On Tuesday morning at 9 a.m. Maura was sitting in her manager’s office trying to explain why she’d been arrested and released without charge. It was not a story the head of nursing wanted to hear, and her disapproval was tangible. If Maura hadn’t been able to feel it rolling off the woman in thick pulses of dismay, she would have been able to see it in the pinched expression and pursed lips. ‘Well, Maura, I really don’t know what to say. This certainly isn’t the kind of thing we expect our nurses to be involved in, and it’s hardly conducive to maintaining professional standards of trust and respect,’ she said.
Maura was tempted to explain that she totally agreed, and that she hadn’t exactly expected to become embroiled in a murder. Not that she’d been given a choice – cold-blooded killers didn’t stop to chat about their moral compass being off kilter before they got down and dirty. Instead she just nodded at her boss and hoped she’d managed to pull off a suitably contrite look.
‘I’m tempted to suggest that you take some paid leave. However, having consulted both your union representative and the UKCC on this matter, and given that you haven’t been charged with anything, I don’t have grounds to press you to do that, but I would prefer it if you made that choice yourself. Given that you’ve recently had so much time off anyway, it might do you some good.’
The thought of it horrified Maura. There was no way she could face endless days rattling around in the house on her own with nothing better to do than think. ‘I’d really rather just get back to my duties.’
There were those pursed lips again. ‘I thought you might say that. In all conscience, I don’t feel it would be appropriate to allow you to work alone in the community. I’m not questioning your competence, but should your involvement in this matter become public knowledge, I do have a duty to reassure people they can rely on our staff.’
The implication was clear. Until another suspect had been apprehended and charged, Maura was under suspicion. If not from the police, then from her own employers. She could feel bile rolling in her belly at the injustice of the situation, but knew there was little she could do or say. Her boss was going to be judge and jury on this one. ‘So what do you suggest?’ she said, her tone as grudging as her acceptance.
The woman sighed and tapped her pen on the desk several times, as if questioning her own wisdom. Maura had the distinct impression that if there had been grounds for instant dismissal her sorry ass would have been out of the building already. Finally the woman spoke. ‘I think the only solution under the circumstances is that we second you to none of the wards for the duration of the case. That way we can reassure people that your practice is being closely supervised. We’ll keep you on your two days a week phased return too.’
She was ass-covering and they both knew it. ‘Which ward?’ Maura asked with ever-grudging resignation.
‘Dugdale. You’ll report to the charge nurse there. You’ll be paid your current grade, but for now will operate in the role of staff nurse. You’ll be supervised on all medication rounds too. I’m sorry, Maura, but I have a duty of care to protect the Trust’s reputation here, as well as yours, of course.’
The token concern was accompanied by a weak smile that Maura would cheerfully have slapped off if such a thing had been acceptable behaviour. Instead she returned the favour and smiled back. She really did need to work on her temper; the urge to lash out at people was getting out of hand. ‘Dugdale – that’s EMI, isn’t it? It’s not an area I’ve had a great deal of experience in.’
The weak smile turned smug. ‘Well, I’m sure you’ll be fine, and dealing with the elderly mentally ill didn’t seem to concern you too much when you took on your private role.’
Touché. She was over a barrel and she knew it. ‘OK. When do I start?’
‘This afternoon. You’re down for a late shift.’
It was a fait accompli, done and dusted before she’d even set foot in the office. The thought of shift work just about put the cherry on the cake. ‘Must I do shifts? I’ve worked in the community for years. It’s been a long time since I did shift patterns or even worked on the wards. Besides, I’m certainly not au fait with long-stay patients any more.’
‘That’s how wards function, Maura. It is what it is. You can, of course, always take the paid leave option.’
The whole thing was starting to smell like an attempt at constructive dismissal, and Maura was having none of it. ‘No, it’s fine. Dugdale it is. Will that be all?’
She was dismissed by a curt nod and left the office carrying her festering discontent as if it was a struggling toddler about to have a tantrum.
To heap insult upon injury, the manager of Dugdale ward seemed to think Maura couldn’t make a cup of tea unsupervised and so set a young student nurse to “shadow” her. Which meant she wanted someone to keep an eye out and make sure Maura didn’t inadvertently bump off any of the patients while no one was looking. Where Maura went, the student went too, even at one point following her to the toilet and making both of them feel grossly uncomfortable when the destination became clear. It wasn’t the kid’s fault; she seemed like a nice girl, though Maura had been too preoccupied to catch her name properly and thought it was either Keeley or Kayleigh. She couldn’t remember which and was too pissed off with the situation to ask. Remaining undecided as to which it might be, she’d managed several hours of avoiding addressing her directly. Life had been so much easier when the staff had worn badges. ‘So, now we’ve cleaned and sorted the clinic, how about you introduce me to the patients?’ she suggested to the girl. There were only so many different enemas and dressings she could stand to stock-check in a shift.
Keeley, or Kayleigh, or whatever her name was, seemed reluctant. ‘I don’t know. Michaela said just to keep you busy for today.’
