by Ken McClure
‘Yes but …’
‘But what? Who has been getting at you? Or have you been stricken by a sudden bout of middle-age?’
Bannerman reacted to the word ‘middle-age’ with a slight wince and Stella noticed. Stella noticed everything. ‘So that is what this is all about,’ she said knowingly.
‘I don’t know what you mean,’ said Bannerman hastily.
‘You’re having a mid-life crisis! That’s what I mean,’ exclaimed Stella. ‘You’re indulging in an orgy of self-analysis! Do you want to lie along the couch and tell me all your innermost fears?’
‘Certainly not,’ insisted Bannerman, feeling vulnerable and wishing he had never broached the subject. He should have known that Stella would see through him right away. ‘I was simply thinking.’
‘Ugh huh,’ nodded Stella. ‘And putting yourself on a diet while you were doing it …’
‘Sometimes I hate you,’ smiled Bannerman.
‘Eat up,’ said Stella. ‘You can always dance it off at the disco on the way home …’
Afterwards, as they sat on the couch with their coffee, Bannerman said, ‘I almost bottled it today.’
‘What do you mean?’
‘Lost my nerve. The tumour section wasn’t as clear as I would have liked and theatre insisted on an answer before the new prep was ready.’
That isn’t exactly the easiest of positions to be in,’ said Stella.
‘I know but it’s what they pay me for,’ said Bannerman.
Tell me about it,’ said Stella.
Bannerman told her the details of what had happened and Stella looked at him in disbelief. ‘You call that losing your nerve?’ she exclaimed. That was an absolutely nightmarish situation to be in, and you got it dead right.’
That’s the way it worked out but it could have been so different,’ said Bannerman. The woman could have lost her breast unnecessarily.’
‘Nonsense!’ exclaimed Stella. ‘She had the best histopathologist in the country examining the biopsy.’
Thanks,’ said Bannerman, but his expression showed that he wasn’t convinced.
‘You really are down aren’t you?’ said Stella. ‘What brought all this on?’
‘I’m not sure,’ said Bannerman, ‘I had a lecture this morning and before it I suddenly found myself thinking what a waste of time it all was.’
‘We’ve all thought that from time to time, especially if you get a bad class,’ said Stella.
‘But they weren’t bad at all as it turned out. We were discussing slow virus brain disease and they seemed genuinely interested. I finished up feeling guilty for misjudging them.’
‘What you need is a change,’ said Stella. Take some time off, re-charge your batteries.’
‘I can’t. I’ve got too much to do.’
‘No one is indispensable Ian, not even you. I’m sure the hospital could survive for a couple of weeks. Leeman could cope with the lab couldn’t he?’
‘Yes,’ agreed Bannerman.
‘And you have a first-class chief technician in Charlie Simmons?’
‘Yes.’
‘So, do it.’
‘I have two more lectures to give on brain disease for the course.’
‘Ah,’ conceded Stella, ‘that’s more difficult. When do your lectures finish?’
‘The last one is a week on Friday.’
That’s not long,’ said Stella. ‘Finish your lectures and then take time off.’
‘I’ll consider it,’ said Bannerman.
‘Do it!’ urged Stella.
Bannerman thought for a moment then said, ‘Maybe I’ll do something I’ve planned to do for a long time but haven’t quite got round to.’
‘What’s that?’
‘Go winter climbing in Scotland.’
‘You’re serious?’ asked Stella.
‘Absolutely. I used to do it when I was a student at Glasgow. I promised myself that I would do it again one day.’
Stella looked bemused and said, ‘I must confess I was thinking more along the lines of you lying on the beach in the sunshine, chatting up dolly birds, drinking ice-cold beer, but if this is what you really want …’
‘We’ll see,’ said Bannerman attempting to close the subject, but Stella made him promise that he would give it some serious thought.
‘I promise,’ said Bannerman. ‘Can I give you a hand with the washing up?’
Stella declined the offer, saying that she would do it in the morning. She wasn’t due at the hospital until eleven. ‘How about you?’
‘I said I’d do the autopsy on the Bryant kid who died at the weekend and I’ve got a meeting at ten-thirty so I’d better get an early start.’
