Fluke didn’t know if it was evidence or not but he wasn’t taking any chances. ‘Right, I want the full works. Tell the lab I’m pre-authorising all the tests they want to do. Get them there tonight. Proper chain of evidence. If there’s anything, I want to know by tomorrow at the latest, today if possible. Get uniform to drive them down.’
As Towler went off to arrange a fast-track forensic examination, Fluke turned to Sowerby who was just starting with the ‘Y’ incision.
‘Anything else, Henry?’ he asked.
‘Nothing really, Avison. We’ve taken all our external samples now: hair, pubic hair, swabs, the lot. Got prints for you as well. The brown substance under her nails looks like it may have also found its way into the turn-ups of her trousers according to your SOCO man there. The lab will tell you if they’re the same. Can’t say what it is.’
‘Cause of death the gun shot wound then?’
‘Technically the cause of death can’t be officially determined until I’ve finished. But yes, the bullet seems to have ricocheted around the inside of the skull causing massive trauma to the brain. That’ll almost certainly be the COD. I’ll have the bullet with you in five minutes if you can wait.’
‘Here till the end bitter end, Doc,’ Fluke replied.
‘Don’t you have an appointment with Leah Cooper?’
‘What? No. Yes. How did you know?’ Fluke said, all semblance of composure gone. He looked round.
‘Don’t worry, no one heard, Avison. No, I popped into in haematology before I came down here; the professor there is an old friend of mine. Leah asked if you were the senior investigating officer.’
‘She seem angry?’
‘Not especially, not with you anyway. She told me not to keep you too long, said you had a blood test to do before the day was out. Told her it would take as long as it damn well took. She nearly tore my head off,’ he grinned.
If she wasn’t angry about the day before he may as well go and get checked now. ‘Look, this bit is going to take about two hours, am I right? I’ll go and get it over with; Towler’ll ring if anything urgent crops up.’
Sowerby didn’t look up but waved a hand to let him know it was fine.
Fluke got to the haematology ward and asked for Leah, only to be told by the staff nurse that she’d just left.
‘Okay,’ he said, relieved. ‘Can you leave a message and say I called in, as she asked. I’ll come back later.’
‘Not happening, Mr Fluke. She left clear instructions that you have to have another blood test today. Very clear instructions. I’ll take the blood and run it straight away. You can go after one of the registrars has had a look at it. Unless they say you can’t, obviously,’ she said.
‘Obviously,’ he repeated, a bit too sharply.
Two minutes later, Fluke had a doctor trying to stick a cannula in the back of his hand. The first two attempts missed.
Fluke hated cannulas. Doctors always struggled to find veins, a legacy of his treatment. On the odd occasion he was having blood taken by someone who wasn’t familiar with his medical history, he always ended up giving an explanation. The most common reason for poor veins was intravenous drug use and Fluke felt compelled to tell them his condition was due to chemotherapy, not heroin.
His hand would be stiff in the morning. It was getting to the point that every time he had his bloods taken, his hand froze up during the night.
Or it could just be that I’m getting old
, he thought. Today it was the turn of a small Asian doctor he’d seen around on the ward but had never spoken to, one of the multitude of junior doctors hospitals seemed to spawn.
‘Sharp scratch,’ she said, as she tried again.
‘Sharp scratch.’
Fluke vividly remembered the first time he’d heard that phrase. It was at the Patterdale Ward in West Cumberland Hospital nearly two years ago. He’d thought then what an odd phrase it was, to describe a needle puncturing flesh as a scratch, and he still thought it now. And they all said it: doctors, nurses, phlebotomists, the lot. He assumed it was part of some blood-letting course. Or it could be the same as detectives picking up evidence up with pens. Monkey see, monkey do. The first doctor to say it had no idea he’d started a global phenomenon.
At the time, the only thing on Fluke’s mind had been getting out of a relationship that had run its course. Hayley, a nice woman, recently divorced and trying to rediscover her youth, but she needed someone younger. Someone who still wanted to go out Friday and Saturday nights. Fluke wasn’t that man.
