John Harvey: Cutting Edge

The first time she had taken off her clothes for him, he had told her she was perfect: not meaning to, not able to stop the word escaping. Perfect. He had met her at a dance two months before and now he pictured her not far from the hospital, occasionally glancing at her watch as she drank a second glass of wine, waiting.

Perfect.

“You look more dead than alive.” The words snapped him back to where he was, the staff nurse facing him, one hand pulling at her uniform where it had bunched above her belt.

“Thanks,” Fletcher said.

Sarah Leonard smiled. “The new admission …” she began.

Fletcher blinked, willing himself to concentrate. He had slept three hours out of the last twenty-four, eleven from the past seventy-two and he thought he might be delirious.

“Probably a stroke,” Sarah was saying. “Neighbor alerted the police. He’d been on his kitchen floor for two days.”

“How old?”

“Seventy?”

“I’ll clerk him in the morning.”

“He’s going to need fluids. You’ll have to put in a Venflon tonight.”

“You could do that yourself.”

“You know as well as I do it’s against policy.”

Fletcher smiled. “I won’t tell.”

She gave him the smile back a little with her eyes. Somewhere along the ward, a patient was breaking one hacking cough upon the back of another. Nearby, a youth with stitches latticed across his face was silently crying. Calls of “Nurse!” rose and fell like a litany.

“Very well, staff,” said Fletcher with mock solemnity.

“Thank you, Doctor.” She waited for him to move then fell into step beside him.

The patient lived alone on the twelfth floor of a tower block and it had taken two ambulance men and one police officer to get him down the stairs after the lift had jammed. Now he lay on his back beneath blankets, his face gray, legs and ankles swollen. He had to weigh close to seventeen stone.

Fletcher slapped the inside of the man’s forearm with the back of his own fingers, searching for a vein. It wasn’t only the excessive fat that was a problem: there was hypothermia, shock.

“He’s peripherally shut down,” Fletcher said, turning over the arm.

Sarah nodded, watching the needle, waiting to apply the necessary pressure higher up.

“I’ll try the back of the hand,” Fletcher said.

He opened his eyes wide and then narrowed them, focusing down. The point of the needle punctured the edge of the vein and passed through.

“Shit!”

He steadied himself and prepared to try again. Behind them, the screaming that had started several minutes ago showed no signs of stopping.

“Can you manage?” Sarah asked.

“Does it look like it?”

Quickly, she applied a tourniquet and left him to it. Fletcher succeeded in finding the vein this time, but was slow in releasing the tourniquet and blood jumped back before he could close off the end of the cylinder. A fine spray speckled his hands and the front of his white jacket and now a puddle was seeping through the top blanket.

He passed Sarah on her way back to the bed. “A thousand ml of natural saline over twenty-four hours,” he said, not breaking his stride.

“Where are you going?” Sarah asked over her shoulder.

“Off duty.”

She picked up the bloodied needle from where he had let it fall beside the patient’s arm and, shaking her head, deposited it in the sharps disposal. The blankets were slowly staining a deeper red and would need changing. Without seeming hurried, Sarah finished setting up the drip.

Fletcher bent low over the sink and splashed cold water up into his face. In the mirror he looked like someone who habitually spent long hours underground. He knew that if he didn’t shave, his stubble would score Karen’s skin raw but it seemed more important to get there before she grew tired of waiting. He would phone as he left the hospital and tell her that he was on his way.

He cupped his hands beneath the tap a final time, combed his fingers through his tangle of dark hair and pulled on a padded blue anorak over his doctor’s coat.

For a change the telephone near the exit wasn’t already in use, but in Karen’s shared house nobody was picking up and answering. After a dozen rings he gave up and hurried up the stairs towards the upper level, fitting the headphones from his Walkman over his ears as he climbed. He pushed through the first set of double doors on to the pedestrian bridge as the duet from the final act of Manon was beginning. The bridge arched over the ring road midway between the underpass and the flyover, linking the hospital with the university and the residential areas that closed around it.

Fletcher immediately identified the familiar smell of rubber that rose from the floor, although the personal stereo, turned up high, kept out the squeak of his shoes as he walked. The air was always stale, the warmth trapped in at either end, no matter the outside temperature.

He walked unsteadily, hands jammed down into his pockets, weaving slightly like someone the worse for drink. The lights of cars moving fast downhill, south from the city, blistered through the wired glass. Here and there, the sides had been flyposted, advertising social events, political meetings, a pram race along the canal.

Fletcher sang along with the music, suddenly energetic and off-key. If things worked out with Karen, he’d get tickets for Opera North next month and bribe himself a couple of evenings off. If things worked out … Unobserved, the door giving access to the steps up from the street swung open at his back.

Fifteen yards from the far side and he had still not heard the accelerated tread of soft-soled shoes in his wake. Strange that he was thinking, not of Karen, but of Staff Nurse Sarah Leonard’s half-smiling, half-accusing eyes, when finally he realized he was not alone. A quick reflection glimpsed in the glass door before him and Fletcher turned his head in time for the downward sweep of the blade, illuminated in a fast curve of orange light.

The blow sent him stumbling backwards, losing his footing as he cannoned against the center of the doors and pitched forward, thinking before the belated sear of pain that he had been punched, not cut. The headphones had fallen from his face and Massenet poured tinnily out. Fletcher raised an open hand to ward off his attacker and the blade sank deep into his palm before swerving clear.

Somehow he got to his feet and began to run. A foot tripped him and his temple smacked against the wired glass, cracking it across. He kicked out, swung into a crouch and blundered through the first pair of doors, within his reach the exit, the steps, the street. His legs went from under him and the side of his face hit the floor with a slap. Through the muffled sound of traffic, he could hear his attacker breathing hard. Not wanting to, he forced himself to turn his head. Through blood he saw black sweater, balaclava, black gloves. Movement. Fletcher screamed and on his hands and knees he tried to crawl away. The blade cut into his thigh and began to slice towards the knee.

Karen Archer upended the empty bottle into the waste bin in the corner of her room and fingered the portable TV set off. By the time she had got downstairs to the phone, whoever had been calling had rung off. It could have been Tim, wanting to tell her he was on his way, apologizing yet again for being delayed.

“Go out with a houseman,” one of her medical student friends had said, “and that’s what you get.”

“What?”

“Not a lot.” Laugh. Except that it wasn’t.

The last time Tim Fletcher had been round he had been fast asleep within ten minutes; she had pulled off the rest of his clothes, tucked the duvet round and sat cross-legged beside him, wearing two extra sweaters and reading Eliot. He hadn’t been a lot of fun either.