Donor E-Book

Ken McClure

• Herausgeber: Birlinn
• Kategorie: Abenteuer, Thriller, Horror
• Serie: Dr Steven Dunbar Thriller
• Sprache: Englisch
• Veröffentlichungsjahr: 2011

Seitenzahl: 427

Beschreibung

The first Dr Stephen Dunbar thriller. When seven-year-old Amanda Chapman is admitted to hospital with acute renal failure, her parents are in despair. Their hope is renewed when Amanda is accepted for treatment in a pioneering, state-of-the-art dialysis unit in an exclusive private hospital in Glasgow, but behind the lavish hospital corridors, private rooms and friendly staff lies something much more sinister. Dr Dunbar goes undercover to find out in the first of Ken McClure's gripping thrillers featuring the ex-Special Forces medic.

Leseprobe

DONOR

Ken McClure

Charity shall cover the multitude of sins.

I Peter 4:8

Contents

Title PageDedicationPROLOGUEONETWOTHREEFOURFIVESIXSEVENEIGHTNINETENELEVENTWELVETHIRTEENFOURTEENFIFTEENSIXTEENSEVENTEENOther Titles by Ken McClureCopyright

PROLOGUE

Amy’s room was cold; the heating had been turned off. Outside, snow was falling from a white-grey sky and the view from the window was blurred as a slight breeze caught the flakes and threw them silently against the glass. There was no rattle of raindrops or hammering of hail. This was as it should be, thought the woman who stood there looking out. The weather was showing proper respect. The whole world seemed quiet; it was holding its breath.

There was a distant hubbub from the people waiting downstairs but that served only to accentuate the silence in a room that had so often been alive with childish laughter. Ostensibly everything about the room itself was the same as it always had been. The pink wallpaper, the Disney curtains, the toys, the dolls, the picture of the boy-band on the wall. Amy’s pyjamas lay on the pillow, neatly folded in a little square parcel; her colouring books were stacked on a bedside table with a box of pencils on top; but none of them would be needed again.

There would be no more brightly coloured pictures of jungle animals for her father to admire before telling her bedtime stories, no improbable pink giraffes or mauve tigers. Red birds would no longer fly off into green sunsets and Jack would not be slaying the giant again to childish sighs of relief. Amy was dead. She lay in the little white coffin in the middle of the room.

The hospital had given special permission for this. It was unusual for the bodies of patients who had undergone postmortem examination to leave the premises. They were usually taken directly to the hospital mortuary to await collection by appointed undertakers on the day of the funeral. But Amy’s mother had dug her heels in and insisted that she be allowed home for the last time. She didn’t know why she’d done it and she suspected the authorities had only given in to avoid a prolonged scene with a grief-stricken woman. She only knew that, as she continued to look out of the window, it seemed right. Amy was going to start her last journey from her own room.

Jean Teasdale’s face was expressionless, her eyes distant. There were no tears; she had cried herself out. She barely acknowledged the fact that a hearse was drawing up outside the house, its wheels silenced by the snow. A few moments later the sound of the hubbub downstairs increased as the door behind her was opened and then faded as it was closed again.

‘It’s time, Jean,’ said her husband softly.

‘What was it all for? Tell me that,’ she asked without turning.

‘I wish I could,’ came the whispered reply.

‘Seven years of life and then nothing. Snuffed out. What a waste, what a stupid, pointless waste.’

Frank Teasdale put his hands gently on his wife’s shoulders and kissed the back of her head lightly. She didn’t turn round but she reached up her right hand to rest it on his.

‘It’s time to be brave,’ he said.

‘It’s stupid, I know, but I can’t help worrying about all that snow out there.’

‘What about it, love?’

‘I keep thinking … when they put Amy in the ground … she’ll be cold.’

Frank Teasdale lost the battle with his emotions; and he had been doing so well up till that moment. Tears flooded down his cheeks and his shoulders heaved with the effort of trying to maintain a masculine silence. Jean finally turned away from the window and they held each other tight as they sought solace; but in this situation none was possible.

Frank broke away, pulling out a handkerchief and blowing his nose as he fought to find composure again. ‘We’d best be getting downstairs,’ he said. ‘Get this over with. People have come from the hospital.’

Jean nodded. ‘That’s nice,’ she said.

They paused together by Amy’s coffin and rested a hand on the lid for a moment in a silent gesture of farewell. Frank looked at Jean; his eyes asked the question. She nodded in reply. They went down to join the mourners, passing between two of the undertaker’s men who were waiting at the foot of the stairs.

‘All right if we go up now?’ asked one.

‘Yes,’ replied Frank without looking at him.

Amy’s coffin was taken from the house and gently loaded into the hearse, to be surrounded by flowers from friends and family. They looked strangely incongruous against the snow, a splash of colour in a black-and-white world. Frank Teasdale found himself mesmerized by them; he kept staring at them through the windscreen of the car behind as he sat in the back with his arm round Jean. It was impossible not to draw analogies: beautiful, ephemeral things there for only a moment in the great scheme of things before withering and dying. He thought, it will soon be Christmas.

The next hour or so saw Frank and Jean Teasdale support each other through their daughter’s funeral service and subsequent interment in the churchyard of St Mungo’s, their local church, although neither had seen the inside of it since Amy’s christening. They clung to each other as if afraid to let go even for a moment. It was almost a relief when the first shovel of earth hit the coffin lid and Amy could now exist only in memory.

