Dick Francis - Under Orders

‘Yes,’ I said. ‘She’s my fiancée.’

‘She isn’t wearing a ring.’

‘She will be next week.’ If she lives, I thought. ‘How is she doing?’

‘Not good, I’m afraid. She’s gone to theatre so I’ve handed her over to a surgeon. Sorry, I should introduce myself, I’m Dr Osborne; I’m the duty Accident and Emergency consultant.’

‘Sid Halley,’ I said. He didn’t offer his hand. Germs and all that.

‘Ah,’ he said, nodding, ‘the jockey. I thought I recognised you from somewhere. Well, your girlfriend has lost an awful lot of blood. In fact, I’m amazed she was still alive when she arrived here. There was no measurable blood pressure.’

‘But she will be all right, won’t she?’ I was desperate.

‘I’m afraid I don’t know. Not yet. She was alive when she went to theatre, that’s the best I can say.’

I could hear my blood rushing in my ears.

‘The bullet missed the knee itself so the joint is fine but it tore open the femoral artery where it becomes the popliteal at the back of the knee, hence the blood loss. I think it was probably a small bullet and it didn’t do much damage to the rest of her soft tissue. She was very unlucky.’

‘But have you stopped the bleeding?’ I asked frantically.

‘Yes, I have for the time being but it’s not that simple. I am worried about further bleeding into her internal organs.’

‘Why?’ I asked.

‘We had to give her a great deal of blood and other fluids to replace what was lost, to fill the pipes up again, as it were.’

I nodded. I knew all about having to have blood.

‘Well, we had to give her an awful lot due to the continuous bleeding.’

‘Didn’t you apply a tourniquet?’ I asked.

‘Something similar. We applied direct pressure to the leg but you have to release it every ten minutes or so otherwise the lower leg begins to die. Whenever we did, the arterial bleeding started again. So, we had to give her much more blood than her whole body normally holds.’

I’d been correct; it had been going right through her.

‘This produces an added problem. Such a large transfusion severely dilutes some of the factors in the blood. It also causes a reduction in usable platelets. The combined effect is to reduce the ability of the blood to coagulate. It’s called dilutional thrombocytopenia. The factors are essential to keep the arteries from leaking blood and causing diffuse bleeding at various points in the body, especially in the internal organs like the kidneys. Until her body can replenish the factors and the platelets naturally, she is living right on the edge. I have to be frank — I believe that any further bleeding might be more than she could take. It would require more transfusion which would further reduce the usable platelets, which in turn would lead to more bleeding and eventually to a complete collapse of her system.’

‘But…’ I swallowed, ‘when will we know?’

‘The next few hours are critical. If she survives that, then her chances are reasonable.’

‘Reasonable’ didn’t sound reasonable enough to me.

‘How long will she be in theatre?’

‘Not long, I imagine,’ he said. ‘She’s gone to have a better repair of the artery. It’s risky but the surgeon and I thought it was better to fix the artery now so that it didn’t rupture again, which might lead to catastrophic failure.’

‘How do you fix an artery?’ I asked.

‘Using a graft,’ he said. ‘We take a piece of vein from her other leg and sew it into the artery to bridge the gap made by the bullet. The procedure is quite normal and is used all the time for heart bypass operations. The problem here is the need to keep blood loss to an absolute minimum.’

I wasn’t really listening to the details. ‘When can I see her?’ I asked.

‘After theatre she will be taken to intensive care. You’ll be able to see her there but she’ll be sedated and asleep. We will try to keep her blood pressure as low as possible for a while. Look, I’m sorry, but I must go now. I’m needed elsewhere.’

‘Thank you,’ I said. It was insufficient.

He went out, leaving Rosie, me and the policeman.

‘She’s in the best hands,’ said the policeman kindly.

I nodded. I felt so helpless.

‘I left my car on the pavement outside the hospital,’ I said. ‘I’d better go and move it.’

‘Sorry, sir,’ said the policeman. ‘You’re not to leave until you’ve given a statement to my super.’

His super turned out to be Detective Superintendent Aldridge of the Metropolitan Police who arrived with another plain-clothes officer in tow. They showed me their warrant cards.

‘Thank you, constable,’ said the Super, dismissing our uniformed friend.

‘I’ll go and check on your car, sir,’ he said to me. ‘What’s the registration?’

‘It’s probably been towed away by now.’ But I gave him the registration anyway, and the keys.

The Superintendent wanted a blow-by-blow account of everything both Rosie and I had done all day. It was tedious and my mind was elsewhere.

‘I’m going to find out how Marina’s doing?’ I said finally with exasperation.

‘All in good time, Mr Halley,’ said the Super.

‘No,’ I said. ‘Now.’

I stood up and walked to the door.

‘Please sit down, sir.’ He said it with a degree of stiffness in his tone.

‘No,’ I said, ‘I’m going to see my fiancée.’ The term was beginning to grow on me.

I didn’t really blame the police. All too often the villain of the piece is the husband or the wife, the boyfriend or the girlfriend. It always seemed to me that to do one of those tear-jerking press conferences appealing for the murderer of a loved one to give themselves up was tantamount to holding up a banner with ‘I DID IT’ blazoned across it.

If he wanted to arrest me, let him. I had a cast-iron alibi in the sandwich man. And I wanted to see my girl.

But that wasn’t as easy as I’d hoped.

I went to the reception desk and asked if Dr Osborne was available.

Sorry, he’s busy.

Could they tell me where Marina van der Meer was? Or how she was?

Sorry, she’s no longer in this department.

Could they tell me how to get to the Intensive Care Unit?

Sorry, ask at the main reception desk.

There was a large notice pinned to a board above the desk. It read: ‘Our staff have the right to work free of verbal or physical abuse from the public.’ I understood the anger that can be present in such places. It is anger born out of fear, frustration and hurt.

I swallowed my own anger and left the A amp; E Department in search of the main reception desk. I found that I had acquired a shadow in the form of the Superintendent’s sidekick.

‘Making sure you don’t leave the hospital, sir,’ he said.

‘Fine,’ I replied. ‘You lot must know where Marina is. Do me a favour and get on your blower to find out.’

He punched numbers into his mobile phone and talked briefly.

‘Can you turn that phone off, please,’ said a man in the corridor. ‘Mobile phones are not permitted in the hospital.’

‘I’m a policeman,’ said the officer.

‘And I’m a doctor,’ said the man. ‘Mobile phones can interfere with medical equipment so turn it off.’

‘OK,’ said my shadow but he listened for a few moments longer.

‘She’s still in the operating theatre,’ he said to me. ‘We have a guard outside.’

Marina needed a guard inside, I thought, a guardian angel.

‘I’m going to the Intensive Care Unit to wait for her.’

My shadow nodded and we went together to the main reception desk to get directions.

I sat on one of the chairs outside the door to the Intensive Care Unit, opposite the lifts. My shadow sat alongside me and time passed very slowly.