‘How is Mr Nyarko?’ Justin asked.
‘He’s better,’ replied Philippa, ‘thanks to you. I’ll keep him an eye on him throughout the night. If the nurses bleep you about him, can you divert them straight to me please?’
‘Sure.’
‘And the rest of the wards?’ Gemma asked.
Philippa felt guilty; she should have been the one checking in. But she was fast finding out that maintaining control of the work of two others was impossible when she was unable to focus on her own primary goals.
Justin had little to report.
‘So apart from the hiccup with Jonathan Wickshaw, we’re doing okay,’ Gemma added.
Karan launched his sandwich wrapper at the bin and dusted off the crumbs on his fingers. ‘I’ll get back to work and see the next one.’
‘I’ll try and join you for that ascitic drain shortly,’ Philippa called after him, as he left the room with Justin by his side.
It was half-past-one.
There had been no cardiac arrest call, but she had to tell Shinji Nyarko about Eric the absconder. Did anything in the clues confirm he was the culprit?
‘Not that it makes a difference,’ Gemma whispered suddenly, ‘but there was quite a lot of blood in that syringe and I had anticipated it would clot, so I sent some off to the lab beforehand. Do you think it would help?’
Philippa Haven couldn’t believe her ears. Brilliant Gemma! What the SNP had done was give rise to the slim chance of proving her hypothesis. ‘It might,’ she replied enthusiastically.
‘Anyway, I should get going: Medical Six asked for my help just before the meeting. Take care of yourself.’
‘Thanks, Gemma.’
When she was sure the SNP was out of ear reach, she stayed behind to phone the laboratory and opened up Apex.
Whilst on hold, she typed in Jonathan Wickshaw’s hospital identifier and perused the results.
The Princess Royal Hospital utilised the most archaic software for blood results; Apex was essentially a black screen with a flashing grey cursor and pixelated fuchsia font.
His blood count was satisfactory, which did not suggest foul play had caused bleeding.
His sodium level was fine.
His kidneys were in working order.
But next to his potassium level, a red exclamation mark glowed in place of a numeric value.
‘What can I do for you?’ asked the lab technician.
‘I need a blood result please.’
‘You got a lab number?’
‘Sure,’ Philippa replied then relayed the ten-digit code.
‘The results are already on the system. Is there a problem?’
‘The potassium – there’s no figure there.’
‘That normally suggests an unreliable or haemolysed result.’
‘Are you still able to check what the value was?’
‘I’ll try; give me a second…’
Philippa heard the tapping of a keyboard in the background.
‘You still there?’
‘Yes.’
‘Our machine measured the potassium level to be eleven so we’re certain it’s a false result. You’ll need to send a fresh sample if you need a potassium level, I’m afraid.’
That won’t be happening, Philippa thought grimly.
‘Anything else I can help you with?’
‘No thanks.’ Philippa Haven replaced the receiver.
Jonathan Wickshaw’s potassium level was over double the upper limit of normal… but more importantly: it was non-compatible with life. That was the evidence Philippa had been seeking – the proof that he had been murdered by a lethal dose of potassium. She dashed towards the Chartwell Unit.
The rendezvous had been productive in many regards, specifically for Philippa’s primary goal of finding and stopping this killer, which overshadowed her now secondary goal of managing the Take and all else medical.
She felt like a child rushing home to tell her parents she had come top of the class at school, this bubble of newly acquired knowledge lambasted away at the nausea.
‘Two things: firstly, it was potassium,’ she said as soon as she opened the door to Bed D.
‘How did you manage to –’
‘Gemma – she’s on the list I gave you of my team members, as Gemma Oliver – one of the site nurse practitioners. She was present at the cardiac arrest. When the porter came back to tell me the blood gas machine was broken, Gemma took the syringe elsewhere but filtered some off and sent it to the laboratory. Jonathan’s potassium level was eleven.’
‘What’s normal?’
‘Less than half that.’
‘And a level of eleven would be lethal?’
‘It would almost certainly lead to the heart stopping.’
Shinji stroked his chin and murmured: ‘I’ll make a note of it. And what about the second murder?’
‘There wasn’t one.’
‘Nothing at all? You were gone for a while.’
‘We had a meeting. That was it.’
Shinji Nyarko shivered momentarily. Each time Philippa returned; he would shrink in his gown. His sleeves hung like a geisha’s kimono, off his hairless arms.
‘I have something to show you too,’ he said suddenly.
Philippa trotted over and caught sight of an Excel spreadsheet. ‘What’s that?’ she enquired.
‘It’s a table – going to be a table of each test; who the victim is, how it’s done. Right now, it’s more just a single dataset… obviously.’
‘Let’s hope we can keep it that way,’ muttered Philippa.
‘But the email,’ he said, raising a finger. ‘Have you heard of a burner email?’
‘Like a burner phone?’
‘Exactly, but for email addresses. The only problem, is that whoever sent it used something called a VPN – virtual private network. This makes them untraceable by masking the IP address and location of the sender. I tried and couldn’t access the information. Furthermore, the burner email created has already expired and self-destructed.’
‘Self-destructed?’
‘A lot of burner emails are temporary and can be set to self-destruct after a period of time. See, I created a burner email myself and tried to send an email back to the killer, but I just got this fail message. Whoever sent this email is sharp with technology.’
‘I can’t think of anyone who would know how to operate something like this…’
‘There’s more: I re-watched the email several times. I think the identity of the statue is important.’ Shinji opened the link again and drew an invisible circle with the cursor. ‘See this arrow here hidden in the corner of the screen?’
