How Far We Fall

by Jane Shemilt

  Good people, then; good imbibed from childhood, as simple and transparent as the water in his glass, though the water in Jura tastes different in different rivers, salty like the sea or coloured brown with peat. His father stopped them drinking from mountain streams in case an animal might be decaying higher up, out of sight. Albie looks through the window into the bleak garden outside the coffee room, the bare flower beds covered with rotting leaves. His ambitions aren’t simple any more. Ted’s betrayals have muddied them, or perhaps they’ve revealed how he felt all along. Doing good isn’t enough, unless it contains the possibility of doing well. Recognition and reward: the salt in the water, the silt at the bottom.

  A nurse puts her head round the door. ‘They’ve sent for the next patient, Mr McAlister.’

  As Albie re-scrubs, the same nurse opens another packet of gloves. The elements that underpin his life seem as tightly twisted as her plaited hair, the drive to do good so interwoven with the need to do well that even if he could disentangle the strands, both would be distorted. Nothing seems straightforward any more.

  The next operation is lumbar spine decompression, harder work; the bones are bigger. After an exhausting tussle, the nerve roots are freed and, as in the case before, he sees the shining white length of the nerve running freely in its canal. While he is sewing up the skin, the message comes through that the next case is cancelled. The patient has been accidentally fed. Back in the changing room, he is undressing when the door opens then slams shut. Loud voices and raucous laughter spill into the silent room. Those who have entered begin to change their clothes, chatting unseen behind a row of tall lockers. One of the voices belongs to the orthopaedic surgeon who cheered for Ed at the party. Ambushed, Albie sheds the last of his clothes and steps swiftly into the shower, turning on the water. He doesn’t want to meet Ted’s friends.

  ‘… Six o’ clock?’

  ‘You’ll beat me hollow. Ted’s away, I’m out of practice.’

  ‘Is he any good?’

  ‘Won the cup last year.’

  A pause. The sound of a belt or buckle being undone.

  ‘… certainly on great form at that engagement do.’ The voice is effortful, as if the man is bending to unlace shoes, ‘… surprised me.’

  Albie instantly turns the water to a trickle and draws the shower curtain back, straining to hear more. The reply is muffled, the speaker must be pulling a theatre top over his head and speaking through fabric.

  ‘… very young … well of course …’

  This is about Ed and the lab. Albie’s body becomes rigid.

  ‘… keeping it in the family … naturally …’

  He’d been family or so he’d thought; his jaw clenches. He hears laughter, the sound of a locker being opened then closed, more words, buried in more laughter. They are laughing at him, he is sure of it, the dupe who did the work, and was cast aside like a dog left to howl in the dark outside a locked door. Albie puts his fist against the wet tiles, the walls close around him. Water trickles on to his head and down his neck; he begins to shiver. Minutes pass before he hears the stamping on of clogs then footsteps walking through the room. Plastic doors slap shut, cutting off further sounds.

  He turns the dripping water off with difficulty, fumbling the heavy tap. He waits a moment or two to be sure that no one returns, then, pushing the curtain fully aside, he steps out of the shower into the warmth of the changing room, and in that moment, steps into his decision. He binds the towel tightly round his waist, takes another and rubs his cold body, tingling with resolve. The choice is made. He dresses quickly and, visiting the recovery room with his briefcase, calmly helps himself to gloves, needles and syringes, a bag of saline. He does this methodically, making no attempt to hide what he’s doing. He puts the items into his case while the anaesthetist and nurses are busy with the patient; they don’t even look up. He phones Bruce outside the recovery room, suggesting lunch, but Bruce’s sentences are muddled and punctuated by long exhalations, he sounds distracted or high. Drunk, maybe. His project is impossible, he says, the results don’t add up to anything sensible. He is on the point of giving up.

  Albie seizes his chance. He offers to help, today if it suits, he has time. Maths is his strong point. Bruce accepts, he sounds on the brink of tears.

  Albie retrieves his car from the hospital car park and heads south, driving fast; if the trial has been started already – as Beth warned – he could be too late. As he weaves rapidly through the traffic, he turns the radio on, tuned to Classic FM. The clear notes of a flute fill the car; the clean sound marries with the image of the glistening nerve running unimpeded in its canal to its destination.

