The Children Act (7 page)

She could have phoned one of three friends, but she could not bear to hear herself explain her situation and make it irreversibly real. Too soon for sympathy or advice, too soon to hear Jack damned by loyal chums. Instead, she passed the evening in an empty state, a condition of numbness. She ate bread,
cheese and olives with a glass of white wine, and passed an interminable period at the piano. First, in a spirit of defiance, she played through her Bach partita. Occasionally, she and a barrister, Mark Berner, performed songs, and she had seen that afternoon that he was listed for tomorrow to represent the hospital in the Jehovah’s Witness case. The next concert was many months ahead, just before Christmas, in the Great Hall in Gray’s Inn, and they had yet to agree on a program. But they had a few encore pieces off by heart and she played through them now, imagining the tenor’s part, lingering over Schubert’s mournful “Der Leiermann,” the hurdy-gurdy man, who is poor and wretched and ignored. Such concentration protected her from thoughts, and she had no sense of passing time. When she rose at last from the piano stool, her knees and hips were stiff. In the bathroom she bit into half of a sleeping pill, stared at the ragged remainder in her palm, then swallowed that too.

Twenty minutes later she lay in her half of the bed listening through closed eyes to the radio news, the shipping forecast, the national anthem, then the World Service. As she waited for oblivion, she heard the news again and perhaps a third time, then calm voices discussing the day’s savagery—suicide bombers in crowded public places in Pakistan and Iraq, shelling of apartment blocks in Syria, Islam’s war with itself conducted by means of twisted car frames and rubble, and body parts flung across marketplaces, and ordinary people wailing in shock and
grief. Then the voices turned to discuss American drones over Waziristan, last week’s bloody assault on a wedding party. While the reasonable voices pressed on into the night, she curled up for a troubled sleep.

THE MORNING PASSED
like a hundred others. Applications, submissions rapidly assimilated, argument heard, judgments delivered, orders dispensed, and Fiona moving between her room and the court, bumping into colleagues on the way, something even festive in their quick exchanges, the clerk’s weary call of “Court rise,” her minimal nod toward the opening barrister, her occasional weak joke fawningly received by counsel for both sides with little attempt to conceal their insincerity, and the litigants, if they were a divorcing couple, as they all were this Tuesday morning, seated well apart behind their representation, in no mood to smile.

And her mood? She counted herself reasonably adept at monitoring it, naming it, and she detected a significant shift. Yesterday, she now decided, she had been in shock, in an unreal state of acceptance, prepared to tell herself that she had, at worst, to endure the commiseration of family and friends and a degree of severe social inconvenience—those embossed invitations she must refuse while hoping to conceal her embarrassment. This morning, waking with a cold part of a bed to her left—a form of amputation—she felt the first conventional ache
of abandonment. She thought of Jack at his best and longed for him, the hairy bony hardness of his shins, down which, half asleep, she would let the soft underside of her foot slide at the alarm clock’s first assault, when she would roll onto his outstretched arm and wait and doze beneath the duvet’s warmth, face into his chest, until the clock’s second call. That naked childlike surrender, before she rose to assume an adult’s armor, seemed first thing this morning like an essential from which she was banished. When she stood in the bathroom, when she stepped out of her pajamas, her body looked foolish in the full-length mirror. Miraculously shrunken in some parts, bloated in others. Bottom-heavy. A ridiculous package. Fragile, This Way Up. Why would anyone not leave her?

Washing, dressing, drinking coffee, leaving a note and arranging a new key for the cleaning lady brought these raw feelings under control. And so she began her morning, looked for her husband in e-mails, texts and post, found nothing, gathered her papers, her umbrella and her phone and walked to work. His silence appeared ruthless and it shocked her. She knew only that Melanie, the statistician, lived somewhere near Muswell Hill. Not impossible to track her down, or look for Jack at the university. But what humiliation then, to find him in a departmental corridor, walking toward her, arm in arm with his lover. Or to find him alone. What could she propose beyond a pointless, ignominious plea for his return? She could demand confirmation that he had left his marriage, and he would tell her what she already knew and didn’t want to hear.
So she would wait until a certain book or shirt or tennis racket drew him back to the locked apartment. Then it would be his task to search her out, and when they spoke, she would be on her own ground, dignity intact, outwardly at least.