Frank had started to guide his wife back along the path to the car park when she suddenly stopped. He felt her arm become rigid and looked up to see what had caught her attention. A woman was standing in the trees off to the side. She was wearing a raincoat and headscarf but Jean had recognized her.

‘It’s that nurse,’ she said. ‘It’s that damned nurse. Why won’t she leave us alone? Why must she go on spreading her poison?’

Frank could sense his wife becoming distraught. He tried to calm her, before taking a step towards the woman in the trees. The woman made an apologetic gesture as if to indicate that he needn’t move; she had not meant to cause trouble. She moved back until she was out of sight.

‘She’s gone,’ said Frank, returning to his wife’s side.

‘Why does she persist?’ demanded Jean.

He looked sadly back to the trees. ‘I really don’t know,’ he said.

ONE

‘Who can tell us where we get bread from?’ asked Kate Chapman. There were eighteen children sitting in front of her. She smiled as a forest of eager young hands went up and enthusiasm filled their faces. She loved teaching, especially at primary school. For her there was something magical about introducing children to the voyage of discovery she firmly believed education should be. She took her early navigational responsibility seriously. Not for her the cynicism that said these would be the surly teenagers of tomorrow, the bus-shelter vandals, the lager louts, that each new generation was more spoilt than the last. Kate simply could not see beyond the innocent little faces that currently vied for her attention.

‘Kerry?’

‘Please, Miss, a baker, Miss.’

‘Good, Kerry. Now, who’s going to tell us how the baker makes our bread?

No hands went up this time.

‘Come on, what does the baker use to make the bread?’ coaxed Kate.

A little boy, wearing glasses with one lens blanked off to encourage a lazy eye, put his hand up tentatively then withdrew it. He did this several times with furtive glances to the side as if afraid of making a fool of himself.

Kate sensed his dilemma. ‘Yes, Andrew,’ she said encouragingly. ‘Come on, have a try. What do you think the baker uses?’

‘Is it flour, Miss?’ asked the little boy, putting his head to one side and then putting the end of his pencil in his mouth.

‘Well done, Andrew. It’s flour.’

He flushed with pleasure.

‘Now, what kind of man makes the flour that goes to make the bread?’

Kate glanced behind her at the colourful pictures that lined the wall. She looked directly at the one showing a windmill with a red baker’s van standing outside it.

Several hands went up as excited children got the clue and made the connection.

‘Yes, Annie?’

‘A miller, Mrs Chapman.’

‘A miller,’ agreed Kate. ‘Well done, Annie. Now then, what does the miller need to make the flour?’ She looked along the rows of children as they struggled to come up with the answer. The expressions on their faces were such that she could almost hear their minds working. But she frowned when she came to a pretty little blonde girl in the second row. She felt a sudden wave of concern. Amanda clearly wasn’t concentrating on the question. Her eyes were dull and distant and her face was pale with a suggestion of moistness on her forehead.

‘Are you feeling all right, Amanda?’ she asked.

The child did not respond and the class murmured uneasily.

‘Amanda?’ repeated Kate.

The little girl turned her face towards her but still seemed distant.

Kate went over to her and put her arm round her shoulders. ‘What seems to be the trouble?’ she asked. She bent her knees, sat on her heels and smoothed the child’s hair back from her forehead. She let her hand rest there for a moment. Amanda was burning up.

‘Oh dear,’ Kate soothed. ‘You’re not very well at all, are you?’

Kate now had a problem. Amanda was not only one of her pupils; she was also her daughter. There was therefore no option but to pass the buck to a third party. Sandy, her husband, a medical lab technician, was on duty at the local hospital and there was no one else she could call on for something like this. They had only moved to Bardunnock a few months before and were still at the settling-in stage.

Kate stood up in front of the class and said, ‘I’d like you all to draw me a picture of what you think a miller might look like while I have a word with Mrs Jenkins. Any questions?’

‘What’s wrong with Amanda?’ asked Tracy Johnson, the local postman’s daughter.

‘She’s not feeling very well,’ replied Kate. ‘I think she’s got a bit of a cold coming on.’

Please God that’s all it is, thought Kate, as she picked up Amanda and hurried along the corridor to throw herself on the mercy of the head teacher, Isa Jenkins.

Isa Jenkins was teaching her own class. Kate looked through the one clear pane on the half-glass door and caught her attention. She saw Isa instruct her pupils to get on with something before coming outside into the corridor.

‘What’s up?’

‘It’s Amanda. She’s not well. I think she may be coming down with flu.’

Isa put her head on one side to look at Amanda, who was resting her head on her mother’s shoulder. ‘Poor wee mite,’ she said. ‘You don’t look well at all, do you?’

Amanda responded by putting her thumb in her mouth and nuzzling into her mother’s shoulder.

‘I’m awfully sorry about this—’ began Kate but Isa stopped her. ‘Nonsense,’ she said. ‘I’m sure we can work this out together. What do you want to do? Take her home or over to the medical centre in Colbrax?’

‘I think maybe home,’ said Kate. ‘I’ll put her to bed and keep an eye on her for a while. She’s got a bit of a temperature but it could subside as quickly as it came on. You know what kids are like.’

‘I should by now,’ Isa smiled. She had been a teacher for thirty-two years.

‘I really hate doing this to you,’ said Kate, ‘but—’

‘Nonsense,’ insisted Isa. ‘I’ll commute between classrooms until the bell.’ She looked at her watch. ‘It’s only another hour and a half. No problem. What are your lot doing?’

‘They’re drawing a miller.’

‘Right, off you go.’

‘Thanks, Isa, I’m indebted to you,’ said Kate, finding another reason for liking the life in Bardunnock.

