Unnatural Death

Part I

The Medical Problem

“But how I caught it, found it, or came by it,
What stuff ’tis made of, whereof it is born,
I am to learn.”

Merchant of Venice

“But if he thought the woman was being murdered—”

“My dear Charles,” said the young man with the monocle, “it doesn’t do for people, especially doctors, to go about ‘thinking’ things. They may get into frightful trouble. In Pritchard’s case, I consider Dr. Paterson did all he reasonably could by refusing a certificate for Mrs. Taylor and sending that uncommonly disquieting letter to the Registrar. He couldn’t help the man’s being a fool. If there had only been an inquest on Mrs. Taylor, Pritchard would probably have been frightened off and left his wife alone. After all, Paterson hadn’t a spark of real evidence. And suppose he’d been quite wrong—what a dustup there’d have been!”

“All the same,” urged the nondescript young man, dubiously extracting a bubbling-hot Helix Pomatia from its shell, and eyeing it nervously before putting it in his mouth, “surely it’s a clear case of public duty to voice one’s suspicions.”

“Of your duty—yes,” said the other. “By the way, it’s not a public duty to eat snails if you don’t like ’em. No, I thought you didn’t. Why wrestle with a harsh fate any longer? Waiter, take the gentleman’s snails away and bring oysters instead … No—as I was saying, it may be part of your duty to have suspicions and invite investigation and generally raise hell for everybody, and if you’re mistaken nobody says much, beyond that you’re a smart, painstaking officer though a little overzealous. But doctors, poor devils! are everlastingly walking a kind of social tightrope. People don’t fancy calling in a man who’s liable to bring out accusations of murder on the smallest provocation.”

“Excuse me.”

The thin-faced young man sitting alone at the next table had turned round eagerly.

“It’s frightfully rude of me to break in, but every word you say is absolutely true, and mine is a case in point. A doctor—you can’t have any idea how dependent he is on the fancies and prejudices of his patients. They resent the most elementary precautions. If you dare to suggest a postmortem, they’re up in arms at the idea of ‘cutting poor dear So-and-so up,’ and even if you only ask permission to investigate an obscure disease in the interests of research, they imagine you’re hinting at something unpleasant. Of course, if you let things go, and it turns out afterwards there’s been any jiggery-pokery, the coroner jumps down your throat and the newspapers make a butt of you, and, whichever way it is, you wish you’d never been born.”

“You speak with personal feeling,” said the man with the monocle, with an agreeable air of interest.

“I do,” said the thin-faced man, emphatically. “If I had behaved like a man of the world instead of a zealous citizen, I shouldn’t be hunting about for a new job today.”

The man with the monocle glanced round the little Soho restaurant with a faint smile. The fat man on their right was unctuously entertaining two ladies of the chorus; beyond him, two elderly habitués were showing their acquaintance with the fare at the Au Bon Bourgeois by consuming a Tripes à la Mode de Caen (which they do very excellently there) and a bottle of Chablis Moutonne 1916; on the other side of the room a provincial and his wife were stupidly clamouring for a cut off the joint with lemonade for the lady and whisky and soda for the gentleman, while at the adjoining table, the handsome silver-haired proprietor, absorbed in fatiguing a salad for a family party, had for the moment no thoughts beyond the nice adjustment of the chopped herbs and garlic. The head waiter, presenting for inspection a plate of Blue River Trout, helped the monocled man and his companion and retired, leaving them in the privacy which unsophisticated people always seek in genteel teashops and never, never find there.

“I feel,” said the monocled man, “exactly like Prince Florizel of Bohemia. I am confident that you, sir, have an interesting story to relate, and shall be greatly obliged if you will favour us with the recital. I perceive that you have finished your dinner, and it will therefore perhaps not be disagreeable to you to remove to this table and entertain us with your story while we eat. Pardon my Stevensonian manner—my sympathy is none the less sincere on that account.”

“Don’t be an ass, Peter,” said the nondescript man. “My friend is a much more rational person than you might suppose to hear him talk,” he added, turning to the stranger, “and if there’s anything you’d like to get off your chest, you may be perfectly certain it won’t go any farther.”

The other smiled a little grimly.

“I’ll tell you about it with pleasure if it won’t bore you. It just happens to be a case in point, that’s all.”

“On my side of the argument,” said the man called Peter, with triumph. “Do carry on. Have something to drink. It’s a poor heart that never rejoices. And begin right at the beginning, if you will, please. I have a very trivial mind. Detail delights me. Ramifications enchant me. Distance no object. No reasonable offer refused. Charles here will say the same.”

“Well,” said the stranger, “to begin from the very beginning, I am a medical man, particularly interested in the subject of Cancer. I had hoped, as so many people do, to specialise on the subject, but there wasn’t money enough, when I’d done my exams, to allow me to settle down to research work. I had to take a country practice, but I kept in touch with the important men up here, hoping to be able to come back to it some day. I may say I have quite decent expectations from an uncle, and in the meanwhile they agreed it would be quite good for me to get some all-round experience as a G.P. Keeps one from getting narrow and all that.

“Consequently, when I bought a nice little practice at … —I’d better not mention any names, let’s call it X, down Hampshire way, a little country town of about 5,000 people—I was greatly pleased to find a cancer case on my list of patients. The old lady—”

“How long ago was this?” interrupted Peter.

“Three years ago. There wasn’t much to be done with the case. The old lady was seventy-two, and had already had one operation. She was a game old girl, though, and was making a good fight of it, with a very tough constitution to back her up. She was not, I should say, and had never been, a woman of very powerful intellect or strong character as far as her dealings with other people went, but she was extremely obstinate in certain ways and was possessed by a positive determination not to die. At this time she lived alone with her niece, a young woman of twenty-five or so. Previously to that, she had been living with another old lady, the girl’s aunt on the other side of the family, who had been her devoted friend since their school days. When this other old aunt died, the girl, who was their only living relative, threw up her job as a nurse at the Royal Free Hospital to look after the survivor—my patient—and they had come and settled down at X about a year before I took over the practice. I hope I am making myself clear.”

