Cruel Legacy

‘I’m sorry, Elizabeth,’ her boss had apologised. ‘But you know how things are: we’re all suffering cutbacks and underfunding, just like everyone else.’

That was true enough. Richard had been complaining that the hospital now seemed to employ more accountants to watch over its budgets than they did nurses to watch over its patients.

‘Richard, have you got a minute?’

Richard paused, frowning as he glanced at his watch.

‘Barely,’ he told the hospital’s chief executive. ‘My clinic starts in half an hour and I’ve got a couple of phone calls I need to make first.’

‘I really do need to talk to you, Richard,’ the other man insisted. ‘We’ve got a committee meeting coming up soon and we still have to go through your budgets.’

Richard grimaced, suppressing his instinctive response, which was to say that he was a surgeon, not an accountant. It was pointless losing his temper with Brian; he was just as much a victim of the financial cuts being imposed on them as he himself was.

‘Look, let’s go into my office,’ Brian suggested, taking advantage of his silence.

Irritably Richard followed him, shaking his head when Brian offered him coffee. ‘No, I forgot for a moment—you’re a tea man, aren’t you?’

‘I drank too much coffee when I was a student and a young intern,’ Richard told him. ‘They talk about working long hours now, but when I first qualified … Still, we didn’t have the same pressures on us then that they do now, nor the huge diversity of skills and facts to learn. These days there seems to be a new drug on the market every day and a new set of complications to go with it, never mind all the new operating techniques, and then of course there’s the paperwork …’

Brian Simmonds watched him sympathetically. He had remarked at last month’s meeting to the new area health chief administrator that it was perhaps unfair to expect some of their senior and older medical staff to be able to absorb the intricacies of the new technology and the tighter control of finances as speedily as the younger ones.

‘If that’s the case, then perhaps you ought to be thinking about pensioning a few of them off,’ had been David Howarth’s cold response. ‘It appals me to see how much money we’re wasting paying top salaries to people who could quite easily be replaced by someone younger—and cheaper.

‘The whole area health system needs reorganising and rationalising. We’ve got far too many small specialist units competing with one another. It would make much more sense to nominate specific hospitals to deal with specific areas of expertise. Out of the eighteen hospitals in this area, a good number of them have specialist heart units, and both your hospital and the Northern have specialised microsurgery units. Older surgeons like Richard Humphries …’

‘Richard Humphries was the first local surgeon to specialise in his field,’ Brian had protested defensively. ‘He really pioneered the treatment in his area …’

‘But Richard Humphries is a man not far off sixty who, no matter how excellent a surgeon he might be, has made it plain that he just isn’t equipped to deal with the financial implications of working in an independent hospital. Christopher Jeffries at the Northern, in contrast, has already shown that he has an excellent grasp of the way we’re going to need to operate in future to make sure we’re financially viable, and he’s twenty years younger than Richard.’

Brian hadn’t repeated their conversation to Richard. Richard and David had taken a dislike to one another virtually at first sight, and Brian already knew from past experience that Richard was simply not a man to compromise on what he believed were the best interests of his patients for any mere financial reasons.

Richard epitomised all that was best in the Health Service, its principles and its goals, while David on the other hand represented the new financial cutting edge that was being imposed on it to try to counteract the burden of a growing population and the rapid advances made in medical technology.

He sighed to himself, knowing that the problem was one thing, but finding the answers to it was something else again, and while David and his like believed that the answer was a far more hard-nosed response to the provision of health services, and while publicly Brian might feel it was politic to agree with him, privately he couldn’t help but sympathise with Richard’s totally opposite point of view.

Sympathising with him was one thing, failing to get across to him the message that if financial restraints were not self imposed then they would be imposed from outside was another matter, and one that could potentially prejudice the whole hospital’s future.

‘Our accountant was on the phone yesterday,’ he told Richard now. ‘It seems that she still hasn’t received your budget forecasts for the next quarter …’

‘What exactly is the hospital paying me for?’ Richard countered irritably. ‘Filling in forms or operating on patients?’