It would not have been apparent, but her spirits were heavy as she set about Tuesday’s list. The last case of the morning was prolonged by complex argument over commercial law. A divorcing husband claimed that the three million pounds he had been ordered to pay to his wife was not his to give away. It belonged to his company. It emerged, but far too slowly, that he was the sole director and only employee of an enterprise that made or did nothing—it was a fig leaf for a beneficial tax arrangement. Fiona found for the wife. The afternoon was now cleared for the hospital’s emergency application in the Jehovah’s Witness case. In her room once more, she ate a sandwich and an apple at her desk while she read through the submissions. Meanwhile, her colleagues were lunching splendidly at Lincoln’s Inn. Forty minutes later, one clarifying thought accompanied her as she made her way to courtroom eight. Here was a matter of life and death.

She entered, the court rose, she sat and watched the parties below her settle. At her elbow was a slim pile of creamy white paper beside which she laid down her pen. It was only then, at the sight of these clean sheets, that the last traces, the stain, of her own situation vanished completely. She no longer had a private life, she was ready to be absorbed.

Ranged before her were the three parties. For the hospital,
her friend Mark Berner QC and two instructing solicitors. For Adam Henry and his guardian, the Cafcass officer, was an elderly barrister, John Tovey, not known to Fiona, and his instructing solicitor. For the parents, another silk, Leslie Grieve QC, and two solicitors. Sitting by them were Mr. and Mrs. Henry. He was a wiry, tanned man in a well-cut suit and tie in which he himself could have passed for a successful member of the judiciary. Mrs. Henry was big-boned and wore outsized glasses with red frames that shrank her eyes to points. She sat upright, with tightly folded arms. Neither parent looked particularly cowed. Outside in the corridors, Fiona assumed, journalists would soon be assembling to wait until she allowed them in to hear her decision.

She began. “You’re all aware that we are here on a matter of extreme urgency. Time is of the essence. Everyone please bear this in mind and speak briefly and to the point. Mr. Berner.”

She inclined her head toward him and he stood. He was smoothly bald, bulky, but with dainty feet—size five, it was rumored—for which he was mocked behind his back. His voice was a decent rich tenor and together their greatest moment had been last year when they performed Schubert’s “Der Erlkönig” at a Gray’s Inn dinner for a retiring law lord with a passion for Goethe.

“I shall indeed be brief, My Lady, for, as you indicate, the situation is pressing. The applicant in the matter is the Edith Cavell General, Wandsworth, which is seeking the leave of this court to treat a boy, named A in the papers, who will be eighteen
in less than three months. He experienced sharp stomach pains on the fourteenth of May when he was putting on his pads to open the batting for his school cricket team. During the following two days these pains became severe, unbearable even. The GP, despite great expertise and experience, was at a loss and referred—”

“I’ve read the papers, Mr. Berner.”

The barrister moved on. “Then, My Lady, I believe it is accepted by all parties that Adam is suffering from leukemia. The hospital wishes to treat him in the usual manner with four drugs, a therapeutic procedure universally recognized and practiced by hematologists, as I can show—”

“No need, Mr. Berner.”

“Thank you, My Lady.”

Berner advanced quickly to outline the conventional course of treatment and this time Fiona did not intervene. Two of the four drugs targeted the leukemia cells directly, whereas the other two poisoned much in their path, in particular the bone marrow, thereby compromising the body’s immune system and its ability to make red and white blood cells and platelets. Consequently, it was usual to transfuse during treatment. In this case, however, the hospital was prevented from doing so. Adam and his parents were Jehovah’s Witnesses and it was contrary to their faith to accept blood products into their bodies. This apart, the boy and his parents agreed to any treatment the hospital could offer.

“And what has been offered?”

“My Lady, in deference to the family’s wishes, only the leukemia-specific drugs have been administered. They are not considered sufficient. It’s at this point I’d like to call the consultant hematologist.”

“Very well.”

