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  She gave him another look, and Kash felt the blood rushing to his face.

  ‘We just seem to be suited,’ Claire shrugged. ‘And to be honest, with her hours and my hours, we’re not “on top of each other”, as you put it, all that much.’

  ‘She certainly seems to be very protective.’

  ‘How do you mean?’

  ‘I don’t know, I just got this sense that she wasn’t too happy about my being here.’

  ‘It’s nothing personal, Kash. She just tends to suspect the worst about men until she gets to know them. I guess it’s because of the experiences she’s had. And she knows I like you, so you must be halfway decent.’

  ‘That’s good to know,’ Kash said, meaning it. ‘So no boyfriend of her own, then?’

  ‘Ah, she has a mystery man.’

  ‘Oh? Who is he?’

  ‘That’s the point of a mystery man, Kash. He’s . . . a mystery.’

  Or he’s not a man, Kash thought to himself. Or he doesn’t exist.

  ‘Talking of mysteries,’ Kash said, ‘Ange told me where Trenchard was, the night of the Edmund Chaloner op.’

  ‘Really? Where? I assumed he was tied up with one of his private patients. Sneakiness and charm in equal measure, that man.’ She paused. ‘Smarm. Or he’d been out to dinner and had a couple of glasses too many, despite being on call.’

  ‘Well, according to Ange, who admittedly was pretty drunk herself when she told me, Hilary Williams told her that she was with him.’

  Claire raised an eyebrow. ‘And?’

  ‘Well, here’s the bit I’m not sure I believe. Trenchard supposedly propositioned her – said he’d give her private work if she slept with him.’

  ‘Seriously?’

  ‘And she stuck her fork into his hand.’

  ‘I suppose it’s hard to knee someone in the balls when you’re sitting in a restaurant.’

  ‘She’s hard up, apparently. She could definitely have done with the work.’

  Claire chewed her lip thoughtfully. ‘Mr Trenchard’s usually pretty good at getting people to do what he wants. The puppet master where usually no one even sees the strings.’

  ‘What do you mean?’

  ‘Oh, come on, Kash. You know what they say about Trenchard: “You have to learn to take the smooth with the smooth.” I bet his amazing success rate as a surgeon is half down to the fact that his patients don’t want to disappoint him by dying. “That lovely Mr Trenchard.” As for the nurses . . .’

  ‘What about the nurses?’

  She rolled her eyes. ‘Most of them are mooning after him like a character in a Mills and Boon novel. And he takes full advantage. Not that the doctors are any better. They all want to be his best student. Look at you.’

  ‘That’s not fair, Claire,’ Kash said, stiffening. ‘Not every junior at my stage gets the chance to assist in theatres and do outpatients . . . and audits. If I do a little clean-up for him here and there, what’s the big deal? Anyway, I’ve only been at the Victory three months. It won’t last forever. And I’m not doing his paperwork tonight, am I?’

  Claire was about to reply when they both heard the click of the front door closing. Tiff had obviously just been teasing when she told Claire she was planning on staying in for the evening. Or perhaps the mystery man had called. Claire turned to Kash with the sort of smile that he had seen all too rarely in his life. She moved closer and gently touched his knee.

  ‘Yes, you’re here with me, Kash. Just the two of us.’ She sighed. ‘And the telly’s on the blink. What on earth are we going to do?’

  13

  ‘Jesus H Fucking Christ.’

  Kash stood in the doorway to Mr Trenchard’s office, his mouth gaping. It felt as if a moment ago he’d been writing a letter to his mum, the taste of stale mac and cheese still in his mouth, and now he was in another reality.

  Everyone looked at him for a second, then turned their eyes back to the figure on the floor behind Trenchard’s desk. Geoff, the anaesthetist, was kneeling over the body. ‘Give us a hand, will you?’

  Kash willed his legs to move. Trenchard was lying with his trousers around his ankles, his genitals bulging out of a pair of tiny black panties. His chest, thick with wiry hair, was exposed through a tight bra, his head thrown back. Max was already at his head, slipping a noose from over his neck. Deep, guttural snores rolled up out of his throat, his pharynx obstructed. Geoff kneeled behind Trenchard’s head and used one hand to pull the jaw forward. The snoring stopped. He turned to the nursing sister, who was already rummaging in the crash box. She passed Geoff a Guedel airway, which he swiftly inserted over the tongue. ‘We’ll need a collar. We can’t be sure that his neck isn’t broken. Until then, the head stays in neutral.’ He looked around.