  15

  London. Autumn 2017

  The stage looks empty; don’t be fooled.

  Scuffles and squeaks, the odd squeal as the night animals rouse. This is their time, but something is different and they sense it; someone is working, if you can call it that. He is invisible, no one sees him for who he is. Almost no one. As we said, the stage looks empty.

  We won’t punish him; we won’t need to. He’ll do that on his own.

  The needle penetrates the tough rubber bung; he withdraws the fluid then pauses, syringe in hand. This, after all, is theft. This could be murder if the odds are against him, child murder, a massacre of the innocents. The kind of thing Sabat’s family would entreat their god to prevent at all costs. Then Albie leans over the basin and ejects the contents carefully down the plughole. His fears are groundless, the product of stress. There will be no need for prayers because there’s no chance of problems, as Beth reminded him, a safety net’s in place. He is speeding the process, that’s all. Viromex will repeat the trial; any dangers he is bypassing now will come to light then. He continues to work his way through the row of vials, peeling back a corner of the foil tab over each rubber bung and then draining them one by one.

  Bruce’s left leg had been jigging up and down when Albie entered his room three hours ago. He glanced up irritably. His skin was pale, a couple of pustular lesions glowed beside his nose, his hair was greasy. The foppish appearance had slipped.

  ‘Finally,’ Bruce muttered.

  No welcome, no thanks for making the effort. Albie’s tension dissipated. Bruce was distracted; his guard would be down.

  ‘I’ve got a few hours,’ Albie told him. ‘We could make a start on sorting out these results of yours. What’s the problem?’

  ‘I’m in such fucking trouble.’ Bruce turned back to the screen but he’d been logged out. He swore, rapidly tapping in his password with nicotine-stained fingers, his long nails clicking on the keys. DEAD RATS. Albie looked away, wincing. Typical Bruce.

  ‘They don’t make sense.’ Bruce stared at the rows of numbers, scrolling up and down. ‘My father funded this PhD. I’m the last fucking hope of a fucked-up family, but I won’t get it.’ His voice was thin with panic. ‘Nothing adds up.’

  ‘Have you or Ed started the rerun Ted wanted yet?’

  Bruce stared blankly back at him.

  ‘Injecting virus into the abdomen of those rats – you must remember, Bruce, the ones who get a second dose later?’

  ‘Christ. What does he expect? Fucking miracles?’ Bruce exploded. ‘Of course we haven’t. Home Office approval only came through two weeks ago. Ed’s in Berne looking at stem cells. He’s left everything to me. I’m screwed, Albie.’

  ‘Anything is possible if you take it step by step.’ He felt weak with relief; there was still time. He smiled at Bruce. ‘As I remember, you’ve grown up five tumour cell lines in petri dishes, all subtypes of glioblastoma from different biopsy samples?’

  Bruce’s eyes were bloodshot. ‘I can hardly remember anything. I haven’t slept for two nights.’

  ‘And you are testing the efficacy of differing concentrations of temozolomide and irinotecan, right?’

  ‘Don’t mock. It may sound simple, but the numbers are muddled. The bloody graphs don’t work.’

  ‘Meaning?’

 
‘You’d think that the stronger the concentration of drug, the quicker the tumour cells are killed, but it doesn’t work like that. There are random anomalies which skew the results.’ Bruce leant over the desk, gesticulating at the screen; the smell of stale sweat was intense. His leg began to bounce again.

  This would be easy, easier than he’d dared to imagine. Bruce was unravelling before his eyes.

  ‘Go home. Eat something, have a bath and go to sleep. This won’t take me long.’ Albie paused. ‘By the way, I don’t think it would help your PhD if it got out that someone else had written up your results. I promise I won’t tell anyone I was here tonight if you don’t.’

  ‘My lips are sealed.’ Bruce eased off his chair, performing a stumbling victory dance and saving himself by holding Albie’s shoulder. ‘I owe you.’

