Control, p.13
Control, page 13
She toyed with the bag, watching as his oxygen levels slipped once more and his heart rate surged in response. Slowly, somehow, she found a pattern: just enough terror, just enough life left in the bastard. One, two, three.
She leaned close to his ear and whispered. ‘Do you know why I’ve done this? Do you know why it had to be me? Think about all the things you’ve done in your life.’
When she drew back, she was no longer smiling. A few more breaths from the mask, and one last look at the oxymeter. The moment was right.
‘I have some things for you, Michael.’
She reached into her bag and, from the bottom, pulled up a stack of magazines. These she splayed around the floor and desk above. Whether Trenchard could see or not hardly mattered. He would know exactly what kind of magazines these were.
‘Control, that’s what turns you on, isn’t it? You controlled everything, everyone around you – but now that’s gone. You’ll never have control again. You can feel it, can’t you?’ In the background, the tone of the oxymeter was in freefall, as the blood supply to his body dropped. ‘Every second, brain cells dying. Every second, your future fades. Will you ever control your limbs again? Stand? Feed yourself? Control your bowels? I don’t think so, Michael.’
She fed him some breaths. Literally, a handful as she squeezed the bag. One, two, three. His heart rate 160. His oxygen at 44 per cent. And for the next ten minutes, she continued, holding the oxygen levels just high enough to sustain life, but low enough to damage the brain.
‘Oh,’ she said, finally, ‘I almost forgot one thing.’
The laces were easy, and the shoes and socks quickly slipped off. The trousers and underwear, already round his ankles, were next. She had the black lacy knickers bundled up in the pocket of the overcoat. It was a bit of a struggle with a man of Trenchard’s size but, with some effort, she hoisted them up. Saturation: 34 per cent. Then, with the same breezy motion, she produced her pièce de résistance: the rope. It had already been tied in a neat hangman’s knot. She fed it over his lolling head, pleased with the rough abrasions it produced when she tightened it around his neck. For now, the blood could no longer return from his head to his heart. The pressure in his veins rose. The heart rate hit 190, and then fell dramatically as his face became engorged. Small blood vessels popped in his eyes. Little red dots appeared. Petechiae. She loosened the noose just a little.
She was arranging him into the best possible position when, out of the corner of her eye, she saw a flutter in his chest. At last, he was breathing of his own accord. As the oxygen levels rose in his blood, she lifted the mask from his face. The pattern of his breath wasn’t good. Sometimes it stopped, only to start up again. Cheyne Stokes ventilation. It was only to be expected. Even his brainstem – the most primitive part of the brain – was struggling to survive. She hoped she’d not overdone it, that he would still know, still be, well – in there somehow. Enough to suffer properly.
A final syringe would help keep him going, at least until the doctors got there. Four milligrams of dexamethasone, a powerful steroid. Perhaps it would stop the brain swelling too much too soon.
She surveyed the scene. The monitor was safely stashed away, as was the gauze soaked in glyceryl trinitrate and the anaesthetic halothane was sealed up. In its place, she’d left a similar bag of gauze and just the glyceryl trinitrate. His hands were cupped inside the black lacy panties he now wore. She knelt and gave him one last shot – a tiny dose of morphine, enough to constrict his pupils further. She squirted the rest on the carpet and threw the ampoule to one side.
She stood back to survey the scene. Before her, a naked man in women’s underwear, surrounded by pornography. A bag of GTN-soaked gauze. A noose around his neck where he had been strangling himself for sexual pleasure. The knot jammed. A failed slipknot. Facial petechiae confirming he’d overdone it. A needle in his hand where he had been giving himself morphine. Too much morphine. The ampoule left lying at his side would confirm the dose. Too tight a noose. Too little oxygen to the brain.
How disgusting.
How pathetic.
How sad.
There had been two things that Michael Trenchard lived for: his reputation, and his ability to control those around him. In a matter of minutes, both were gone. Goodbye reputation – and farewell control.