  Everyone nodded.

  Kash kneeled down, his mind beginning to work properly again. He reached his fingers into Trenchard’s groin, feeling for his femoral artery. ‘Pulse good and strong . . . but slow. Less than fifty. Good God, what happened to him?’

  ‘Autoerotic asphyxiation, I’d say,’ Geoff replied. ‘He’s certainly dressed for it. And’ – Geoff waved a hand at half a dozen magazines scattered on the floor – ‘he seemed to be keeping on top of the literature.’

  Kash stole a glance. Leather, whips, things he had no name for.

  ‘And he had a noose around his neck.’

  Geoff raised Trenchard’s eyelids. The eyes were staring straight ahead, the pupils tiny, the white sclera speckled with myriad red marks. ‘Yup. Petechial haemorrhages. Might have done his pons in. The pupils are pinpoint.’ He looked round. ‘Will somebody turn that bloody music off?’

  The night sister carefully lifted the needle from Trenchard’s record player, as if worried that he was about to berate her for scratching the vinyl. A thick silence settled as they all surveyed the scene. There were magazines everywhere. Kash picked one up between thumb and forefinger before dropping it back on the floor. It was simply too much to take in. He took a deep breath and pulled off the bra Trenchard was wearing before attaching a set of sticky ‘dot’ electrodes to the skin of his chest wall. As he hooked them up to the monitor-defibrillator the night sister had laid on the floor, he noticed his hands were shaking slightly. Then he caught sight of Chris, the Victory’s medical registrar, crashing through the door, flushed and panting.

  ‘Jesus,’ he gasped, taking in the scene.

  ‘The next person who says that . . .’ muttered Geoff.

  ‘Sorry.’ Chris kneeled beside Kash and quickly assessed what he was seeing. ‘Autoerotic asphyxiation. Too tight a noose. Signs of strangulation – petechiae, rope burn. Larynx intact. No crepitus or stridor. Breathing on his own, but the pupils are one millimetre and fixed.’

  ‘Brainstem?’ Geoff asked.

  ‘Looks like it.’ Chris’s eyes flicked to the monitor. ‘Bradycardic, thirty-five,’ he said. ‘Looks nodal or a high bundle escape. Six hundred of atropine please.’ He moved to Trenchard’s side as Kash passed him a preloaded syringe. ‘Glad you got a line in, guys. But next time, make it a venflon, not a butterfly, will you?’

  All eyes turned to the butterfly needle, neatly taped in place, and the syringe attached to it, and then to Geoff. ‘Hey, I’m fast. But not that fast! He must have been using. Ideas?’

  Kash stood and looked around. ‘There!’ He pointed at a glass ampoule, scarcely afloat in the sea of pornographic pages.

  Chris picked it up. ‘Morphine, ten mg.’ Nearby was a plastic bag and gauze. He sniffed it hesitantly. ‘Poppies, poppers and porn.’

  Kash bristled. How could he be so flippant at a time like this?

  Chris turned to the nursing sister. ‘I think we can manage for now. Would you mind heading to the emergency department and grabbing a collar and a scoop?’ A scoop was an aluminium clip-together stretcher, and each half could be slid beneath a collapsed patient before joining them together. ‘We’ll need to move him shortly I think. Oh and mum’s the word, eh?’
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  He removed the syringe from the butterfly and passed it to Kash. ‘Best save that for toxicology.’ Then, connecting up the atropine, he pushed in half the dose while staring at the monitor. ‘Four hundred mics of Narcan, please, Kash.’ He flushed the line, injected the Narcan, and then repeated the process to give the remaining atropine. ‘That’s better. Heart rate ninety-six. Looks like sinus rhythm to me?’ Kash nodded. ‘Pupils?’

  Geoff raised the eyelids again. ‘Still pinpoint and unresponsive.’

  At Trenchard’s head, Geoff intubated him. Once Trenchard’s airways were secure, he connected the ambubag, squeezing it to augment Trenchard’s ragged breaths, which came in waves of increasing depth and frequency before receding again.