She’d phoned earlier asking if they could go out and Fluke had lied, saying he wasn’t feeling well. He’d reheated the previous night’s corned beef hash and settled down in front of the TV for the night. And in truth, he’d been feeling a bit unwell; a sore stomach that had been bothering him for some time. Not enough for painkillers, but enough for him to go and see his GP.
But she’d called his bluff and turned up anyway. She took one look and called the emergency doctor’s number. Fluke would never know whether she’d been trying to make a point or she genuinely thought he looked ill. He’d been using the ‘too ill’ excuse more and more to get out of things.
Whatever her real motivation, he’d been given an immediate appointment. Despite living in Carlisle, the out-of-hours appointment was thirty-five miles away at the old Workington Hospital. Trapped in his own lie, he’d no choice but to play along and attend. She’d even driven him there.
Lying on a bed in a ward that wouldn’t have looked out of place in a Hammer Horror film, Fluke had been expecting the standard ‘I can’t find anything, see your GP if it persists’, medical terminology for ‘fuck off and stop wasting our time’.
That wasn’t what was in Fluke’s immediate future, however – the doctor found something. And he hadn’t had to look too hard either. His lower right abdomen was as hard as iron. When he felt it, he was amazed he hadn’t noticed it himself. Looking back he remembered small things though; favouring the same side when he slept, not being hungry, heartburn.
Small things, big problems.
Admitted to hospital that same night, he was nil-by-mouth and subjected to a battery of tests. Ultra-sound, X-Ray, endoscopy, colonoscopy, bloods, urine, Fluke had the lot while the doctors stood round scratching their heads – they knew something was wrong but they didn’t know what.
It wasn’t solved until they rolled out the big gun. The dark mass the MRI found was obvious, even to the untrained eye. A dark mass that had insidiously wrapped itself round one of his kidneys and part of his bowel.
To Fluke’s amazement, he was then discharged, booked in for a biopsy a week later and told not to worry in the meantime. At a loss what to do, he went back to work.
A week later, he was back, signing consent forms allowing a surgeon to basically do what he felt was best if a biopsy wasn’t going to be enough when he opened him up. He confirmed to the anaesthesiologist he wasn’t allergic to anything then went into surgery.
As with any other surgery he had no idea how long he had been under, but when Fluke woke he was told he’d undergone an eight-hour operation involving two surgical teams. With the anaesthetics starting to wear off, the pain began and it was through a cocktail of painkilling medication that Fluke learned he no longer had a right kidney, part of his bowel had been cut out and that a grapefruit-sized tumour had been removed. His wound stretched from the centre of chest to his navel and had over fifty staples holding it together. It looked like an eighteen-inch crude zip.
Two days in intensive care for pain management, two weeks on the gastro ward with a group of old men, an argument with the hospital social worker which ended with her in tears after he told her to mind her own business, and he was discharged.
While waiting for the biopsy results, during one of the daily visits from the district nurse to look after the wound, he’d begun vomiting – uncontrollable vomiting that lasted for two days – nothing stayed down, not water, not the painkillers he tried to take to manage the terrible headache the dehydration was causing. The district nurse finally had enough and called an ambulance.
That’s when Doctor Leah Cooper came into his life. She introduced herself as his oncologist and that she was in charge of his treatment. A serious woman doing a serious job, she sat next to the raised bed and told him what he already knew; he had cancer. A classic case of Burkitt’s Lymphoma, she’d told him. Usually confined to the jaws of children on the African continent, it was very rare in the Western world.
At least they’d heard of it
, he’d thought.
Nobody wanted an illness with no name. Ah, Mr Jones, you have a bad case of Fluke’s Disease.
There was good and bad news. Because it was such an aggressive cancer, paradoxically, it was curable. The faster they grow the faster they can kill it, Doctor Cooper told him. The bad news was that the treatment was the worst there was. There was a very real chance that it would kill him. And it had to be delivered, as an inpatient, in an isolation ward.
Fluke remembered barely batting an eyelid. He wasn’t stupid. He wasn’t expecting her to say, ‘Take two of these and go home.’ Cancer was a word that struck dread into even the calmest of people, yet Fluke’s reaction, she admitted much later, had surprised her.