Brian sighed again. ‘Richard, I know how you feel, but try not to make too much of an enemy of people like David.’ He moved uncomfortably in his seat. ‘There are areas where savings can be made. The Northern——’

‘The Northern has a far lower post-operation recovery-rate than we do here,’ Richard interrupted, and added bluntly, ‘And you already know my opinion on the reasons for that …’

‘You’re getting too old and too idealistic, Richard,’ his GP son-in-law had told him drily the last time they had met. ‘And if you think you’ve got problems you should sit at my desk for a couple of days.’ Too idealistic he might be, but too old … Richard frowned, wondering why the thought should make him feel so edgy and defensive. He wasn’t even sixty yet. No age for a surgeon. Heavens, he could remember when he’d got his first internship: the senior surgeon had been close to seventy and everyone apart from the matron had gone in awe of him. It hadn’t mattered that you had to shout to make yourself heard because he was going deaf; watching him operate had been a privilege. In those days age and experience had been things to honour and respect—not like today, when the moment you got past forty-five you were considered to be past your best.

Back in his office, he found that his secretary, Kelly, had already sorted his mail into urgent and non-urgent piles. On the top of the urgent pile was a GP’s report on one of her female patients. As he studied it he pushed aside his conversation with Brian, frowning as he read the doctor’s findings.

A lump had been detected in the patient’s breast and an immediate operation would be necessary to perform a biopsy and removal if the lump was found to be malignant. She was a relatively young woman, only in her mid-thirties, and he knew from experience the trauma she would experience over the potential loss of a breast, but given the choice between that and losing her life …

His frown deepened as he reached into his jacket pocket for his diary, flicking it open until he found what he was looking for.

‘Kelly, how much emergency space have I got left on Thursday?’ he asked his secretary.

‘Thursday,’ she repeated, studying his lists. ‘None …’

‘Well, then, we’ll have to make some; Mrs Jacobs needs surgical attention straight away.’

‘But Thursday’s just two days away; you could afford to hold on until early next week.’

‘No, it has to be Thursday the tenth; the date is crucial,’ he told her. ‘Let me see the list, will you?’

When she handed it to him he studied it thoughtfully.

‘We’ll cancel Sophie Jennings’ non-urgent operation and put that in the beginning of next month,’ he announced.

Kelly pulled a small face. ‘We’ve had to cancel it once already due to another emergency, and you know how much she complained then …’

‘It can’t be helped,’ Richard told her. ‘Get her file out, will you, and I’ll write to her? Oh, and get me Mrs Jacobs’ file as well; I’d better phone her and speak to her personally.’

‘Problems?’ Elizabeth asked later that evening as they sat at their table in Mario’s and she watched Richard pushing his food unenthusiastically round his plate.

‘No more than usual,’ he told her drily. ‘All I ever seem to hear from Brian these days is money and budgets. What the hell is happening to the world today, Liz, that we judge the success of a hospital not on how many lives it saves, or on how much it improves the quality of its patients’ lives, but on how much money it can save?’

Elizabeth shook her head sympathetically. It was a familiar argument and very much a sore point with him at the moment.

‘The Health Service is under a great deal of financial pressure,’ she reminded him gently. ‘Look at the way you’ve had to go to the public to raise money to help fund this new Fast Response Accident Unit. At least that’s one cause that you and Sir Arthur are united on.’ She smiled. ‘He’s every bit as keen and determined to get the unit for the General as you are.’

‘Yes,’ Richard growled. ‘Someone ought to tell him that he’d be doing everyone a better service if he concentrated more on his fund-raising and less on finding fault with everything we do … Everything’s changing, Liz—good men being pensioned off for no better reason than the fact that …’ He paused, shaking his head. ‘I feel so out of step somehow. Am I wrong to believe that we should put our patients first?’

‘No, you’re not wrong,’ Elizabeth assured him. She put down her knife and fork, feeling her way as tactfully as she could. ‘But knowing you’re right isn’t always … you can be very stubborn,’ she told him gently. ‘There are circumstances when it’s sometimes easier to get your point of view across by being a little more flexible.’

