The Watchful Eye (13 page)

‘But, you understand, the features of Reye’s Syndrome are quite distinctive.’

Why didn’t he just get on with it?

‘However…’

Daniel fingered his pen impatiently. He was finding his colleague’s tone intensely irritating.

‘…I found none of the usual findings consistent with Reye’s Syndrome, the pâté de foie gras liver, an oedematous brain and so on. Therefore I would have been unhappy to have made this connection without firmer pathological evidence.’

Another pause.

‘The police removed some of the bedding of the child. She slept without a pillow, which is common practice these days. Amongst other items found in the child’s bedroom they also removed a small, embroidered cushion from a chair. This was found to have traces of the child’s saliva on it. I further removed two tiny fibres from one of the child’s nostrils that looked superficially the same as the fibres on the cushion. Of course we will have to wait for microscopic comparison analysis.’

In spite of the gravity of the situation Daniel could not resist a smile. Pathologists are the perfect, indistinguishable mix of lawyer and doctor. A scientific policeman.

‘I have discussed this matter with the police and we are of the opinion that there is a very real possibility that the child was smothered using this cushion, and the finger inevitably points towards the mother. The mother is the usual perpetrator of such an assault. Was there any history of illness or pseudo-illness induced by the mother?’

Daniel felt ice seep up from his feet, slowly permeating through his body as though he had been drinking a glass of hemlock. Something – life – happiness – trust – or a belief that he had a future as a doctor – was draining out of him. If this turned out to be infanticide, he would feel morally responsible but that was preferable to them finding something physical that he had missed through incompetence.

He was honest enough to admit that his feeling of guilt was because he had had his suspicions but hadn’t acted on them. He’d sat back and done nothing. Waited for some proof or indisputable evidence. Now he had it and he was indirectly responsible for the child’s death. He’d never involved the Social Services, even though he had been suspicious that all was not well between Vanda and her silent little daughter whose tongue had merely reddened her chin and cheeks without uttering a single word. He should have protected the child. It was part of his job. His duty. Instead he’d waited and now it was too late.

He’d failed her. ‘There was a history of repeated illnesses,’ he replied lamely. ‘She’d been admitted to hospital on numerous occasions but nothing concrete was ever found.’

The pathologist hesitated before continuing smoothly. ‘We-ell, you obviously know the family better than I. So I wondered what your opinion is of this theory. Of course it’s possible that little Anna-Louise slobbered over the cushion on some other occasion, bu-ut the presence of the particles in her nostrils appears quite damning. Can you answer me these questions: Is Miss Struel capable of smothering her own child? Had you any prior suspicion that all was not well between Vanda Struel and her daughter? Is there anyone else in the picture who might have been involved? The police told me the
child’s uncle was resident with them and was in the house when Anna-Louise died. Have the Social Services ever been involved with the family? Have you had suspicions on other occasions of non-accidental injury? We took the precaution,’ he added quickly, ‘of X-raying her entire body and failed to find any old fractures, which tends not to support my theory. Also there were none of the other signs of traumatic smothering – bruising inside the mouth, etc. The lungs were congested but there are other causes of that and I cannot give a cause of death with any certainty on that sign alone.’

Daniel couldn’t remember what exactly he muttered in response. The questions he could answer honestly he did: that the Social Services had not been involved in the case; that he had toyed with the idea that Vanda might have been capable of causing her own child’s illnesses; that there was a question mark over whether mother and daughter had truly bonded but that he had never sensed any ill feeling on Vanda’s part towards Anna-Louise – rather an indifference; that Vanda lives with her brother, who is an aggressive drunk who pumps up his body with exercise and anabolic steroids which are well known to shorten the fuse of their takers. ‘But I’ve only ever seen him display a certain…’ His mind drifted to the image of the tiny child propped up on the sofa, her cardigan wrongly and clumsily buttoned, ‘tenderness towards her.’

He ignored the pathologist’s snort of doubt. But he hadn’t seen the two together, the town thug and the tiny, vulnerable two-year-old. He had.

Other questions he could not answer. Was Vanda capable of harming her own child deliberately?

He didn’t know. How can a family doctor make this
judgement when all their training is to trust what their patient tells them?

He needed time to think before he started making rash statements. He fobbed the pathologist off with something about needing to search through his records, tagging on the fable that he would ring him back later.

Anything to get him off the hook and give him time to stew through his thoughts.

But his bad luck was far from over.

Ill winds were gusting around him.

On Friday, as his mind was busily planning the menu for the following night, Christine, the receptionist, met him in the corridor. ‘The coroner wants you to ring him after surgery,’ she said.

It rang no alarm bells. He assumed it would be a further enquiry about Anna-Louise.

There is nothing unusual about a telephone conversation with the coroner in general practice. Any unexplained death is referred to him. As it is often the GP who has vital information about the patient he is frequently the first port of call so the lines are open between the coroner’s office and the doctor’s surgery.