Holst was still booming through the speakers. Leaving the scene of tragedy behind her, she lifted the needle from the record and picked up the telephone at its side.
*
In another basement, a line lit up on the hospital switchboard. ‘Crash desk?’
There was no voice on the other end of the phone, only loud music.
‘Crash desk?’ she repeated.
And still there was no answer. Momentarily stunned, she looked at the extension number flashing in red lights on the switchboard; 232 was Mr Trenchard’s office – but surely that had to be an error?
Lives had been lost on hesitations like this. She spun in her office chair, punched a code into the console and spoke: ‘Cardiac arrest. Mr Trenchard’s office, outpatients department. Cardiac arrest. Mr Trenchard’s office, outpatients department. Cardiac arrest. Mr Trenchard’s office, outpatients department.’
26
Kash was surprised by the coroner’s court. He had expected to find some cinematic courtroom, all gavels and gowns, wigs and witness boxes, mahogany, mellow lighting and ‘m’lud’, but in truth the building was more like a parochial town hall. Plastic chairs had been arranged in neat rows in front of a small oblong table. To its right, only eight feet away from where Kash and Ange took their seats, sat an elderly form mistress of a woman, straight-backed and immobile above the shoulders. As the courtroom prepared, she set about organizing her papers and pens and some form of typewriter, by the look of it. Kash and Ange exchanged glances but said nothing to each other as they waited.
Anna Chaloner, Edmund’s mother, sat in the front row in a plain grey suit, her hair pinned back sternly, face immobile. There was a dignified beauty to her. And it was only now that he got to wondering what she was thinking, how hard it must be to even manage routine daily rituals, let alone come here to face an inquest with no one to support her.
At precisely nine o’clock, the coroner entered. Taking his place behind the small desk, he positioned a large lever-arch file in front of him. Dressed in a slighty shabby dark blue suit, his headmasterly look perfectly matched that of the form-teacher clerk who sat nearby. When he spoke, his voice was deep and sonorous – and he only had to raise it very slightly to silence the room.
Anna Chaloner was visibly nervous now. Through the other bodies, Kash could see her fingering a small gold locket that hung around her neck, rubbing it between her fingers. Perhaps it contained a picture of her boy, or a lock of hair from when he had been a baby. Kash tried not to think about it.
The coroner opened his file and started to read.
‘Case 45-417. The inquest into the death of Edmund Chaloner, aged fourteen. It is to be noted that Mr Chaloner died at the Victory Hospital, having undergone emergency surgery. It is further noted that the testimony of Professor Whitely, the pathologist acting for the Home Office in this matter, is not disputed. Post-mortem serological examination confirms that the patient was infected with the Epstein Barr Virus.’
He looked up from his notes and scanned the court room. Epstein Barr was one of the most common viruses a person could contract; almost 90 per cent of all adults would show signs of prior infection if they were to be tested. Most never knew they were ill. For some, infection seemed nothing more than a common cold. Others developed debilitating glandular fever, and perhaps chronic fatigue. But in rare cases, it could prove fatal.
‘Edmund Chaloner suffered a rare, but recognized, complication of this illness,’ the coroner went on, ‘that of spontaneous splenic rupture. It is further accepted that such a complication carries a high attendant risk, and a significant associated mortality. None of these facts are in dispute.’
Then what are we here for? Kash wondered. This would be a simple cut and dried case. He relaxed, and glanced at Ange. Then his pulse quickened once more. There was a dead set to her eyes. She stared forward, intently. This was the look of anticipation. She was waiting for something to happen.
‘It is an uncontested matter of record that, under normal circumstances, such a death might not be subject to a formal inquest such as this . . .’
Kash tensed. ‘Ange,’ he whispered, ‘something isn’t right here, something . . .’
Some heads were turning towards them. ‘Be quiet, Kash.’