‘Okay, now what?’ he’d said.
She’d explained that due to the complexity of the treatment, he’d have to be transferred to Newcastle, where the haematologist had a full support team of specialist registrars, house doctors and senior fellows. Cumbria just didn’t have the resources or the need for a team that size. She’d remain his consultant but the treatment would be delivered by others. She’d attend fortnightly case meetings, be consulted on his care and, if he survived, would deliver his aftercare for the next ten years.
‘So when do I go?’ he’d asked, wondering how long he’d have to tie up loose ends at work.
‘An hour. They’re expecting you by six and you’ll start your chemotherapy tonight.’
‘Hang on,’ he’d protested, before she cut him off.
‘No arguments. The tumour we removed a fortnight ago has already grown back to the size of a tennis ball. That’s why you’ve been vomiting. It’s wrapped round your small intestine.’ There was a finality to what she said next. ‘We start fighting this thing now.’
A taxi drove him the hour and a half to the Royal Victoria Infirmary, known locally as the RVI, and there he’d stayed for five months.
For five months, he’d taken everything they threw at him: chemotherapy drugs that were bright green and made his hair fall out; drugs that were light sensitive and had to be kept in a bag; drugs that ruined his nerve endings through weekly intrathecal injections into the base of his spine. Some of the drugs were so complex, they needed drugs of their own to work.
Chemotherapy to kill him. Antibiotics and antifungals to keep him alive. Fluke took it all without complaint. He had a Hickman line fitted into one of the large veins in the chest as the drugs were destroying his smaller veins and for months he walked round with a plastic tube sticking out of his chest.
Each day was a learning experience on a course he hadn’t signed up for.
The only way to destroy the cancer was to destroy him. The team took him as close to death as they dared then stopped and let him build up his bloods and health only to do it all over again. Three courses of treatment. Three times he was taken to the brink.
Finally, the scans showed that it had worked. His bloods were allowed to build up. Physios got to work on teaching him to walk with his nerve-damaged legs. Visitors were allowed in his room without wearing face masks. He was allowed to see his newborn nephew for the first time.
He’d been a fit man when he’d been admitted, an ex-Royal Marine, and while he was never in the same league as Towler – who was a freak of nature – the job meant he had to stay in decent shape. He left hospital a shell of a man, down to eleven stones and unable to walk without crutches and splints. He was too weak to cook but that was okay as he had no appetite.
Doctor Cooper told him it was normal. His appetite would come back. The Burkitt’s wouldn’t.
After nearly six months in hospital and three months of recuperation at home, putting up with well-wishers, genuine and nosey, he was ready to go back to work. Some of his strength had returned. His appetite was back. His legs were still troubling him but he kept that to himself.
One good thing had happened during his illness: Hayley decided that she didn’t need the hassle of looking after anyone at her stage of life and had broke it off in his first month of treatment. Fluke didn’t blame her, although others did.
He still had to see Doctor Cooper – would have to for the next ten years – every week to begin with, to get his bloods checked and his lymph nodes poked. He discussed with Occupational Health a return to work date.
In the past, someone who was off sick either ran out of sick notes and had to come back, or just decided they were fit to return and turned up.
For Fluke there was meetings with Occupational Health, with Chambers, and even the chief constable, all glad he was feeling better, all doubting he was ready. He rejected an offer of a temporary desk job out of hand.
In the end, it had taken a letter from Leah stating that he was fit to return to operational duties. Straight into the job he had nine months before: Detective Inspector, Force Major Incident Team.
Fluke sat in the dayroom on the haematology ward, lost in his thoughts, while he waited for his blood test results. It obviously wasn’t the right time of day for outpatients; he was the only one in there. He picked up a discarded travel magazine and flicked through it, staring at the beaches, at the five-star hotels and stunning views. It all looked so nice, but Fluke couldn’t help looking past the smiles and the sunshine. Most of those tropical islands were plagued with poverty and crime.
It’s the lot of the policeman
, he thought,
to see the worst of everything
. He threw it back down on the seat beside him.