When he had seen his morning’s patients Daniel dialled the number.

Tom, the coroner’s assistant, answered. ‘Oh yes, Doctor Gregory,’ he said. ‘It’s about an old lady, Mrs…’ Daniel heard him shuffle through some papers.

‘Allen.’

Daniel felt initially puzzled, then, as Tom proceeded in his slow Staffordshire voice, he began to feel upset. ‘What? I
only saw her yesterday. She looked well. I hadn’t expected…’ His voice trailed away as his foreboding increased. ‘What happened?’ he asked sharply.

‘It looks very much like an overdose of some medication, Doctor. Tablets were found at the side of her bed. You’d prescribed some tranquillisers?’

Daniel felt a snag of concern. ‘She was naturally anxious and was having trouble sleeping,’ he said defensively. ‘But she was too lucid a woman to take the wrong dose of tablets.’

‘Well…’ Tom paused. ‘There was a note. The relatives say she’d been a bit distracted. Apparently she’d recently been diagnosed with cancer.’

‘We-ell.’ Daniel was finding it difficult to know what to say. ‘Not exactly. I’d had my suspicions and I’d referred her for an opinion but I hadn’t had the results back yet from the hospital so the diagnosis hadn’t been confirmed.’ He felt bound to add something more. ‘But she was an intelligent woman. I think she knew she had cancer and probably realised that I suspected it had spread.’

‘Right.’ Tom’s voice leaked no emotion. ‘Well, I shall relay this to the coroner and in all probability he will request a post-mortem and some toxicology reports. That’s all then, Doctor Gregory – for now.’

Daniel put the phone down with a growing feeling that something here was not quite right. In his mind he revised his physical findings, together with the initial prescription. Then he sat down at his desk. She had asked for the sleeping tablets, he realised now, not because she was having trouble sleeping but because she intended to take her own life. He recalled their final encounter, outside the supermarket, her vote of confidence in him.

He put his head in his hands and remembered her interest in Holly. He felt a stab of grief for the passing of yet another from that brave, resourceful and inherently decent generation. Even the way she had elected to take her own life rather than allow the cancer to destroy her inch by inch, little by little, reflected her character, her dignity. She had known how cruel this disease could be.

What he did not yet understand was how this would affect him.

The weekend with Holly did something to allay his anxiety. He heard nothing from Claudine and as though Holly sensed that something was not quite right she didn’t even mention her new friend. But his problems were only beginning.

Monday morning brought further trouble.

The day began badly with a telephone call from the pathologist who had performed the post-mortem on Maud Allen. Dr Gray was back.

Such specialists frequently adopted a condescending manner towards their colleagues in general practice and Doctor Michael Gray was no exception. Although he’d known Daniel for a number of years he cut straight to the chase without preamble.

‘I understand that you had made a diagnosis of breast cancer which had metastasized to the lymph gland and the spine.’

The back of Daniel’s neck felt suddenly hot. ‘No I hadn’t,’ he said defensively. ‘Not exactly. I’d examined her and found a
breast lump which I felt to be suspicious. She was complaining of backache and I also found an enlarged lymph node in her neck. I’d done some blood tests and referred her to the rapid-access breast lump clinic. That was what I’d done.’ He was tempted to add,
Have you got a problem with that?
but knew there was no point in antagonising his colleague.

Michael Gray cleared his throat noisily and Daniel just knew he was building up to something. ‘Well – for a start I did find a
cystic
lump in her breast,’ he began slowly. ‘It was quite large, about the size of a golf ball. I’ve taken a section and sent it for histology but I’d bet my bottom dollar that it wasn’t malignant. It looked perfectly innocent to me.’ His tone was smug.

It took the wind out of Daniel’s sails. He felt his face contort into a hostile scowl.

‘Well, of course,’ he finally spluttered, ‘you had the advantage on me. You actually
saw
the wretched thing.’ He thought how peevish and petty he sounded. ‘
I
didn’t.’

The pathologist took absolutely no notice but ploughed on – with increasing malice. ‘I also understand from the relatives that you suspected that the lump in her neck was a secondary deposit from this primary.’ It was a statement not a question.

‘It was a natural assumption.’ Daniel winced at the resentful tone in his own voice.

‘Oh.’ The pathologist pulled out his trump card. ‘Well – it looked like an old fractured clavicle to me. The relatives tell me that Mrs Allen fell off her horse when she was about fourteen. She broke her clavicle and it was badly set. She’d had a lump there for years.’

‘When I touched it,’ Daniel said, ‘she didn’t say anything.’

He could already guess where this was heading.

‘But of course Mrs Allen didn’t die of misdiagnosed cancer, did she?’

