Sister Pitrose attached the ECG machine, and ran the standard leads: there was no evidence of a recent cardiac infarction, and the complexes were of normal amplitude – no potassium abnormalities as yet!
After half an hour, I gave her a further 50 units of insulin, and started the second half-litre of the IV infusion – to run in over the next hour. Thereafter, I arranged for the patient to have half a litre of saline 0.5% every hour with 50 units of insulin. We checked her jugular venous pressure and lungs regularly to ensure that she was not overloaded with fluids; and monitored her pulse, BP, skin elasticity, level of consciousness, blood glucose, urinary glucose and ketones, and ECG.
Jo cleaned up the patient, changed her into a new nightie (which her cabin steward had delivered, when Agatha Pitrose had located him), and sponged her forehead to bring down her temperature. When there was a lull in the hectic activity, Mr Slater took his leave; although frequently dour, tonight the pharmacist had been both helpful and affable.
“Well, I'll be off, back to me bunk ... But don't 'esitate to call me back, if you need anythin' else, anythin' at all ...”
The senior sister, grinned wryly, as the door closed behind him:
“Dr Hardcastle insisted on having a set of keys to the Pharmacy as well as those to the theatre and hospital. Mr Slater was very much opposed ... Didn't want anyone disturbing his pristine domain; wanted everything left just so ... Well, I've seen Charlie Hardcastle emerging from the pharmacy at dead of night. What was he doing, creeping about like that, I want to know. Our Senior Surgeon's not always as dull and fuddled as he likes to make out ...”
After three hours, Mrs Hubbard's tongue was moist, her skin elasticity was returning; her level of consciousness was much improved, though she still didn't want to talk much. Her breathing was now normal, and there were no ketones in her breath or urine; the blood glucose had fallen to 200mg%, and there was just a small quantity of sugar in the urine. The amplitude of the complexes on the ECG tracing was diminishing, so I asked Jo to give her potassium chloride in her drinks. I put up 5% Dextrose solution, to run in at one litre every four hours, and prescribed 50units of insulin intravenously with each bottle.
As day was breaking, Sister Pitrose and I retired to our beds, leaving Jo Flinders alone with her charge. She would wake Maureen Delaney in a couple of hours, to take over from her.
I returned shortly before my 11.00 am crew surgery. Sister Delaney was in charge. The patient sat out of bed; the infusion was running slowly into her vein.
“Good morning, Mrs Hubbard.”
She looked vastly better; her colour had returned to her face, her hair was tidy, and she wore a new night-dress with matching light blue bed jacket. I checked the charts at the foot of her bed: fluid balance was satisfactory; temperature was still a little elevated at ninety-nine degrees Fahrenheit, pulse 80, respirations 20, BP 120/80, urine sugar and ketones both negative; I was pleased to see that the ECG tracing had normalised.
“I'll just check you over ... and then I'll need a proper history for my records ...”
Her tongue was moist, skin elasticity had returned to normal; there was no anaemia. My reading of the pulse was 82, regular, good volume; JVP not elevated; peripheral pulses normal; heart and lungs normal to auscultation; abdomen was soft and non-tender. More detailed examination of the nervous system, including fundi, light touch, position and vibration sense, were all normal.
Next, I elicited the history: she was aged seventy-four, widowed two years ago (with three grown-up children), and was on a round-the-world cruise (the classic “widow's cruise”). Her husband had run several successful garages in Essex and East London, and she was now comfortably well-off.
“I was diagnosed with diabetes when I was forty eight ... started with tablets, but changed to insulin after two years ...”
She had been well controlled on Insulin Zinc Suspension (IZS) subcutaneous injections twice daily with only occasional hypoglycaemic attacks, but nothing like this before. She had had no diabetic problems with her eyes, her nerves or her kidneys.
“I 'ad a small heart attack three years ago ... called it 'prolonged angina', and a few minor episodes of chest pain since, going down me arm, but they soon settle with TNT tablets under the tongue ...”
For the last two or three days she had been feeling feverish – probably mild flu'.
“Last night I started to feel sick ... I vomited a couple of times ... called my steward when I began to get drowsy ... felt terrible, thought I was going to die ... Don't know how I got here ... can't remember anything till I woke up this morning ... can't even remember you, doctor.”