‘I didn’t notice that before.’
‘Any idea who the statue might be?’
Philippa shrugged.
‘I didn’t either at first.’
‘You found out?’
‘Leonard Pisano.’
‘I’ve never heard of him.’
‘Also known as Leonardo Bonacci,’ he added, tilting his laptop to prove the images he searched online were of the same statue.
‘Still haven’t heard of him.’
‘What about Fibonacci?’
Philippa felt a jolt to her head. ‘Fibonacci? The mathematician Fibonacci – as in the Fibonacci sequence?’
‘It would seem.’
‘But why…’
‘I haven’t got that far yet. I was hoping you might have an inkling. Are you associated with him in any way?’ Shinji asked. His fragile shoulders quivered.
‘I can call my Mum but I’m pretty sure there is no Italian in my bloodline. What about the hanging lady; do you think it’s a real person?’
‘I typed several variations of hanging lady into Google and I didn’t get any matches. I’m not sure if that makes it more or less likely that she is a real person.’
‘But if she is, what if she is the second test?’ cried Philippa.
‘Hold it, I don’t think so. These windows wouldn’t match anywhere in the hospital, I’m guessing? And the clothing she’s wearing – she could be from the eighteenth century for all I know.’
That did not make it any more reassuring.
Philippa recited the Fibonacci sequence in her mind: 0, 1, 1, 2, 3, 5… the series of numbers cut short only by the interruption of the bleep clinging to her belt like a parasite. Her frustration was like a vine entangling her lungs. The killer was teasing her, outsmarting her and she hated being outsmarted.
‘Something about timing perhaps? Time zero was when the whole thing started at nine… I don’t know…’
‘Bed numbers?’
‘Jonathan Wickshaw was in Bed Sixteen and I can’t see a way to make sixteen from the first few numbers, which are all pretty low.’
‘Wards?’
‘Surgical Four, he was in.’
‘Four is missing from the sequence.’
‘Which means the next ward should be Surgical or Medical Six. Should I check on those?’
‘If you have time, but when you came into the room, you mentioned you had two things to tell me.’
‘Yes. Here’s another couple of names. Nicole is the girl who should have been on shift tonight but apparently swapped out of it, but more interestingly: I have a likelier suspect. His name is Eric Pails,’ Philippa replied, before telling Shinji Nyarko all she knew about the absconding patient.
‘He definitely sounds dangerous enough to conduct some of the things we’ve encountered.’
‘Only some?’
‘I don’t wish to sound judgemental but a lot of the technical aspects of the case seems pre-meditated and require a degree of…well… intelligence. This Eric Pails does not strike me as someone who fits that, but is there any way of finding out more about him?’
There is someone I could talk to,’ Philippa thought aloud.
The detective shivered again then began coughing.
‘Shinji?’
‘I’m fine.’
‘Let me check you over.’ Philippa grabbed her stethoscope and began examining him. ‘You’re burning up and your pulse is racing.’
‘I’m fine. Honestly.’
‘No, Shinji, I need you as close to full health as possible tonight. Or we will never stop this killer.’ She ran to the door and threw it open. ‘Effy, I need your help now! Could you get a set of obs please?’
The nurse donned her protective gear then wheeled the machine into the cubicle.
Shinji Nyarko began exhibiting rigors and his fingertips felt contrastingly arctic even through Philippa’s latex gloves.
‘Blood pressure ninety-five over fifty-two. Heart rate is tachycardic, one-hundred-and twenty. Temperature is thirty-nine,’ Effy announced. Up close, it was clear Effy was short for something much longer and less pronounceable.
‘Philippa, I’m okay…’ he said but his sickly voice suggested otherwise.
Philippa swore. ‘How are the sats?’
‘Oxygen sats are ninety-five percent,’ the nurse replied.
‘Can we get some paracetamol and a shot of gentamicin?’
‘How much?’
‘Do you know your weight, Shinji?’
The question brought him some sadness. ‘Fifty kilos last measured.’ He had lost a huge amount of weight if his Get-Well card photograph was any evidence to go by.
‘Two-hundred-and-forty milligrams please, Effy.’
‘I’ll draw it up,’ acknowledged the nurse, who hurried to the clean utility with her long ponytail playing catchup.
Philippa’s bleep ran riot once more. She needed to answer it soon or else A&E would just persist; the department never understood the medical registrar was probably busy if they missed a bleep.
‘Go and find out more about this Eric Pails,’ Shinji stuttered. ‘It’s nearly two o’clock. If we’ve missed the second test, we don’t have long before the third.’
‘No, I’m not leaving you until I know you’re better. Forget about these tests.’
‘Philippa, other lives are at risk. Mine is but an insignificant one in comparison.’
‘That’s not true. How could you say that?’
‘You are required elsewhere. Get your colleague to help – the young man who saw me earlier.’
‘Justin?’
Shinji nodded.
‘I don’t know if I can trust him. How am I supposed to know who is behind all of this without you?’
‘You hardly have a choice, Philippa. I will be wary of him.’
Philippa crossed her arms and pursed her lips.
‘Sometimes, instead of trying to work out who the killer is, try starting with the ones you’re sure are innocent…’
‘Fine, I’ll get him to come now, but I’m asking Effy to stay by your side the whole time.’
For some reason, Philippa trusted her nursing colleague. Her instinct had been called upon aplenty during her career. Occasionally she had been off-piste but right now, more than ever, she needed it to spot-on.
Every few days... 