Maura suppressed a sigh, and wondered just how heavy her boss had needed to get to persuade the ward to take her at all. ‘OK, though I don’t see you’re going to learn much from counting packs of Norma Sal, or stacking Inco pads. What about coursework? We could go through that and I’ll help you if you like.’
The girl thought about it for a moment and smiled. ‘Yeah, OK. I’m doing a case study on one of the patients.’
Maura smiled back. Despite recent experiences she wasn’t completely inhuman… yet. ‘Brill. Lead the way.’
The girl seemed more eager when she was confident Maura wasn’t about to run amok on a killing spree and happily chatted about her college work as they left the clinic and made their way back to the office. Once there she pulled out her folder and showed Maura what she’d been working on. ‘It was hard to choose someone at first. I mean, it’s elderly care, right? So, most of them are going to have Alzheimer’s, and that’s been done to death – not that it doesn’t interest me, it does, but it’s not, like, that intriguing really, is it?’ She prattled on while Maura kept smiling in what she hoped was a benign manner. She’d like to have put the girl straight, but as she was the resident persona non grata figured it was best to stay silent at that point. ‘So, then I came across JJ. She’s a little bit different from the rest. She’s been in hospital for years and years, so I figured she would be a good example of the long-term effects of institutionalisation. I mean, she’s been here since 1989, which is what? Twenty-six years? And before that she’d had frequent admissions.’
Maura interrupted, just to show interest really. ‘What was she originally treated for?’
The girl was warming to her subject. ‘Well, that’s where it starts to get interesting – the old records state she had a nervous breakdown. Of course we don’t call it that these days, do we? So, I started to look into her case, and I’d say she was suffering with endogenous depression and OCD.’ She said this with a triumphant little smile, as if she’d just solved an age-old psychiatric conundrum.
Maura nodded. ‘Interesting… They liked their old-fashioned blanket terms, eh? So, what led to her being here long-term?’
Keeley, Kayleigh (or whatever her name was) beamed with excitement. ‘That’s when it gets really interesting. Up until 1987 she’d been treated with drugs and ECT. She’d have short periods of comparative wellness, go home for a while, then end up back in hospital. Not this one, of course. The old one – the asylum.’
Maura remembered it well, a huge old place like some Gothic mansion with long, green-painted corridors and rambling passageways that led to turret rooms and hidden, lockable wards. It had even had its own shop and a ballroom with a sprung dance floor. It had been quite a place until they’d pulled it down and built a Tesco superstore on it. She’d completed some of her own nurse training there just before it closed and still held personal opinions on the value of asylum in the truest sense of the word. People found little safety and sanctuary in the community in her experience, and there was still some argument for those vast places, though they had never outweighed the arguments against them. ‘I did part of my training there,’ she said, almost nostalgically. Plus, it was where she’d first come across Dr Moss. He’d been a doctor there too. There’d been a bit of a scandal if she remembered rightly, but it was a long time ago and she wasn’t keen on thinking about Dr Moss at that moment. Not after what he’d got her into and what had happened to him.
The girl seemed impressed. ‘Did you? Wow. I’d have loved to have seen it. Those places were fascinating! So, if you were there, do you remember a psychiatrist called Dr Mechan?’
Maura cast her mind back. It had been six months, back in the late nineties, and she hadn’t been much older than the girl. A lot of years had passed since then. ‘Very vaguely. I think he’d retired by then but the name rings a bell. I think I remember a portrait of him in the entrance hall. Why?’
The girl gave another small yet triumphant smile. ‘Well, he ought to be more well-known – he was the last psychiatrist in England to carry out a trans orbital leucotomy under ECT.’
Maura raised her eyebrows. ‘Blimey! I thought that kind of barbarism had died out by the 1950s in most places.’
The girl shook her head. ‘Not here it didn’t. They didn’t do many, but he did the last one in 1982, just before the Mental Health Act came into force. And he did it to JJ. That’s why she ended up here long-term. It left her with severe epilepsy that couldn’t be managed at home, so her family dumped her in hospital. Poor woman.’
Poor woman indeed, Maura thought. Leucotomy was known by most people as lobotomy, and a trans orbital leucotomy was a piece of crude surgical butchery which involved hammering a spike into the brain via the eye socket and wiggling it about a bit to destroy the part of the brain thought to govern personality. It had been believed that it would improve mood stability and make people more docile. Sometimes it did, but it also left some people emotionally detached, some as gibbering idiots, and some dead. The fact that the girl’s patient had ended up with chronic epilepsy came as no surprise to Maura. There were good reasons why the practice had died out, though most didn’t know it did still happen in rare cases, but that they had sanitised it by calling it neurosurgery. Procedures that were carried out in a theatre, with men in masks, using state-of-the-art equipment, were much more palatable – even when those men were still deliberately destroying areas of someone’s brain. The only real difference now was that the patient’s informed consent was needed and an ethics panel had to clear the procedure. It hadn’t been that way in 1982, way before Maura’s time, and though she’d never come across the procedure, she’d known it had gone on and nursed people living with the results of it.
Maura had been absently scanning through the girl’s essay while she’d been talking, noticing more the poor grammar and lousy spelling than anything else. ‘So, how has JJ fared since coming into hospital full-time?’ she said, passing the essay back to the girl.