“The drip can come down when it has run through, Sister ...”
I started her on a four-hourly modified Lawrence regime: check the urine every four hours, and give subcutaneous soluble insulin based on the results of each test – nil if the test is negative, 10 units for sugar +, 20units for ++, 30 units for +++, and 40 units for ++++.
“I'll pop in again after lunch ... you can eat and drink normally now, Mrs Hubbard ... Bananas are good for you ... contain plenty of potassium ... This episode was probably triggered by an infection ... may well have been the flu'. There's no protein in the urine, so urinary infection is unlikely; I could find no evidence of pneumonia or a skin infection, such as a boil or carbuncle ... in future you must be especially careful of your diabetic control, if you develop a fever.”
I didn't tell her how close to death she had been last night.
Thursday 18th August: We met in the bowels of the earth, in the small lobby just outside the ship's galley, for Kitchen Inspection: the captain, the chief officer, the head chef, the senior surgeon, and I; all but the chef carried heavy duty torches. This was an unscheduled visit, designed to find any evidence of poor hygiene practises (such as the presence of cockroaches), and to catch the kitchen staff napping. As I arrived, Mr Kipper flashed me a warm smile, and his right eye closed in a secret wink; I was amazed! The chef, Maurice Smith, was already sweating profusely; he refused to enter into the banter directed towards him by the ship's officers, and his pudgy pale face maintained a surly closed expression. He took these visits very much to heart – he was fiercely independent on behalf of his kingdom. He followed behind the rest of us, saying very little, occasionally swearing softly in a Bermondsey accent. He had stubbed out his cigarette on my arrival, and I noticed the nicotine-stained fingers of a heavy smoker; the multiple tattoos visible on his bare arms suggested a long life at sea. We moved from room to room, switching on lights, flashing our torches into dark corners. Our tour of inspection took over forty minutes: the galley complex was as neat as a new pin; not a cockroach in sight!
“What are these doing here?” As we were leaving, the chief officer had spotted four large sacks in a corner of a dark ante-room; from a small rent in one of these, a trickle of white powder had spilt onto the floor.
“It's just flour,” muttered Smith, going red in the face.
“Well, we can't have that,” said the Captain tersely. “It might attract rats from the bilges. See to it, Mr Smith ...”
The chef fished in his pocket, and brought out a roll of sticking plaster (reminding me of my nightmare) with which he secured the tear. I had the impression that the two of them had been down this path more than once before ...
“Would you like to see my cabin?”
It was situated near the rear of E deck. She waited just inside the door, fingering the top button of her blouse (the gesture reminiscent of Jo Flinders). The small room was abnormally tidy – this was no accidental meeting or casual invitation. The curtains were drawn, a side light was switched on casting a warm intimate glow over the place; the coverlet of her bunk was drawn back; a bottle of Tia Maria and two polished liqueur glasses stood on a small ledge. A photograph in a silver frame lay face down on the bedside table; idly, I picked it up, and glanced at the picture – a heavy-faced man with black hair and a five o'clock shadow on his jowls gazed seriously back at me.
<
br /> I felt rather than saw her flush:
“My fiancé ...” she murmured.
She was unbuttoning her blouse, slowly and thoughtfully at first, then with increasing urgency. The blouse fell to the floor, then her bra. Her breasts rose, and her dusky crimson areolae and nipples stood erect, as her hands moved behind her head. Dark-gold tresses cascaded over her shoulders and breasts like a curtain, cutting off the view. She stepped out of her skirt and lace panties, and was in my arms. I felt her hands undress me, while I stood in the centre of the tiny cabin, hardly daring to breathe. Then I was on my back on the bed, feeling the cool sheets beneath me, her soft warm body on top of me, and her lips devouring me.
I must have dozed. When I glanced at my watch, it was half-past two – I'd been here two hours, and we'd missed lunch. I nudged her with my chin; her huge violet eyes gazed down at me, and a smile hovered on her lips.
“I've got to go, Wendy ... I'm supposed to be on call.”
