Authors: Andrew Puckett
He smiled, said, ‘It’s fine, beautiful place, a bit like Edinburgh. But it’s somehow a mite pleased with itself, complacent.’
‘Also a bit like Edinburgh?’
‘Aye.’ He grinned at her – she was leaning back in her seat, her head slightly to one side, holding her coffee cup in both hands between her thighs. ‘You’ve been there?’ he asked.
She nodded, then said, ‘How long have you got with us now?’
‘Three years and a bit.’
‘So where d’you think you’ll go after that?’
‘Anywhere that’ll have me, within reason.’
‘Not back to Scotland?’
He took a mouthful of coffee before answering. ‘I don’t think so. There are more opportunities in England.’
‘You don’t miss Scotland?’
Again, he paused. ‘That’s a bit like asking an East Ender whether he misses England. What about you?’ he continued quickly. ‘Have you not been tempted to move on? To better things?’
She smiled briefly, recognising the equivocal nature of the question, but took her time to reply.
‘Events have conspired to keep me here,’ she said at last. ‘At the moment – it’s my mother – my father died last year and—’
‘I’m sorry to hear that.’
‘Thanks. It would hurt her if I moved away just now, especially as my brother’s living abroad.’ She spoke with a slight, but perceptible Avonian accent, rather attractive.
‘You could always move to one of the other labs round here.’
‘Easily, if I was prepared to downgrade, which I’m not. Besides, that kind of move usually involves swapping one set of problems for another. And anyway’ – she smiled to show him she knew what he was getting at – ‘Terry doesn’t bother me so much as he does some of the others.’
‘I’ve noticed,’ he said. Then: ‘What kept you here before your mother?’
He immediately regretted asking the question, but was saved by the buzzer at the lab entrance.
‘That’ll be the sample for the cross match,’ she said, getting up.
He watched as she left the room – her T-shirt had rucked up slightly over her backside and the sight of it as she walked away sent a shot of pure gold into his veins.
He washed up the mugs, then went to find her.
‘I’ll take another look at Brian, then I’ll be away,’ he said. ‘I hope you’re not up all night.’
‘So do I.’ She smiled. ‘Thanks for the coffee.’
‘My pleasure.’
Goodman still hadn’t regained consciousness, although his colour had improved and his breathing was easier. Fraser reassured his wife again, then drove home.
Sleep wouldn’t come. Images flickered: her face with its delicate colours framed by her dark, almost black hair, the T-shirt painted over her body, her long legs…
He got up, padded naked downstairs and poured himself a whisky.
Lust?
he wondered as he sipped.
Something more?
He’d had a brief and rather unsatisfactory affair in Bath with a nursing sister called Emma. She’d been clever, sophisticated and superficial. A girl. Whereas Frances, for all he’d thought of her as the raven-haired girl, was a woman… How old would she be? She was a Senior, so she’d have to be twenty-five… and he’d have bet anything that the other ‘event conspiring’ was a long-term affair…
Was she interested?
More to the point, was he? Did he really want an affair with someone he worked with?
Aye, he rather thought he might in this case… although Connie wouldn’t approve of him fraternising with the lab staff.
And there was something else Connie wasn’t going to like, he remembered – having resolved one problem in his mind, he turned it to another.
The next day, between clinics, he spent an hour going over patient records in the computer, then another on the phone. Then he went to Connie’s room.
‘Can I have a word?’
‘Of course you can, Fraser. Come and sit down.’
He closed the door and sat. ‘You’ll have heard about Brian Goodman?’
‘Yes, Ian told me, D’you think he meant it?’
‘Yes, I do.’ He explained why. ‘The thing is, Connie, I’ve been looking back over the records and I’m beginning to wonder whether maybe JS was right.’
‘Right about what?’
‘Alkovin causing severe psychotic effects.’
She frowned. ‘You’d better explain.’
In the four treatment centres in the area, he told her, they’d had twenty-one cases of ALL treated with DAP in the last nine months, and in ten of these the patients had suffered from depression. In three of them, they’d also suffered from paranoia and/or dementia.
‘Is that all, Fraser? I’d have expected all of them to be depressed, not just ten.’
‘I’m talking about clinical depression, occurring—’
‘How exactly d’you define that?’
‘Profound, prolonged, accompanied by feelings of guilt and self-blame – not to mention suicide.’
‘The fact is, Fraser, people do tend to have these feelings when they’re told they’ve got leukaemia.’
This was turning out to be even more difficult than he’d thought. ‘The symptoms I’m talking about are occurring after consolidation, not immediately—’
‘That’s a list of them, is it?’ She nodded at the paper in his hands. ‘Can I see?’
He handed it over and she quickly scanned it.
‘How many of these have you actually seen for yourself?’
‘About half,’ he admitted.
