The Silent Sleep of the Dying (Eisenmenger-Flemming Forensic Mysteries) (8 page)

"So … ?"

There, so quickly, was the rub.

It was really only to say something, anything, so that he wouldn't look stupid that he remarked, "This must be an inherited syndrome."

To his great relief, Belinda didn't dismiss this with a contemptuous snort, but actually took it seriously. "Of course!" Disillusionment set in immediately afterwards, for she then enquired, "But which one?"

Which one indeed. There were numerous inherited syndromes, usually caused by a single gene mutation, that resulted in families dying of cancers in their early years, often dying of a variety of cancers, but Hartmann could not think of one that resulted in fifteen or twenty tumours occurring simultaneously in a single individual.

"I don't know," he admitted.

"The odd thing is," Belinda was off again, musing into areas that were beyond Hartmann, "she's not known at the hospital. Surely if she had cancer — only one cancer, let alone so many — she would have found her way into the hospital system."

"Perhaps she didn't want to know."

Belinda clearly found this unlikely. The very old, afraid or just uncaring were the ones who kept their fungating tumours hidden under layers of clothing, not young people; certainly not young people working in the Medical School.

He knew that he wasn't going to get anywhere solving this without time, thought and a good few textbooks. It was already nearly eleven o'clock and he still had another autopsy to perform as well as some paperwork to clear up before he left for Glasgow. Deciding that he had made enough of a prat of himself, he said, "Whatever's going on, I think the thing to do is to take some samples for histology."

Which meant that he would have to give the Coroner's Office a presumed cause of death as opposed to a definite one (they hated that); the relatives would have to be informed of the samples he took for microscopy and much paperwork would have to be completed.

Denny came in. As it was nearly time for lunch, not even a Royal Command from Genghis Khan would have made him do any work in the dissection room in the afternoon. "Haven't you fuckin' finished with that one yet?"

Hartmann smiled at him.

"Nearly, Denny. Nearly."

"Well don't forget you've still got cocky to do," he pointed, gesturing at the unfortunate cyclist who was slowly desiccating behind them. "If I'm still clearing up in here this afternoon there'll be fuckin' hell to pay."

The implication was menacing and not lost on Hartmann. He said sweetly to his subordinate, "Don't worry, Denny. I'll be finished soon."

When Denny had again wandered away Hartmann began cutting a small piece of tissue from each organ. Each was about five millimetres thick and two by one centimetres in area. These he dropped, about twenty in all, into the pot of formalin.

Belinda asked, "What about freezing some tissue? It might be worth doing some genetics."

Again she had proved to be ahead of him. He nodded and she said at once, "I'll do that."

He was undecided between trying to appear in charge and trying to appear anal-retentive. He decided on the latter and asked, "Why?"

"You know I've been doing some research in Professor Bowman's laboratory? On the cell biology of adrenal tumours?"

One of Patricia's interests. Belinda had been enlisted, as all registrars were.

"I could probably do some of the analysis … " She paused, uncertain. "If that's all right … "

He said only, "Let's see what the microscopy shows first, shall we?"

This was clearly a rebuff. He caught her fleeting look of discomfort and said, "We ought to proceed in steps, don't you think? We'll take the samples but before we do any fancy molecular biology, I'd like to have a chat with Medical Genetics. See what they think, okay?"

She nodded and went in search of sterile pots to label for the various specimens. She came back with them piled in her arms. They spent the next fifteen minutes taking further samples and then labelling the pots. Having done that, Hartmann began to pile all the organs into a silver bowl.

"I probably ought to be going now," said Belinda.

Hartmann had turned his attention to the cyclist. He was feeling and bending each limb in turn. He didn't look up as he said, "Fine."

She began to strip off her gown, moving towards the body store, while he tried to reassert his self-confidence. He had picked up a clipboard on which were cartoons of a human body, front and back, and was noting down the external injuries. He had just started on the dissection of the organs when Belinda tentatively came back to the viewing balcony to speak to him over the perspex screen.

"Would it be all right if I were to come and see you when you're going to look at the tissues down the microscope?"

Hartmann hid his concern that here was another chance to play the jerk. "Of course. It'll be a couple of days. I'll let you know when the stuff's ready."

Denny and Lenny came in some ten minutes later. They had considerable fun in telling Hartmann exactly what they thought Belinda needed to make her a happier human being.

*

Belinda had been entrusted with the samples. She had taken the ones in formalin through to the cut-up room so that the laboratory technicians could put them into cassettes for processing over the weekend; the slides made from these would then be ready by Monday afternoon for Hartmann to examine. She was now taking the fresh samples to the molecular biology lab to put them into the freezer.

Hartmann had told her not to start the analysis straight away but she suspected he didn't know how long it took. The tissue had to be digested with enzymes, the nucleic acids extracted and stored before any tests could be run, and that would take several days; the analysis itself might take a further week.

Surely it would be better to start matters at once. She wasn't, she rationalized, disobeying Hartmann, since her action would not technically be starting the analysis, merely preparing the tissue. And it would save valuable time when, as she was sure it would, the analysis became necessary.

Thus decided, she didn't put the samples directly into the freezer. As per the protocol, she split the tissue pieces into two with a sterile scalpel on sterile petri dishes; half of each sample she froze (this was done to provide spare tissue in case something went wrong), the rest she put into plastic disposable test tubes. Then she poured onto them a solution of protease. The rack of test tubes she then put into a waterbath set to body temperature.

