Vicious Circle

by Douglas Clark

  Masters took out his warrant card and showed it to the receptionist. After reading it, she looked up and gathered from the gentle shake of his head that she shouldn’t disclose their identities to the patients waiting within earshot.

  “I . . . I see. Perhaps . . . yes, I think you should see the practice manager.”

  “He or she?”

  “Er . . . Mrs Pine. She’s doing the Next Appointments this morning.” She leaned forward through her hatch and pointed to her left. “If you go through that door which says Surgeries on it, and turn right, not left, you’ll see the exit sign. Mrs Pine is in the little office near the door.”

  “Thank you. You have been very helpful.”

  The receptionist blushed with pleasure at this courtesy. Green paused to whisper to her: “Let me know if anybody ever calls you a dragon. I’ll come in and breathe fire over him.”

  She smiled. “They’re only rude because they’re poorly. You have to ignore it.”

  “You’re as good as a bottle of medicine yourself,” said Green, and followed Masters who had already passed out of sight.

  “Mrs Pine?” asked Masters.

  “Which doctor?” asked the bespectacled woman without looking up.

  “Here we go,” breathed Green.

  “Dr Whincap.”

  “How many weeks’ time?”

  “Now, please.”

  The woman looked up from her juggling with future appointment sheets. “See the receptionist in the waiting room for appointments today. But I don’t think Dr Whincap can see you. One of the other doctors may have a blank time.”

  “Mrs Pine, I am a policeman.”

  “It doesn’t matter who you are, we take patients in strict order.”

  “A very senior policeman, Mrs Pine. From Scotland Yard.” As yet his voice had been quiet. Now it took on added timbre. “Please tell Dr Whincap I am here.”

  “He’s engaged.”

  “Please tell him, now, or I shall go to his consulting room myself.”

  The woman hesitated. Green said: “Look, love, you’re having to pay for us on the rates. Every second you keep us here is going to cost you another penny in the pound.”

  At that moment a woman patient came out of one of the consulting rooms down the corridor and approached the practice manager. Masters and Green stood back for her. The woman opened her mouth to announce her business, but Mrs Pine snapped: “I’ll attend to you in a minute,” and then picked up the internal phone.

  David Whincap came out of his room to greet them. After they had introduced themselves, he said: “Excuse me for a moment, gentlemen. I still have two patients on my list for this morning. I’ll arrange for Dr Mosser to see them.”

  “No need for that, Doctor. If they are only going to take a short time . . .”

  “Five minutes or so apiece.”

  “In that case, is there somewhere we could wait?”

  “There’s a staff room at the end of the corridor. The door is marked Private. There should be some coffee in there by now. Go in and help yourselves. I’ll join you as soon as I can.”

  “Thank you.”

  “Hello! Can I help you?” The occupant of the staff room was in the blue overall and cap of a nurse ready for domiciliary calls. She looked wholesome—sturdily built, with strong legs in heavy gauge stockings, sensible shoes, short hair just showing below the cap, little or no make-up and above all, a smile.

  “Can I help you? This is a private room. If you’re looking for somebody . . .”

  “We are policemen,” said Masters. “Dr Whincap asked us to wait in here.”

  She blushed. “Oh, I am sorry.”

  “Not to worry, love,” said Green. “The doc also told us to help ourselves to coffee.”

  She handed the cup she was holding to Green. “Have this. I haven’t touched it. I’ll get another.”

  “Ta. Can I help myself to sugar?”

  “You can, but you shouldn’t.” She smiled. “You know how we describe it?”

  “Tell me,” said Green, spooning the stuff into his cup.

  “Sugar—pure, white and deadly.”

  “Now you’re trying to frighten me.”

  She had been filling another cup for Masters, who thanked her and then asked: “Are you the practice nurse?”

  “I’m afraid I am.”

  “Afraid?” asked Green.

  “Very, because if you two are policemen, you must be here because of Mrs Carlow, and I used to help with the daily visits to give her the digoxin.”

