Donor (21 page)

‘But she was much better today,’ interrupted Kate. ‘Just like the nurse said she would be, and she’ll probably be even better tomorrow. You’ll see. They’re very pleased with her. Yesterday was just because of the tests they had to do.’

‘But they didn’t have to do them. That’s just the point. She’d already had all her immuno-typing done. It must be in her notes. Why did they put her through all that pain all over again?’

Kate shook her head as if it were an unreasonable question. ‘You know much more about these things than I do,’ she said. ‘But the nurse said they were just routine procedures to check her immunology … something or other.’

‘Immunology pattern. Yes, I know, but that’s all been done before. Her blood group, her tissue type, everything has already been done. It all had to be done before they entered her on the transplant register. Why put her through the misery of a marrow puncture?’

Kate shrugged and said, ‘Well, I suppose I’m happy to assume that the hospital knows best.’

‘Hospitals depend on that,’ said Sandy sourly.

‘Who’s being cynical, then?’ said Kate with a cajoling smile.

He relaxed a little and said, ‘All right, maybe I am worrying unnecessarily but I work in hospitals, remember. I know they’re not infallible. Mix-ups happen, mistakes are made, wrong tests are ordered, overdoses are given. In many ways they’re the most dangerous places on earth. Reservoirs of infection posing as havens of hygiene and sterility.’

Kate had heard it all before. ‘Look, if you’re really upset about this test thing, why don’t you make an appointment to see one of the doctors and ask them outright about it? I’m sure they’d be happy to tell you.’

‘I suppose because I don’t want to be seen as a troublemaker. They’re treating our daughter for free and they’re the best chance she’s got. In fact, they’re probably the only one. It would look like ingratitude and, believe me, I’m not ungrateful.’

‘I still think it would be all right if you asked politely. After all, you’re in the business, so to speak.’

‘Hospitals hate that worse than anything,’ said Sandy. ‘They prefer complete ignorance in their patients and relatives, followed by unquestioning acceptance of anything they care to tell you.’

‘Well, if you don’t want to ask them, why not ask Clive Turner? Maybe he knows why they did the tests again. He’s always been very nice to us and you wouldn’t question anything he’s done.’

‘Now that’s a good idea,’ he agreed, brightening. ‘I might just do that. In fact,’ – he looked at his watch – ‘I’ll try to catch him right now.’

‘Paging Dr Turner for you,’ said the hospital voice.

‘Dr Turner.’

‘Clive, it’s Sandy Chapman here.’

‘Hello there. I was just thinking about you folks this morning. How’s Amanda doing?’

‘That’s really why I’m calling. She was quite ill when we went to see her yesterday and a nurse told me that she’d had her dialysis withheld while they did some tests on her, including a marrow puncture.’

‘A marrow puncture?’

‘That’s what I thought,’ said Sandy, acknowledging the surprise in Turner’s voice. ‘The nurse there said it wasn’t unusual for transplant patients. I pointed out that Amanda has already had all these tests done, but I don’t think I got through to her. I didn’t like to request a meeting with the doctors over it because I didn’t want to make a fuss but, on the other hand, I’d still like to know why they put her through that. I thought you might have some idea?’

‘I’m embarrassed to say that I haven’t,’ replied Turner. ‘Amanda’s immunological data is all known and recorded on the register.’

‘That’s what I thought.’

‘I can’t imagine why they’d want to repeat it all, although I suppose there must have been a reason … I’m trying to think if there’s any way I could find out for you without stepping on sensitive toes.’

‘I don’t want to make waves, but it’s something that’s been niggling away at me.’

‘I can understand that,’ said Turner. ‘There’s a chap I know over there called Steven Dunbar. He’s a doctor but he’s not actually on the medical staff so he won’t be inclined to take offence. Maybe I’ll ask him if he can find out for us discreetly. I know him through the negotiations to have Amanda admitted there.’

‘I think I know him too,’ said Sandy, recognizing the name. ‘He helped me push-start the car one night when it played up. He’s some kind of government official, isn’t he?’

‘That’s right. Truth to tell, you have him to thank for Amanda’s referral to Médic Ecosse being successful. He had the final say over it and didn’t question it at all. Simply gave it his seal of approval. He seemed like a good bloke.’