‘So your diagnosis of severe psychosis applies to only five patients, not ten.’
‘I’ve checked on the others inasmuch as I can—’
‘There’s been nothing in the literature – has there?’
‘Not so far as I know.’
‘Haven’t you checked?’
‘Not yet.’ He silently cursed himself.
‘Well, don’t you think you should?’
‘I take your point, Connie, and I will. But I still think we should look into it.’
‘You check the literature and I’ll have a word with Ian about it. But I do suggest you check your facts more thoroughly in future before raising alarms like this.’
A week later, Connie convened a meeting in her room with Fraser, Ian, Leo and Robert Swann, the new consultant. She started by asking Fraser to reiterate his concerns about Alkovin, which he did. He hadn’t found anything in the medical journals, although he had researched further into some of the cases.
The husband of one patient had told him how his wife had threatened suicide and that he was convinced she’d meant it. Antidepressants had helped her. And a woman had told him how her husband had suddenly become violent, hitting her and then threatening her with a kitchen knife. Afterwards, he’d broken down and begged forgiveness and a day or so later had apparently erased the whole thing from his mind. Both patients had subsequently relapsed and died.
After a moment of silence, Connie said, ‘Tragic though these cases are, we must remember that we’re dealing with people who have, effectively, been told they’re likely to die. We can all produce anecdotes of patients who, in similar circumstances, have behaved outrageously – because, with respect, Fraser, that’s all you’ve given us – anecdotes.’
She and Ian had been busy as well and had the advantage that, between them, they had seen all the patients involved. They went systematically through all the others on Fraser’s list. Yes, they’d suffered from depression, but in their view, not to any exceptional degree. Even episodes of violence were not uncommon in very sick people. The only possible exception was Brian Goodman…
‘Attempted suicide is far from unknown in leukaemia,’ Ian said, ‘and it was only a matter of time before our turn came round.’ He turned to Leo. ‘They’ve had a lot more experience using the drug in America. We haven’t found anything in the literature – have you heard of anything from the trials there?’
‘Not a thing,’ Leo replied – predictably, Fraser thought.
Sure, patients with leukaemia got depressed, maybe even a little psychotic occasionally – Prednisolone had been known to have mild effects of this nature.
Robert, who hadn’t said much until now, spoke up.
‘Since Fraser’s seen fit to raise this problem—’
‘
Alleged
problem,’ Leo corrected.
‘All right, alleged problem,’ Robert agreed. ‘The thing is, it can’t hurt for us to keep an eye on things, be ready to treat with antidepressants as soon as any symptoms appear, maybe even prophylactically in some—’
‘I’m not keen on prophylactic treatment,’ Connie interrupted. ‘By all means treat symptoms when, and if, they arise, but to treat them before they even appear would be to wish the problem on us.’
Which is all damn fine
, Fraser thought a few minutes later when the meeting ended,
but
… But, when it came down to it, he’d achieved nothing except to lower himself a few more yards in Connie’s estimation.
Serves you right for sleeping with the boss, he told himself, although, as he remembered it, there hadn’t been a deal of sleeping.
He started towards his office without much idea of what he was going to do there when he saw Frances making for the way out. On impulse, he followed and caught up with her in the corridor.
‘Going to lunch?’
‘Into town. Shopping.’ She sounded in a hurry.
‘Ah…’ A poster he’d seen on the way to work floated into his mind and he said, ‘There’s a Stoppard on at the Foundry I’d like to see. Would you like to come with me?’
She’d stopped, looked at him without expression for a moment, then she’d said, ‘Yes, I would.’
July 1999
She was home from hospital again, for ten days, and Fraser had taken time off. The treatment had put new lines round her mouth now, giving her face a slightly pouched look, adding several years to it.
‘I’m sorry, but I don’t think I could,’ she said in bed, a small voice, when he ran his fingers over her breast. ‘Please, just hold me.’
She didn’t want to go out, she just read or watched TV. On the second evening, he made a lasagne, one of her favourites. She took a couple of mouthfuls and put her fork down.
‘It’s very nice, Fraser, but I’m not really hungry.’
‘Are you all right?’
Her face soured as she stared at him and her mouth pursed. ‘God, you have no
idea
how sick I am of hearing that phrase –
Are you all right
?’ she mimicked. ‘
Are you all right
?… Of course I’m not fucking all right, I’ve got fucking leukaemia, haven’t I?’
She made to get up and go, but he caught her wrist.
‘We’ve got to talk about this, Frances—’
She snatched her hand away. ‘Leave me
alone
… and get something into your head, I am not fucking depressed – OK?’ Without warning, she picked up her plate and propelled it into his face as though it were a custard pie, then she stared open-mouthed at him for a moment before collapsing on to her arms on the table, weeping hysterically.