At six o’clock Kate was in the kitchen when she heard Sandy’s car come round the bend at the foot of the hill and labour up to the tight right-hand turn into the drive of the cottage. The car was a green, eight-year-old Ford Escort they had named Esmeralda.

‘Where’s my princess?’ Sandy Chapman called out as he opened the door. He paused to wipe his feet on the coarse mat before stepping inside. For once his call was not answered by the sound of running feet and laughter. Kate emerged from the kitchen, drying her hands. ‘Your princess isn’t very well, I’m afraid. I had to bring her home from school this afternoon.’

Sandy stooped to kiss Kate on the forehead and put his arm round her shoulder before asking, ‘What’s the matter?’

‘I thought it was just a cold but now I’m not so sure. I thought I’d wait till you came home before I called the doctor.’

Sandy nodded, now looking worried. He climbed the stairs to Amanda’s room and pushed open the door. Amanda’s head didn’t move on the pillow but her eyes looked up at him.

‘Hello, Princess,’ said Sandy softly.

Amanda didn’t reply. Her gaze drifted off to the window but her focal point was miles beyond.

Sandy’s head nearly touched the ceiling in the upstairs rooms of the old cottage and his shoulders almost filled the doorway. He sat down on the floor beside Amanda and rested his elbow on the bed. ‘Poor Princess,’ he said. ‘Have you picked up some nasty bug?’

He ran his fingers lightly along his daughter’s forehead and felt the film of moisture on her pallid skin.

‘I think we are going to call Dr Telford to give you some medicine to make you well again.’ He looked at Kate meaningfully and she got the message. She left to telephone while Sandy continued to talk to Amanda.

‘Tell Daddy where it hurts. Is it your tummy?’

Amanda shook her head slowly.

‘All over?’

A nod.

‘Have you been to the bathroom today?’

‘Can’t remember.’

‘Can you remember what you had for lunch?’

A blank look.

‘The same as the other children?’

A nod.

‘You didn’t eat any of the berries off the bushes in the garden did you, Princess?’

A slow shake of the head.

‘Well you cuddle in now. The doctor will be here soon and he’ll make you all better.’ Sandy put Amanda’s teddy bear beside her and tucked in the covers.

‘What do you think?’ asked Kate when he came downstairs.

Sandy shrugged. ‘Same as you, I guess. I want to believe it’s just a cold or flu but I think it’d be as well to get a qualified opinion.’

Kate put her head against his chest and he wrapped his arms round her.

‘Oh God, I hope it’s nothing serious,’ she said.

‘We’re probably worrying unnecessarily,’ said Sandy, but he glanced at his watch and asked, ‘Did you get any idea how long the doctor would be?’

‘The receptionist thought about half an hour. He still has a couple of patients to see at evening surgery.’

There wasn’t enough room in Amanda’s bedroom for all three of them to crowd in, so Sandy stayed downstairs while their GP examined Amanda and her mother provided reassurance by holding her hand. Sandy stood looking out at the garden while he waited. There was no escaping the unease he felt, despite knowing that nine times out of ten a parent’s fears were unfounded. The chances were that the doctor would come downstairs joking with Kate, tell them that there was nothing to worry about and accept their apologies for calling him out unnecessarily.

He recognized that the nature of his job at the hospital tended to distort his view of how much serious illness there was around. Was it the same for policemen? he wondered. Did they see crime and potential criminals everywhere they looked? He heard Amanda’s door open and turned round to look up the stairs. Dr Telford came down first, with Kate behind. They were not joking.

Sandy knew George Telford through his job. General practitioners in the area were encouraged to participate in the care of their patients while they were in the district hospital.

‘What do you think?’ asked Sandy.

‘I’m not happy with her,’ replied Telford, looking concerned. ‘I think we should take her into hospital overnight and run some tests.’

‘Have you any idea at all what’s wrong?’

‘I’ve an idea her kidneys aren’t working properly,’ replied Telford. ‘I could be wrong but I think we ought to run some biochemistry on her. Can’t do any harm.’

‘I suppose not,’ said Sandy. Kate had come over to stand beside him and he had his arm round her shoulders.

‘Has she shown any sign of having trouble with her waterworks in the past few days?’ asked Telford.

Sandy looked to Kate, who shook her head. ‘None at all,’ she said. ‘She’s been as right as rain.’

‘Well, a thorough examination at the hospital should put our minds at rest.’

‘What hospital were you thinking of?’ asked Sandy.

Telford looked thoughtful. He said, ‘I’m trying to decide whether to take her in to the district hospital for overnight observation or maybe have her taken directly up to the Sick Children’s Hospital in Glasgow.’

‘She doesn’t seem to be in too much discomfort,’ said Kate, hoping to influence the decision in favour of the local hospital. That would be more reassuring than having Amanda taken off to Glasgow.

‘True,’ agreed Telford. ‘That’s what we’ll do, then. We’ll take her over to the district hospital and have some preliminary tests done.’ He looked at his watch and said, ‘I suppose at this time it’ll mean calling out the duty technician in the lab. That’s not you this evening, is it?’

‘Not tonight,’ replied Sandy.

‘I’ll stay at the hospital tonight,’ said Kate. She knew from Sandy that on occasion the parents of young children were permitted to stay over in a guest room at the hospital.

‘Good idea,’ replied Telford.

It was just after eight thirty when Kate turned to Sandy and said, ‘You must be starving. You haven’t had anything to eat.’ They were waiting in the small side room outside the ward while Amanda was settled by the nurses.

