Control
CONTENTS
Prologue
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Chapter 42
Chapter 43
Chapter 44
Chapter 45
Chapter 46
Chapter 47
Chapter 48
Chapter 49
Chapter 50
Chapter 51
Chapter 52
Chapter 53
Chapter 54
Chapter 55
Chapter 56
Chapter 57
Acknowledgements
About the Author
Copyright
To Oscar and Fergus
PROLOGUE
NOVEMBER 1987
Kash gulped down the last spoonful of microwaved macaroni cheese and pushed the plastic container across the little table, savouring the peace and quiet. Well, relative quiet. The noises of a bursting-at-the-seams general hospital – the bangs and crashes, the raised voices, the occasional screams – were always faintly discernible in the background, even when he was back inside his hospital flat with the door firmly shut. But it was still an oasis of calm by comparison, and after another frantic shift on the wards, lurching from one emergency to another until he could no longer see – let alone think – straight, it felt like paradise.
A compact version of paradise, for sure. There was a tiny sink and hob in one corner, the latter largely redundant since the electric kettle and microwave together were sufficient to provide for all his nutritional requirements; a bookshelf crammed with medical textbooks; the table he was sitting at; two kitchen chairs; and a boxy little armchair covered in an unidentifiable orange fabric, which he largely avoided. A tiny bathroom and dorm-like bedroom just big enough to accommodate the bed and a single narrow wardrobe completed the picture.
It was cramped and uncomfortable and lacking in the remotest sense of homeliness.
Kash loved it.
He’d learned that being a junior doctor was a lot like being a soldier in action: if you found an opportunity to eat or sleep you took it, whatever time of the day or night it was, never knowing when the next one would come. So the first thing he’d done was to quickly shovel down some carbs with a garnish of E numbers, and, hunger satisfied, his mind and body were now crying out in unison for sleep; in fact, he knew all he had to do was shut his eyes, even sitting as he was now, straight-backed (in case you’re watching, Mum) at the kitchen table, to plunge instantly into a slumber so profound it would approach the medical definition of coma. But brain-achingly tired though he was, there was something else even more important that he had to do before he could sleep. Stifling a yawn, he reached for the writing pad and took the top off the gold fountain pen that lay beside it, reading the inscription for the millionth time with the same mix of pride and embarrassment: Dr Kash Devan: who would have thought! He tapped the bottom of the pen against his teeth for a few moments and began:
Dear Mum,
Sorry for the long time since my last letter. Yes, as you will have guessed, I have been very busy. I don’t think I knew what busy was until I started working at the hospital. But that is no excuse. I will do my very best to write more regularly. And, you can rest assured, even when I am not writing, I am thinking about you. And Dad, of course.
In answer to your first question, no, I am not making any money. Not yet! In the fullness of time, of course, I expect to have a Harley Street clinic where I will charge exorbitant fees for the most cursory examination in between trips to the golf course and the opera, but for now I am – despite my grand title which you are so proud of – a mere slave, at the beck and call of every sick person who turns up at the hospital. But, please be reassured, I am happy. Tired, occasionally frustrated, but happy. I am doing what I always wanted to do – what you and Dad worked so hard for me to be able to do – and the worst day here, when everything goes wrong, is still better than any other I could imagine. Like working in Uncle Terrance’s accountancy firm, for instance. But let’s not go there! Really, please, let’s not.
In answer to your second question (I may have been a very inattentive son – please don’t pretend to disagree – but I still know exactly what you are thinking), yes, I have ‘met’ someone. Please do not say ‘finally’ in that tone. As I think I mentioned, I have been busy saving lives and whatnot with precious little time for socialising. You may be surprised to learn that they do not hold tea dances at the hospital where it is possible to meet eligible young ladies. (Do I even know what that means? Not really.) Instead, at the end of an exhausting week, we all go the nearest pub and (feel free to put your hands over your ears at this point) get so drunk that even if I were to spend the evening conversing with the most beautiful, charming and – yes – eligible, girl you could imagine (and I know you have imagined a fair few), the next morning, I would not remember anything about it, and neither would she. I can see you shaking your head and you are right, it is not a very good system. But somehow in the midst of all this mayhem and amnesia, I have managed to find a girl whose name I can actually recall from one day to the next, and who, even more remarkably, can recall mine – and I dare to say even with a modicum of affection as she does so. What is she like? Hold your horses: I haven’t told you her name yet—. Oh blast.
*
‘Beep-beep beep!’ Loud and grating, his bleep screeched beside him on the table. Not the more common ‘someone-wants-you-please-look-at-the-number-on-the-screen’ alert, but a crash call. Kash was already on his feet, pager in hand, as it spoke. ‘Cardiac arrest. Mr Trenchard’s office, outpatients department. Cardiac arrest. Mr Trenchard’s office, outpatients department. Cardiac arrest. Mr Trenchard’s office, outpatients department.’
Kash sprinted down the corridor and shoulder-barged the fire door at one end, its handle smashing into the plaster of the wall beyond. Twenty metres on, and someone was following behind, the same crashing noise now punctuating his progress, his confusion. A cardiac arrest, sure, but in Mr Trenchard’s office? It didn’t make any sense.