Mr. Rodney Carter took the stand and was sworn in. Tall, stooping, severe, thick white eyebrows from under which he glared with ferocious disdain. From the top pocket of his pale gray three-piece suit there protruded a blue silk handkerchief. He gave the impression that he considered the court procedure a nonsense and that the boy should be dragged by the scruff of his neck to an immediate transfusion.

There followed standard questions to establish Carter’s bona fides, his length of experience and seniority. When Fiona cleared her throat softly, Berner took the hint and pressed on. He asked the doctor to summarize for the benefit of the judge the patient’s condition.

“Not at all good.”

He was asked to elaborate.

Carter drew breath and looked about him, saw the parents and looked away. His patient was weak, he said, and, as expected, showing the first signs of breathlessness. If he, Carter, had had a free hand in treatment, he would have expected an eighty to ninety percent chance of a full remission. With the current course, the chances were much reduced.

Berner asked for specific data concerning Adam’s blood.

When the boy was admitted, Carter said, the hemoglobin count was 8.3 grams per deciliter. The norm being around 12.5. It had declined steadily. Three days ago it had been 6.4. This morning it was at 4.5. If it dropped further to 3, the situation would be extremely dangerous.

Mark Berner was about to ask another question but Carter spoke over him.

“The white cell count is usually somewhere between 5 and 9. It’s now 1.7. As for the platelets—”

Fiona interrupted. “Would you kindly remind me of their function?”

“Necessary for clotting, My Lady.”

The norm, the consultant told the court, was 250. The boy’s count was 34. Below 20 one would expect spontaneous bleeding to occur. At this point, Mr. Carter turned his head a little away from the barrister so that he seemed to address the parents. “The latest analysis,” he said gravely, “shows us that no new blood is being produced. A healthy adolescent might be expected to produce five hundred billion blood cells a day.”

“And if, Mr. Carter, you could transfuse?”

“The boy would stand a decent chance. Though not as good as it would have been if we’d transfused from the start.”

Berner paused briefly, and when he spoke again, he lowered his voice, as though to dramatize the possibility of Adam Henry overhearing him. “Have you discussed with your patient what will happen to him if he is not transfused?”

“Only in the broadest terms. He knows he could die.”

“He has no idea of the manner of his death. Would you care to give the court an outline?”

“If you want.”

Berner and Carter appeared to be colluding in the grisly facts for the benefit of the parents. It was a reasonable line of approach and Fiona did not intervene.

Carter said slowly, “It will be distressing, not only for himself but for the medical team treating him. Some of the staff are angry. They routinely hang blood, as the Americans put it, all day long. They simply can’t understand why they should risk losing this patient. One feature of his decline will be his fight to breathe, a fight he will find frightening and is bound to lose. The sensation will be one of drowning slowly. Before that he may suffer internal bleeding. Renal failure is a possibility. Some patients lose their sight. Or he may suffer a stroke, with any number of neurological consequences. Cases differ. The only sure thing is that it would be a horrible death.”

“Thank you, Mr. Carter.”

Leslie Grieve for the parents rose to cross-examine. Fiona knew Grieve a little by reputation, but at that moment couldn’t recall whether he had ever appeared before her. She had seen him about the law courts—somewhat foppish, with silver, center-parted hair, high cheekbones, long thin nose, haughtily flared. There was a looseness or freedom of limb that was
in agreeable contrast to the reined-in movements of his graver colleagues. The entire grand and gay effect was complicated by a problem he had with his vision, a squint of some sort, for he never appeared to be looking at what he was seeing. This disability added to his allure. It sometimes disoriented witnesses in cross-examination and it may have caused the doctor’s tetchiness now.

Grieve said, “You accept, do you not, Mr. Carter, that the freedom of choice of medical treatment is a fundamental human right in adults?”

“I do.”

“And treatment without consent would constitute a trespass of the person, or indeed an assault of that person.”

“I agree.”

“And Adam is close to being an adult, as the law defines it in such instances.”

Carter said, “If his eighteenth birthday was tomorrow morning, he would not yet have attained his majority today.”

This was said with vehemence. Grieve was unruffled. “Adam is very nearly an adult. Is it not the case that he has expressed his view to treatment intelligently and articulately?”