‘I’m not hungry,’ replied Sandy.

‘Me neither.’

‘What do you think?’ she asked anxiously.

There was no need to ask what she meant. Sandy said, ‘I think she’s got worse in the last hour.’

‘It could just be the upset at coming into hospital.’

‘Maybe,’ conceded Sandy, but he sounded far from convinced.

‘Why don’t you go on home?’ Kate suggested. ‘There’s nothing you can do here. I’ll be here for her if she wakes in the night.’

Sandy nodded as if only half considering the suggestion. ‘I think I’m going to pop along to the lab first to see if Charlie got the specimens okay,’ he said. ‘Maybe I’ll hang around until he’s got the results. If they seem okay I’ll go on home. You will call me if anything changes?’

‘Of course,’ replied Kate. ‘And don’t stand over Charlie. You’re an interested party, remember.’

Sandy nodded; he kissed Kate on the forehead and turned to go.

The district hospital lab was situated in a small brick building, separate from the main building and hidden behind a row of conifers that bent in the wind as Sandy left the warmth of the hospital and walked down the path towards it. He got intermittent glimpses of the lights on in the building as the lower branches of the trees separated. Icy raindrops started to pepper his face as he turned into the shelter of the ivy-covered porch outside the lab. The door was locked. He fumbled in his pocket for his key but discovered that he’d left it at home. He rang the night bell and a few moments later the door was opened by a short, dark-haired, studious-looking man wearing a white lab coat with a green plastic apron over it. His dark-rimmed glasses seemed too large for his round face, giving him the look of a wise old owl.

‘Evening, Charlie,’ said Sandy as he stepped inside and closed the door behind him.

Charlie Rimington smiled and said, ‘I had a feeling I might be seeing you when I read the label on the specimens. How is she?’

‘Not good, but it’s always hard to tell with kids. How are the tests coming along?’

‘Up and running. I take it you’re going to wait?’

‘If you don’t mind.’

‘I’ve got kids too, remember.’

The insistent bleep of an electric timer distracted them and Sandy turned off the machine he was standing beside. He’d done this a thousand times before for other people’s children’s samples. It had never felt like this.

Feeling awkward because it was Rimington’s duty shift and not his, he stood back to allow Rimington to open the loading cage and extract the specimen tube. He saw the ward label on the side of the glass: ‘Amanda Chapman’. It made the hollow feeling in his stomach worse.

Rimington tore off the print-out from the machine and sat down, pencil in hand, at his desk to read it, using the pool of light from an anglepoise lamp. Sandy stood at his shoulder feeling impatient but fighting hard to hide it. After thirty seconds of silence he could stand it no longer.

‘Well?’ he asked.

‘No signs of infection and no toxic substance present,’ said Rimington.

‘But?’ said Sandy anxiously.

‘All the signs … suggest sudden renal failure.’

‘Jesus,’ said Sandy, gripping the bench and letting his head fall forward. He remained like that for a few moments before asking, ‘What are we talking here? Mild?’ He took the analysis sheet from Rimington’s hand and read the results for himself. ‘Jesus,’ he repeated. ‘We’re talking dialysis.’

‘’Fraid so,’ agreed Rimington.

Sandy stood by while Rimington phoned the result through to the ward. There was no question about it: Amanda would have to be transferred to a hospital with a dialysis unit, and the sooner the better. The district hospital did not have this facility. It would have to be Glasgow after all.

A knot of fear formed in the hollow space in Sandy’s stomach. He was worried sick about Amanda but he had to be strong for Kate’s sake. Then there were the logistics of the transfer to be worked out. Kate could go in the ambulance with Amanda, while he drove up to Glasgow in Esmeralda so that he and Kate could get back, whenever that would be. He couldn’t see that far ahead.

Charlie Rimington said, ‘Don’t worry about the lab. Andrew and I can cover for you. Take as much time as you need.’

‘Thanks,’ said Sandy, turning to leave. ‘I appreciate it.’

Outside, it was now raining heavily. Sandy was soaked by the time he got back up to the hospital. He paused just inside the door to wipe the water from his face and push his wet hair back from his forehead before entering the ward.

Kate was talking to George Telford, who was telling her the results of the tests. There was anguish on her face. She saw Sandy arrive and came towards him.

‘Oh, Sandy,’ she sobbed.

Sandy took her in his arms and held her tight. ‘Come on now, Kate,’ he encouraged her. ‘She’s going to be okay. We just have to get her to the right place.’

‘Dr Telford says she has to be transferred tonight,’ said Kate.

‘It’s for the best,’ said Sandy.

‘But how will we—’

Sandy put his finger on her lips. He said, ‘Let’s just take everything one step at a time. You travel in the ambulance with Amanda. I’ll drive up. Then, when we’ve heard what the doctors in Glasgow have to say, we’ll decide what’s best.’

Kate nodded and wiped away her tears.

‘Come on now,’ soothed Sandy. ‘Let’s be strong for Amanda.’

Sandy had to fight against recurrent feelings of disorientation as he followed the ambulance on the road to Glasgow. He was having difficulty in coming to terms with just how quickly everything in their lives had been turned upside down. Only a few hours before he had expected to be watching television with Kate in front of the fire in their cottage while Amanda slept safely upstairs in her room. Now here he was heading north through driving rain on a dark night, with Amanda seriously ill in the vehicle in front and Kate in a terrible state. He wanted it to be a bad dream. In a moment he would wake up and find he was in bed at home with absolutely nothing amiss. Ahead, the ambulance pulled out to overtake a heavily laden lorry in the nearside lane of the dual carriageway. Sandy did the same and hit the wall of spray coming from the lorry’s wheels. He turned the wipers up to maximum speed. This was no dream. It was a nightmare.

