Chapter Seventeen

‘What time did she die?’ In truth, she did not know why she even asked.

‘Must have happened just before the rendezvous, around one-ish? It was fortunate that you sorted her resuscitation status and ceilings of care in time so, thank you for that or we’d have had a futile arrest call to deal with,’ explained Gemma. ‘Don’t look so downbeat Philippa, it was because of you that Mary died a peaceful death. I know that some of the family were a pain but they should be grateful. And if anyone’s looking down on you up there, they will know too.’

Mary Surrey…

That explained was why there had been no cardiac arrest call…

Her competitive spirit led her to become frustrated with the lack of test but now it had surfaced, she felt a dread like no other. Philippa had failed the test before it had even started. But the event albeit expected had still come too soon. How had the killer timed her death so accurately?

Philippa closed her eyes. She was trembling – an amalgamation of fear and anger. The killer had outsmarted her yet again and right underneath her nose.

‘Are you okay?’ she heard Effy ask.

But nothing mattered anymore; the Take, Dr Steer’s inevitable disappointment that she had not performed the lumbar puncture, how she felt…

‘I’m fine,’ Philippa answered. She mustered the remaining strength to open Shinji Nyarko’s door.

She no longer felt tepid in the cubicle. The light reflected off her tears and back into her eyes.

‘What’s going on, Philippa?’ Shinji asked. He tried in vain to sit upright in his bed.

‘A patient died at one. That was the second test…’

‘But… how?’

‘She was already approaching end of life. I… made her not for resuscitation, but I don’t know how the killer ensured she would die at one o’clock.’ She came close to punching the wall.

‘Let’s stay calm and think this through.’

‘Stay calm? No, I need to head there now. I need to find Rob and let him know, but we might be onto something with the Fibonacci sequence. The patient’s in Medical Six!’

‘Wait, Philippa. We must not –’

‘Don’t worry Shinji, I’ll bring you the crime scene ASAP.’

Philippa now had less than thirty minutes before the next innocent patient in this hospital would die. That spurred her on. She was not going to let this killer continue doing this – not on her shift.

Medical Six was the Gastroenterology Ward and the vomit-inducing aromas from stools of all textures led Philippa to question why anybody in their right mind would pursue such specialty by choice. But tonight, the scents masked the stench of murder.

The radio by the nurse’s station was playing a concerto by Rachmaninoff. That happened to be one of Philippa’s favourites. In fact, she had excelled at the piano and would have loved to have become a concert pianist, before medical school came knocking on the door to consume all her time. Right now, the tune gave her the wrong type of butterflies.

After this, the next test will be on either Medical Seven or Surgical Seven, she thought. At least that gave her and Rob a chance.

Mary Surrey had been relocated to a side-room so that she would at least be offered some end-of-life privacy. She did not have any gastroenterological issues; her transfer to this ward was purely because this was the only vacant side-room left in the hospital, and once it had been cleaned, it would reclaim that status… death did not have a lasting impact in hospitals.

Her feet were languishing but they were determined to carry her. She needed to inspect the crime scene whilst it was still as intact as possible – that she had learned from her tutor, Shinji. Time was running out.

As she wiped away her tears of anger and scoured the whiteboard for Mary’s name, she became aware of a group of crying relatives between the ages of about six and fifty down the corridor. Philippa spotted Davina sitting amongst them but she avoided any eye contact with the next-of-kin. Seeing the suited lady made her recall their fractious argument…

It was their round two. Round one had ended in a tie. The curtains had come down prematurely after Davina called for a timeout. When she eventually returned, she had both a replenished cup and from the sounds of it, rejuvenated verve.

‘Davina, resuscitation refers purely to CPR. So, if your mother’s heart was, for whatever reason, to stop i.e. she was to die, should the medical team jump up and down on her chest to try and restart her heart,’ Philippa explained.

‘Well of course, why would you let her die?’

‘It’s not a decision we ask you to make as that would be an extremely cruel responsibility. It is a clinical decision that we as doctors make.’

‘You play God, essentially?’ she replied straightening the collars of her blazer.

‘We’re merely being humans accepting our mortal status. If we were playing God, we would reverse the ageing process.’

Davina was temporarily silenced. She folded her arms.

‘We base the decision of CPR on lots of factors. For example, you appear fit and well, why wouldn’t we attempt to resuscitate you. But your mother is already in a nursing home and is bedbound. She does not have a significant quality of life.’

‘I disagree. She can still eat.’

‘But she needs to be fully assisted in feeding and the fact she needs prompting suggests she doesn’t necessarily feel hunger like we do. And we don’t know whether she even has enjoyment from food.’

‘I think it’s a bit rash to assume she doesn’t.’

The nurse in Resus, perhaps sensing the rising temperature of their debate, gathered Mary Surrey’s notes and held them up as if preparing a shield.

‘Many people with dementia can still enjoy food… but your mother also has lots of other serious medical issues. She is immensely frail. Even if we tried to restart her heart, we wouldn’t succeed – in fact, the only thing we might do is break her ribs and cause more damage in those final moments of her life. We only live once but we only die once and we need to get it right.’

‘You would still be letting her die though?’

‘People die, Davina. That is what will happen to all of us one day. If we kept people alive forever, death wouldn’t exist. There’s a difference between leaving her to die and letting nature take its course. CPR is very undignifying, have you ever witnessed it?’

‘Why would that matter?’

‘It might change your perspective on things.’

Philippa’s bleep went off. If this conversation was not causing her patience to explode, the bleep undoubtedly would.

‘We as doctors have to try and do what is best for our patients.’