  “Please believe me, Nurse . . .?” began Masters.

  “Scramsie. Audrey Scramsie.”

  “Nurse Scramsie, thank you. I was about to ask you to believe me when I say that to the best of our knowledge you have nothing to be afraid of. We shall want to talk to you about Mrs Carlow, of course. But we shall leave even that until after we’ve spoken to Dr Whincap. We shall tell him we intend to have a few words with you—out of courtesy. We have no wish to approach his staff behind his back.”

  She smiled and shook her head, almost in disbelief. “You’ve no idea what a relief it is to hear you talk like that after hearing how gruff the police can be.”

  “Oh, we’re gruff,” said Green. “Sometimes, that is. When we have to be. We don’t like people who hurt kids, for instance.”

  “Neither do I. My blood boils when . . . but it’s always so difficult to be sure or to prove.”

  “Baby battering?” asked Masters.

  “Yes. When I see a poor little mite covered in bruises and its mother says it has fallen downstairs, I always feel like . . .”

  “Murder?” asked Masters quietly.

  “Don’t answer that, Audrey,” said Whincap sharply, coming in at the door.

  Masters turned. Whincap said: “I didn’t hear much of that conversation, but what I did hear makes me think you are trying to trap Nurse Scramsie into some unworthy admission.”

  “No, doctor,” said the nurse. “It wasn’t like that at all. We were talking about parents who maltreat children.”

  “I see. In that case, I apologize.”

  “They haven’t mentioned Mrs Carlow. In fact they said they wouldn’t talk to me about it until they’d got your permission.”

  “Not quite that, love,” said Green. “We can talk to anybody we like at any time. But Chief Superintendent Masters has old-fashioned ideas of courtesy. He said he’d mention it to your boss before we discussed Mrs Carlow with you.”

  “Whichever it was,” said Whincap, “I’m grateful. Now, Mr Masters, I have my rounds to do and I have been summoned to attend the inquest at two o’clock.”

  “In that case, I can come to see you at a later time.”

  “My room is free. If ten minutes will do . . .?”

  “Excellent. Help yourself to your own coffee and we’ll chat while you have it.”

  Whincap sat at his desk, with Masters in the patient’s chair and Green occupying the spare.

  “You reported Mrs Carlow’s death to the coroner, Dr Whincap. As I understand it, she was a long-term patient of yours with a cardiac complaint for which you prescribed, repeatedly, and thus, continuously, a daily maintenance dose of digoxin.”

  “Quite correct.”

  “So it could be claimed that the deceased was under treatment by you right up to the moment of death.”

  “I hadn’t seen her for more than a month.”

  “Look at it another way, doctor. If Mrs Carlow had died from what we usually described as natural causes, would you have issued a death certificate?”

  “Yes.”

  “Even though this usually means that the doctor has attended within fourteen days of death?”

  Whincap paused for a moment before replying.

  “It is accepted practice that where a doctor has provided active and continuous care for the deceased over a long period of time—even if he doesn’t see the body until after death—the certificate can be accepted even though the last visit was not within the
usual fourteen days.”

  “So had your suspicions not been aroused, you would have issued a certificate which stated what?”

  “The precise cause of death. It might have been infarction or thrombosis, but I would have stated that whatever the terminal event, it was likely to have been the result of the cardiac disease for which I had been treating her.”

  “Good. May I remind you of one other point? At present, a doctor can issue a certificate without seeing the body after death.”

  “True.”

  “Had Mrs Carlow died before you reached her would you have issued a certificate without seeing her?”

  “It is not my practice to do so, but I would have felt perfectly at liberty to do so—an elderly woman with chronic heart disease? Her death at any time would have been no surprise.”

  “Forgive me for taking you through this catechism, but I am trying to get the feel of events. You state that Mrs Carlow’s death at any moment would not have surprised you. I understand you were taking great care to ensure that she hadn’t the means to commit suicide; and yet . . .”

  “Yet what?”