‘I heard about that,’ said Stella. ‘Very sad, brain cancer wasn’t it?’
‘Almost certainly,’ said Bannerman, ‘but I suppose I’ll know for sure tomorrow. If it is, the MRC will want a full report for their survey.’
‘What survey?’
They’re monitoring the incidence of brain disease in the UK to get an overall picture of the situation.’
‘Is this a routine survey or has something prompted it?’ asked Stella.
They’re pretending it’s routine but it has a lot to do with the BSE scare we had last year. People suddenly realized that no one has a clear picture of what is going on because brain disease is so difficult to diagnose and classify. The temptation is always to use vague generalities like, “dementia”.’
‘Somehow I get the impression that things like Alzheimer’s disease are on the increase. Is that right?’
‘I fear so,’ said Bannerman, ‘but the survey should give us a clearer picture when it’s complete.’
Stella looked at her watch and said, ‘It’s late and if you’ve got to get up early …’
Bannerman nodded and got to his feet. He thanked Stella for dinner and took hold of both her hands to say, Thank you for being my friend.’
‘Off with you,’ smiled Stella. ‘And …’
‘Yes?’
‘Don’t stay too long at the disco.’
Bannerman woke at three in the morning with the sweat pouring off him. He had awoken from the nightmare just at the moment when the naked woman had raised the knife above her head to stab him. The act of stretching had caused the jagged surgical wounds on her chest, where her breasts should have been, to split open and weep blood over him.
Bannerman sat bolt upright, breathing heavily and repeating an oath under his breath. After a few moments he swung his legs out from below the duvet and sat on the edge of the bed to light a cigarette. He took a deep lungful of smoke and let it out slowly while he massaged his forehead with his fingertips.
The nightmare had been so vivid that there was no question of lying back down again and risking sleep. The woman with the knife would be waiting for him just below the brim of consciousness. He pulled a dressing-gown round him and went through to the living-room to turn on the television. It didn’t seem very interesting — some American film from the sixties by the look of it — but it provided a distraction, and that was the main thing. The soundtrack was therapeutic as he shuffled into the kitchen to turn on the kettle to make tea.
James Stewart and an actress he didn’t recognize were about to live happily ever after and there were two more cigarette stubs in the ashtray before Bannerman felt like risking sleep again.
At ten-fifteen in the morning, Bannerman returned to his office from the post-mortem suite with the taped report he had compiled of the autopsy on Paul Bryant, aged nine. ‘I’ll need an MRC report form Olive,’ he said to his secretary on passing. ‘He had cancer of the brain.’
‘You aren’t forgetting the monthly Health Board meeting at ten-thirty are you?’ said Olive.
‘No,’ replied Bannerman without enthusiasm.
Olive Meldrum smiled. She knew how much Bannerman hated routine meetings.
Bannerman sat down behind his desk and picked up the telephone. The events of the previous day and night had b
een preying on his mind too much. He resolved to do something about it. He pressed a four digit code and waited for a reply.
‘Drysdale,’ said the voice.
‘Dave, it’s me, Ian Bannerman. Do you think we could have a talk sometime today?’
‘What about a drink at lunch-time?’
‘I meant a more professional talk,’ said Bannerman.
‘Oh I see. Well I think I should warn you that I suspect your “patients” are a bit beyond psychiatric help,’ said Drysdale.
Bannerman did his best to respond to the joke but it was laboured and Drysdale sensed it. ‘How about two-thirty?’ he asked.
‘That suits me fine,’ said Bannerman. ‘Your place or mine?’
‘Come up,’ replied Drysdale.
For Bannerman to arrange a meeting with a psychiatrist it had been very much a case of the singer not the song because he had little time for psychiatry. On the other hand, he had great respect for David Drysdale whom he had known and liked for five years. Drysdale knew and freely admitted the shortcomings of his speciality. He never hid behind meaningless jargon as Bannerman suspected so many of his psychiatric colleagues of doing. When he heard Drysdale describe electro-convulsive therapy as ‘wiring the patients up to the mains to see what would happen’ he knew that he had found a psychiatrist he would like. As he got to know him better, he discovered that the man had a genuine and sincere concern for the welfare of the mentally ill. It was his regret that so little could be done to help in so many cases.