‘In addition,’ the coroner went on, his voice rising fractionally again, ‘I am mindful of the fact that proceedings such as these may cause distress to the child’s mother.’ He looked to his left. ‘You have my apologies. We shall do everything in our power to ensure that today’s events cause as little such distress as possible. No, today’s inquest is held in response to information received from one of those involved in the care of the deceased.’
Now Kash understood. He turned to Ange once more, but she would not look at him.
‘For those of you unacquainted with such matters, the individual who signs a death certificate must be confident the death was not due to violence, privation, or neglect. In this instance, the certifying doctor could not provide such assurance. Under such circumstance, it is a matter of legal process that a post-mortem examination and inquest be held. To make such responses is to choose the more difficult path – a choice for which the certifying doctor should be commended. However’ – and here the coroner looked up, scanning the crowd until he found Angela sitting there, her knee trembling instinctively – ‘I would appreciate more factual, and less theatrical, referrals in future.’
The coroner coughed and returned, momentarily, to his notes. In the fleeting silence, Kash hissed, ‘What did you do, Ange?’
‘Later, Kash.’
‘Not later, Ange. You’re the one who brought this on? You could have completed that certificate yourself . . .’
1a – Direct cause of death: splenic rupture. 1b – Factors which led to that: glandular fever. 2 – Other factors contributing to but not directly causing death: none. The coroner would have accepted that, surely. And yet something Ange had done had dragged this to court. Whatever she had done, it had also dragged Anna Chaloner into this room, to live again the moments of her only son’s death . . .
‘You reported him missing, didn’t you? Missing in action . . .’
At the front of the room, the coroner was speaking again. Ange replied in a strident whisper, ‘Somebody had to.’
‘Those called to give evidence will be sworn to tell the truth in its entirety. Any perceived lack of gravitas associated with this environment,’ he waved a hand around the room, ‘should in no measure be taken to infer any laxity of process. Witnesses will give evidence under oath. As in any court, the full weight of the law may descend upon any who might choose to tell incomplete truths.
‘This case may involve discussion of the appropriateness of behaviour of the staff involved. In particular, the role of a Mr Michael Trenchard will be the subject of scrutiny. Few of us here can be unaware of the recent reports of Mr Trenchard’s illness. However, I must point out that Mr Trenchard is not on trial here. Indeed, the purpose of a coroner’s court is not to establish guilt or culpability, but merely the facts. Neither should any reports which one might have read in the papers be in any way considered pertinent to this case. The propriety of Mr Trenchard in the management of this patient must be viewed in isolation.’ The coroner paused, seemingly for effect. ‘All this said, let us begin.’
*
Anna Chaloner was the first to take the stand. She walked to the coroner’s side with what seemed to Kash great effort, holding her head up high. As she sat down, and before she read her oath from a small laminated card, the coroner offered his further condolences. Kash thought it seemed like an empty gesture, considering what was to come.
‘Mrs Chaloner,’ the coroner began. ‘Might we start by explaining, to the court, a little about the evening in question.’
‘Edmund was my only . . .’ She was about to say ‘child’ but changed tack suddenly and said ‘son’ instead. Her voice had an edge of steel to it, flinty, without a tremor. To Anna Chaloner, this was a reckoning, the final chance to speak about her son before returning to the terrible privacy of grief. ‘I had a daughter once, but I was young – a young fool, you might say. So when Edmund came around, I knew I had to cling on to him with everything I had. Even when his father left us, I knew it would be OK, because that was how much I loved Edmund.
‘But when he got sick . . . I’d done some training to be a nurse myself, and I just knew something wasn’t right. He’d been off school, which wasn’t normal, not for Edmund. Our doctor thought it was flu, so when it got worse, I just did as he’d said and gave Edmund paracetamol. It wasn’t until he got the abdominal pains, though, that I took him in. He looked grey. He was sweating, icy cold. So I got him in the car and rushed him here as fast as I could . . .’
