“Not really,” smiled Sarah, attempting to cover her embarrassment. “A detail. I’ll just nip along and see to it while I remember.” She turned with another attempt at a smile and left the room feeling as if her shoes were full of tin tacks.
“McKirrop, John McKirrop,” Sarah repeated for the benefit of a clerk who seemed hard of hearing. “He died yesterday morning.”
The clerk turned away from the reception desk and put on spectacles that hung from a gold chain round her neck. She started to run her fingers along rows of cardboard folders, angling her head to see through the bottom portion of her bifocal lenses. “And you say he was from?”
“HTU,” repeated Sarah.
“We have a John McCluskey... and a John McIntyre.”
“McKirrop,” said Sarah through teeth that were beginning to clench.
“Ah yes, here we are. Couldn’t see it for looking at it.” The woman chuckled as she pulled the file and handed it to Sarah who opened the X-ray envelope. She pulled the films half way out of the envelope. There were two. “There were three!” she murmured out loud. She removed the two X-rays that were there and held them up to the light. The one she wanted wasn’t there! “One of this man’s X-rays is missing!” she said.
“I’m sorry. What’s missing?”
Sarah looked at her blankly. “An X-ray,” she said, but her voice was distant. She was thinking that this was no accident.
“Typical,” said the woman. “People are so careless these days. It’ll be lying around somewhere in the ward.”
Sarah handed back the case file and left the Medical Records office. She felt dazed. Her proof that John McKirrop had been murdered had evaporated. Without that X-ray, she had nothing. If she made an accusation now she would be ostracised — if not thought to be mentally deranged. The whole notion would be deemed to be quite ridiculous. A tramp murdered by a member of staff? Absolutely ludicrous.
Sarah had an anxious hunt around HTU for the missing film, just in case it really had been left out of the file through error but found nothing. In her heart she had known that that she wouldn’t find it. She had been out-thought. That in itself was a chilling thought. Someone had suspected she might go looking for the X-ray.
Derek Logan came into the doctors’ room while Sarah was still searching. “What have you lost?” he asked curtly.
Sarah felt gooseflesh break out her neck, “An X-ray,” she replied.
“You’ve lost an X-ray?” asked Logan sarcastically. It put Sarah’s back up.
“Not me exactly,” she said. “It appears to have gone missing somewhere between here and the Medical Records Office. I’m just trying to locate it.”
“What X-ray are we talking about?” asked Logan.
Sarah looked him straight in the eye and said, “One of John McKirrop’s head X-rays.”
Logan held Sarah’s gaze for what seemed to her like an eternity before saying, “What do you want that for?”
“I just wanted to see it again,” replied Sarah, watching him for any reaction she could construe as guilt.
“McKirrop is dead,” said Logan brusquely. “Do you think we could concentrate on our living patients before any of them decide to join him?”
“Yes, Doctor Logan,” Sarah answered through clenched teeth.
Before either had time to say anything else, an alarm went off on the console desk and a nurse called out, ‘Beta three! Cardiac arrest! Steven Miles!’
Logan and Sarah both ran through into Beta suite and personal animosity took second place to dealing with the emergency. Sister Roche and a younger nurse arrived close behind with the crash trolley and Logan took charge. The cardiac monitor over the patient’s bed had gone to flat-line instead of spikes and a continuous monotone had replaced the comforting regular bleeps. The patient was a seventeen-year-old boy who’d fallen from a third storey window and fractured his skull. He had been in a coma for four weeks but this was the first sign of complication.
Sarah took over from Logan in applying cardiac massage while he prepared to shock the patient. One solitary green spike on the oscilloscope had been the only reward for their efforts after ninety seconds.
“Preparing to shock,” announced Logan loudly.
The nurses cleared everything out of the way.
“Clear!” said Logan and everyone stepped back as the current was applied to the patient’s chest. There was a loud thump and the patient’s body responded to the voltage racing through him with an involuntary jump. The monitor started to bleep again and the horizontal base line on the scope broke into spikes. But the sound was irregular, two bleeps followed by a pause then three quick bleeps followed by the monotone again. Logan applied the paddles again: two bleeps followed by the monotone. A third attempt was no more successful. Logan straightened up and put down the paddles. “We’ve lost him,” he said as the continuous monotone jangled everyone’s nerves. “All agreed?”
Everyone did.
Logan noted the time of death and turned the monitor off. He walked away leaving Sarah and the two nurses with the dead seventeen-year-old.
Sister Roche turned to the younger nurse, “He has Sigma probes. Inform the lab will you?”
Sarah said, “I’ll do it. I need to ask them for some more chart paper anyway.”
Patients with Sigma Probes who died had to have them removed by skilled technicians. It was a delicate procedure and the probes were expensive but could be re-used after cleaning and sterilising if undamaged. When a Sigma patient died the HTU staff would call the lab and they would come immediately to deal with the body. Sarah called the number written on the wall beside the phone in the duty room and was told that the team was on its way. They would also bring her more Sigma chart paper. Within ten minutes Steven Miles’ body was removed from the unit.
A shadow hung over HTU for the rest of the morning. It inevitably did when a young person died. It always seemed so unfair, almost as if an unjust mistake had been made and everyone felt aggrieved by it. But by three in the afternoon, Beta three was no longer empty. A new patient had been admitted. He was a forty-four year old demolition worker who had been hit on the head by falling masonry. The empty bay was no longer a focus for grief and reflection. A new challenge had moved in to fill the vacuum.
The patient had been stabilised by the A&E team before transfer to HTU. Sarah checked his pulse and blood pressure again to make sure that there had been no worsening of his condition in the move. Satisfied that he still seemed stable she set about connecting the monitoring probes to his head. Logan arrived in the bay while she was positioning the last one. “Everything all right?” he asked.
“He’s stable,” replied Sarah.
“How about blood tests?”
“On their way to the lab.”
“He’s going to need surgery,” said Logan. “Did you send blood for cross matching?”
“Also on its way,” said Sarah. “But surely he’s too weak for surgery?”
“Agreed,” said Logan. “So what would you suggest in the meantime?”
“A full scan in the morning?” suggested Sarah. “That should give us some information about the degree of damage sustained without putting him under any added stress.”
“Pencil it in then,” said Logan. “You can do it.”
Sarah did not react to the suggestion. She simply said, “Very well. Is he to have Sigma probes inserted?”
Logan shook his head and said, “I don’t think so. The area of trauma is well defined and limited. We’ll decide after we see the X-rays.”
Sarah found it difficult to look Logan in the eye for fear that he might see suspicion there. Another part of her wanted to accuse him openly of complicity in John McKirrop’s death, and she was glad when he left. Shortly afterwards, Nurse Barnes came hurrying towards her. “Sister Roche asks if you would mind taking a telephone call?”