*

In truth, Hartmann wasn't particularly interested in non-Hodgkin's lymphomas but at least it was a weekend away, and away, moreover, at the luxurious Pretender Hotel on the southern edge of Loch Lomond, all paid for, bar the drinks. Three days of relative freedom; freedom from responsibility, freedom from Annette, freedom from Jake and Jocasta, freedom from debt. He planned to enjoy himself.

On the Friday afternoon, he flew up to Glasgow Airport then took a taxi to the hotel. It was every bit as splendid as he had hoped, the hotel a converted castle set in pinewoods that sloped down to the loch's edge. There was a gymnasium, a swimming pool, a sauna and an eighteen-hole golf course. There was also an air of opulence that he found at once relaxing. He decided that perhaps life wasn't too bad.

He was checked into a room that managed to avoid the sterile conformity of most modern luxury hotels, then showered, changed and wandered down to the reception buffet. The procedure over the next few hours was exactly as it always was on such occasions. When he registered, he picked up the obligatory wallet (filled with a list of delegates, a plastic name-tag, a bound collection of abstracts, a pen and a pad of lined writing paper) and headed for the nearest wine waiter. Red wine in hand he turned to look around at the assembled company. Perhaps thirty of the expected sixty were there and he recognized no one. He was neither surprised nor disappointed by this since he was a newcomer to the subspecialty. He found a rather comfortable chair in a bay window that looked down through the woods towards the loch then he took the programme and the delegate list from the wallet.
New
Advances
in
the
Understanding
of
the
non
-
Hodgkin's
Lymphomas
. The programme of speakers was, he had to admit, impressive; the problem was that he wasn't particularly interested. He was only there because he had been forced to take over reporting haematological malignancies and, since his knowledge of this area of pathology was less than complete, he had thought it wise to undertake some rapid cramming on the subject. He had chosen this conference as much because of the location as the educational content, but he had to admit that it was a fairly high-powered line-up.

He went in search of more wine and decided to raid the food table. The room was filling up but he was again unsurprised to note that there was still no familiar face in the room. When his plate was full he returned to his station and scanned the delegate list. He recognized none of the names.

It wasn't that he was pathologically unsociable, but this weekend he rather fancied freedom; there were certain lectures coming up in the next two days that he had already marked down as too indigestible for human consumption and during those he planned to partake of the various hotel facilities without having to explain himself to some over-attentive colleague. Anonymity was his desire that weekend.

The food was the usual curious buffet mixture of sandwiches, sausage rolls, samosas, chicken sati and quiche — around the world in eighteen dishes — which he ate without enthusiasm, then packed the documentation back into the wallet. The inevitable selection of gateaux was arrayed on the table but he decided against them, opting instead in favour of some more wine and he accordingly obtained a full glass.

The room was now quite crowded, most of his fellow delegates appearing to know each other. He had to move across the room by constantly edging around people and avoiding elbows and glasses and the occasional flipped backhand. It was like ten thousand other medical or scientific conferences.

At the back of the room were some double doors that he guessed led into the main conference room. Arranged along either side of these were sales stalls, another unchanging component of such occasions. The things they sold were usually related to the subject of the conference and in this case they were telling him of new treatments for lymphoma. On either side of the stalls there stood the representatives, people who, in Hartmann's opinion, had the hardest of all jobs, having to sell to doctors. Normally his contact with such a tribe lasted only until he confessed that he was a pathologist, whereupon their smiles remained while the expectant, welcoming light in their eyes went walkies. You can't sell drugs to a pathologist.

It was no different this time. His brief perusal of their displays was followed by a bright conversation that became rapidly desultory when they found he wasn't in any sort of position to prescribe several tens of thousands of chemotherapeutics. He could only offer them interest and that was not enough. They allowed him to take the cheap pens and sticky paper pads, but the real prizes — the desk lamps, the laser pointers and the elegant clocks — remained under the table. He left the room, went to the bar for a final malt whisky, then went to his bed.

*

He slept quite well, considering it was a hotel. The bed was comfortable and the sheets smelled wonderfully fresh. He had, he mused as he showered, stayed in considerably worse establishments than this.

He enjoyed the full Scottish breakfast and then, newspaper tucked into the wallet, he took his place at the back of the conference hall, ten minutes before the scheduled start. He was relieved to find that the chairs were fairly plush (his buttocks had painful, ache-filled memories of many long lectures) and that the projection screen was large.

The day passed uneventfully. The lectures varied from incomprehensible to dull but he was able to extract some sense of self-justification for his presence, actually making the odd note. The lunch was another buffet but he expected no more; at least the coffee was drinkable. By the time the afternoon break came he felt that he had learned enough to merit skipping the last two talks — and headed for the bar. He bought himself a large gin and tonic and ensconced himself on one of the large, olive green sofas dotted around the open plan lounge. He took two long draughts and then closed his eyes and relaxed, feeling happy with the world.

"May I join you?"

The voice startled him. On opening his eyes they revealed a rather attractive young woman. He looked around. He must have dropped off for the bar was now busy with conference delegates and the lounge had filled up considerably. He smiled at the woman and said, "Of course, of course."

She sat down opposite him and he thought that she looked vaguely familiar but he couldn't place her. She had long black hair, dark blue eyes and full lips and he guessed that she was perhaps thirty years old. She also had a figure to die for. Hartmann felt irrationally flattered that she had chosen to sit with him.

She took from her handbag a gold lighter and a packet of cigarettes. "You don't mind, do you?" He shook his head at once, noting her voice had a trace of Essex in it. "Help yourself, if you want," she offered, indicating the cigarettes and lighter that she had put on the table between them.