‘
Help me please Fraser help me help me help me
…’
He hurried round the table, trying to wipe the mess from his face with a serviette. He pulled up a chair, sat beside her. ‘I’ll help you, please let me…’
She threw her arms round his neck. ‘Please, please help me…’
After a while, when he’d calmed her down, he left her on the sofa and phoned his GP’s surgery. His doctor was there, but with a patient. Fraser asked the receptionist if he could call back, urgently. He came back to him after five minutes, listened, then said he’d be there as soon as he finished his appointments.
He was there in an hour. He examined Frances, listened to Fraser, then prescribed Prozac and a sedative to help her sleep.
Fraser put her to bed and stayed with her, waiting for it to work. When she was asleep, he went downstairs. He knew there would be no sleep for him that night without bottled assistance.
She was still sleeping when he woke in the morning, turned towards him and snoring slightly. Sleep had smoothed the lines round her mouth so that, with her hairless head, she looked like a baby, so vulnerable that he lay there watching her for a while.
Fraser didn’t feel too bad, considering the booze he’d put away the night before, although there was an ominous fuzziness around his forehead. He showered, hoping the jets of water would drive it away, which they did for a while. She woke as he dressed.
‘What time is it?’ she asked drowsily.
‘Half-past eight.’ He sat on the bed beside her. ‘How are you feeling?’
‘OK.’ She looked up at him. ‘Why do you ask me like that?’
He studied her face. ‘You don’t remember last night?’
Her brow furrowed. ‘Oh… did we have a row? I thought it was a dream.’
‘You don’t remember Dr Parker coming here?’
‘No… we had a row and then you put me to bed… didn’t you?’
‘D’you not remember what happened in between?’
She shook her head.
‘Well, it was some row.’ He thought quickly, decided it was best to tell her the truth…
‘Wow,’ she said when he finished. ‘And you think it’s the Alkovin?’
He nodded. ‘I’m sure of it.’
‘Me – on Prozac. Wow – so I’ve finally made it. To the middle classes,’ she explained at his puzzled expression.
‘Yeah.’ He grinned. ‘So how
are
you feeling?’
‘Not much different from yesterday. Pissed off. Glad you’re here. How long does it take to work?’
‘Prozac? Anything between one and three weeks.’
‘Well, let’s hope—’
The phone rang and he picked it up.
‘It’s your mother,’ he said, handing it to her. ‘D’you want some tea?’
She nodded as she took it from him.
He was at the door when she said, ‘She wants to come round – that’s OK, isn’t it?’
An hour later, when mother and daughter were ensconced in the sitting-room over coffee, Fraser mumbled something noncommittal and slipped out. He went straight to the hospital and Connie’s room.
‘I thought you were on leave, Fraser.’
‘I am. I came in to tell you that Frances had a breakdown last night.’
‘How d’you mean, a breakdown?’
‘Our GP diagnosed severe depression. He’s put her on Prozac and a sedative.’
‘I’m very sorry to hear that, Fraser,’ she said carefully. ‘However, I do think I should have been consulted about it.’
‘Why? So that you could have refused her treatment?’
‘Don’t be ridiculous. So that, as her consultant, I could have assessed her condition and treated her accordingly.’
‘The treatment of severe depression is well enough—’
‘I might have decided on a different drug, one with sedative properties, perhaps. I might well have thought counselling more appropriate—’
‘Counselling!’ The fuzziness returned, twisting the muscles round his forehead. ‘For Christ’s sake, she’s depressed to the extent of being disturbed—’
‘Perhaps you could describe her symptoms, preferably without shouting.’
He swallowed, forced himself to relax, and told her, not holding anything back. Connie regarded him coolly from behind her desk, her face smooth, impassive, unemotional. She said ‘I won’t alter the medication, now it’s been prescribed and she’s taking it, but I do very strongly recommend counselling. For both of you,’ she added.
‘I beg your pardon?’
‘You heard me.’
‘You’re suggestin’ that
I
need—’
‘This is a very stressful time for both of you. It’s bound to affect your relationship, which has to be a major factor in the symptoms you describe.’ She stood up. ‘And now—’
‘I don’t think you’re in any position to be a judge of anyone’s relationship, Connie, let alone mine.’
‘You’d better explain that, Fraser.’ Her voice was still, her face expressionless.
‘I don’t have to explain
anything
to you, Connie, not a damned thing. You are the one’ – he pointed – ‘who’s going to have to explain why you persisted with the use of a drug with dangerous side-effects.’
She laughed. ‘Put your finger away, Fraser, you look silly like that. And you’ll sound silly,
very
silly if you try to bring that old chestnut up again.’ She came round from her desk, moving towards the door. ‘You don’t seem to have grasped yet that Alkovin may,
if
we’re lucky, enable me to save your girlfriend’s life.’ She stopped, about a yard away from him. ‘I don’t expect gratitude, but I would have hoped for more professional respect, even from one of your background.’
