Pulse Page 19

‘No,’ I said. ‘I’m not. I know I’m right.’

  ‘Could you prove it beyond a reasonable doubt in a court of law?’

  ‘But I’m telling you the truth,’ I asserted with frustration.

  ‘As may be,’ said the detective, ‘but the truth is no guarantee of justice.’

  ‘Isn’t that rather cynical?’ I said. ‘Especially from a policeman. Surely justice is all about finding out the truth.’

  He shook his head in disagreement. ‘Justice is determined by the facts, and those facts are decided solely by the jury based only on the evidence presented to them in court. Whether or not the events actually took place is irrelevant. In my experience, the truth doesn’t usually enter into it.’

  If I couldn’t even convince the police, what chance did I have with a jury? And what danger would I be placing my family into in the meantime?

  I could feel the stress rising in me once again.

  Grant had been listening carefully to everything that had been said and he had clearly not been impressed.

  ‘Chris,’ he said, turning to me. ‘You have to let the police do their job and not get involved. The safety of our children is far more important than some suspected corruption in horseracing, or a dead man we don’t know.’

  He was right. Of course he was right. But something inside me was telling me not to let it go.

  I was like a drug addict who knew perfectly well that what he was taking was harmful to his health, even critically dangerous, but that didn’t stop him doing it. Addiction was a major characteristic of obsessive-compulsive disorder and I was well wedded to that concept.

  Maybe Grant could see the determination in my eyes.

  ‘Darling,’ he pleaded, ‘you must stop. Promise me you will leave this all alone.’

  I looked across at the policemen.

  ‘Don’t you even want to know the number plate of the Mercedes?’

  PART 3

  April

  23

  ‘Adult trauma, six minutes.’

  The hospital Tannoy call caused a surge of adrenalin through my system – a rise in my heartbeat and a mixed feeling of excitement, fear and nervousness. Especially nervousness.

  It was just my second day back.

  Only a week previously, I had passed the assessment of my competence to return to work at Cheltenham General, although I hadn’t thought so at the time.

  Initially, the assessing panel had been interested in what I had been doing with my time since I’d been discharged from Wotton Lawn just before Christmas.

  I decided against telling them anything about the unnamed man or the spot-fixing, concentrating more on how I had taken the opportunity to catch up with advances in emergency medicine by reading specialist publications. And I told them that I’d spent a day as a medical officer at the racecourse, without actually elaborating on what had happened later.

  They had appeared impressed by all that but then they still spent quite a lot of time asking me about the medications that I was taking, and about my ongoing consultations with the psychiatrist Stephen Butler.

  ‘We have to be so careful,’ the lady chairman of the panel had said in explanation. ‘We can’t take any unnecessary risks. We have to be satisfied that your medical condition poses no threat to the welfare of our patients.’

  It had been at that point I’d become certain that I would fail whatever I said, so I’d thrown caution to the wind and told it how it really was.

  ‘I have a mental health problem,’ I said to them. ‘I repeat. I have a mental health problem.’

  I stared at the three of them, one by one.

  ‘Do you have any idea how difficult it is for me to say those six words to complete strangers?’

  I took a deep breath.

  ‘I’ve been off work now for four months but I’ve been ill for far longer than that, well over a year, probably longer. Initially I denied it, especially to myself. I made excuses for my strange behaviour and hid myself away so that others couldn’t see. But denial is very damaging. It may be the natural defence mechanism against acceptance of a painful truth but it makes things worse. Getting anxious because one is fearful of displaying that very anxiety is self-perpetuating. It is a chain reaction like an atom bomb that, if not defused, will detonate and destroy not only you but everything you hold dear – your marriage, your family, your house and your job. Everything, including your life itself.’

  I paused.

  No one said anything. They just waited for me to go on.