‘Come on.’ Daniel felt bound to defend himself. ‘I couldn’t possibly have anticipated that she would commit suicide on the back of my findings. I made my examination and acted on it. I referred her. I was doing my duty as her GP to give her the best possible chance of life. When she said she couldn’t sleep I naturally prescribed what I thought was appropriate treatment for her.’

‘It’s very unfortunate that you prescribed opiates
and
sleeping pills after planting the seed in her mind that she was terminally ill.’

There was not a trace of sympathy in the pathologist’s voice.

So Daniel had enough to worry about to make him forget about the threats from Arnie.

It was Sammy Schultz who collared him on the following afternoon, looking uneasy and serious. For no reason at all Daniel’s heart did a little flip.

‘Sammy?’ he said.

His partner was holding a piece of paper in his hand, held at arm’s length as though he wanted no part of it.

‘Umm, can we go into my room?’

Daniel felt the same way as when he had thrown a snowball at a school window and the headmaster had found out who it was and summoned him to his office for a caning. Meekly, he followed his partner into his consulting room and felt a further snatch of alarm when Sammy Schultz closed the door very deliberately behind them.

‘I don’t know how to say this, Dan,’ he said.

Daniel gave a humourless laugh. ‘Spit it out, Sammy,’ he suggested. ‘That’s the best way.’

Sammy sucked in a deep breath. ‘Why don’t you sit down?’

Daniel sat.

‘We’ve had a complaint.’

Daniel frowned. ‘What sort of complaint?’

Sammy Schultz was practically wringing his hairy hands. ‘Oh, Dan,’ he said. ‘I don’t believe a word of it. Not a goddam word.’

‘What sort of complaint?’ Daniel repeated quietly.

‘The very worst sort.’

Daniel waited silently for the axe to fall.

Sammy couldn’t even look at him. ‘Sexual harassment,’ he muttered. ‘Inappropriate examination. Intimate fondling.’

‘What?’ He was so shocked it was all he could do to stop himself from grabbing the letter out of Sammy’s hand.

He didn’t need to. Sammy handed it to him, a look of intense sadness – almost grief in his manner.

‘I know things have been difficult since Elaine left.’

Daniel was horrified. ‘What are you saying?’

He scanned the piece of paper twice. It was badly written, in childish writing with numerous spelling mistakes but there was no mistaking the accusation.

‘I toeld the doctor I ad a pain in my tummey. E got me to liey down in a littel cubikcle with nuthing on and he tuched me up. All over. He’s a perv and I don’t want him for my doctor no more.’

It was signed
Chelsea Emmanuel
(
Miss
).

Sammy’s eyes were on him, waiting for an explanation.

‘I take it you have examined the young lady in question recently?’

Daniel nodded.

‘Surely you had a chaperone?’

‘She refused one. She said she didn’t like the practice nurses so I asked Marie to wait outside the door. By the time I got into the examination room Chelsea was starkers.’

Sammy looked resigned. ‘You should have insisted, Dan. The girl is only fourteen years old.’

It was on the tip of Daniel’s tongue to point out that Chelsea was no innocent. She was a sexually precocious tart. But that wouldn’t help his cause so he listened meekly to his partner.

‘This may cost you dearly, Dan. And it’s terribly bad for the practice – particularly on top of the little Struel girl’s death. In a small town like Eccleston it doesn’t do to gather such publicity. I take it we’re still waiting for the verdict on that.’

Daniel nodded.
And they didn’t even know the full facts that surrounded Maud Allen’s suicide
.

He felt very alone and very afraid. It was hard to disentangle these events. He stood up, his resignation on the tip of his tongue but Sammy Schultz slapped his shoulder in a sudden display of bonhomie. ‘Weather the storm,’ he said, ‘but I advise you to contact the Medical Defence Union.’

The Medical Defence Union were helpful – sympathetic even – but he couldn’t mistake the underlying seriousness of their tone.

‘Well, Doctor,’ they said, ‘this is unfortunate,’ before they advised him to write down his recollection of the entire consultation, exact times, words said, precise examination details. They asked him to fax his computer records through and his personal details. He heard a distinct and regretful ‘Hmm’ when he said he was divorced.

He spent an hour gathering information on the consultation from the computer and composing his fax to the MDU and left the surgery with a burning feeling of indignation. He didn’t need anyone to tell him how potentially serious this could be. No matter that
he
knew he was innocent. It wouldn’t make any difference to anyone else – not the townsfolk, his patients. The allegation was enough.

He felt dejected, defeated and helpless, paralysed because there was no way to fight back. He felt a sudden fury against her. It struck him then that he had lost his one ally – Maud Allen – who had believed in him. She had abandoned him when he could have done with her.

As he walked along the High Street he felt paranoid. He felt people were watching him because he realised that if Sammy Schultz had his doubts, then how much more so would all these other people who knew him only slightly – as a doctor – and not as a man?

