Ken McClure: White death

‘We won’t know for sure until…’ Sands paused as he realised he was about to mention the post mortem that would have to take place and changed his mind. This wasn’t the time… ‘We don’t have all the lab results back yet but it now seems pretty certain at this stage that your son died of something we call necrotising fasciitis.’

Marion Taylor looked blankly over the top of the wad of tissues she held to her mouth, Dan shook his head slightly.

‘The papers often refer to it as the flesh-eating bug,’ said Sands, letting his voice fall to a whisper in deference to the images he knew he was conjuring up and causing Dan to close his eyes again.

‘And what causes that?’ asked Dan, clearing his throat and trying to sound controlled when, in reality, his heart was breaking.

‘It’s a rare condition, usually caused by a bacterium called streptococcus,’ said Sands. ‘It’s a strange bug because it can cause so many different conditions, ranging from sore throats to scarlet fever and unfortunately, on rare occasions, to necrotising fasciitis. We really don’t know why its behaviour can change so dramatically. But other bugs can also cause the condition, staphylococcus, clostridium, vibrio and a number of others. We’re not at all sure what triggers it off.’

‘And these drugs you were giving Keith…?’

‘In theory, they should have dealt with streptococcus, and I would have thought most of the others,’ said Sands. ‘But obviously, on this occasion, they didn’t. Hopefully the lab will be able to tell us why not.’

‘I want to see my son,’ said Marion Taylor in an unexpectedly firm voice.

Sands moved uncomfortably in his chair. ‘Mrs Taylor… I really don’t think that’s a good idea…’

‘I want to see him.’

Sands looked to Dan Taylor for support before saying, ‘Keith underwent a great deal of trauma before he died although I can assure you he felt no pain. He never regained consciousness. I honestly think it would be better if you just remembered Keith the way he was.’

Dan Taylor got up and put his arms round his wife while maintaining eye contact with Sands. ‘The doctor’s right, love. Let’s just remember our lad the way he was, not as the victim of some…’ He searched for inspiration. ‘Bastard disease.’

The words ‘flesh-eating’ were still going round and round inside his head. He was praying that Marion wouldn’t stick to her guns. She looked up at him and finally acquiesced with a small nod.

‘Bloody bizarre,’ muttered pathologist Simon Monkton. ‘How come the lab can’t grow anything when he’s absolutely riddled?’

‘I think they’re quite embarrassed about that too,’ replied Sands, who had chosen to be present at the post mortem on Keith Taylor. ‘I spoke to the consultant bacteriologist earlier. He was very apologetic.’

Monkton gave Sands a look that suggested apologies were less than useful.

‘You are sure it was necrotising fasciitis?’ asked Sands.

‘What else could it be?’ replied Monkton. ‘It’s practically eaten the poor kid alive.’

‘So that’s what you will be putting down as cause of death on the death certificate?’

Monkton paused in what he was doing and looked at Sands over his half-moon specs. ‘Of course. Why do you ask?’

‘The boy’s GP told me that Keith Taylor was part of a monitoring study being carried out by the Department of Health. He is obliged to inform them immediately about any health issues that crop up.’

‘Health issues?’ snorted Monkton. ‘I suppose you could say dying of necrotising fasciitis was a health issue that cropped up… poor kid. I take it you are absolutely sure he wasn’t taking any antibiotics when he became ill?’

‘That was the first thing I thought of when the lab failed to grow anything from his specimens but his GP and his family assure me that he was taking nothing apart from his usual immuno-suppressant drugs.’

‘Ironically, I suppose that’s probably why the infection ripped through him so fast,’ said Monkton. ‘The drugs would severely compromise his natural defences. I take it the suppressants were stopped as soon as he was admitted?’

‘Of course.’

‘Well, that’s it then,’ said Monkton, stripping off his gloves and dropping them in a pedal bin he opened with his foot. ‘When God throws a curve ball… you’re out.’

‘His parents are coming in later to be told the findings of the PM.’

‘Something no parents should ever have to do,’ said Monkton. ‘I don’t envy you dealing with the living.’

‘Horses for courses,’ said Sands. ‘I can’t say I envy you your job either.’ He was looking down at the open cadaver of Keith Taylor.

Edinburgh

March 2007

‘I don’t want to go to school.’

Virginia Lyons glanced at the kitchen clock on the wall. ‘Look, Trish, you have to go. There’s nothing wrong with you. Why have you started doing this to me? You’ve always liked school, you know you have.’

‘Don’t want to go,’ mumbled her daughter, looking down at the floor.

‘Forget the “don’t want to go” nonsense. There has to be a reason. Tell me.’

‘Just don’t want to, all right?’

Virginia stayed silent for a moment to let the spark of anger in her daughter die down. ‘Are you being bullied?’ she asked. ‘Is that it? Just tell me if you are because I’m not having that. I’ll go straight to the head teacher about it. We’ll nip this in the bud.’

Trish shook her head silently, still staring studiously down at the floor.

‘Then what?’

Silence.

Virginia looked at the clock again and felt her stomach tighten. She was going to be late for work again and, as a divorced single mother, she needed the job even if it was only as a filing clerk in an estate agent’s office. It was a busy office. ‘Please Trish, tell me.’ She tried to make eye contact by taking Trish’s hands in hers and pulling her to her feet.

‘They’ve started calling me Patch in the gym class.’

‘Patch? And this is what this is all about?’ exclaimed Virginia. ‘Some silly children calling you some silly nickname?’

‘I don’t like it. I want it to go away.’

Virginia back-pedalled on derision when she saw the tears start to run down her daughter’s face. In recent months Trish had developed a patch of white skin on her right shoulder which ran nearly all the way down her right arm. Since she was dark haired and sallow skinned, it was very noticeable. The doctor had said it was really nothing to worry about and probably the result of hormonal changes in her body — she had just turned thirteen. He was confident that, given time, the discolouration would disappear of its own accord but it had been three months now without much change if any.

‘Look, if it will make you any happier, we’ll go back to the doctor and tell him there’s been no improvement.’

Trish nodded. ‘Yes please, Mum.’

‘You go off to school now and ignore these ignorant people. I’ll call the doctor before I leave for work and try for an evening appointment. Okay?’

Trish nodded and kissed her mother goodbye.

‘I’m not sure what you want me to do,’ said Dr James Gault when Trish and her mother told him the rash wasn’t getting any better. He sounded irritable. ‘It’s not technically a rash,’ he corrected. ‘It’s just an area of skin discolouration and most probably psychological in origin.’

‘Whatever it is, it’s showing no signs of going away and some of her class-mates have started calling her names and it’s very upsetting.’

Gault shrugged. ‘It’s absolutely harmless and what’s a little name calling. Sticks and stones, eh Trish?’