  ‘Acceptance is the key. Acceptance that one is ill is the very first step towards being well again. Instead of hiding away, acceptance allows one to seek out those who can help. But it is not just acceptance by me that’s important, it is acceptance by others, by my family, my friends and my colleagues. Acceptance provides a sense of belonging that is vital to recovery, a purpose that is essential for healing.’

  I took another deep breath.

  ‘I have been a doctor for nearly twenty years and I have been a specialist in emergency medicine for the past ten of those. I know my job and I am sure I would not be a threat to the welfare of patients. Quite the reverse.’

  I paused once more and looked at them.

  ‘I want my job back. I want it back because I feel able to provide a worthwhile service to society. But I also want it back because I need it. I need it to become properly well again.’

  I fell silent with my hands lying in my lap.

  After a few seconds the lady chairman cleared her throat.

  ‘Thank you, Dr Rankin,’ she said. ‘Most interesting. We will let you know our decision in due course.’

  And they had, and quickly too.

  I’d received a letter only three days later stating that I was cleared to work again in the Accident and Emergency Department at Cheltenham General Hospital. The only caveat being that, provided I agreed, I would be working for the foreseeable future under the supervision of the other consultants rather than as one of them, although I would retain my outward status, and my salary.

  I’d swallowed what little pride I still retained, agreed to their terms, and had gone gleefully back to work the following Monday, i.e., yesterday.

  ‘A sixty-four-year-old man has fallen fifteen feet off a ladder,’ said the nurse who had taken the trauma call from the ambulance service. ‘Seems he was trying to fix his TV aerial. Stupid idiot. Fell onto a concrete path.’

  ‘Head injury?’ I asked.

  She shook her head. ‘Landed on his feet. The ambulance service think he may have broken both ankles.’

  Painful, but it shouldn’t be life- or limb-threatening providing the breaks hadn’t disrupted the blood supply to his feet. That would be the first thing I would check on his arrival.

  ‘You take this one, Chris,’ Jeremy Cook said over my shoulder as I sat at the desk. ‘I’ll just be on the periphery if you need me. Glad to have you back.’

  ‘Thank you, Jeremy,’ I said. ‘It’s good to be back.’

  The patient arrived and I set to work stabilising his condition and confirming that there was a detectable pulse in each foot. Next I sent him for X-rays as well as a full-body CT scan. It was clear from their positions that he had indeed broken both ankles, but it was vital to ensure that there were no other critical injuries, such as internal bleeding, which might be easily missed until it was too late. A fall from fifteen feet onto a hard surface would have resulted in large forces acting on all the major organs, maybe enough to cause a rupture.

  Thankfully, however, the CT scan showed nothing out of the ordinary, no obvious further injuries.

  I had already paged an orthopaedic specialist and together we now set about realigning the patient’s ankles and placing them in temporary plaster casts. There was every likelihood that he would require surgery to have one or both of them fixed properly but that would be for tomorrow, after the initial damage to the surrounding soft tissue had been given a chance to settle.

  As the man was wheeled away to o
ne of the hospital wards, I breathed a small sigh of relief. The first major trauma I’d dealt with in almost five months and I’d felt completely at home, with not a tingle detectable anywhere in my fingers.

  ‘Well done, Chris,’ Jeremy Cook said. ‘Good job. Exactly according to the book.’

  I smiled.

  I was back in business.

  The following Monday I appeared as a witness at the reconvened inquest of the unnamed man at Gloucester Coroner’s Court.

  Except that he was no longer an unnamed man. Police enquiries had finally produced a result.

  ‘Good morning, Dr Rankin,’ said DS Merryweather, meeting me in the glass vestibule of the brand-new coroner’s court complex. He was with DC Filippos and they shook my hand in turn.

  ‘Thank you for coming,’ said Constable Filippos. ‘How are you?’

  ‘I’m fine, thanks,’ I said. ‘I’m back at work.’

  ‘I’m delighted to hear it.’ He smiled as if he really meant it.