  “I get the impression from both written and verbal reports that from the moment you were told Mrs Carlow was ill, you acted as though you expected tragedy.”

  “What are you asking me, precisely?”

  “If Mrs Carlow could have died naturally at any time without causing you any surprise, why—before ever you got to her bedside—did you act as though an unnatural death was occurring?”

  Whincap scratched one ear. “I really have no answer to that except to say that my background knowledge of the patient and my past experience in treating her caused me to be fully prepared for tragedy and to act accordingly. My fears were justified.”

  “Were you expecting tragedy, after taking such stringent precautions to prevent it?”

  “No. I thought I had successfully circumvented what appears to have happened.”

  “Yet you still thought, from the moment you were called out to Mrs Carlow, that you would find tragedy.”

  “Could. Not would.”

  “So you did not have complete faith in your arrangements for seeing Mrs Carlow got her correct dose each day?”

  “Funnily enough, I did.”

  “A bit of a paradox, then?”

  “If you like, Mr Masters. But I assure you I had not—as you appear to be suggesting—any prior knowledge of what I would find at the Carlow house.”

  “You must forgive me if I have given the impression of suggesting you had prior knowledge of the death or the means used to bring it about. In fact the reverse is true. I was trying to satisfy myself that you truly did not have such prior knowledge, and that your response to the call for help was in all respects consistent with good medical practice.”

  Whincap looked somewhat relieved. “You could have fooled me.”

  “Maybe, doc,” said Green. “But we have to be a bit like you and not take things at their face value. If some chap comes to you with a bellyache you don’t just assume he’s eaten too much and give him some minty tablets.”

  “With some I do—knowing the patient and the rotundity of his figure.”

  “Yes, but if like us, you don’t know the bloke you’re talking to, you prod and test for ulcers or what’s the word . . . oesophagitis? Is that it?”

  Whincap grinned. “You wouldn’t like to stand in as locum for a few days would you, Mr Green?”

  Green looked pleased at the compliment on his medical knowledge. Masters got to his feet. “We’ve kept you too long already, doctor. Just before you go, however . . .”

  “What?”

  “Our two sergeants will be calling here to establish—as a must—that the amounts of digoxin prescribed by you, those given to your patient and those remaining in the bottle all add up to what they should do. I take it you keep a drug record for each individual patient?”

  Whincap nodded.

  “Would you be prepared to instruct your staff to let our sergeants see that belonging to Mrs Carlow?”

  “Willingly. I’ll warn Mrs Pine.”

  “And warn her from me, too, doc,” added Green. “She’s not the greatest PR asset in the business.”

  “I realize that, but she is a good administrator. Which would you prefer? Drug records kept up to date or a languid charm?”

  “Both,” said Green.

  “You want jam on it.”

  *

  Nurse Scramsie was waiting in the corridor.

  “Any urgent cases for me, Dr Whincap?”

  Whincap lifted one knee to act as a table on which to rest his bag. He snapped back the fasteners and handed the nurse two sheets of instructions. “Mrs Lomax and old Mr Fowler. Both the same as before, but I think Fowler’s daughter is getting a little tired.”

  “Has he been keeping her awake at nights?”

  “No. It’s just that she needs a rest and a change. See what you think. We could get him into the Cottage Hospital for a couple of weeks if she could get right away for a holiday. I don’t want to do it if she’s going to spend all her time visiting him. Oh, yes. And he is developing a bed sore on his posterior. Show her how to treat it.”

  “Right, doctor. Nothing special for Mrs Lomax?”

  “She’s going along nicely. But she never opens a window. Try to get that helpful neighbour to put a chair in the garden so that the old dear can get a couple of hours of fresh air. It’s warm enough for her now.”

  Nurse Scramsie picked up her own heavy bag and left.

  “My idea of what a practice nurse should be,” said Green. “I reckon people must look forward to her dropping in to help.”

  “She’s a gem. Now, if you’ll excuse me . . .”

