If she reported Clive, he would go straight to the police about Mrs Walker. Yet she couldn’t pretend tonight hadn’t happened. It would not be safe to simply replace the ampoules and use them on other patients. Discarding them wasn’t an option either. Pharmacy would be up here like a pack of bloodhounds, baying to find out where they’d gone.

  Why shouldn’t she tell Claudia? If Clive counterattacked by blabbing about Mrs Walker, all Dawn had to do was appear vehemently shocked and astonished. After all, who were people going to believe? Clive? A bitter, thwarted addict out for revenge? He would be laughed all the way to the police station.

  The morning was a long time in coming. It seemed forever before Dawn was finally sitting down to lead the morning handover round with the day staff. At eight, she left the ward with the envelope of ampoules in her bag. Claudia’s office was on the ground floor, off the main hall. To reach it, you had to go down the narrow side corridor near the entrance. Dawn slowed as she approached the mouth of the corridor. Nearer … nearer …

  Then she kept on walking, right past the corridor entrance. Further on was the Pharmacy, with its large green cross lit up on the wall. Dawn went to the counter.

  ‘Good morning, Matron.’ Sally, the chief pharmacist, came smiling to greet her. ‘What brings you down to us today?’

  Dawn took the envelope of ampoules from her bag. ‘Good morning, Sally. There’s been a problem with this batch of morphine.’

  ‘Really? What sort of problem?’

  ‘It isn’t working. It’s had no effect at all on the patients.’

  ‘That’s strange.’ Sally took the envelope and peered in at the ampoules. ‘Unusual for that to happen with morphine.’

  ‘Perhaps the ampoules weren’t stored properly during transport?’

  ‘But the storage wouldn’t affect—’

  ‘Regardless of the reason,’ Dawn said firmly, ‘the drug is ineffective. I would be grateful if you could remove these ampoules immediately from circulation. And send a fresh batch up to Forest Ward as soon as you can.’

  ‘Of course, Matron. I’ll arrange it this morning.’

  Dawn left Sally, still perplexed, peering into the envelope. She walked through the hospital entrance and down the hill to the street.

  She hadn’t done it. She hadn’t reported Clive to Claudia. She just hadn’t been able to bring herself to take the step. Two streets from here, on Latchmere Road, was the Lavender Hill police station. Dawn’s other plan for this morning had been to go there and tell them everything that had happened. All she had to do was take the next left turn.

  She didn’t take it. She walked on past the turn to her bus stop. It was a quarter to nine. The bus to Silham Vale was jammed with teenagers in ties and stripy blazers, shouting and jostling each other with their backpacks. Dawn sat on the front seat at the top, staring through the blur of trees and shops as they passed her by.

  So. She had made her decision. She had not reported Clive. All morning he would be huddled by his phone, waiting to hear from someone at the hospital. By this afternoon, when no phone call had come, he would know.

  So now what? They were at a stalemate. Neither of them could do anything without making things worse for themselves. Would Clive turn up for his shift tonight as if nothing had happened? And if he did, what would Dawn do? Treat him exactly as usual? Turn a blind eye while he continued to make his trips to the men’s toilet with his morphine ampoules and his miniature dentist’s drill?

  At Silham Vale, she got off the bus. She bypassed the Georgian terrace with its row of shops and takeaways, and turned down Crocus Road. She was so preoccupied that it wasn’t until she had reached number 59 that she realized that the bars of the gate were empty. No dark, wet nose snuffling and poking through them to greet her. Normally Milly was ready and waiting when she arrived, alerted by the sound or smell of her from yards away.

  ‘Milly?’

  Milly wouldn’t be expecting Dawn home at this hour of the morning. She was probably still fast asleep in the porch. Or too stiff with her arthritis to climb off her rug. Dawn lifted the latch of the gate and went up the path.

  But the porch and the paw-print rug, slightly rumpled, were empty. The bowls of water, both still full, were outside the door. The pile of biscuits was scattered over the grass.

  ‘Milly?’

  Dawn paused on the step, looking around. She could see most of the garden from here. The neat box hedge along the wall, the narrow strip of lawn, the maroon and black tiled path to the gate. The gate had definitely been shut when she’d come home just now. Had Milly jumped out over it? She had been so anxious yesterday for Dawn not to leave her. But she had never jumped it before. And it would have been particularly difficult for her last night, with the state her hips had been in recently. Perhaps Will had called to take her for a walk. But it seemed unlike him not to have phoned to let her know.

  She was still thinking this, gazing around her, when the shadow of a branch stirred under the box hedge. The ground beneath the hedge lit up in the sun, all except for one spot, far at the back. A dark mound, like a rock or an old coat lying on the earth. Dawn hurried to the hedge, knowing already what she was going to find.

  ‘Oh Milly, Milly, my little friend. Please be OK.’ But the dark mound was stiff and very cold. It had been there for quite some time. A single brownish leaf lay on the coal-black fur.

  ‘Milly!’

  Dawn knelt on the grass. She took Milly up. She stroked her head and down her back in long, sweeping movements, as if by doing so she could start the blood flowing again. ‘Milly. Milly.’ The fur felt strange, too smooth and heavy, like artificial matting. The skin beneath had the texture of cool rubber, nothing at all like the skin of a real animal. When she lifted Milly’s head, the front paws came too, sticking straight out into the air. Milly’s eyes were half open, the exposed corneas covered with a dry film. How long had she been here? Had it been quick? A sudden heart attack? Or something slower, the pain and distress worsening as the hours had passed so that the long night had dragged like a chain? Why hadn’t Dawn taken her to the vet long ago? Why had she thought she knew everything, that she was such an expert she could diagnose and treat Mi
lly’s illness by herself? This was why Milly had not wanted her to leave yesterday. She had known, had felt, that something was wrong.

  ‘I’m sorry.’ She rocked the stiff little body back and forth. ‘I’m so sorry. I honestly didn’t know.’

  Her head felt full, too heavy to hold upright, but her eyes were dry. This was a dog. An elderly dog, who had led a long and mostly happy life which had now come to a natural end. In hospitals all over London, at this very minute, human beings were going through far worse. So Dawn waited, and after a moment the flare of emotion subsided. She lowered Milly’s head to her lap. That was better. More natural now, as if Milly had come over of her own accord and put her chin on Dawn’s knee. Here I am. Later, Milly would chase the magpies from the back lawn and they would go for their morning walk to the green. Milly would race ahead, then stop to pant and look back at Dawn, her triangular eyes bright with excitement. Come on! Let’s go!

  The grass was chilly under her knees. It was a warm day but the dew still lay on the ground under the hedge where the sun had not reached. Dawn lifted Milly’s head again from her lap.

  ‘Wait here,’ she told her. ‘I’ll be right back.’

  She lowered Milly to the ground. As she did so, something beneath her was dislodged and went rolling away from them, out over the lawn.

  Dawn’s first thought was that the object had come from her. She felt a flash of puzzlement, a sense of something being where it shouldn’t be. Then the disorientation settled and she realized what she was looking at: an empty 5ml syringe with a blue opiate label stuck to the side. Lewis’s morphine syringe. Of course. She must have put it in her pocket last night after giving him his dose and now here it had fallen out on to the lawn.

  The syringe lay on the grass, its stubby, transparent barrel gleaming in the sun.