  I wanted to ask him about all sorts of things, in particular, if he’d discovered who owned the long black Mercedes, but I’d promised Grant that I wouldn’t get involved. I’d assured him I would leave everything to the police and not ask any questions of anyone to do with the dead man or anything else that had happened at Cheltenham Racecourse.

  So I was here only to answer questions from the coroner and not to ask any. As Grant had reminded me only that morning. But it didn’t mean I wasn’t interested. Perhaps I would just have to wait for information to be offered.

  ‘You may have heard that we have identified the dead man,’ said the detective sergeant.

  ‘So I believe,’ I replied. The summons I had received to attend had given the man’s name as Rahul Kumar but no further details beyond that.

  ‘As we had suspected, he was from India, from Delhi. The authorities there came up with a name and DNA comparison tests have confirmed it.’

  An usher came into the vestibule and loudly announced the inquest for Rahul Kumar. The two policemen and I filed into the courtroom and took places on one of the rows of blue-covered seats at the back.

  I’d attended many inquests before in my professional capacity but I never forgot the reasons why we were here. An inquest was held solely to ascertain the answers to four simple questions: who, what, where and when?

  Who was the deceased? What caused him to die? Where did he die? And when did he die? Nothing else. Long gone were the days when an inquest could apportion blame to someone responsible for causing a death.

  Unlike in a criminal court, where prosecution and defence counsel argue about the facts of the case in an adversarial system while the judge remains mostly silent, dealing only with points of law, the coroner’s proceedings were inquisitorial with the coroner asking questions of the witnesses from the bench in order to reach his conclusion.

  Juries only sit at inquests under certain limited circumstances, for example if the deceased died while in custody or if the coroner considers that there is particular public interest.

  In this case, neither of those applied and the coroner sat alone, calling DS Merryweather as the first witness to give evidence of identification.

  ‘The deceased’s name is Rahul Kumar,’ the sergeant said loudly and clearly from the witness box while consulting his notes. ‘He was an Indian citizen and his home was in Narela, in the northern district of Delhi. Positive identification was confirmed using DNA comparison with his mother and brother.’

  ‘Did he have any family other than a mother and brother?’ asked the coroner.

  ‘Yes, sir,’ said the sergeant. ‘Two sisters and various nieces and nephews.’

  ‘No children of his own?’

  ‘No, sir. Mr Kumar was unmarried.’

  ‘Is the family represented in any way at this hearing?’

  ‘No, sir,’ said the detective. ‘His family were unable to travel. Full details are included in the report we submitted to your office.’

  ‘Yes, thank you,’ said the coroner. ‘I have read the report. Most interesting. May I congratulate you, sergeant, on your efforts to discover who this man was. Quite a puzzle. Do you have any further information to add?’

  ‘I have, sir,’ he said. ‘Since the report was written, we have determined that Mr Kumar arrived in the UK seven days prior to his death on an Air India flight from New Delhi. His whereabouts during those seven days have yet to be determined and any belongings he may have brought with him have yet to be located.’

  ‘Did he have a profession?’ asked the coroner.

  ‘New information has just arrived from India that indicates Mr Kumar had previously been an officer in the Indian Police Service but had retired some time ago to become a member of a private security organisation.’

  ‘Is there any reason to believe he was working while here in the UK?’

  ‘None, sir,’ replied the sergeant. ‘But there is no evidence at all of the purpose of his visit. He obtained a standard visitor visa in person using the 24-hour super-priority visa service at the British visa application centre in New Delhi on . . .’ He consulted his notes. ‘. . . the third of November last year and booked his flight on the same day via the internet. He left India the following day, arriving at Heathrow on the morning of the fifth.’

  A very sudden decision, I thought. There had to have been a pressing reason for his trip.

  The court had answered the ‘Who?’ question.

  Next into the witness box went Constable Filippos, who described how the man had been found in a cubicle in the gentlemen’s lavatory at the racecourse by one of the cleaning staff.

  ‘And the cubicle was locked from the inside?’ asked the coroner.

  ‘Yes, sir.’

