Mo Hayder - Skin

‘I know.’

He sighed. ‘I thought you might.’

‘It was the scar that looked like a Caesarean. Remember? After you left I opened her up and her uterus hadn’t been touched. She was G zero.’

‘G zero?’

‘Gravida zero. Never gave birth and had never been pregnant. The incision didn’t go into the deeper aspects.’

‘You said it was a mess. What did you mean?’

‘Not untidy – there was a lot of skill there. And I mean a lot. But I got the feeling the surgeon cut far too low – lower than he needed. Cut away half her pubis. And she had a sympathectomy. It must have happened at the same time, judging by the healing.’

‘A what?’

‘She had the sympathetic nerve cut. It’s the nerve that controls blushing and sweating in the face. Remember those nicks under her arms?’

He remembered them. Two scars in the armpits.

‘It’s the sort of thing you’d see if someone had had a lung biopsy done through a video-assisted feed. You insert a thin tube into the chest cavity and push the blade down through it. But in this case he was going for the nerves, not the lungs. Lots of people have it done. Usually it’s a bloody disaster – they have to have it reversed. And that fails too. Surgeons in the States are waking up to it. They clamp the nerve now in case the patient changes their mind. We’re a bit behind, though.’

Caffery saw Lucy’s face on the video – Welcome to my atelier – remembered her hands fidgeting around her stomach. The way she wasn’t blushing. It hadn’t been something spiritual or a rise in confidence that had made the difference. It had been an operation. And somehow he’d missed it. He pulled hard on the cigarette. Everything – everything – he’d thought he knew about Lucy Mahoney before her death was wrong.

‘Why didn’t you-’

Beatrice held up a hand warningly. ‘I know what you’re going to say and you know what I’m going to say…’

‘That it’s all in your report? That I should’ve read it?’

‘Did you?’

‘We’ve been talking about nothing else for the last couple of days. There must have been a moment you thought to say something.’

‘I just asked, did you read my report?’

‘You could have told me. That’s all. You could have said something.’

‘I could have told you lots of things.’ She threw a tennis ball to the setter and it leapt away in the grass, its hindquarters bucking like a horse’s. ‘I could have told you she’d broken her ribs when she was, I don’t know, about twelve. Or that she had bad teeth – four crowns and five root canals. I could have told you the colour of her toenail polish and the brand of her bra. None of those seemed relevant so I put them in the report and didn’t talk to you about them. Cosmetic surgery two years ago not related to the cause of death isn’t something I’d have flagged up. It’s my job to think about cause of death, not ante-mortem behaviour, especially from two years ago.’ She whistled at the dog, beckoning it to come back. ‘That part, I’m afraid to say…’

Caffery sighed. ‘Yeah, yeah. I know.’ He pinched out the cigarette and put it back in his tobacco wallet.

That part was his job.

‘I’m going to make an incision here – I’ll go in through your Caesarean scar – then pull this part back.’

Ruth is sitting on an examination table. She’s wearing her bra and her underpants. Her high heels are still on and she’s resting her feet delicately, so as not to go through the strip of paper towel and mark the leather underneath. The room is well lit, airy and wood-panelled, with the surgeon’s degrees framed and mounted. Outside a gardener is cutting the grass. No doubt about it, the clinic is top drawer. Not the sort of place that asks for money up front.

‘We need to expose the muscles under here.’ The surgeon lifts up the flesh around her abdomen. ‘Then I’ll pull them together like this. Remove a little of this fat and skin here. When you come round there’ll be a couple of drains – one on either side. Just for the first forty-eight hours. Sometimes with an abdomectomy this muscle here, your rectus muscle,’ he drew his finger down the front of her belly, ‘can get a bit sore afterwards. It might make you feel nauseous too so I’ll inject into it while you’re under. OK?’

‘OK.’

‘You know there’ll be a bit of discomfort?’

A bit of discomfort here? In the Rothersfield clinic with its fancy landscaped gardens and bellboys in smart little hats? With satellite telly in all the rooms and champagne cocktails on the menu if you’re feeling well enough? She can deal with that. She pulls on her T-shirt and watches him squirt Spirigel on his hands, wipe them with a starched towel and go back to the big leather-topped desk. He’s not good-looking. Not really. A bit dowdy. But he’ll be loaded probably. Just the sort she needs.

He opens her notes and scribbles a few words with a scratchy Montblanc. Makes circles around the stomach of an outlined diagram. Pulls out a sheet of pink paper and starts filling in boxes.

‘Do you smoke?’

Ruth wriggles into her skirt. ‘No.’

‘Drink?’

‘Only if you’re having one.’

He gives a small, pained smile. ‘How many units do you drink each week?’

‘I don’t know. I’m a social drinker.’

‘So, ten to twenty-one drinks a week?’

‘That’ll do it.’

‘Live alone?’

‘Now it sounds like you’re asking me for a date.’

‘It’s a serious question. We need to know if you’ll have someone to care for you on your discharge from the clinic.’

‘Yes. I mean – I do. I live on my own. But I could arrange for my son to come. He’d be happy to be there.’ She buttons her skirt. This guy might be minted but he’s got no sense of humour. She gets off the table and takes the seat opposite him, crossing her legs and tensing the muscles so her calves look nice. She rests her fingernails on her knee.

‘My, uh, my niece works here. She recommended you.’

‘Did she?’ He doesn’t look up. ‘Kind of her.’

‘She and I are very close. She tells me everything. She confided in me.’

‘Confided?’

Still writing. Still not interested.

‘Said she thought you were one of the best surgeons around.’

He looks up at this. ‘Thank you. Always nice to hear.’

‘I think she spoke to you about…’

‘About a discount?’

She breathes out, relieved. ‘That’s right. A discount. She did speak to you.’

‘Yes, she did. Marsha will deal with it. My secretary. When you make the appointment she’ll take you through all that. I’ve got some spaces late June.’

Ruth narrows her eyes. ‘When do I pay?’

‘Marsha will invoice you.’

Her heart jumps. Invoices take days. Weeks. Time to milk Little Miss PI a bit more. ‘When?’ she says.

The surgeon looks up. ‘Don’t worry about that,’ he says. ‘We’ll be in touch after the procedure.’

Rothersfield clinic wasn’t dissimilar from the Farleigh Park Hall clinic to look at, Caffery thought, with its oak-panelled waiting rooms, marble staircase and rooms with sliding glass doors that led out on to sweeping lawns. But there the similarities ended. Here, there was a porter service, five-course meals chosen from handwritten menus, and no one expected you to clean the toilets as part of your treatment. Chauffeurs waited in the driveway in their Mercedes and Bentleys for their rich employers to recover from their facelifts.

In a little office at the back of the building overlooking a knot garden, where one or two patients were wandering in their towelling robes, the nurse, Darcy Lytton, was waiting for him. Not yet changed for work, she looked the part of the girl rumpled from a night with a boyfriend: she wore scruffy Atticus skinny jeans, a studded belt and a black T-shirt with the words ‘Don’t make me kill you’ slashed across the chest. Her eye makeup was last night’s too: it was smudged into the folds under her brown eyes. She sat with her hands jammed between her knees, biting her lip. She’d been crying.