He absorbed this, then said, ‘You asked me to explain myself just now. What I meant was that bein’ a failure at relationships yourself, you are now tryin’ to undermine one that’s success—’
She caught him a ringing slap on the side of his face that knocked him sideways, then another on the other cheek without giving him the option of turning it first… and there would have been more, but for the fact he seized her wrists and held them.
‘Let go of me,’ she hissed into his face.
He gripped harder. ‘Not until you—’
She brought her knee up into his groin. He gasped, dropped her wrists as she let out a piercing scream and ran to the door.
‘Help! Ian, he’s assaulting me…’
Fraser painfully straightened himself up as Ian came running in.
‘Connie… what in God’s name… Fraser…?’
‘He assaulted me, Ian,’ Connie said breathlessly. ‘Get the police.’
‘Surely we don’t need—’
‘He came in here shouting about Frances, then he grabbed me – look…’ She held up her wrists, which were already beginning to bruise where he’d gripped her.
‘If there was any assault, it was she who assaulted me,’ Fraser said, aware as he said it of how feeble it sounded.
‘I was trying to defend myself,’ Connie said. ‘Call the police, Ian, now. If you don’t, I will.’
By now, several other faces were peering in through the door – Robert, Sophie, Terry Stroud.
‘Oh, Jesus wept,’ said Ian despairingly. He phoned the police.
They came and took statements. Fraser was told he could go home and was advised to stay there. He knew he had to tell the British Medical Association, the doctors’ trade union, what had happened, and thought about doing it from a phone box, so as to avoid worrying Frances or Mary, then realised they would have to know sooner or later anyway.
Both women listened slack-mouthed to his account. Frances knew about their relationship, so it wasn’t quite so much of a shock for her, but Fraser didn’t care for the way Mary’s look became increasingly askance.
‘I have to say that Dr Flint struck me as the last kind of person who would do such a thing,’ she said.
‘Well, it doesn’t surprise me,’ Frances said. ‘She’s a complete bitch underneath all the charm.’ She sighed. ‘I wish you’d told me where you were going, Fraser.’
‘So that you could have stopped me, I suppose?’
‘Too damn right.’
He pressed his lips together, then said, ‘Well, so do I, now.’
‘It’ll sort itself out,’ she said.
But after Mary had gone, she said, ‘It’s a mess, isn’t it?’
‘I’ll not be allowed to go on working there.’
‘No, you won’t. Would they let you go to one of the other hospitals in the region to finish your contract?’
‘I don’t know.’
‘D’you think Ian believed her?’
‘I don’t know that either. Why?’
‘Would he give you a reference?’
‘He might,’ Fraser said slowly. ‘It’s in their interest to get rid of me as quietly as possible.’
They talked over their options during the rest of the afternoon. Fraser couldn’t help noticing that his problems had, paradoxically, seemed to lift Frances’ mood, so much so that they went out for a meal that evening. Later, though, she became spiky and unstable again and it took all his diplomacy to avoid another row. At least she agreed to take the sedative, which helped her to sleep – that night, and over the weekend.
On Monday, after a visit to the Trust HQ where an administrator told him he was suspended on full pay, he went to the small office the BMA had in the city.
‘You realise, Dr Callan, that as an organisation we represent both you and Dr Flint?’ Dr Smith was earnest, bespectacled and, underneath his elderly medical student image, rather shrewd. ‘So it’s in our interest to find a compromise, one that suits both of you. What is not in our interest is the public spectacle of two professionals fighting. You do see that, don’t you?’
‘Sure I do,’ Fraser said. ‘But I will not, cannot, compromise my position on Alkovin. It’s a dangerous drug.’
Smith considered him, then said, Tell me about it again – how, exactly, did it come to be used in your department?’
He listened carefully while Fraser went through it in detail, putting in questions now and again.
At last he said, ‘I’m going to give you the phone number of some people in London who may be able to help you provided you forget it was me who gave it you.’
Fraser rang it as soon as he got home and was put through to someone with the unlikely name of Tom Jones.
‘Can you come up on Wednesday?’ Jones asked after Fraser briefly told him what it was about. He had a marked London accent.
Fraser asked Frances who shrugged and said, ‘All right.’ She looked so miserable after he put the phone down that he went and put his arms around her.
After a few moments, he said quietly, ‘Why don’t we get married?’
‘We are, in September.’
‘No, I mean this week. Get a special licence and just have your mother and maybe one or two others.’
Her expression went from astonishment to delight. ‘What a lovely idea…’ She thought about it, savouring it for a while, then sighed. ‘We’ve told everyone September, and I think it would be unlucky to change it. But thank you.’
She was probably right, he thought, it might give the wrong message to rush things.
It was strange how he’d known what he’d wanted from the time he first took her out…