He hurtled down the corridor. Another turn, and now into the doctors’ mess, and out the other side, careening through a set of screen doors, startling relatives waiting anxiously outside the emergency department. Then down the long hall between departments, rain beating a tattoo against the skylights above. Losing his balance as he turned a corner, he slipped and fell, his bumbag spilling a tourniquet, his Oxford Handbook, four syringes, two green needles, a collapsing patellar hammer and a handful of coloured biros. As he scrambled to retrieve them, a strong hand reached down to heave him back up and he looked up to see Max, a young doctor famous for his lopsided grin and terrible jokes.
But he wasn’t joking now.
Kash got to his feet, thanked him with a cu
rt nod and together they took off again.
Outpatients was normally deadly quiet at this time of night, but as they approached, they could hear an unaccustomed buzz of activity at the end of the basement hall. Kash saw light spilling out of the open doorway to Trenchard’s office, then something weird – the unmistakeable sound of Holst’s Planets – it was ‘Mars, the Bringer of War’ – blasting out at maximum volume. Kash had heard it playing in the background in Trenchard’s office so many times it would pop unbidden into his head at the strangest moments. It was, he thought, almost like Trenchard’s theme tune: powerful, commanding, smashing through any obstacles in his way. Kash heard it and thought, yes, that’s what you have to be like to be a successful surgeon – a really successful surgeon like Mr Trenchard. He slowed down, for the first time starting to feel apprehensive about what he was going to find. Max overtook him and then one of the night sisters appeared out of nowhere, carrying the portable crash-box and defibrillator, rekindling Kash’s urgency. His jaw set, he hurried after her into the room.
Almost instantly he stopped, took one look at the scene before him, put a hand to his forehead and said, ‘Jesus H Fucking Christ.’
The group around the figure on the floor turned as one. No one had ever heard him swear before.
1
THREE MONTHS EARLIER
The Victory had once occupied palatial grounds on the edge of parkland in South-East London, but now it sat at a conflux of roads, surrounded by a looping flyover and a motorway bridge at which the traffic was already stacked at 7 a.m. On a number fifty-nine bus, caught squarely in the middle of the traffic jam, Kash squinted through a window on the top deck and wondered if the grimy behemoth he could see below could really be the end point of all his hopes and dreams. No more studying, no more exams, no more rehearsals. This was the real thing. The end of the line. He would finally be able to say, ‘Trust me, I’m a doctor,’ even if he couldn’t quite believe it himself.
Pressing his face to the glass like a kid outside a sweetshop, Kash imagined himself purposefully striding down the corridors, perhaps with a couple of juniors trailing behind, as he did his ward rounds, tossing out brilliant diagnoses as he went. The bus suddenly lurched forward as the lights changed, and his forehead banged on the glass. As the Victory disappeared from view, Kash realized he was about to miss his stop, and had a momentary panic that if he did so, the bus would just keep going, faster and faster and the Victory, along with all his hopes and dreams, would gradually melt like a distant mirage.
He leaped to his feet, pushed the bell, and squeezed his way past a heavyset woman to reach the lower deck. At first the driver appeared to ignore him, eyes fixed on the road ahead, before violently decelerating and swerving toward the roadside. The doors wheezed open, and Kash felt himself being propelled onto the pavement by the press of eager commuters behind him. He put a hand out to steady himself, but stumbled and snatched at the air, falling and banging his knee painfully on the concrete. He let out a cry of anguish, not so much because of the pain, but in fear that he had fractured his patella and would make his first entrance into the Victory being carried on a stretcher into the A&E department, rather than proudly walking through the front entrance.
As the pain receded he let out a sigh of relief – his big day was not going to be a disaster after all – only to see the handful of personnel forms he’d been clutching starting to blow away in the bus’s exhaust fumes. He had a sudden, odd sensation, as if he’d been in this exact situation before, or would be again in the future, when he felt a gloved hand close over his. He looked up. The woman who was bent low next to him, her other hand grasping the personnel forms before they could tumble over the motorway bridge, looked like a kindly ageing mother, but her eyes suggested she had too often seen things she might wish that she hadn’t. It took Kash a moment to realize she was wearing nurse’s whites under the grey woollen coat, which was fastened with a silver brooch.
‘You’re Devan,’ she said, matter-of-factly. ‘Kash Devan. No, don’t look so surprised. It isn’t magic. I’ve seen your face pinned up on the ward rounds board. They do it for all newbies. Helps us old warhorses know who’s coming.’ She stopped, mildly amused that he was still crouching down in the gutter, squatting as if about to empty his bowels. ‘Well, come on, Kash. You can’t loiter here all day. People to see. Patients to save. Blood pressure and bedpans, and all that; I’m sure you know the drill. I’m Sister Vale, by the way.’ She reached into her coat to look at her watch, a silver timepiece that hung from the pocket of her uniform. ‘And soon, we’ll both be late. I don’t imagine Mr Trenchard will be very pleased about that.’