Drysdale’s office was two floors above the pathology department. The walls were decorated with examples of schizophrenic art and a small print of Edvard Munch’s, The Scream. Drysdale, a sallow-skinned man with dark hair and heavy-rimmed spectacles, which made him look like an East European student, invited Bannerman to sit. ‘What can I do for you Ian?’ he asked.
‘I think I may need help,’ said Bannerman awkwardly.
Drysdale considered making some comment about ‘not thinking he would see the day’ but thought better of it, seeing the troubled look on Bannerman’s face. Tell me about it,’ he said.
Bannerman told him about his experience with the emergency section. ‘My hands were actually shaking,’ he said. ‘And then I had a nightmare about it last night.’
Drysdale nodded and said, Tell me.’
Bannerman related all that he could remember about the dream and then asked, ‘Do you mind if I smoke?’
Drysdale made a sign with his hands that indicated resignation but not approval. ‘You should give it up,’ he said.
Bannerman ignored the comment.
‘What else should I know?’ asked Drysdale.
‘Sometimes I’m sick after doing post-mortems.’
Drysdale nodded. He had started making notes. ‘How old are you Ian?’
‘I’ll be thirty-eight next birthday.’
‘How do you feel about that?’
‘Rotten.’
‘Me too,’ said Drysdale. ‘I’ll be thirty-nine. Any other problems?’
‘Insomnia.’
‘You waken up at three in the morning and feel wide awake. You can’t get back to sleep for about an hour. This happens every second night on average?’
‘How did you know that?’
‘Sheer bloody brilliance,’ said Drysdale. ‘But apart from that, I recognized the symptoms. They’re textbook. It’s depression not insomnia.’
‘So you think I’m clinically depressed,’ said Bannerman.
‘A little,’ replied Drysdale, ‘but the main problem is stress.’
‘Stella thinks it’s a mid-life crisis,’ said Bannerman.
‘She’s right,’ said Drysdale, ‘but there’s another factor involved and I’m not quite sure what it is. I’ll have to have a think about it.’
‘What do I do about it in the meantime?’ asked Bannerman.
‘I can suggest pills but you know as well as I do they’ll just dull your senses so you won’t feel so stressed. That’s probably not such a good idea in our line of work. How about booze in the evening?’
‘I think I’ve used up that option,’ said Bannerman.
‘Me too,’ said Drysdale. ‘How about a break? A holiday might be just what you need.’
‘Stella suggested that. I’m considering going climbing in Scotland.’
‘In January!’ exclaimed Drysdale. ‘You’re sicker than I thought!’
To each his own, Doctor,’ said Bannerman with a smile. He got up to go.
‘I’m sorry I couldn’t be of more help,’ said Drysdale, ‘but keep in touch. I don’t think it’s anything serious and Stella’s probably right about it being fear of forty but if you should begin to feel worse give me a call, any time, day or night.’
Bannerman thanked Drysdale and promised to buy him a drink in the near future. He returned to the Pathology Department where Olive had left a package on his desk. It was marked ‘On Her Majesty’s Service’ and had come from the Medical Research Council by special delivery. He opened it and found three microscope slides and a covering letter. The letter was from the coordinator of the MRC’s Survey on Degenerative Brain Disease, Dr Hugh Milne. It asked if he would mind examining them and reporting his findings as quickly as possible. There was also a message to say that Stella had phoned; it was nothing important but he was to be reminded that he couldn’t call her back because she would be in theatre all afternoon.
Bannerman took the slides to his personal microscope and removed the dust cover. He clipped the first to the stage and adjusted the tungsten light before focusing on the stained section of the brain. There had been a marked lack of details with the package and no indication about the source of the material, save for the fact that they were brain sections. There was an air of anticipation about him as he scanned around to find the clearest fields. It didn’t take long to find what he was looking for — unequivocal evidence of degenerative disease.