‘Then you’re not trying hard enough. You should be trying to help people and she needs help with this infection.’

Philippa gritted her teeth. ‘If you could just please try and appreciate what we’re doing for your mother. We’re treating Mary right now, not you.’

‘Well I’m her next-of-kin,’ Davina snapped, like a spoilt child.

‘Yes, I’m aware but I make the decisions about what is best for your mother and what she would want if she could see herself like this. If fifty years ago she was told that today in 2019 she would be lying in a hospital bed with a severe pneumonia, dementia and unable to do anything for herself, would she want us to be aggressive in treating her and try to restart her heart?’

‘Mum would want to be resuscitated,’ insisted Davina, entombing both her hands within her long hazel fibres.

‘Are there any other family members?’

‘Why?’

‘Do you think it would help if I spoke with them?’ Perhaps they would be more reasonable, thought Philippa.

Davina did not reply.

‘Can I get you a glass of water?’

‘No.’

‘Do you have any questions?’

‘I’m going to go now. Just do what you can. I’ll see you in the morning,’ she fumed before stomping out of the department.

Philippa sat down and opened Mary Surrey’s notes amongst the ticking of pumps and alarming of monitors.

‘Would you like one of these?’ the nurse asked.

Philippa hesitated then reached out a hand to grab the red form and thanked her.

Either way, Philippa would look like an utter fool if the whole exhausted night team ended up having to waste precious time with such a fruitless exercise. More importantly, the poor elderly patient was not a candidate for resuscitation and at this rate was likely to die within the next forty-eight hours.

Philippa closed her eyes and thought of her cosy bed. How she longed to be under those covers.

The sound of a patient’s buzzer jolted her mind. It didn’t take a police detective to figure out which side-room Mary had been in; just outside one such room and blocking Philippa’s path was a lightwood coffin that may even have been utilised earlier in the night.

I’m too late…

The youngest amongst a group of relatives was wiping her eyes with her tender little hands.

Poor thing; to experience death at such a young age, Philippa thought.

The porter pushed the coffin down the corridor towards the tearful huddle. Then much to Philippa’s surprise, he pulled out a tissue, knelt down and wiped the child’s cheeks.

‘I’m sorry dear,’ he said softly. ‘Look, I’ve got something for you.’ And from his pocket, he fished out a lollipop for her.

The girl, with her shoulders jerking intermittently was nudged by another lady who was not Davina.

‘What do you say, Lucy?’

‘Thank you.’

‘That’s quite alright,’ the porter replied, patting the child on the head.

She seemed to cheer up slightly once the lollipop had been unwrapped.

Philippa watched as the porter wheeled the coffin around the corner towards the exit of the ward and disappeared out of sight.

The door to Side-room Two was about twice the width of a normal door. The bedside folder was in-situ of a lopsided blue compartment just below the fenestration. These windows usually allowed staff to check on patients from outside but the darkness gave nothing away. The corner of that red form poked out as a cruel reminder of her argument with Davina.

Philippa tried the door. It budged less easily than she expected and crepitated like an arthritic joint.

Aside from the orange illumination emanating from the patient’s buzzer there was no other light in the room. She felt a cold spiral wind down her back. The hospital menu with upcoming breakfast options lay open on the bedside table – not that it would have been of much use to Mary Surrey. The air smelt fresh and the ensuite floor appeared damp.

Philippa pulled the blind and turned on her phone’s flashlight. There was a portable whiteboard on wobbly wheels at the foot of the bed and three plastic chairs. Philippa pictured Mary Surrey’s family slumped and weeping upon them. At least her death was less of a revelation when compared to Jonathan Wickshaw’s.

The whiteboard technique was often utilised to help keep a patient with dementia orientated to time and place.

Philippa studied the board like a chest radiograph. The writing was immaculate, perhaps effeminate. Most of the information, Philippa knew already; the date, the name of the hospital and this ward. She did however gather that the nurse who had cared for Mary during her final moments alive was called Alice.

At the bottom of the board was a terrible attempt at a decoration; a sketch of a house of some sort consisting of two cuboids stacked upon each other. The marker-pen drawing of a leafless tree was as lifeless as the atmosphere in the room. But at the other corner, more interesting still, was a small symbol, dissimilar to the one Shinji had discovered in security ink on Surgical Four. It resembled rather, a complex jigsaw of hexagons and pentagons.

Philippa wasted little time and began taking snapshots of the room. She reluctantly browsed the pedal bin but it was full of used paper towels. She grabbed some gloves and rummaged through the litter more thoroughly.

Nothing at all.

There was a bag of toiletries by the bed. Had Mary’s family left them behind? She searched the bedside cupboard drawer but the trend from Jonathan Wickshaw’s crime scene did not continue.

A few more items were on top of the cabinet; a used tube of toothpaste, a tube of red lipstick and a newspaper folded in half. Someone had tried to complete the crossword without success.

A gentle breeze managed to work its way between the window and its frame. Philippa walked over to close it.

A tiny speck of light outside caught her eye.

She froze. What was that?

She raised the blinds further and peered through the wet glass.

On this level, she had a bird’s-eye view of the cemetery, hundreds of eerie graves lined up like a Morse code message. Some had been neglected for so long that they had toppled over and, in the distance, the spire of the church where Melissa Dowd was found, reached up to the sky as if ready to present the spirits of the deceased for judgement.

The speck of light reappeared briefly.

Philippa squinted.

At last, the source became clear.

It puzzled her.

There, stumbling amongst the gravestones, was a familiar person dressed in a well-ironed pink shirt and navy trousers.