*
To look at it, the Victory was anything but special. Built by subscription after the First World War, and bombed to oblivion in the Second, it had risen from the ashes, less phoenix than half-pecked city pigeon. Outside, its face was weathered and cracked, its windows blind with grime. Inside, the obligatory coats of ‘hospital green’ paint were peeling like eczema from the weeping walls, trickles and stains the inward signs of blocked gutters and pipes. But none of this mattered to Kash. It was a central London teaching hospital; what it looked like wasn’t the point. So, here he stood at the entrance to the Victory – with its stained lino, dented doors and blown bulbs, smelling of blood, sweat and air freshener, his home for the coming year and the launch-pad to a brilliant future.
Up the stone flag steps, past a vacant reception desk and on down the corridor, and Sister Vale stopped. ‘What were your orders?’ she asked. ‘Or was it just “work it out on the day”?’
‘Pretty much,’ he admitted. ‘Apparently the last houseman left his bleep and a handover list in a pigeonhole in the mess. I’m supposed to pick it up, and meet the registrar on the ward.’
Sister Vale looked at her watch again. ‘OK. Quickly then.’ She bustled on, pointing out key parts of the hospital as they went. Pharmacy was in one direction. Outpatients was down there alongside a set of other offices. He noted the Hospital Friends’ Coffee Shop, the canteen – and, at last, the Doctors’ Mess. Sister Vale pushed open an old oak door, weirdly out of place amid the general shabbiness, suggesting that some magic kingdom lay beyond. Inside, however, was nothing but a wasteland of pizza boxes, discarded crusts and crushed plastic cups, with a smattering of yellow rice on the threadbare carpet.
Sister Vale held the door open, but made no move to enter, whether out of disgust or lack of entitlement Kash couldn’t tell. Across the room, beside a bar counter, were some pigeonholes. In one, he found an A4 sheet with ‘Kash/ Mr Trenchard H/O’ written on it, wrapped around a pager and held in place by two elastic bands. Kash seized it, returned to Sister Vale and waved it triumphantly.
‘Trenchard? Oh, yes.’ A fact, as if some reality had only now become crystallized and concrete. She seemed paralysed for a moment, before recovering. ‘Right, come on. Let’s get you to the ward. You can meet the registrar there for his 7.30 ward round.’
When they reached the ward, Sister Vale pointed towards a door. ‘Doctors’ office. There’s probably a spare white coat in there somewhere – and you can get a new one from the laundry later. Sort yourself out, then head onto the ward. This is where I leave you for now. I’m boss on this ward for a few months more, but then I move to fourteen as Matron. I think you have your second six months there too, so we’ll be seeing a lot of each other.’ She reached out a hand. ‘Good luck, Kash. If you’re unsure, just ask. You’d better hurry. Trenchard is a stickler for time.’ She paused. ‘Oh, and, Kash? You seem like a nice chap. Mind your back.’ She turned on her heel and briskly marched away.
Mind your back? Of all the things that had been keeping him awake at night before this moment, worrying about that wasn’t one of them. He shrugged and entered the office.
The doctors’ office – his office, he thought – was best described as utilitarian. A long desk surface. Two telephones, some biros, an almost bare stationery rack, and a metal desktop stack, each drawer filled wit
h a different sort of form. Three straight-backed chairs. A notes trolley, bulging with patients’ files. A faded ‘Cardiopulmonary Resuscitation’ poster held at three points to the wall with yellowing tape. Behind the door, a number of white coats hung limply. He selected one which lacked a name badge, filled its pockets with Handbook, notebook, British National Formulary, tape measure and pens, then passed a red and white pin (for neurological examination) through his lapel. He clipped the bleep to his belt, buried the tourniquet deep in a trouser pocket, dumped his bag and, with the patient handover list folded into his top pocket, opened the door and looked out onto the ward.
He stood there, savouring the moment, like a diver poised on the edge of the high board, at once fearful and excited. He took a deep breath and plunged in.
Uncertain where he was actually supposed to be going, Kash advanced towards the nurses’ station. Behind it, someone was busying herself with an observation folder.
*
‘Hi. I’m Kash. Mr Trenchard’s new house officer. I was told to come here to join his ward round?’
The nurse looked up, and immediately smiled, her brusque pace slowing. She extended a hand.
‘Hello, then, new boy. I’m Claire.’ She was slim and efficient-looking, with chestnut hair tied back in a neat ponytail. ‘Don’t worry. I’ve only been here three months myself. You’ll soon get the hang of things.’ She was about to continue, then stopped in her tracks, her whole body stiffening to attention as she caught sight of something or somebody over Kash’s shoulder.
Kash turned and saw a tall man in a dark blue pin-striped suit approaching. He must have been six feet four, with swept-back grey hair and piercing blue eyes, that would have made him stand out in any gathering. But what actually struck Kash most forcefully was his air of total focus and calm. In a place where everybody seemed to be hurrying, he was utterly relaxed, as if the most dire emergency would wait for him until he decided he was ready. Feeling his own pulse racing, his mouth dry, and a trickle of sweat between his shoulder blades, before he’d even come face to face with his first patient, Kash envied Trenchard’s air of impeturbability. That’s how I want to be, he thought with sudden clarity: the eye of the storm, the unmoving mover, like God himself.