  ‘So how was access gained?’

  ‘The cubicles were constructed of prefabricated panels that didn’t go all the way to the ceiling. One of the racecourse staff leaned over from the adjoining cubicle and used the cleaner’s mop handle to slide the lock open.’

  ‘Was that before or after you arrived at the scene?’ asked the coroner.

  ‘Before, sir. The method was described to me with a demonstration. The police were only called because the racecourse staff initially thought the man was drunk.’

  ‘Do we have the people present who found the man?’ The coroner looked around the court expectantly.

  ‘No, sir,’ said the constable. ‘The racecourse staff member was a young man on a short-term work exchange from Racing Victoria, in Australia. He has since returned home.’

  The coroner pursed his lips in obvious disapproval.

  ‘And the cleaner?’ he asked in an acid tone.

  ‘The cleaner gave a statement to one of your assistants,’ the policeman said. ‘It should be with your notes, sir. She had originally thought the unresponsive man was already dead and she was badly shaken up at the time by the experience. It was not thought necessary for her to attend today.’

  The coroner shuffled the stack of papers in front of him and found the statement, but he clearly didn’t like being seen to be put in his place by a young constable.

  DC Filippos went on to describe how he had called for an ambulance and had then accompanied the man to Cheltenham General Hospital. He also told the court how he had returned to the racecourse later that evening and had discovered a whisky bottle in the waste bin, later found to bear the fingerprints of the deceased.

  ‘Do we have any indication where this bottle originated?’ the coroner asked.

  ‘No, sir,’ said the constable. ‘The bottle was branded as Bell’s Blended Scotch Whisky. The size was twenty millilitres, a fraction more than a quarter-bottle, and it was made from plastic not glass. Such bottles are available as duty-free sales at airports or on board aircraft but we have no indication of exactly where this particular bottle was purchased or where it had been prior to being found in the waste bin.’

  The coroner made some notes. ‘Thank you, officer.’

  Next it was my turn. I collec
ted my papers and walked to the witness box.

  I took the Bible in my right hand. ‘I swear by Almighty God to tell the truth, the whole truth and nothing but the truth.’

  I sat down on the chair provided.

  ‘My name is Dr Christine Rankin, fellow of the Royal College of Emergency Medicine and consultant physician at Cheltenham General Hospital. I was the receiving consultant in the A&E department on the night Mr Kumar was admitted.’

  I went on to describe the treatment given to the man, referring regularly to the medical notes I had brought with me. I told the court about the suspected supraventricular tachycardia, how I had prescribed adenosine to try to bring down his heart rate, and how he had subsequently died of a cardiac arrest.

  ‘Did the administration of the adenosine cause the cardiac arrest?’ the coroner asked.

  ‘No, sir,’ I said, keeping my breathing as even and calm as possible.

  The truth, the whole truth and nothing but the truth.

  But I was telling the truth.

  ‘Supraventricular tachycardia is caused by improper electrical activity in the upper part of the heart. Adenosine causes a momentary block in the atrioventricular node which should reset the heart rhythm. However, in this case that did not occur.’

  ‘Because the man was not in fact suffering from supraventricular tachycardia?’

  ‘The man’s heart did not respond to the adenosine due to the extent of the cocaine overdose,’ I said, not quite answering the coroner’s question.

  ‘Had you consulted with a cardiac specialist before administering the adenosine?’ the coroner asked.

  ‘No, sir,’ I said. ‘None were available in the hospital on a Saturday evening and I was of the opinion that to wait for the on-call cardiologist to arrive would be detrimental to the well-being of the patient.’

  ‘You thought he might die if you waited?’ asked the coroner, looking me directly in the eye.

  ‘Yes, sir,’ I said.

  ‘But he died anyway.’

  ‘Yes, sir.’

  It didn’t sound particularly good, even to my ears.

  ‘Thank you, Dr Rankin, you may step down now but please remain in the court. I may wish to recall you later.’