Keeley/Kayleigh was more confident now – she’d warmed to her theme and was emboldened by Maura’s interest. ‘Come and see for yourself, I’ll introduce you to her.’
They found JJ in her room at the end of the ward, a tall, insubstantial shadow of a woman with translucent skin that had the texture of cheap tissue paper. The smile she gave to Maura was toothless and habitual, something she’d learned to do on command and not because she felt any warmth. ‘Say hello, JJ. This is Maura, our new nurse.’ The girl’s tone was naïve, indulgent and well-meaning, but the patronising essence of it still made Maura cringe.
The woman gurned again and swung from side to side on her bare feet as she placed her sticky hand into Maura’s. ‘JJ, JJ, JJ,’ was all she could say. Maura let the sticky hand go and resisted the urge to wipe her own on her trousers to rid herself of the unpleasant sensation.
She watched as JJ went back to what she’d been doing before they’d come into her room, circling it with her shoulder, nudging the wall and repeating the same two letters over and over again. After two full circuits of this mindless loop Maura could stand no more and walked out of the room quietly. In the corridor, she turned to the girl. ‘I take it that’s why she’s called JJ. Is it all she can say?’
The girl nodded. ‘She used to talk when she was first admitted, but according to her records it’s the epilepsy that’s caused the ongoing damage. Personally, I think it’s the long-term side effects of the drugs too. From what I can find she’s been on everything going at some point over the years. She’s like a soft little zombie.’
It was the perfect description and made Maura want to shudder – and shout at the girl for her judgement of the fragile and intriguing JJ. ‘Do you still have her notes? I wouldn’t mind having a read.’ It had to be better than being packed off to count the bandages again.
‘Sure, they’re in the office. In fact I’ve got to take them back to Health Records. As Michaela doesn’t seem to want to give you a real job to do, why don’t you take them back for me?’
Maura had been about to give the girl a warning look. She might well be persona non grata, but like hell was she going to be a student’s lackey. However, the prospect of time out of the cloying atmosphere of the ward seemed like a heaven-sent opportunity. ‘Sure. I might as well go on my break while I’m at it.’
The file was thick and heavy; the girl had put it inside a tired old manila envelope to hold it together for fear that some of its contents might get lost. The implication for Maura was that it wasn’t going to be light reading. The quietest and most peaceful place in a hospital was never the library, as one might suppose, but always the chapel. In all her years of nursing she’d never once been disturbed in a hospital chapel, not even by a chaplain. She’d often wondered whether God popped in for a bit of peace sometimes too, given how often people on the wards claimed he was talking to them. She had to admit she’d never sensed his presence among the blond-wood pews and dust and supposed maybe he was a bit like her, eager to go unnoticed. She found a discreet corner and pulled the file from the envelope, her breath stalling in her chest as she looked at the faded name. It seemed God did indeed provide, in the strangest, most coincidental ways.
The file proved to be the gift that just kept on giving. As she read, more and more pieces fell into place. It was like looking at a jigsaw puzzle without its lid and fumbling about with the pieces until it was half finished, but complete enough so she could guess at the picture and fill in some of the gaps with her imagination. Only the fine details were missing.
She might have doubted it, thought the name was just a fluke, if she hadn’t also found the document that recorded the leucotomy. Handwritten in Dr Mechan’s scrawl, which looked more like Elvish than English, she might have missed it, but the neatly typed document accounted for the whole procedure, including who was present. There was even a photograph – a macabre-looking image of an inert Jane Henderson lying on a table with a metal instrument protruding from her right eye socket. A faceless, unnamed nurse stood with her back to the camera, checking her patient’s pulse, while Mechan stared imperiously at the lens, flanked by his assistant – Senior House Officer Philip Moss.
The whole scenario was hideous, like the vile click bait photos that turned up on the Internet to entice those with a more salacious turn of mind.
A consent form was attached to the document with an old treasury tag. Had Gordon signed away his wife’s right to a thinking, feeling life with a single blithe flourish of his pen? Even if he’d made the decision with a heavy heart and sense of desperation, Maura couldn’t forgive him now she’d met the result of his actions. Jane Henderson was an apparition, a shade, a revenant, unable to even utter her own name coherently. Whatever had been wrong with her, she hadn’t deserved that. And she wasn’t buried in the woods – just buried alive in a hospital, out of sight and out of mind.
Knowing who had done this to Jane, knowing she had cared for a man capable of bringing about such a thing, made Maura’s stomach lurch, her temper rise and any vestige of guilt over Gordon’s death take wing and fly like a bat into the shadows. Was a man capable of this also capable of the murder of an innocent woman and child? Perhaps, but it was hard to trust that Poole and his compadres would find that out. Kelsoe was a bitch, Gallan was a plodding fool and Poole was an arrogant tosser. She had no faith in them and was fast losing any she’d had in anything else. The caring profession she so believed in had resulted in the creature that was now JJ. Her own incompetence had resulted in the man she’d been caring for ending up dead.
She put the file back into the envelope and left her guilt over Gordon to roost in the rafters of the chapel where it could wrestle with God of its own accord. She wanted nothing more to do with it.