She knew what was really bothering him; she and Sara and been discussing it earlier.

‘How’s Dad going to feel if the General amalgamates with the Northern and they offer him early retirement?’

‘Offer him early retirement?’ Elizabeth had queried ruefully. ‘Your father is far more likely to see it as being pensioned off; he won’t like it at all.’

‘No, and it won’t help that your working and your career is just beginning to take off …’

‘Oh, Sara, you’re not being fair,’ she had protested. ‘Your father has always encouraged me in my work …’

‘Mmm … but his career has always taken priority, hasn’t it? Oh, I know how pleased he is for you, how proud he is of you, but if he was sitting at home all day while you——’

‘It won’t come to that,’ Elizabeth had interrupted her firmly.

‘No? Ian was saying the other day that two or three of the older, more senior men at the Northern have already been approached with a view to getting them to go, and Dad is only a few years off sixty …’

Now, as she watched him, Elizabeth’s heart sank a little. She knew how much his work meant to him and she knew what a blow it would be to his pride, his sense of self-worth if he was asked to retire before he was ready.

Perhaps if she subtly tried to underline the advantages of his not having to work as hard, just as a precautionary measure. Her mouth curled into a rueful smile. Burgeoning career woman she might be, but in many ways she was still very much caught up in the traditional role of the supportive wife. That was how her generation had been brought up.

‘Oh, did you manage to get over to see Sara?’ Richard asked her, changing the subject.

‘Yes,’ she told him. ‘She’s feeling a bit frazzled. I offered to have Katie for a few days to give her a break; I’ve still quite a lot of holiday leave to take.’

‘You always were a soft touch,’ Richard told her. ‘For all of us …’

‘I’m glad you’re honest enough to include yourself in that comment,’ she teased him.

‘How do you feel about getting out of here and going home?’ Richard asked her urgently, leaning across the table so that the hovering waiter could not overhear what he was saying.

Elizabeth looked at him quickly to confirm that she hadn’t misunderstood the subtle message he was giving her. In the early days of their marriage, when their passion for one another had still been new and exciting, it had been no strange thing for them to leave early from dinner parties and other social events, Richard claiming quite untruthfully that he was on call, when in fact what he had wanted, what they had both wanted, was to go home and make love.

Laughing together, they had hurried back to their small flat, their urgent eagerness for one another as intoxicating as a heady wine, but these days their lovemaking, although still pleasurable, tended to be a far more leisurely and considered affair, its spontaneity tempered originally by the demands of a growing family and more latterly by their individual career demands and a certain natural lessening of the intensity of their desire.

‘Does that mean what I think it means?’ she asked him in amusement, and then laughed as she saw the way he was looking at her.

‘We are not teenagers any more!’ she told him ten minutes later when he took hold of her in the street, kissing her firmly before hurrying her towards their car.

‘Who says we need to be?’ he whispered as he paused to kiss her a second time. ‘Just because we aren’t under thirty, it doesn’t mean that we automatically stop functioning properly, that we aren’t just as capable as our juniors. There are, after all, times when experience and knowledge count for a lot more than youth and enthusiasm …’

Elizabeth touched his face gently.

‘Oh, Richard.’ There’s no shame in growing older, she wanted to tell him, but how could she, when all around them was the irrefutable evidence that there was? Being old and ill and dependent—these were now the taboo subjects that sex and birth had once been.

Richard wasn’t alone in dreading retirement as an acknowledgement of the beginning of his own old age.

CHAPTER FIVE

PHILIPPA opened her eyes and shut them again quickly as she remembered what day it was.

Outside it was still not properly light, but she knew she would not go back to sleep. She threw back the duvet, shivering as she felt the cool draught from the half-open window.

The cremation was not due to take place until two o’clock—plenty of time for her to do all the things she had to do …

‘You’ll be having everyone back to the house afterwards, of course,’ her mother had announced when she had rung to discuss what arrangements Philippa had made for Andrew’s cremation. ‘It would look so odd if you didn’t.’