Reluctantly I disengaged myself, rolled out of bed and put on my uniform. She was lying on the bed with her eyes shut, as I gently closed the door. A passing passenger gave me a strange look, stopping me in my tracks. Would I be in trouble with Mr Kipper again? And what about Jo Flinders? I experienced a pang of guilt.
I'm in an Oriental Palace with gold walls; there are rich carpets on the walls and floor. Sunlight diffuses through the windows, and in the distance I catch a glimpse of snow-peaked mountains. A light breeze rustles my hair; it is pleasantly cool. On a raised dais is a richly ornamented throne on which sits Charlie Hardcastle. He wears a crown, a long cloak, and he holds a jewelled sceptre; he stares at me, his face empty of expression. I sit opposite him on a padded ottoman.
I notice music, but can't locate it. Two maidens with flowing golden hair appear from opposite ends of the room. They are dressed in baggy pyjama trousers, as in the Arabian Nights, with a jewel in the navel; their breasts are bare. They sway and dance in time to the music. They seem familiar: suddenly I realise that it's Wendy Alexander and Jo Flinders. They approach, smiling enticingly; they stroke my brow and touch my arms; they want me to chose between them – but I can't! They turn to Charlie. He doesn't speak, but I understand he is delivering the judgement of Solomon: “Tear him apart – each can have half.”
The one who truly loves me should now relinquish me to the other, so that I am not harmed. However, neither is willing to give me up; instead they both pounce on me, eyes flashing, expressions ferocious. Each grabs an arm, and they begin tearing me apart – like the wish-bone of a chicken. I appeal to Charlie Hardcastle, but he remains motionless, his face blank. A searing pain spreads from my arms to my sternum. I want to cry out, but no sound comes ...
I woke in a cold sweat, my heart hammering madly against my ribs, a burning pain in my throat, radiating down my chest to the pit of my stomach. The cold light of dawn was breaking through the port-hole of my cabin.
Chapter Seven
West Coast of America and Central America, 19th to 28th August 1966
Friday, 19th August: I was up early for our entry to Vancouver. According to my guide-book, the region had first been explored in 1792, by a British Naval Captain, George Vancouver; the settlement was subsequently located at the Pacific terminus of the Canadian Pacific Railway in 1856. Gold was found in the Frazer River in 1858, and the area was declared a British colony in the nick of time as twenty-five thousand American prospectors arrived from California for the gold rush.
The Koh-i-Noor passed Vancouver Island, winding her way carefully through an archipelago of smaller islands into the Strait of Georgia, past the Red Indian totem poles of Stanley Park, and thence towards the Port of Vancouver, where she anchored in deep water, some distance from land. It was a crystal clear day, with a slight chill in the air; a brisk breeze from the shore forced me to hang on to my peaked cap for fear of it flying off. From the officers' deck, I could see wide lawns, and pine forests stretching to the Canadian Rockies in the distance, a symphony in greens. Saw-mills dotted the estuary; further east, the sky-scrapers that marked the City of Vancouver appeared on the sky-line.
A handful of passengers were let off here, but the majority merely stayed on the for'ard observation deck with their binoculars and cameras, as enthralled with the sights as I was. I was not permitted ashore, confining myself to photographing the scene from the ship. We cast off at five o'clock in glorious sunshine.
When I returned to my cabin, I found that my cabin steward had left a large pink gin on a tray on my desk.
“How thoughtful of him,” I mused, as I took a sip. “But why has he served it in a water-glass?”
The drink tasted more bitter than usual;I swirled it around in my mouth; at the same time I noticed that there was no slice of lemon, and no ice-cube: Constanzio was getting careless ... Suddenly alarm bells were ringing in my head. I spat the drink out and rinsed out my mouth with water, convinced it was laced with strychnine! My heart thumped forcefully, and my eyes went misty. I sat staring into infinity, waiting for the muscle spasms to start ... One minute passed, five minutes, ten, fifteen minutes. Nothing. I appeared to have got rid of it all – or perhaps there had been no poison in the first place; perhaps the whole thing was just a figment of my imagination.