It was so obvious that Bannerman was puzzled to the point of feeling mildly annoyed that he had been asked for his opinion on something so clear-cut. He had rarely seen spongioform areas so well marked. This was the kind of slide that could be used for illustrating text books. The second and third slides were almost identical to the first. ‘What on earth are they playing at?’ he muttered as he removed the last slide and turned off the lamp. He asked Olive to get him the MRC coordinator on the phone.
‘Dr Bannerman? Good of you to call,’ said Milne after a short wait. ‘I take it you received the slides?’
‘I’ve just had a look,’ said Bannerman.
‘What do you think?’
‘I think I’ve just looked at three perfectly prepared brain sections from the same patient. He or she would be in their mid to late seventies and has just died of Creutzfeld Jakob Disease.’
‘You’d be wrong,’ said the coordinator.
‘What?’ exclaimed Bannerman.
‘What would you say if I told you that each of the slides came from a different patient, all were under thirty and none had been ill for longer than three weeks?’
‘I’d say there had been a mix-up in the slides,’ said Bannerman.
‘We are assured that there has been no mix-up.’
‘I find that incredible,’ said Bannerman.
‘Suppose I was to add that the three dead patients worked with infected sheep?’
‘What?’ exclaimed Bannerman. ‘You’re not suggesting that they died of Scrapie by any chance?’
‘I wish I wasn’t. Can we meet to discuss this further?’
‘When?’ asked Bannerman.
‘I think it had better be as soon as possible,’ said the coordinator.
‘Why me?’ ventured Bannerman.
‘Your reputation, Doctor. Your work on degenerative brain disease is second to none and right now we need the best we’ve got. I’ll explain more when I see you. Would tomorrow at eleven be a possibility?’
Bannerman checked his diary before saying that it would.
‘
Did you see about taking time off?’ asked Stella when Bannerman saw her later.
Bannerman brushed the question aside and told her about the call from the MRC. ‘I saw the slides Stella! They were classic Creutzfeld Jakob but Milne said they came from three men who had been working with Scrapie infected sheep!’
‘You mean the men died of Scrapie not Creutzfeld Jakob?’ exclaimed Stella.
‘That’s what Milne seemed to be saying.’
‘But that can’t happen surely? Scrapie is a disease of sheep. It can’t pass to man. There’s a what-do-you-call-it?’
‘A species barrier,’ said Bannerman. ‘Last year cows, this year people …’
‘What was that?’ asked Stella.
‘I was just thinking that last year Scrapie was shown to have passed from sheep to cows through the food chain
‘You’re not seriously suggesting that it could do the same to humans?’
‘Up until today I would have said that there was no chance of that at all,’ replied Bannerman.
‘Then what do you think is going on?’
‘My initial reaction is to think that some kind of mistake has been made, some kind of mix-up in the path lab, but the chap I spoke to said not.’
‘Maybe I should think twice about having lamb for Sunday dinner?’
‘It’s a bit early for that,’ smiled Bannerman. ‘I’ll know more when I see the MRC people tomorrow.’
THREE
It was raining heavily when Bannerman’s taxi pulled up outside the headquarters of the Medical Research Council in Park Crescent. It turned to hail and battered deafeningly on the roof of the cab as he paid the driver before getting out and making a run for the entrance.
‘What a day,’ smiled the woman behind the desk. ‘Rain, sleet, hail, whatever next?’
Bannerman brushed at his shoulders and said who he was, adding, ‘Dr Milne is expecting me.’
‘Take a seat Doctor,’ replied the woman, indicating with one hand while picking up the telephone with her other. A few minutes later a young man appeared in the hall and said, ‘Dr Milne asks if you wouldn’t mind waiting in the library until everyone is here?’
‘Of course not,’ replied Bannerman automatically, but wondering about the word, ‘everyone’. He was under the impression that this was to be a meeting between himself and Milne. He followed the young man up to the library where he was invited to sit beside a small table that was bedecked with magazines. He picked up one with two smiling Africans on the front and flicked through the pages without taking in too much. The magazine was comprised of a series of reports on successful projects undertaken to improve health care in the Third World.