‘I don’t think that’s a good idea,’ Philippa had protested. ‘Especially in the circumstances.’ Death was a difficult reality for people to handle at the best of times, but when it came through suicide …

‘You’ll have to do it, Philippa,’ her mother had insisted. ‘People will expect it.’

What people? Philippa had wanted to ask her. She supposed she ought not to have been surprised by the number of people—their so-called ‘friends’—who had rung ostensibly to commiserate with her and offer their sympathy, but in reality to dissociate themselves from Andrew and the taint of his failure just as quickly as they could.

Oh, they would want to be seen to be doing the right thing: they would send flowers, expensive, sterile displays of wealth and patronage. They would talk in public in low voices about how shocked they had been … how sorry they felt for her, and of course letting it be known how tenuous their acquaintance with Andrew had actually been, but she doubted that many of them would be seen at the crematorium.

And after all, who could blame them? Not Andrew, who would have behaved in exactly the same way had he been in their shoes.

Her black suit hung on the wardrobe door. She eyed it rebelliously. It wasn’t new and certainly had not been bought for an occasion such as this. She liked black, and it suited her fair paleness.

The fine black crepe fabric clung flatteringly to her body, or at least it had done; with the weight she had lost since Andrew’s death she doubted that it would do so any longer. The black velvet reveres of the jacket added a softening richness to its simple classic design.

It was really far too elegant an outfit to wear for such an occasion.

A woman … a widow who wasn’t really grieving for the loss of her husband would not have cared what she wore; there could not be any colour that could truly portray to the world what she was feeling.

A surge of contempt and bitterness swamped her. The contempt she knew was for herself; and the bitterness?

She walked into the bathroom adjacent to the bedroom. The bitterness … That was for Andrew, she admitted as she cleaned her teeth.

As she straightened up, she stared at her reflection in the mirror. Her face, wiped clean of make-up, showed beneath the harsh lighting of the bathroom exactly what effect the last few days had had on her. Pitilessly she stared at it, noting the fine lines touching the skin around her eyes, the pale skin and the tension in the underlying bones and muscles.

There, she was admitting it at last: it was not grief she felt at Andrew’s death, not the sorrow and pain of a woman who had lost the man who was her life’s partner, her lover, her friend, the father of her children.

What she felt was anger, bitterness, resentment.

Andrew had known what lay ahead of him … of them … and, unable to confront the situation he had brought upon himself, he had simply turned his back on it … evaded it, leaving her …

Her body started to shake as she tried to suppress her feelings, her hands gripping the edge of the basin.

Anger, bitterness, resentment; these were not emotions she should be feeling … but the guilt, the guilt that went hand in hand with them, that underlined them and seeped poisonously into her thoughts—yes, that was an emotion she could allow herself to feel.

Andrew had been her husband and, yes, she had married him willingly, caught up in a rebounding tide of pride, determined to prove that she was fully adult, fully a woman … and a woman capable of being loved by a man who would treat her as a woman and not a stupid child.

She closed her eyes. She had tried her best to be the wife Andrew wanted, to keep the bargain she had made with fate; she had tried to do it, to infuse into their relationship, their marriage, the warmth and sharing which Andrew could not or would not put into it; but nothing she had been able to do had ever really been able to disguise the poverty of the emotional bond between them, and in her worst moments since Andrew’s death she had even begun to wonder if this was his way of punishing her, if by leaving her in the manner he had … But then common sense had reasserted itself and she was forced to acknowledge that their marriage had come so far down the list of Andrew’s priorities that it would have been the last thing he would have taken into account in making his decision … that she would have been the last thing he would have taken into account?

Oddly, that knowledge, instead of freeing her from the burden of her guilt, only served to increase it. Yes, she had tried, but had she really tried hard enough?

‘You can’t be serious. You didn’t even know the man; why the hell should you want to see him cremated? It’s ridiculous … disgusting …’

‘Ryan thinks it’s the right thing to do.’ Deborah stared angrily across their bedroom at Mark.

The violence of his objections to the discovery that she intended to attend Andrew Ryecart’s cremation had caught her off guard, and touched a nerve which she herself had not wanted to acknowledge.