Kate and Sandy sat on a bench in the hospital corridor while Amanda underwent further tests. They stood up when the doctor who had been dealing with her came out and introduced himself.

‘Mr and Mrs Chapman? I’m Dr Turner.’

‘How is she, Doctor?’ asked Kate.

‘She’s pretty low at the moment but I should stress that she’s not in any danger. There’s just been a build-up of toxic substances in her blood because of the kidney problem. Once we clear these away she’s going to feel a whole lot better, I promise you.’

‘Any idea why she went into renal failure?’ asked Sandy.

‘Impossible to say at this stage,’ replied Turner. ‘But there are a lot of tests we still have to do over the next few days.’

‘Is there a chance that this was just a one-off problem?’ asked Kate.

Turner displayed the unease of a man being asked to provide an encouraging answer he knew he couldn’t give. ‘I … I don’t really feel that’s likely,’ he said.

‘So you think she’ll need further dialysis?’ said Sandy.

‘It’s early days yet, but in all honesty I fear so. That’s usually the case.’

Sandy felt his spirits sink and his limbs become heavy. The chances were that Amanda was going to need regular dialysis from now on unless … He shut out thoughts of what might lie ahead and tried to confine himself to what was going to happen tonight.

‘Is it okay if we stay?’ he asked.

‘Of course,’ replied Turner. ‘But if you’ll take my advice you’ll go home and get some rest. She’s in good hands.’

‘But what if she should need us in the—’

Turner shook his head. ‘We’re going to keep her well sedated. Come back tomorrow. We’ll be able to tell you much more after we’ve carried out some more tests.’

Reluctantly, because all Kate’s instincts said that she should stay near Amanda, Sandy and Kate took Turner’s advice. It was a thirty-mile drive back to Ayrshire but the roads would be quiet in the early hours of the morning and the rain had settled down to a drizzle rather than the earlier downpour. They didn’t speak much as they walked to the car down the wet cobbled lane at the side of the hospital. They were both preoccupied with their own thoughts and could think of nothing encouraging to say to each other. A black cat that scurried off among the dustbins seemed to be the only other living creature in the darkness of the night.

The house was cold when they got in; the heating had switched itself off some hours ago. The coldness added to the feeling of quiet and emptiness that met them.

‘Are you hungry?’ Kate asked as Sandy knelt down to light the gas fire in the living room.

‘Not really. But I could use a drink.’

Kate poured them both a whisky. They sat on opposite sides of the fire. They hadn’t yet taken their coats off.

‘Everything’s been going too well,’ said Kate. ‘Something like this was bound to happen.’

Sandy looked at her questioningly.

‘You get your job, then I get mine. We find the cottage in the perfect village. Everything has been going just too smoothly. It had to stop.’

‘Nonsense,’ said Sandy softly. ‘That’s a very Scottish thing to say.’

‘We’re very Scottish people,’ replied Kate.

‘That doesn’t mean we have to subscribe to the “Weary Willie, we’ll pay for this somehow” philosophy.’

‘I suppose not,’ agreed Kate with a wan attempt at a smile.

‘Anyone found enjoying themselves will be dealt with severely,’ mimicked Sandy in severe Presbyterian minister tones.

Kate’s smile grew broader. She got up from her chair and said, ‘I’ll make us some toast. We’ve got to eat something.’

Neither of them managed much sleep. Both were relieved when it was time to get up and busy themselves. They phoned the hospital and were told that Amanda had had a comfortable night and that it would be best if they waited till early afternoon before going in. By then the doctors would have the results of the tests they planned for Amanda and should have something concrete to tell them.

Kate phoned Isa Jenkins to tell her what had happened and that she would not be at school today.

‘Don’t worry about it,’ said Isa. ‘I rather thought that might be the case. The wee soul didn’t look well at all. I took the precaution of calling one of the supply teachers over in Ayr last night and warning her she might be needed today, so everything’s under control.’

Sandy called Charlie Rimington at home and was given similar assurances. ‘Nice people,’ he said when he put down the phone. Kate nodded.

‘Dr Grayson and Dr Turner will see you now,’ said the nurse who put her head round the door of the waiting room. Sandy and Kate followed her a short way along the corridor and were shown into a small, sunny room where the two men were sitting. Both got up when Kate and Sandy entered, and Grayson was introduced to them as the consultant in charge of the renal unit.

‘She’s looking better this morning,’ said Turner with a smile to Kate, who was looking anxious.

Kate nodded. ‘Yes, she is.’

‘She had a good night’s sleep, which I dare say is more than either of you two did.’

Sandy nodded his agreement.

With the pleasantries over, Grayson got down to business. He was a man in his mid-forties with thinning grey hair and a pepper-and-salt moustache. His dark suit looked expensive and appeared to have been made to measure with millimetric precision. The cuffs of his white shirt showed one centimetre on both sides and his gold cuff links seemed to rest at precisely the same angle on the table as he sat with his hands clasped in front of him. His shirt collar seemed to ride a little high and looked distinctly uncomfortable to Sandy’s way of thinking but it was the perfect foil for the dark university tie that hung below. The overall impression was of a man precise in all things.

‘Frankly, the news is not good.’

Sandy felt as if he had been hit by a train. He swallowed and looked at Kate, who seemed to be reeling too. He took her hand and squeezed it.