  ‘It’s the other way round.’ Albie looked Bruce in the eye. ‘I’m grateful you’re running that trial. Frankly I’m relieved to be out of it. Time is short. I’ve taken over Ted’s private patients too, so—’

  ‘You always were a greedy bastard,’ Bruce butted in with a short laugh.

  He had wanted to punch Bruce then. He puts the syringe down, letting the surge of fury subside. He was never greedy; it was never just about the money. The private work is incidental. What he is doing now concerns the future of treatment for brain tumours in children. In a few months he, Albie, will be the author of miracles. His presence will be requested as the key speaker at international conferences, the acknowledged leader in the field. No one will take his success away after that; it will be Ted in the audience then, listening in the dark.

  Before he left, Bruce had reached for an untidy stack of green notebooks pushed against the wall at the back of the desk. ‘The data is all in here, if you want to double-check anything.’

  Albie opened the first page; numbers stretched down the paper in messy columns, figures crossed out several times, notes scrawled alongside, with pencilled arrows pointing to different sums. He turned a few more pages, trying to mask his surprise.

  ‘It’s on the screen as well.’ Bruce was watching his face. ‘If you’re going to be anal about it.’

  Albie accompanied him down the corridor, glancing at the ceiling. Still no CCTV cameras. At the door Bruce turned. ‘You’re a mate.’ He stepped forward and launched himself at Albie. The musky smell of cannabis was overwhelming, followed by a fainter wash of alcohol and nicotine.

  Albie made a cup of coffee in the staffroom, heaping in the granules. It would take a while to correct Bruce’s project, then the work of the night could start. No one else was about now. He felt as excited as a student with a deadline, as determined. Back then, he’d spent whole nights in the Glasgow research centre, hiding behind the door from Hilary, the laboratory manager, while she prowled her labs, checking for lingerers. Once she’d gone, he worked through his rat stress experiments, free from the censorious gaze of those narrow hazel eyes. It was unpleasant work, the rats had frozen with fear under the strong light then scrabbled to get away, tearing each other’s coats. There were casualties, but despite his guilt he persisted. The bigger picture was the one that counted, he told himself, the longer view. In time he would make a difference; he held to that.

  A row of keys hung on hooks under the cupboard of mugs. The one for the animal fridge had a red tab – that’s where the vaccines would be, with the tumour solutions and chemotherapy agents, all carefully labelled.

  Light footsteps came down the corridor towards the coffee room. He stepped swiftly away from the keys as Skuld came in; she glanced at him incuriously as she reached for a glass on the shelf above the sink.

  ‘Oh, hi there, Skuld.’ His heart had plummeted. This was worrying, he’d reckoned on an empty lab. ‘You’re working late tonight.’

  She filled her glass from the tap but didn’t reply. He studied the slim back view.

  ‘I’m correcting Bruce’s PhD; it’s a bit of a secret.’ A quick laugh. ‘I wouldn’t want anyone to think he’d been cheating.’

  Her head tipped back as she swallowed; a listener, he reassured himself, not a gossip.

  ‘It’s good to see you,’ he continued. ‘I’ve been wanting to ask if you knew about the lab being handed to Ted’s son? You go to those meetings; I’m mostly in the hospital these days, but if there was anything to tell me, you could always leave a message with the departmental secretary and I’d come to find you.’

  She turned, her fair eyebrows slightly raised as if puzzled. She shook her head silently.

  ‘Well, it doesn’t matter now.’ It does matter, it still hurts. It will always hurt. ‘I just wondered, that’s all. Things are busy, it’s probably for the best.’

  A smile flickered over her face; encouraged, he smiled back.

  ‘I thought I saw you running on the Heath with your sisters a while ago now, a glimpse but—’

  ‘Take care.’ The words were breathed quietly, like a wind on a summer night, light enough to be imaginary, cool enough to make you shiver.

  ‘Sorry, what—’

  ‘See you.’ She walked past him and the door swung shut behind her; a faint scent of summer grass lingered in the air.

  He stood still, staring at the door. She couldn’t possibly have guessed what was afoot. Take care is simply another way to say goodbye, like see you. His coffee had gone cold and he topped it up from the kettle. She didn’t mean he should be careful any more than she meant she would see him.