She dismissed the thought, reminding herself that she couldn’t afford to damage her professionalism with inappropriate feminine behaviour.

‘It’s a token of respect, that’s all,’ she told Mark, turning away from him so that he couldn’t see her face.

‘What? Don’t give me that … It’s blatant voyeurism and if you really believe anything else … You’ve changed ever since Ryan gave you this commission.’

‘No, I haven’t,’ she denied. ‘If anyone’s changed, it’s you. What’s the matter with you? You’re behaving almost as though you’re jealous.’

‘Jealous … who the hell of?’ he challenged her.

It had been on the tip of her tongue to say, ‘Me’, but suddenly, for no real logical reason, her heart started to beat too fast and she found she could not actually say the word.

‘I suppose you mean Ryan,’ he told her, answering his own question. ‘My God, that only underlines what I was just saying. If you really think I could ever be jealous of a creep like that …’

As he studied her downbent head and the way her dark hair swung over her face, concealing her expression from him, Mark knew that he had over-reacted. The bright morning sunshine highlighted the chestnut shine on her hair and the lissom softness of her body.

His own ached abruptly in a sharp spasm of sexual response. He wanted to pick her up and carry her over to their bed, spread the soft, warm femaleness of her underneath him and make love to her with such passion that she would not be able to suppress her sharp cries of pleasure, her body’s response to him, her need and desire for him. He wanted, he recognised, her recognition of him as a man … as a source of power and strength. That knowledge shook him, disturbing him, making him reject the sexual message his body was giving him.

What he wanted, a cold black corner of his mind told him, was her acknowledgement of his power over her, her subservience to him.

But no, that could not be true. He was not that kind of man; he never had been; that kind of egotistical need was a male trait he despised. Their relationship was one of mutuality and respect.

Or at least it had been. Deborah seemed to have more respect for Ryan these days than she did for him.

Test her, a small inner voice urged him. Let her prove to you that you’re wrong.

‘If you’ll take my advice you won’t go,’ he heard himself saying.

Deborah lifted her head and frowned as she looked at him. ‘I don’t have any option. I have to go,’ she told him. ‘Ryan …’ When she saw the expression on his face, she reminded him quietly, ‘He is my boss, Mark.’

‘Yes,’ Mark agreed equally quietly.

It was only later, when she was actually in her own office, that Deborah asked herself why she had not pushed Mark to explain more rationally why he felt she should not attend the cremation.

Admittedly Philippa Ryecart was not involved with the company in any official capacity and until she had had her first meeting with the bank, who were the company’s main creditors, she would not know to what extent Andrew’s personal assets were involved. It was not unknown in such cases where a man knew his business was failing for him to withdraw as many of its assets as he could, converting them into funds for his private use, and it would be part of her job to discover if this had happened.

Scavenging among the rotting carcasses of the dead, Mark had called it, and she supposed to some extent he was right.

It all depended, though, on what attitude you took. ‘The company’s creditors have every right to try to recover their money,’ she had pointed out to him defensively.

‘Every right,’ Mark had agreed and had then added, ‘How will you feel, Deborah, telling people that they’re going to lose their jobs; that their redundancy money and very probably their pension as well has gone?’

‘I’m not responsible for the company’s failure,’ Deborah had defended.

‘No, but you’re the one who’s going to have to stand there and tell them … you’re the one who’s going to have to look at their faces and see the fear in them.’

‘Stop it,’ she had told him fiercely, asking, ‘Why are you doing this to me, Mark? It’s my job, you know that …’

‘Yes, I’m sorry,’ he had apologised, his face softening as he’d recognised her distress.

They had made it up and she had told herself that it was silly to feel so hurt, but now they were quarrelling again.

It had been tempting this morning to admit to him that she didn’t want to go to the cremation, but Ryan had warned her against letting her emotions get in the way of doing her job properly. He had also let it slip that some of the other partners felt he was taking a risk in allowing her so much responsibility and that they had felt he should have appointed a man to head the team, with her as second in command.