‘Amanda’s renal failure is quite severe, though we can see no reason for it. She has responded fairly positively to dialysis, although not as well as we expected. As regards prognosis, I think we should be looking at dialysis as a way of life well into the foreseeable future.’

Sandy rubbed his forehead. Grayson didn’t fool around with dressing up what he had to say. His worst fears were being confirmed at an alarming rate.

‘Can I ask what you do?’ continued Grayson.

‘I’m an MLSO at Dunnock District Hospital,’ said Sandy. He looked to Kate to see if she was going to reply for herself. She was looking down at her shoes. ‘Kate’s a teacher,’ he added.

‘Good,’ said Grayson. ‘Then, thinking ahead, I feel we should be considering a home dialysis unit for Amanda when one becomes available. You’re both obviously quite capable of dealing with its demands.’

Sandy raised his right hand slightly. It was a gesture designed to slow Grayson down. He was reeling from the onslaught. ‘You said, “foreseeable future”,’ he said. ‘What exactly does that mean?’

‘It means that Amanda will need dialysis until such time as a kidney transplant becomes available for her.’

The word ‘transplant’ seemed to have put Kate into shock. She sat with her eyes wide, staring at Grayson as he spoke.

‘A transplant,’ repeated Sandy slowly.

‘Yes.’

‘It’s that serious? But how? When? I mean, how long?’

‘Far too soon to start talking about that,’ replied Grayson. ‘We’ve lots more tests to do.’ He looked distracted, and almost before they could respond he had made his excuses and left, leaving them alone with Clive Turner.

Turner seemed more sensitive to their feelings and almost embarrassed at Grayson’s manner. ‘I know what you must be thinking,’ he said softly, ‘but these days kidney transplants are very common and very successful.’

‘But you need a suitable donor,’ said Sandy.

Turner nodded. ‘True, and that’s where the waiting comes in. Amanda will be tissue-typed and her details entered on an international register. As soon as a match comes up we can get the organ and do the surgery.’

‘How long?’ asked Kate. Sandy barely recognized her voice.

Turner shrugged uncomfortably. ‘It could be some time,’ he said.

‘Weeks? Months? Years?’ Kate persisted.

‘It could be a year or so,’ admitted Turner.

Sandy looked at Kate. He couldn’t remember ever having seen her look so unhappy. Her world was collapsing around her.

TWO

The convoy of three official vehicles accompanied by a police car swung through the gates of the Médic Ecosse Hospital in Glasgow and came to a halt at the entrance. Their drivers opened passenger doors and stood by respectfully as the eight occupants got out and waited around like camels at an oasis. They orientated themselves with their surroundings, straightened their ties and fidgeted with the buttons of their jackets until the official welcoming party emerged through sliding glass doors to greet them. The smiles were all on the welcoming side.

Leo Giordano, administrative secretary of the Médic Ecosse Hospital, part of the Médic International Health group, stepped forward and shook the hand of the junior minister from the Scottish Office, Neil Bannon. Giordano was tall, dark and good-looking with an olive skin that implied Mediterranean ancestry, although he himself was second-generation American. Bannon was short, ginger-haired and running to fat. He had recently grown a moustache in the mistaken belief that this would lend gravitas to his presence. Unkind observers thought it made him look more like a second-hand-car salesman than ever.

Bannon and Giordano had met on several occasions during the planning stages of the hospital and now exchanged a few pleasantries before Giordano commenced the formal introductions. These were dealt with quickly in deference to the drizzling rain and icy wind and the bowed huddle moved inside.

‘I thought we might have coffee first before getting down to business. It’ll give people a chance to get to know each other.’

Bannon nodded his assent without enthusiasm or comment and followed Giordano across the carpeted entrance hall to a long, low-ceilinged room with large picture windows looking out on to a formal garden. At this time of year the garden displayed all the starkness of winter in northern climes. Bare branches criss-crossed a grey sky and moss crept along stone paths, flourishing as nothing else could in the damp and cold. As a centrepiece, it boasted a lily pond with, at its head, a sculpture clearly influenced by ancient Greece. The hunting figure seemed pathetically far from home.

Coffee was brought in by waitresses carrying silver trays and wearing pale pink uniforms with the Médic Ecosse logo on them.

‘It’s no bloody wonder they’re in financial straits,’ whispered one of the visiting party, a local Labour councillor. ‘This isn’t a hospital, it’s a bloody gin palace. Look at it! Carpets everywhere, air-conditioning, tailored staff uniforms. Hospitals shouldn’t be like this.’

‘On the contrary,’ replied his colleague. ‘You may prefer Victorian slums smelling of disinfectant and echoing to the profanity of Saturday-night drunks, but frankly I happen to believe that all hospitals should look exactly like this, and the sooner they do the better.’

‘Privatization, you mean,’ sneered the councillor. ‘Fine for the rich, but what about the rest of us? Tell me that. And what about the chronic sick and the mentally ill? Who’s gonna look after them?’

The second man clearly had no heart to enter an old argument all over again, particularly one there would be no resolving. He put a stop to the tack they were on with a raise of his hand. ‘All right, I know the words of the song. Let’s not sing it this morning.’

‘I’ll tell you one thing,’ said the councillor. ‘If they think I’m going along with any plan to sink any more taxpayers’ money into this monument to privilege unconditionally, they’ve got another think coming. We were promised that this place would be self-sufficient within twelve months and making a handsome profit within eighteen. We were promised jobs and rates money to improve the district and here we are, three years down the line, and they’re looking for handouts again. It’s offensive. The public just won’t bloody well stand for it.’

