Donor (7 page)

‘Are you going to have time for something to eat before you start work?’ asked Kate.

‘’Fraid not,’ he replied. ‘I’ll just drop you at home and then get on up there. I’ll have something later when I get home.’

‘I’m sure Charlie won’t mind if you’re half an hour late,’ said Kate.

‘Normally no,’ agreed Sandy. ‘But it’s one of his kids’ birthday today. I said I’d be on time.’

Sandy dropped Kate at the foot of the hill leading up to their cottage, at her suggestion, and drove on up to the district hospital. He was only five minutes late.

FOUR

It was Sunday evening. Steven Dunbar took the airport bus from Glasgow Airport into the centre of the city. Outside it was dark and it was raining. That and the general gloominess of the dark Victorian buildings – made to seem even blacker by the rain water – did nothing to inspire good feelings in him. He was due to begin his attachment to the Médic Ecosse Hospital on the following morning.

It was something he certainly wouldn’t have bet on when he’d heard the Scottish Office contingent refuse to modify in any way their demand for swingeing cuts to James Ross’s research budget. Their intransigence had come as a complete surprise to almost everyone at the meeting. In retrospect it had been embarrassing that the Scottish Office had not seen fit even to make a token gesture in the interests of making the negotiations seem genuine. The feelings and work of an eminent surgeon had been of no importance at all.

Dunbar had fully expected Ross to tender his resignation and, in doing so, set off a train of events that would have led to the closure of the hospital and a backfire of the whole gamble, but it hadn’t happened that way. Instead, and to everyone’s surprise, Ross had acceded to the Scottish Office demands, taking it philosophically and saying simply that he understood the awkwardness of their position and the financial constraints they were operating under.

Dunbar supposed that some kind of behind-the-scenes deal between Ross and the Médic International group must have been done to retain Ross’s services and to avoid closure of the hospital, but there had been no official acknowledgement of this or of continuing research funding for Ross from an alternative source. Ross had simply stated that, as a doctor, he felt obliged to carry on with his work at Médic Ecosse. He had a waiting list of patients he felt responsible for and couldn’t let them down. It would be business as usual as far as the transplant unit was concerned.

It was clear that the Scottish Office people had pulled off a major triumph in the re-negotiation of terms of their involvement at Médic Ecosse. The look of surprise and relief on Bannon’s face when Ross had swallowed his pride and acceded to what he must have thought were impossible demands was only fleeting but Dunbar had seen it. Now it wouldn’t be known if he had ever intended to back off at the last moment. The injection of more public funds into the hospital would now be offset by the much more favourable terms of the agreement and by greater public access to the Médic Ecosse facilities. Even the Labour opposition at the meeting had been forced to concede that it was a good deal.

As part of the agreement there was, of course, his own secondment to Médic Ecosse as the government’s man on the ground, the overseer of public funds. His masters’ subterfuge had worked well. He was now in place to begin his investigation.

Sci-Med’s involvement had been precipitated by a complaint from a staff nurse who no longer worked at the hospital. She had maintained that there had been something improper about the treatment a transplant patient had received at Médic Ecosse some five months before. The young patient, Amy Teasdale, had died after rejecting the kidney she had been given during what was thought to be, at the time, a routine transplant operation. The staff nurse, one Lisa Fairfax, maintained that there had been a serious mix-up resulting in her patient being given the wrong organ. She was unable to be more specific, stating only that the sub sequent rejection had been so severe that no other explanation would suffice. In other circumstances her claims would almost certainly have been dealt with at local level but what had caught Sci-Med’s attention was the fact that a similar complaint had been lodged only months after the hospital opened, almost three years before and again by one of their nursing staff.

That time Sister Sheila Barnes had said much the same thing after a young boy in the transplant unit rejected the kidney he had been given. She had subsequently resigned in protest at what she saw as being ignored by the authorities, who had interviewed her but refused to take her claims seriously or to mount an internal investigation. She had maintained at the time that the authorities were keen to dismiss her complaint because they feared the bad publicity would damage the new hospital. Sister Barnes had never retracted her claim. She had intended to press for further investigation, but shortly afterwards had contracted cancer and had had to abandon her campaign. She was now in the terminal stages of her disease, a resident at The Beeches, a hospice for the terminally ill down at Helensburgh on the Clyde coast. She and her allegations had been largely forgotten until Staff Nurse Fairfax made her own complaint and Sci-Med’s computer had drawn attention to the similarity as part of its collating programme.

All reports of allegations of wrongdoing in British hospitals were recorded, filed and collated on the Sci-Med computer, however trivial they might seem. Most of them were indeed trivial, usually disgruntled patients making unfounded accusations, or staff with grudges against their employers making equally spurious allegations. But occasionally the computer picked up something that might otherwise have been overlooked. This time it had noted the remarkable similarity between the two nurses’ allegations. Both women maintained that their patients had rejected their transplant because they had been given the wrong organ. Now one of these women was currently dying of cancer and the other, Staff Nurse Fairfax, had been dismissed from her post.

Dunbar checked into his hotel near the city centre and found it pleasantly anonymous. It was also warm, which was a bonus because he was feeling chilled. Scotland always seemed to be three or four degrees colder than the south of England, where he lived. He had noticed this again as soon as he had stepped off the plane. The raw dampness of early March made things worse. He threw his briefcase on to the bed and walked over to the window to look down at the traffic moving slowly below in the wet city streets, their lights reflecting in the puddles that were proliferating as the storm drains struggled to cope.

After a few minutes he closed the blind and turned away. He picked up the phone, called room service and asked for a large gin and tonic, some chicken sandwiches and a pot of strong black coffee. After that he would have a warm bath before getting down to reading through his notes and deciding on a plan of action.