  ‘What have you got up there?’ asked Chris.

  Geoff looked again. ‘Pupils still pinpoint. No corneals, no gag when I intubated him, no doll’s eyes.’ Geoff rubbed his knuckles firmly against Trenchard’s breastbone. ‘No response to pain. Cheyne Stokes breathing if you haven’t seen it before.’ He nodded to Kash. ‘Goes with the brainstem. Or lack of it.’

  *

  ‘Lights are on, but there’s nobody home,’ Max chipped in.

  ‘Pontine, then,’ ventured Chris.

  Geoff grimaced. ‘My guess is that it’s global. That noose was bloody tight. He’s got petechiae all over his face, his eyes, his palate.’

  Chris got to his feet. ‘OK. Thank you, everyone. A job well done. We need to move him, and fast. Max, run up to the ICU. Tell them we’re coming up, and tell them who it is. Remind them about confidentiality. We need to keep this one between ourselves for now. Go! Kash, call for the porters. We’ll need a trolley, obviously, and an oxygen cylinder too. Make it clear we want the cylinder now, and not in an hour after the dinner trolleys have been taken back to the kitchen. Obviously, he doesn’t move until that collar is on. Treat him like an unstable spine. And Kash! Snap out of it! I know it’s a shock, but this probably isn’t the worst thing you’ll see this month.’

  ‘Sorry, it’s . . .’ He couldn’t finish the sentence.

  A loud bang, and the nursing sister arrived, carrying the stretcher and collar. She was panting. Together, she and Chris stacked the magazines to one side and helped put on the collar to immobilize the neck. With Geoff controlling the head, they slipped the two halves of the stretcher beneath Trenchard. Moments later, two porters appeared.

  ‘Not a word of this to anyone please, gentlemen.’ Chris’s voice was firm.

  They didn’t seem to have heard him. ‘Christ! Is that . . .?’

  ‘Yes. So we need to load him up and get to the ICU, and fast, please. Geoff? Good to go?’

  Geoff nodded. ‘Soon as the oxygen is on.’

  Kash stepped back as the trolley was wheeled into place and Trenchard was lifted onto it. Kash took the foot end, but was working automatically, his thoughts whirling. He let go as the porters gently nudged him out of the way and watched the trolley move quickly down the corridor towards ICU, feeling as if life as he knew it was disappearing along with it.

  He knew there was nothing more he could do. For a few moments he just stood there, not knowing where to go. He needed to find a quiet place to think about what he had just seen, and . . . what? Deal with it? Come to terms with it? No, something more concrete than that. He needed to work out exactly what he had seen.

  Then another thought occurred to him.

  He took off, hurtling up and out of outpatients, towards the theatres.

  14

  His heart was heaving by the time he got there. The theatre changing rooms were dark and silent. Lockers stood in rows behind the slatted wooden benches. Most were empty, doors ajar, ready for whoever was operating the next day, but at the centre of the wall stood the locker that had been Mr Trenchard’s and his alone for as long as anyone could remember. Another sign of his special status within the hospital. Kash approached it tentatively, his heart rate only just finding a steady equilibrium. He fingered the door, expecting to find it locked – only Mr Trenchard had the key, so far as he knew – but, at his gentle touch, the door squeaked open.

  ‘Jesus,’ Kash said under his breath. These things . . . he had never . . . Handcuffs and silk ropes, a gag made of studded black leather, contraptions whose use even he – having seen every surgical instrument in existence, designed to open and clamp and restrain and penetrate – could not imagine. A black latex mask whose features, even hanging flaccidly here, seemed somehow to be the features of Mr Trenchard himself, looking down at Kash in that fatherly, yet amused, way he had.

  He thought he could hear footsteps. Probably it was some theatre nurse. Although time seemed to have stopped for Kash, the world inside the Victory had not stopped turning, after all.

  Instinct seized him. There was a holdall in the bottom of Mr Trenchard’s locker. He lifted it out, spilling more magazines he dared not look at, packets of condoms and a single used syringe, which he crammed back in hastily, together with the rest of the locker’s contents. His heart hammering, he hoisted the bag over his shoulder, turned and hurried away.