Anna described the emergency department, how a very nice doctor called Marcus had been with them at once. Marcus, she said, had examined her son with speed and compassion, taken blood samples, put up a drip and immediately called another doctor.
‘Is that other doctor in the room?’ the coroner asked.
Anna Chaloner lifted a finger. ‘She’s there. Dr Warner. Dr Angela Warner.’
‘What happened next, Mrs Chaloner?’
Angela seemed to have come straight away. She’d brought with her the other doctor, Kash Devan, and after another quick examination, they’d announced that they needed to operate at once.
‘Did Dr Warner offer a diagnosis?’
‘No,’ Anna replied, ‘but you could see in her face it was serious. I signed the form without hesitating. But that was the last I saw of Edmund . . . alive . . . as they wheeled him away towards the theatre. I gave him a kiss. You know. “See you soon.” The next time I saw him . . . Well, it wasn’t him. Just his body.’
It was the first time Anna Chaloner had betrayed her devastation. She paused to smear the tears on each cheek. Only when she was finished did the coroner, respecting the moment, resume.
‘And Mrs Chaloner, can you tell me – do you have any concerns?’
‘Plenty,’ Anna replied. ‘How to cook for one. What to do on a Saturday afternoon now that I’m not taking Edmund down to his football. But about his operation? No, none at all.’
‘And you had heard that Dr Warner operated alone?’
‘I had.’
‘That Mr Trenchard had not been in attendance in his capacity as senior surgical opinion?’
Anna Chaloner nodded.
‘And were you aware of the difficulties Dr Warner and Dr Devan had in contacting Mr Trenchard that night?’
‘Not at the time, but . . .’
Kash tensed. Surely, she had. He’d been standing only yards from her when he’d been making the calls. He felt Ange, at his side, likewise freeze.
‘ . . . I’m quite certain everything that could have been done was done. Mr Trenchard wasn’t there, but Dr Warner did everything she could. I want . . . I want to put this to bed, you see. Nothing is bringing my Edmund back, nothing at all. They tried to save my son but it was too late to save him and . . .’ She looked around, found Ange in the sea of faces. ‘I want you to know: it was nobody’s fault.’
It was a beautiful balm, a simple homeopathy of few words but great power to soothe Angela. But there was something else in them, something that Kash found hard to fathom. This was too calm, too measured, too . . . understanding. A beloved fourteen-year-old boy snatched from the world, a man to blame being offered up on a platter – and she’d turned it down.
‘Ange, they’re calling you.’ Kash nudged her firmly.
At his side, Ange was lost in a reverie of her own.
‘Ange, it’s your turn on the stand.’
She looked at him abruptly, as if only now coming to her senses. She straightened herself, stood, and strode to the front of the room.
After she had taken her own oath, Ange began to recount that night in the Victory. There was no drama to it, none of the flourishes of a storyteller with a point to prove, but a scalpel wielded by an expert surgeon: pure, cold, surgical steel. Never make an unnecessary cut. Only cut when you can see your target . . .
‘The spleen had ruptured by the time we got in there. With the first incision, it was evident. We tried to staunch the bleeding but Edmund died there, on the operating table, and didn’t respond to resuscitative measures.’
‘I want to come back to the start of the events in hand. You tried reaching Mr Trenchard, but he was not to be found?’
‘I had tried, and I had failed. I then instructed my colleague, Dr Kash Devan, to continue those efforts.’
‘Yes, I have his statement here. We may yet hear his testimony separately, but perhaps recount for us . . .’
‘Mr Trenchard did not respond to his pager. We were confident he was not in the Victory – we’d called his office and he wasn’t in the operating theatres. Kash tried to locate him at St Philippa’s.’
‘St Philippa’s?’
‘The local private hospital, sir. He wasn’t there. But it turns out he had been: earning money when on call for the NHS. But now he had gone. Nor was he at home, where he might otherwise be expected to be. In fact—’