I rang for Constanzio, who arrived, smiling as usual, tucking his crucifix under the collar of his uniform tunic. His large family lived in Portuguese Goa (South India), but he saw them for only a few weeks each year; some of his children were now grown up; he tried to keep cheerful, though he missed them all, he had confided. His smile faded when he saw the expression on my face. I nodded towards the glass:
“Did you leave this for me, Constanzio?”
“I would never leave a drink in your cabin, Sir, without asking ... Also, it is a water glass not a wine glass, as is customary, Sir ... And there is no starched white cloth on the tray – it is not my tray.
“Never mind, Constanzio ... No, don't clear it away ... As it's here, I'll hang on to it ...” (He looked blank.) “I'll keep it.”
When he had gone, I made my way to the ship's hospital – it was deserted; from a cupboard I collected a plastic universal container with a screw-cap; back in my cabin, I swirled the gin around in its glass to mix it thoroughly, before pouring it into the container; I marked it “Sample”, appended the day's date, and hid it behind my medications in the bathroom cabinet. Finally, I rang the ship's duty officer. Davey Goodenough came on the phone. I told him what had occurred, and what I suspected.
“Do you want me to come round?” he enquired.
“No need,” I said. “I'm afraid I threw the sample away ... Perhaps you could just enter it in the ship's log ... ”
I wasn't sure whom I could trust.
That evening, I sat in my cabin, watching the sunset through the port-hole, and musing on the afternoon's events. The people with the easiest access to strychnine (and therefore the strongest suspects) were my closest work colleagues: Dr Hardcastle, Mr Slater, the three nursing sisters, and Joe Spall, the hospital orderly. From my Gladstone bag I fished out my special file, now slightly battered, and jotted down my thoughts ...
Sunday, 21st August: I was woken by the sound of a fog-horn as we sailed into San Francisco Harbour, around eight o'clock in the morning, and was off the ship by nine-fifteen. I was due to meet my mother's cousin, Aunt Pauline, who had married an American GI during the war, and now lived with him and their two teenage children in Oakland, a suburb of San Francisco.
“What you got here, buddy?” demanded an unsmiling customs officer.
“An elephant,” I blurted out, without thinking.
“You tryin' to be smart with me?”
He ripped off the wrapping paper of my package to reveal one of the ebony elephants I had purchased in Ceylon, a present for Aunt Pauline and Uncle Jack. He was even more furious when he caught sight of the contents.
Out of the corner of my eye, I glimpsed Christopher McFee passing smoothly through customs; he waved to me as he
disappeared from sight (seeing his girl-friend?), but I daren't wave back.
“Are you, or have you ever been, a member of the Communist Party?”
I resisted the temptation to give a facetious answer, contenting myself with “No, Sir.” There was a long pause; then:
“OK, pass through ...”
My uncle and aunt were waiting for me at the exit to the customs shed.
We piled into their massive Cadillac limousine, and, as the mist cleared and the sun broke through, Uncle Jack drove us to their home across San Fancisco Bay. What appeared to be a spacious bungalow, turned out to be a home on wheels – though it would probably never be moved. I was given a guided tour: I confessed myself much impressed by the spacious kitchen with its fridges and freezers (complete with ice cube dispenser), its multiple ovens and hobs, its washing machine and dish washer. All very space age.
In a Californian accent much more pronounced than her husband's, and at great length, Aunt Pauline related the anecdote of the family who returned from holiday to find their home had disappeared. Due to a mix-up with house numbers, it had been towed two hundred miles down the inter-state highway! By the end of her story, Sally and Chuck, my cousins, had appeared, and we were ready to depart for our sight-seeing tour of San Francisco.
First stop was California University campus in Berkeley, at the centre a collection of nineteenth century buildings in the Beaux Arts Classical style; beyond this was a colonnaded library, and a modern expansion dating from the nineteen-fifties. We wondered through a wooded area, through which gurgled a stream; we loitered in the empty cloisters, absorbing the tranquillity of the scene. Suddenly, at a mute signal from within, there was pandemonium: a swarm of earnest young people, laden with books, emerged from the buildings and scurried like ants across the broad neat lawns to their next lectures. We fled.
Death on the Koh-i-Noor (Edwin Scott Crime Trilogy Book 3) Page 14