  Back through the swing doors, up and out of theatres, he kept his head down, certain somebody was watching him, certain he would stumble over his own feet and send everything in the holdall cascading over the floor. By the time he reached the stairway leading up into the hospital apartments, his chest was burning. He stopped to compose himself, heard footsteps following behind, and pressed on, desperate to get to the safety of his flat. Mr Trenchard would be in the ICU by now. No doubt he was hooked up to a ventilator. They’d be getting an arterial and central venous line in by now.

  Kash reached his door, fumbled for a key and almost fell inside. He didn’t want to look in the holdall, let alone examine its contents. Not knowing what else to do, he crammed it under the bed. He’d think about what to do with it later.

  Suddenly there was a hammering on the door. He froze. Someone had seen him take the holdall and followed him to his room. Or worse, they had alerted security. How was he going to explain himself? Maybe he should just keep quiet, pretend he wasn’t there and hope whoever it was would go away. But what if they knew he was in there? If he didn’t answer the door he really would look as if he had something to hide. He swallowed hard, and with a trembling hand opened the door. Claire stood framed in the doorway, a look of concern on her face.

  His first reaction was relief – followed by panic. She was the last person he wanted to see the unspeakable contents of Mr Trenchard’s holdall. If she thought for a moment that any of this stuff belonged to him . . . ‘Kash, you look awful,’ she began. ‘What on earth’s wrong? I saw you running up the stairs like a mad thing, and I . . .’ She stopped in her tracks, looking past Kash into the room. Kash turned, following her gaze. The holdall was jutting out from under the bed. A pair of handcuffs could clearly be seen, half dangling over the side as if they were trying to escape, while the corner of a magazine was poking out, a woman’s naked torso clearly visible, her face hidden behind a leather mask.

  Claire went white. ‘Kash, what the . . .’

  She wrenched her eyes away from the holdall and its contents and turned on him.

  ‘Is this what I think it is? What the hell have you got in there, Kash?’

  He put his hands on her shoulders. ‘Claire, no, no, no – it’s not what you think, they’re not . . . it’s not mine!’

  ‘Then what’s it doing in your room – under your bed?’ She said the last word with disgust.

  ‘I took it from Mr Trenchard’s locker. I was trying—’ He gripped her shoulders more tightly, trying to get her to understand, but she shrugged him off angrily.

  ‘Don’t you dare touch me!’ She gave him one final look, a mixture of shock, fury and – most wounding of all for Kash – disappointment, then turned on her heel and marched out.

  He started after her, then realized he was better off letting her go. If they ended up having a row in the corri
dor, that would only make things worse. He had a quick look to make sure no one else was there who might have heard their conversation – if you could call it that – and gently closed the door. With trembling fingers, he shoved the holdall’s contents firmly inside and zipped it up, then firmly pushed it as far as it would go under his bed.

  He stood silently for a minute or two, waiting for his breathing to return to normal. Although it was out of sight, he felt the holdall’s presence, like a malevolent spirit in the room. Muffled groans and maniacal laughter seemed to be seeping from beneath the bed.

  Pull yourself together. He sat down at the little table, and saw his unfinished letter to his mother. A letter he would never finish now, the good news – the wonderful news – about Claire having been blotted out by the scene of horror in Mr Trenchard’s office.

  Dear Mum, he imagined writing. Sorry for the interruption. I had to go down to Mr Trenchard’s office – remember my boss, I told you about him – and guess what? He was lying there in women’s underwear with a noose round his neck and a needle in the back of his hand. He’s now in ICU but I don’t imagine there’s much hope for him. He told me I needed to chill out, have more fun. Well, now we know what his idea of fun was. Just shows, you never can tell with people, right?

  He put his head in his hands. But Trenchard was a great surgeon, wasn’t he? Had been? This doesn’t change that, surely. He saved lives. People admired him, loved him. I wanted one day to be like him. But now? Is all that undone, erased, gone? His reputation will certainly be destroyed, however many lives he changed for the better. And what about him? The man, the person. What will be left of him?

  He shook his head like a man trying to rid himself of a troublesome insect. What had he been thinking? Why hadn’t he left everything in Mr Trenchard’s locker where he found it? He’d been trying to protect him somehow, he supposed. But from what? Once the news spread, a few more sex toys and fetish magazines here and there wouldn’t make any difference, would they? But something had made him do it. Something he didn’t yet quite understand.