  Back at the desk, Albie checked the numbers on the screen against those in the notebook and saw a mismatch on the very first page, another on the fifth. He shook his head in disbelief. Bruce had simply failed to translate the correct numbers from page to screen; basic errors, though enough to spoil the expected trend. He must have been high on drugs and alcohol for weeks, too confused to think clearly; the errors were those of a tired child. Bruce might be brilliant, but he’d forgotten fundamental accuracy, and a single mistake would be enough to wreck the results. In three hours Albie had checked every number and corrected several more copying mistakes. He began to feed the corrected information into the computer, generating graph after graph. They all demonstrated the predicted relationship between concentration of drug and destruction of cancer cells; by midnight the last one had been completed. It was time to start the real work of the night.

  He glanced in the animal room; Skuld had gone home. Wearing the gloves he’d stowed earlier, he retrieved the keys and unlocked the fridge. The labelled boxes were on the middle shelf: Primer varicella solution: Batch 82297X for intra-abdominal inoculations was clearly written on the cardboard in blue felt tip. In matters like this, Bridget took no chances. The other boxes were labelled with orange felt tip: Varicella solution for intracerebral inoculation. It was that easy. He removed the blue-labelled box and took it to Bruce’s room. If the night porter came by on his rounds, he should have time to push it under the counter.

  He’s halfway there. He removes the bag of saline from his case, withdraws a syringeful then refills each vial to the previous level marked on the side. He takes care to use the puncture point he made before and presses the silver foil top down afterwards, smoothing it flat. He bends close to inspect the vials; they look exactly as they did before he began. No one could possibly guess at the change. Bruce will drain them again in a day or so, unwittingly delivering a quarter of a millilitre of saline into the abdomen of each rat. Intracerebral dosing will follow, Viromex’s tests and later, the children’s trial. His part is over.

  He replaces the vials in the box, then the box in the fridge, locks the fridge door, puts the key back on its hook, then stows the syringes and needles in his case along with the gloves and empty bag of saline. He checks the sink is swilled out and tidies the pile of notebooks.

  ‘Done,’ he mutters, exhausted. ‘All done.’

  Ted’s coat is still hanging behind the door in the locker room, untouched for the last two years, the underground car park pass still in the pocket. He removes the card, takes the
stairs to the ground floor and continues to the lower ground then basement. His presence on the CCTV cameras in reception earlier won’t matter, but exiting now could attract attention. The dark car park is empty. There is a ramp leading to the exit, which might have CCTV cameras in place. He begins to walk around the perimeter. He is being overcautious – Ted’s training again. No investigation will ever be necessary; he knows that. Nevertheless, he doggedly continues his search until he finds a door in the corner with the slotted metal box. He swipes the card rapidly: nothing. He wipes the plastic against his sleeve and tries again and this time the door opens with a dull click. He steps into a dark cul-de-sac which leads to an alley; another turn brings him out to Great Ormond Street.

  The sky is lightening over the Heath as he drives up Haverstock Hill, but in Hampstead Hill Gardens, all the curtains are still drawn. He gazes up at the house, his grandparents’ house; safe now. The mortgage will be paid by the end of the year. Their children, their children’s children, will grow up here. He walks down the steps by the side of the house to the garden door and lets himself into the kitchen quietly. Lit candles on the dresser gutter in their holders. Beth has fallen asleep in a chair, legs tucked under her body, but her eyes snap open as if she can feel his gaze on her skin. She smiles sleepily and stretches to retrieve a champagne bottle in a bucket of melting ice on the table by her side.

  ‘Something a little unexpected happened …’ He takes the champagne glasses from the dresser and gives them to her.

  ‘Unexpected?’ Her smile falters.

  ‘I hadn’t realised Skuld would be in the lab so late at night.’ He shakes his head. ‘She didn’t see anything, but if there are problems further on, it might come out that I made an unscheduled visit just before the trials were due to start.’

  Beth sets the glasses down and picks up the champagne bottle. ‘What problems could there be, Albie? Viromex’s trials will uncover any risks. There won’t be any problems. Relax.’ She removes the cork with a deft twist as if she’s been practising in readiness for just this moment. She proffers his glass, lifting her own high.