As he lay in the bath with the water lapping just below his chin, Dunbar closed his eyes and wondered about James Ross’s decision to stay on at Médic Ecosse. Ross was by all accounts a popular man, a brilliant surgeon and a highly regarded researcher in his field. But, although clearly dedicated to his patients and well liked by his colleagues, he was still a human being and therefore subject to the laws of human nature. Dunbar set great store by these laws and recognized them as the driving force behind almost everything that happened in society. Very often he had to pick away at various levels of veneer applied by clever, self-seeking people in positions of power but always, underneath, the same rules applied, whether it was on the factory floor or in the boardroom, the operating theatre or the accounts department.

Ross was a proud man – he had every reason to be. He was also a surgeon with the typical extrovert tendencies of the profession. Timidity and surgery did not go hand in hand. Self-doubt had no place in the operating theatre. According to Dunbar’s rules, it didn’t befit such a character to lose face in public as Ross had done. The humiliation of having such savage cuts applied to his research funding with not the slightest suggestion of compromise should have pushed him into a dignified resignation, but it hadn’t.

Of course, it might have been the thought of his colleagues losing their jobs if the hospital closed that had weighed so heavily on him. Being single-handedly responsible for the closure of a hospital would be a heavy burden for anyone to bear. The man, of course, might also be a saint and therefore outside Dunbar’s rules.

He supposed it would be easy enough for him to check on alternative sources of research funding once he had access to the accounts at Médic Ecosse, and he would like to know if a deal had been struck behind the scenes with Médic International; but that still wouldn’t answer his question about why Ross had acted out of character. That was the more important thing.

Having been thinking about Ross, Dunbar decided to go through his notes on the surgeon as soon as he was out of the bath. He didn’t intend going out again or even downstairs in the hotel, so he just pulled on a sweater and jeans and didn’t bother with socks or shoes. He sat cross-legged on the bed with his papers spread out in front of him, the bedside lamp angled to provide light.

James Ross’s career to date had been nothing short of outstanding, with prizes and awards punctuating his progress from medical school in London through appointments at a succession of top hospitals both in the UK and the United States. Early on in his studies Ross had been transferred to a leading medical school in New York, where he had been admitted to a programme that had enabled him to do a PhD at the same time as his medical degree. His research for his doctorate had been in immunology. This explained his intense interest in transplant research, thought Dunbar, and his high standing in the scientific community as well as the medical world.

Many doctors played at being researchers, but the days of significant discoveries being made by candlelight in the ward side room had long since gone. Those times had largely disappeared with frock coats and brass, monocular microscopes. To succeed in the extremely demanding and competitive world of medical research in the late twentieth century, you had to be a trained researcher to start with, with all the background knowledge that that entailed. Ross was just such a person. The fact that he had obtained both a PhD and a medical degree concurrently suggested that he was exceptionally gifted intellectually.

He could, of course, still be a lousy administrator, thought Dunbar. There were lots of intellectually gifted people who ended up in charge of university departments when they didn’t have the managerial capacity to run a pie stall. If Ross was an ivory-tower researcher, it was conceivable that the running of his unit might suffer but, again by all accounts, this was not true. The transplant unit at Médic Ecosse was regarded as one of the most successful in the country and Ross was no absent-minded professor. He was very much a hands-on leader, not at all the sort of man to preside over a unit where a patient could mistakenly be given the wrong organ.

There was some information on Ross’s personal life in the file. He had been married to an American woman, a radiologist he had met while working in Boston, but things hadn’t worked out and they had divorced four years ago after three years of marriage. There were no children. His ex-wife had returned to the States, where she had since remarried. Ross lived alone in Glasgow in the penthouse flat of a modern block of flats in Kelvingrove, although he made frequent working trips to Geneva as a clinical consultant.

In the year to April last, Ross had earned £87,000. He drove a two-year-old ‘5’ series BMW and was a member of two clubs. He held an honorary senior lectureship at the University of Glasgow on account of an agreement to deliver a series of four lectures a year on immunology.

Attached to the file were reprints of four of his most recent research publications. One dealt with something called ‘Immuno-preparation’; the other three were on the possible use of alternative species as donors of organs for human transplant. Dunbar put them aside to read when he had more time. They’d probably demand a deal of concentration. Immunology and transplant surgery were a far cry from his own area of medical expertise, which was field medicine.

* * *

The only son of a Cumbrian schoolmaster and his music teacher wife, Steven Dunbar had grown up in the Lake District, in the small village of Glenridding on the shores of Ullswater. He’d studied medicine before completing two residencies, one in Leeds in general surgery and the other in Newcastle in Accident and Emergency. It was around this time that he’d started to question his motives for entering medicine and begun to consider other options. He felt as if he’d been on a treadmill since leaving school. Teachers and parents had been delighted at his success in gaining entry to medical school and he’d been swept along in the approval and pleasure of others. None of them, including himself, he had to admit, had ever considered if he really wanted to be a doctor. It wasn’t until a friend suggested he think about the army that his future had taken shape.

He opted for the rigours of life in the Parachute Regiment and had been extensively trained, first as a soldier and then in field medicine. The next few years brought all the physical challenges he could have ever dreamed of as he served with units of the regiment and occasionally on secondment to Special Forces. It was, though, a lifestyle that couldn’t continue indefinitely, and when the time came for him to stop he knew and accepted it. The big question had been what to do next.

The army ran courses for officers returning to civilian life but Dunbar wasn’t included. He was a doctor; it was assumed he’d be returning to medicine in civvy street. Luckily, he had confided in a fellow officer that he had no wish to continue in medicine, for a while at least. This had led to a suggestion through a friend of a friend that he might be suitable for a job with the Sci-Med Inspectorate. Now, after four years with Sci-Med he felt settled and content.