  “Don’t forget to warn Mrs Pride otherwise she’ll certainly prejudice our lads against her,” said Green.

  “Mrs Pine,” corrected Whincap.

  “Same difference, doc. If you know your Hiawatha you’ll remember he called them black and gloomy pines.”

  “Ah, yes,” said Whincap. “I remember that. By the shore of Gitche Gumee . . .”

  “I think you’d better be going, doctor,” interrupted Masters.

  “Oh, yes, of course.”

  Whincap hurried towards the exit door.

  “He’s forgotten to warn Mrs P after all.”

  “Not to worry, Bill. You tell her.”

  “Why me?”

  “In theory you’re still the coroner’s officer.”

  When they reached the HQ building, Masters and Green went direct to the room allotted to them. On the desk was a note from Reed addressed to Masters.

  “Lucky so far, Chief. The pharmacist hasn’t sent off last month’s prescriptions yet. We saw Mrs C’s script and got the details.”

  Masters passed it to Green who read it without comment.

  “The sergeants will have to do their sums,” murmured Masters. “There could still have been a few left from the previous supply.”

  “Back to Christmas I’d say. They should be able to work it out.”

  “I imagine so, because the pharmacist will be asked to supply a definite number of tablets—as opposed to small packs, I mean. Digoxin can’t be sold over the counter, so it will be kept in bulk packs for prescription.”

  “What amounts would Whincap prescribe each time?”

  “I should think fifty. He can’t ask the chemist to do up thirty-one in January, twenty-eight in February and so on. It’ll have to be a nice round number each time.”

  “The lads will manage that even though nobody leaves school as a numerate member of society these days—except for chalking up at darts matches.”

  “Mrs Rainford?”

  “Might as well. I’ll ring her old man on the internal to let him know we’re going to his place.”

  Rainford led the way in his car. The first part of the journey from the old college building was through countryside, then a mile or so of town, and then out again to a pleasant suburb, past the small, elderly
railway station and down a pleasant avenue of as good a mixture of houses, old and new, big and small, as any environmentalist could hope for. There was little moving traffic here and plenty of room to park outside the house. Of thirties’ vintage, it stood alone. A four-bedroomed villa with a lot of whitened pebble-dash and applied wooden plates. Masters classified it as a mood house—in some moods he would feel comfortable living in it, but in others he would yearn for something less capable of being pigeonholed as a classic representation of its time.

  “The missus is in,” said Rainford as they gathered on the pavement. “I did phone her, but only to warn that we might be coming.” He grinned at Green. “I didn’t even answer her question when she asked what you were like.”

  Green grunted his approval of this news and followed Rainford up the drive to the door.

  “D.C.S. Masters and D.C.I. Green. Margarethe.”

  The introduction was simple in a house accustomed to welcoming policemen. Margarethe Rainford, fully composed despite the prospect of the interview, led them into her sitting room.

  “It’s nearly lunchtime,” she said, “so I’ve brought the drinks tray in. Will it be in order to ask Theo to pour for us?”

  Masters smiled. “In weather like this a cold beer would help matters along splendidly.”

  “Mr Green?”

  “Me, too, love, please. If you’re drinking yourself, that is?”

  Margarethe laughed. “I shall have to keep my wits about me, but I’ll hold a small sherry.”

  Rainford got the drinks. Masters, in an armchair alongside the fireplace, took out his pipe. He held it up towards his hostess. “May I?”

  She seemed pleased to find it was to be so informal. Her husband, as if sensing that Margarethe had relaxed, said: “They’re clever-dicks, sweetheart. They claim they never grill anybody, but by heavens they can give you a roasting. I know. I’ve had some.”

  “Oh! Have they sorted you out?”

  “And I’m not even implicated in this business except by association.” He handed Margarethe her sherry.

  Masters put a match to his pipe. There was a short silence while he watched the initial glow grow into an even burn. Green accepted his beer and broke the silence.

  “Have you had our two sergeants round ma’am?”