‘I didn’t know that,’ exclaimed Sandy. ‘He never said. I owe him one.’

‘An unusual civil servant,’ said Turner. ‘Anyway, I’ll see if he can shed any light on Amanda’s marrow puncture.’

‘I’m obliged to you again,’ said Sandy.

* * *

Turner called Dunbar the following morning. They exchanged pleasantries, then Turner said, ‘I know this is not strictly up your street but I wonder if you can help me out with something?’

‘Not another free transplant, I hope,’ joked Dunbar.

‘Nothing like that,’ laughed Turner. ‘I do realize your resources are finite. I have a question I hoped you might be able to answer for me … discreetly.’

‘Try me.’

‘I’ve had Amanda Chapman’s father on the phone. He was a bit worried about why his daughter had to go through the unpleasantness of a marrow puncture when all her immunological data is already known. He didn’t want to make a fuss and appear ungrateful up there, so he asked me and, frankly, I couldn’t think of a reason either. I thought I’d try to find out quietly. That’s what made me think of you.’

‘I see,’ said Dunbar. ‘You don’t want to ruffle any professional feathers in this neck of the woods.’

‘Exactly. I thought you might conceivably have access to relevant files and might take a little look for me?’

Dunbar smiled to himself and said, ‘I can’t promise anything but I’ll see what I can do. If I come up with anything I’ll get back to you.’

Dunbar put down the phone and thought. He waited until Ingrid had left the room before requesting a current-costs listing for Amanda Chapman from the computer. It was hospital policy that reasons had to be given for all tests and procedures carried out, to avoid possible later accusations of performing unnecessary ones just to inflate the bill. Although Amanda’s parents were not paying, the computerized listing procedure was routine and would therefore apply in her case too. It would be too much trouble to change it all for an individual patient.

But the listing that came up on the screen made no mention of any marrow puncture having been carried out on Amanda Chapman. None at all. He checked the date on the file. It had last been updated that morning. Dialysis charges and standard daily fees were given, but there was nothing about any special tests or minor surgical procedures.

Dunbar sucked the end of his pen and considered. It could simply be that the staff had been tardy in keeping Amanda’s file up to date, knowing that in the end there would be no bill to settle, but that seemed unlikely in a hospital that ran like clockwork. The only alternative was that someone had taken a conscious decision not to enter the marrow puncture in the notes. Why? Because they didn’t want a record of it? Maybe that was being too melodramatic. A marrow puncture was not that uncommon a procedure. It was simply the fact that all her immunology stats were already known that made it seem questionable.

Some kind of mistake? Unnecessary duplication? Had one of the more junior staff, through ignorance of Amanda’s case, written her up for a procedure she didn’t need? It seemed plausible. Dunbar wondered how he could check. He supposed there must be a record of the test somewhere, even if it hadn’t been entered in the patient’s notes. He would call up the record of theatre usage for the past few days and find out where the marrow puncture had taken place and who had carried it out. He didn’t want to make a big thing out of it; he just wanted to know.

The computer obediently showed the schedules for each theatre in turn. There was no record of Amanda being treated in any of them. There was, of course, a theatre in the Obstetrics wing being used by the Omega patient. No information was available on its use, in keeping with the total confidentiality rule for these patients, but that didn’t seem a very likely choice … or did it? Dunbar suddenly remembered the little girl being taken into the lift leading to the Omega wing on the night he’d raided the Radiology Department. Now it made sense. The girl must have been Amanda Chapman.

Ingrid returned and said, ‘I’ve done the costings you asked for on transplant patients.’

‘Well done.’

‘I think you’re in for a bit of a shock,’ she said, putting the file in front of him.

Dunbar looked at the final figure and let out his breath in a low whistle. ‘That much!’ he exclaimed.

‘I’m afraid so,’ said Ingrid. ‘It’s an expensive business.’

Dunbar nodded and she smiled. ‘You’ll be regretting having agreed to the free NHS referral case,’ she joked.

‘Money isn’t everything,’ he replied.

‘I don’t think the Scottish Office would be too keen on hearing you say that,’ said Ingrid.