The councillor moved off, to be replaced by a member of Bannon’s personal staff who had overheard what had been said.

‘I don’t know about you but I’m not sure I can see an alternative,’ said the newcomer. ‘Having committed twenty-seven million to the project already, we can hardly write it off and walk away. Apart from anything else, the opposition would have a field day.’

‘Quite so, but I remember the noise they made at the planning stage. They said it would never happen. They said there was more chance of setting up a distillery in Riyadh or a pork-pie factory in Tel Aviv, but up it went, an exclusive private hospital in the very heartland of the Glasgow Labour Party. Ye gods.’ The man smiled at the recollection.

‘It was only high unemployment in the building trade that swung it in the end. The prospect of losing a major building project was just too high a price to pay for the sake of anyone’s prejudice,’ said the official.

‘Principles have a habit of becoming “prejudices” when there’s money involved,’ said the man.

The official smiled. It was a worldly-wise little smile. The smile of someone who knew the game and how to play it.

‘How bad is the trouble they’re in?’

‘If you ask me, it’s nothing that couldn’t be solved with a bit of judicious marketing. Business has been a bit slower in appearing than anticipated and there’s a good chance that Médic International the parent company, are trying it on. They think the government can’t afford to let the hospital go to the wall with all the attendant publicity and loss of jobs, so they’re making a play for more public investment instead of underwriting the problem themselves. Rumour has it that Bannon’s hopping mad.’

‘So why has business been slow? Why didn’t all these rich folk and their families materialize to receive the best medical treatment money could buy?’

‘Hard to say. Maybe they prefer to go to London for their triple by-passes and hip replacements,’ said the official. ‘Down there they can always have their food sent over from the Dorchester and nip out to Annabelle’s for the odd alcohol-free lager when they start to feel better.’

The man smiled at the allusion to religious abstinence. ‘But I understand it’s different when it comes to transplants,’ he said. ‘Médic Ecosse has already built a reputation as one of the finest transplant hospitals in the country.’

‘No question,’ agreed the official. ‘And James Ross is acknowledged as one of the best transplant surgeons.’

‘I met him at a reception once,’ said the man. ‘Nice chap. Unusual combination, brilliance and niceness.’

‘I understand his research output is also phenomenal. His publication list in the journals is the envy of many a university department. Maybe the prestige thing will carry some weight in the decision.’

‘I think we’re about to find that out,’ said the man as he saw the Scottish Office minister and the administrative secretary start to move off. A tall man who had been standing beside them moved off too and the question was asked, ‘One of yours or one of theirs?’

‘His name’s Dunbar. He’s up from London,’ replied the official. ‘Don’t ask me why.’

The man in question was Dr Steven Dunbar, tall, dark-haired and dressed in a dark business suit that suggested a good London tailor. His tie told of a past association with the Parachute Regiment and he had dark, intelligent eyes that were constantly looking and learning. His mouth was generously wide, giving the impression that he was about to break into a grin, although he never quite did.

He had been sent by the Home Office, or more precisely a branch of the Home Office known as the Sci-Med Inspectorate. This comprised a small group of investigators with varied and wide-ranging skills in science and medicine. They were used by central government to carry out discreet investigations in areas outside the usual expertise of the police.

Although the police did have certain specialist branches, like the Fraud Squad and officers trained in the dealings of the art world, it was generally acknowledged that there were large areas of modern life where their understanding of what was going on was sadly lacking. Sci-Med inspectors provided an expert interface. It was their remit to investigate reports of possible wrongdoing or unusual happenings and establish whether or not there might be a problem deserving more detailed investigation. Dunbar was one of their medical specialists.

As discretion was important when dealing with the sensibilities of often powerful and influential professional people, Dunbar’s credentials had not been announced. He was officially present as a London civil servant attached temporarily to the Scottish Office, where only Neil Bannon had been informed of his true mission.

Dunbar had been treated politely but coolly by his hosts since his arrival the previous day. This hadn’t worried him. He was used to working on his own as an outsider. He preferred it that way. The fewer people he had to confide in the better. It made his job easier. The perfect mission was one where he arrived at the job, found out what he wanted to know and left again without anyone realizing what he’d really been doing. No one liked having a snooper around, particularly when, as it often turned out, there was no real problem to investigate.

Keeping an investigation secret was perhaps the most difficult aspect of Dunbar’s job but it was also probably the most important. Any suggestion of incompetence or malpractice brought out the worst in the medical profession. No other section of the community did a better line in self-righteous indignation or closing ranks. He had to be awfully sure of his ground before breaking cover. At this early stage he had only the unsubstantiated allegations of two former nurses at the hospital to go on. He would need a lot more than that before revealing who he was and why he was there.

Dunbar settled himself into the well-upholstered chair in front of his name card on the oak table. He poured himself a little water from the crystal decanter and sipped it as he watched the others take their places. The thickness of the carpet made it a strangely silent operation. He knew little of the circumstances that had brought the visiting party to Médic Ecosse, only that the hospital was in some kind of financial trouble and was requesting more government help. His masters had seen it as an opportunity to get him inside the hospital unannounced. It had all been a bit of a rush. He had had a minimal briefing from the Scottish Office and had also managed to pick up snippets of what had been going on through listening to conversations outside while people had been having coffee. He thought he knew who the important players were, so now he was going to observe the in-fighting and blood-letting he suspected might ensue.