His partner should trust him. Surely? Sammy knew him better than his patients did. He’d known Elaine and Holly. Their families had once mingled. And he thought him capable of deriving sexual satisfaction from touching up that grubby little…?

He walked on, meeting no one’s eyes. He knew now what it was like to walk down the High Street, feeling conspicuous because all eyes were on him.

As he stepped down the street the words of the Medical Defence Union rep rang in his ears: ‘
No chaperone, Doctor? Her word against yours. We suggest you don’t continue to see female patients alone but insist on a chaperone being present at all physical examinations. For your own protection, Doctor.
 
At least until this mess is sorted out.’
Brief pause.
‘And, as you know, these matters can take some time.
’

Daniel felt unbelievably paranoid. The eyes were on him.

As luck would have it Arnie suddenly planted himself in front of him.

Daniel held his breath.

‘You’ve bin touchin’ up a little kid, haven’t you?’

So – the news had spread. Mouthy little Chelsea had told her story, gained an audience. Of course – now he worked it out – Chelsea Emmanuel and Vanda Struel were friends. He’d seen them a couple of times together, strolling down the street, Anna-Louise in her pushchair, watchful and wary as ever. Sharing her experience with Vanda was as good as putting it in the cards in the window outside the Post Office. Arnie was taking his revenge. And already Daniel sensed that the town would swiftly polarise – those who believed her story and the others who would surely trust him? He felt an air of desperation.

It was all conspiring against him. More. What chance would there be of having custody of Holly with all this hanging over him? Mistaken diagnoses and now this.

He felt terribly tired and depressed. His life was unravelling in front of his eyes and he was powerless to stop it.

The policeman had finished his stint of night duty and was vigorously digging the garden, working manure into it with real gusto. Guy was watching him from the shelter of the rim of trees. With Brian working as lookout he couldn’t enter today but he’d be back again and again. One of these days the house would be empty again. And then…

He smiled. Just knowing the power he held over them was enough.

Brian stopped digging for a moment, straightened up and looked around. The neighbouring gardens were empty. Everyone was out at work. He scanned the field which appeared empty. He stood very still for a long moment, staring out towards the lake and wondered. Was he imagining a movement in the trees or was it the wind, teasing him by lifting branches and dropping them again, whispering tunes in the rustling leaves? He wasn’t sure but now when he resumed his digging he had a cold feeling down the back of his neck and knew that it was from that line of dark trees that eyes had observed him. Not only him but Claudine and Bethan too.

Distracted by all the events of the past weekend and work, Daniel had almost forgotten about his date with ‘M’. The pub he’d chosen was in Stone, a market town five miles away: far enough to trust he would not be recognised. It was an old-fashioned place, near the canal. He’d been there a couple of times with Elaine, in their early, settling years in Staffordshire, in happier days, when they had still been convinced this would be their joint and permanent home. She’d grumbled, he remembered, at the house white wine, making a face as though she was being given vinegar.

He settled himself with a pint of beer, in a corner seat, facing the door. He could spot the mysterious woman the moment she walked in and decide. He had a great belief in physical attraction forming relationships.

He sneaked a surreptitious glance at his wristwatch. Ten minutes past eight. She was late.

Maybe she wouldn’t come at all. It was perfectly possible that she’d lost her chirpy confidence and was going to stand him up.

What humiliation – to be stood up on an Internet first date at the age of forty.

This was worse than his real first date – at the age of sixteen with a classmate he’d always fancied. Like many first dates it had been excruciatingly awful, the pair of them blushing and tongue-tied.

Fortunately, he mused, subsequent dates had been worlds better.

The door opened and a woman walked in, glancing around as she did so. She was wearing a shiny black Mac with the collar pulled up and had long, shining, straight brown hair.

So far so good.

The woman scanned the bar and he had an impression of a lot of black make-up around the eyes, red lips and a certain vague familiarity that he had met this woman before.

Her eyes reached him. She smiled. He drew in a deep breath. Oh no. This couldn’t be happening. Not on top of all the other sheer awfulness. It was a mirage. ‘Hello, Daniel,’ she said, walked straight up to him and sat down in the seat opposite.

It was Marie Westbrook, his own practice nurse, and he felt as acutely embarrassed as on that very first dreadful date.

‘I did wonder,’ she gave a self-conscious smile, ‘if it would be you and then I thought, no, it couldn’t be. Too much of a coincidence.’

He stiffened and wondered how he could get out of this one.

She looked very different from when she was at work. For a start her hair was always pinned up in a sort of plastic bulldog clip thing. She wore no make-up. And her clothes. At work she wore the regulation navy blue dress and sensible shoes. But as she slipped her coat off he caught a glimpse of a generous cleavage, a short leather skirt, stiletto shoes and a great deal of jewellery. She flashed her teeth at him and he tried to focus above her breasts, onto the swinging silver earrings.