‘Perhaps not. But maybe a good part of the cost will be offset by the money coming in from the Omega patient?’

‘I’m sorry, I don’t think I understand.’

‘I just thought that Omega patient fees might subsidize the hospital’s generosity when it came to free transplant cases.’

‘Oh I see,’ said Ingrid.

‘Amanda Chapman isn’t the first transplant patient the hospital has taken on for nothing,’ said Dunbar. ‘I noticed there were two others in the past. They were on the list of free referrals you prepared for me. I just wondered if the cost of their operations had been offset against Omega patients too?’

‘I’m not sure.’ She sounded a little uncertain, but soon recovered and said, ‘I suppose you may be right.’

Dunbar was puzzled. There was so much money involved that he felt sure Ingrid ought to know how the free transplant referrals had been financed. In fact, he was surprised that more had not been made of the hospital’s generosity, in terms of publicity. After all, the news of Médic Ecosse using large fees to finance expensive charity cases would have reflected very well on the hospital and particularly, as most of the costs would have been borne by the transplant unit, on James Ross and his staff. It would, of course, be at odds with a unit callously conducting animal experiments on some of their patients …

Dunbar thought he could see a way of asking Ingrid about the tests on Amanda Chapman without arousing suspicion. He looked down her list of transplant costs, then said jokingly, ‘It looks like you folks are short-changing Amanda Chapman.’

‘What do you mean?’

‘According to her costing file, she hasn’t had any of these tests you put on the list for transplant admissions.’

Ingrid came over to stand behind him and look at the screen. Dunbar brought up Amanda’s file. ‘See?’

Her face relaxed into a smile and she said, ‘Oh, I know why not. Amanda didn’t have these tests because she came here from the Children’s Hospital. She had all her immunology stats done over there. She didn’t need them. She’s already on the register.’

‘Of course,’ said Dunbar. ‘I should have thought of that.’

But her words raised new questions. Just what the hell had Médic Ecosse been doing, giving Amanda-Chapman a marrow puncture at night in the Omega patient’s wing? If Ingrid Landes, a secretary, realized that Amanda didn’t need further immunology testing, then so without doubt did the nursing and medical staff. Come to think of it, how did Ingrid know about immunology testing? She worked for Giordano in administration; she wasn’t even a medical secretary. It made him curious. The next time she was out of the room he would pull her personnel file.

In the meantime, he resigned himself to working his way through the accounts for the last financial year, while he waited for the answer to his request for the exhumation of Amy Teasdale. To offset some of the boredom, and check up on things that it might be useful to know in the long run, he’d try to find out something about the money allocated to Ross’s research.

Until the Scottish Office had pulled the plug on the previous arrangement, he recalled, Ross’s funding had been a proportion of transplant unit profits. As that was the case, the hospital accounts might hold itemized costings for the research. Dunbar wanted to know what the money was being spent on. He also thought he might find out where Ross’s research funding was currently coming from.

At first, the accounts seemed to have no reference at all to money being allocated to a research budget. Dunbar couldn’t understand it. It wasn’t as if it was secret. Ross was a widely acclaimed researcher. Everyone knew about his research programme. If the item he was looking for was not listed as research money, it must be listed under something else. He checked the file-names again, and his eye was caught by something called ‘Vane Farm Account.’ What was that?

He clicked it open and found what he was looking for. Ross’s research labs were located at a place called Vane Farm. Dunbar supposed it made sense if a lot of the work was concerned with experimental animals. Everything connected with Ross’s research seemed to be itemized in the Vane Farm account, from technicians’ salaries to rent for the property, from laboratory equipment to security expenditure. He also noted the purchase of pigs.

There was, however, nothing about alternative sources of funding in the current year. Dunbar had expected to find an increase in core funding from Médic International, which would have been the simplest explanation for Ross having stayed on after the withdrawal of unit-linked funding. But there was no sign of such an increase. He supposed, however, that this could still be the case. There would be no requirement to channel such funding through the hospital accounts, particularly as Ross’s research facilities were located elsewhere. That must be the explanation, unless Ross was funding his own research; and for that he would have to be awfully rich.