James Ross, consultant surgeon and director of the transplant unit, was one of two senior members of the Médic Ecosse medical staff present at the table. The other was Dr Thomas Kinscherf, medical director of the hospital, urbane, smiling and generally very much at home in dealing with people. Ross was seated opposite Neil Bannon, listening politely to what was being said around him and smiling at intervals. An occasional glance at his watch betrayed a slight impatience for proceedings to begin.

Ross was a pleasant-looking man in his early forties, of average build and with fair hair swept back from his forehead. His skin was smooth and tanned and he wore frameless glasses with large, square lenses. He looked like a man at ease with himself, self-confident, successful in his chosen career and with nothing left to prove to anyone. His suit was conservatively dark but he wore a pink bow tie with matching handkerchief in his breast pocket. The typical, give-away flamboyance of the surgeon.

The admin secretary, Giordano, was exuding charm as he spoke to the Scottish Office contingent. Any word uttered by the visitors claimed his rapt attention, any suggestion of humour brought a large grin and a hearty laugh. It was clear that the Médic Ecosse people were on their best behaviour. The day was all about good public relations.

‘Shall we begin?’ asked Bannon. He was one of the few people not smiling.

Giordano brought the meeting to order and requested that the ‘financial parameters for debate’ be established. This translated into the reading of finance reports both from Médic Ecosse’s accountants and from the financial officials of the Scottish Office team.

When they had finished, Bannon looked round the table at the gloomy faces and said, ‘Gentlemen, I think we should cut the Gordian knot and come straight to the point. It’s quite clear that this hospital cannot continue functioning unless it receives an immediate injection of cash. It’s a question of where this cash is going to come from.’ He paused. People round the table exchanged glances. ‘I understand that Médic International feel that they’re not in a position to invest any more at this time. This leaves public money and, frankly, this too is quite unthinkable at a time like this when we’re urging restraint on public spending and cutting back on even essential services.’ He paused again to let the buzz die down before continuing. ‘But there again, the alternative is equally unpalatable. The hospital would have to close down, with the loss of money already invested and the accompanying human cost in terms of jobs. This leaves us, as our American cousins might say, between a rock and a hard place. Personally I think it would be an absolute tragedy if an almost brand-new, state-of-the-art hospital with a world-class medical staff had to close its doors, but these are the bare facts.’

‘Not to mention politically embarrassing and bloody expensive for the Tory party,’ muttered the Labour councillor.

‘If it’s so state-of-the-art and world-class, why is it losing money?’ asked a distinguished-looking man who, unlike the others, favoured a light-coloured suit. He was a representative of a major Scottish insurance company which had invested at the outset in Médic Ecosse.

‘We feel it’s a problem we can deal with,’ replied Thomas Kinscherf. ‘We simply don’t have enough patients at this moment in time.’

‘Why not?’

‘It appears that would-be clients still prefer London hospitals, although we believe that with the right marketing this problem can be overcome. It’s just a geographical thing that we didn’t consider seriously enough at the outset and still haven’t taken the appropriate steps to remedy.’

‘There are plenty of patients not more than a mile from here,’ interjected the councillor. ‘It’s just that they don’t have the money to pay for all this fine treatment.’

‘I think we’ve been through all that,’ said Bannon rather testily. ‘The hospital’s being run as a business for foreign clients who bring money into this country. It’s a service industry, just like hotels and theme parks. There’s nothing wrong with that. It benefits us all in the end.’

‘Not if it doesn’t actually make any money.’

‘It will, sir,’ interjected Kinscherf. ‘We just need a little more time.’

‘And a lot more public money,’ added the councillor.

‘Frankly, there is no question of further unconditional funding,’ said Bannon. ‘Our people have carried out an in-depth analysis of the figures from each department and come up with projected figures for the next three years. Based on these we will be prepared to offer funding at a suitable rate of return but with conditions attached.’

Giordano and Kinscherf exchanged glances. Neither man was smiling any more.

Bannon continued, ‘Our money people have highlighted a certain problem area which we’d like to see dealt with. In fact, we would insist on it.’

‘I’m sure we would be willing to consider your findings,’ said Giordano.

‘We are disturbed at the very low profit margin being shown by the transplant unit,’ said Bannon.

James Ross looked surprised. He shifted uneasily in his seat. ‘Are you suggesting my department doesn’t pull its weight?’ he asked. His surprise was obviously shared by many at the table.

‘Far from it,’ replied Bannon, ‘Your unit is clearly a success story. Unfortunately, at the moment, it’s the only one.’

‘So why pick on us?’

‘Frankly, and not to put too fine a point on it, it’s more of a medical success than it is a financial one. Your overheads seem uncommonly high.’

‘We have to do our best for our patients,’ said Ross, taken aback. ‘Transplant surgery is an extremely expensive business in terms of both equipment and staff but our results are second to none.’

‘And this is reflected in the fees charged by the hospital,’ countered Bannon. ‘No one is disputing your expertise, Doctor. The excellence of your department is why you’ve been so successful in attracting custom. As I understand it, the survival rate shown by your patients is extremely good.’

‘Quite outstanding,’ interjected Giordano.

‘So what is it you want from me?’ asked Ross. ‘I can hardly cut staff.’

‘It’s not a case of cutting staff, Doctor. The money is coming in to your unit but investors don’t seem to be seeing the returns they should from it. We have pinpointed the problem as being your very high research-budget costs.’

Ross seemed to search for words before replying calmly, ‘My contract states that research funds at an agreed proportion of income will be made available to me. That’s why I agreed to come here in the first place.’