“Perfectly. Was there another nurse?”

“Not at that time. The patient was able to get about, visit acquaintances, do light work about the house, flowers and knitting and reading and so on, and to drive about the place—in fact, most of the things that old ladies do occupy their time with. Of course, she had her bad days of pain from time to time, but the niece’s training was quite sufficient to enable her to do all that was necessary.”

“What was the niece like?”

“Oh, a very nice, well-educated, capable girl, with a great deal more brain than her aunt. Self-reliant, cool, all that sort of thing. Quite the modern type. The sort of woman one can trust to keep her head and not forget things. Of course, after a time, the wretched growth made its appearance again, as it always does if it isn’t tackled at the very beginning, and another operation became necessary. That was when I had been in X about eight months. I took her up to London, to my own old chief, Sir Warburton Giles, and it was performed very successfully as far as the operation itself went, though it was then only too evident that a vital organ was being encroached upon, and that the end could only be a matter of time. I needn’t go into details. Everything was done that could be done. I wanted the old lady to stay in town under Sir Warburton’s eye, but she was vigorously opposed to this. She was accustomed to a country life and could not be happy except in her own home. So she went back to X, and I was able to keep her going with visits for treatment at the nearest large town, where there is an excellent hospital. She rallied amazingly after the operation and eventually was able to dismiss her nurse and go on in the old way under the care of the niece.”

“One moment, doctor,” put in the man called Charles, “you say you took her to Sir Warburton Giles and so on. I gather she was pretty well off.”

“Oh, yes, she was quite a wealthy woman.”

“Do you happen to know whether she made a will?”

“No. I think I mentioned her extreme aversion to the idea of death. She had always refused to make any kind of will because it upset her to think about such things. I did once venture to speak of the subject in the most casual way I could, shortly before she underwent her operation, but the effect was to excite her very undesirably. Also she said, which was quite true, that it was quite unnecessary. ‘You, my dear,’ she said to the niece, ‘are the only kith and kin I’ve got in the world, and all I’ve got will be yours some day, whatever happens. I know I can trust you to remember my servants and my little charities.’ So, of course, I didn’t insist.

“I remember, by the way—but that was a good deal later on and has nothing to do with the story—”

“Please,” said Peter, “all the details.”

“Well, I remember going there one day and finding my patient not so well as I could have wished and very much agitated. The niece told me that the trouble was caused by a visit from her solicitor—a family lawyer from her home town, not our local man. He had insisted on a private interview with the old lady, at the close of which she had appeared terribly excited and angry, declaring that everyone was in a conspiracy to kill her before her time. The solicitor, before leaving, had given no explanation to the niece, but had impressed upon her that if at any time her aunt expressed a wish to see him, she was to send for him at any hour of the day or night and he would come at once.”

“And was he ever sent for?”

“No. The old lady was deeply offended with him, and almost the last bit of business she did for herself was to take her affairs out of his hands and transfer them to the local solicitor. Shortly afterwards, a third operation became necessary, and after this she gradually became more and more of an invalid. Her head began to get weak, too, and she grew incapable of understanding anything complicated, and indeed she was in too much pain to be bothered about business. The niece had a power of attorney, and took over the management of her aunt’s money entirely.”

“When was this?”

“In April, 1925. Mind you, though she was getting a bit ‘gaga’—after all, she was getting on in years—her bodily strength was quite remarkable. I was investigating a new method of treatment and the results were extraordinarily interesting. That made it all the more annoying to me when the surprising thing happened.

“I should mention that by this time we were obliged to have an outside nurse for her, as the niece could not do both the day and night duty. The first nurse came in April. She was a most charming and capable young woman—the ideal nurse. I placed absolute dependence on her. She had been specially recommended to me by Sir Warburton Giles, and though she was not then more than twenty-eight, she had the discretion and judgment of a woman twice her age. I may as well tell you at once that I became deeply attached to this lady and she to me. We are engaged, and had hoped to be married this year—if it hadn’t been for my damned conscientiousness and public spirit.”

The doctor grimaced wryly at Charles, who murmured rather lamely that it was very bad luck.

“My fiancée, like myself, took a keen interest in the case—partly because it was my case and partly because she was herself greatly interested in the disease. She looks forward to being of great assistance to me in my life work if I ever get the chance to do anything at it. But that’s by the way.

“Things went on like this till September. Then, for some reason, the patient began to take one of those unaccountable dislikes that feebleminded patients do take sometimes. She got it into her head that the nurse wanted to kill her—the same idea she’d had about the lawyer, you see—and earnestly assured her niece that she was being poisoned. No doubt she attributed her attacks of pain to this cause. Reasoning was useless—she cried out and refused to let the nurse come near her. When that happens, naturally, there’s nothing for it but to get rid of the nurse, as she can do the patient no possible good. I sent my fiancée back to town and wired to Sir Warburton’s Clinic to send me down another nurse.

“The new nurse arrived the next day. Naturally, after the other, she was a second-best as far as I was concerned, but she seemed quite up to her work and the patient made no objection. However, now I began to have trouble with the niece. Poor girl, all this long-drawn-out business was getting on her nerves, I suppose. She took it into her head that her aunt was very much worse. I said that of course she must gradually get worse, but that she was putting up a wonderful fight and there was no cause for alarm. The girl wasn’t satisfied, however, and on one occasion early in November sent for me hurriedly in the middle of the night because her aunt was dying.

“When I arrived, I found the patient in great pain, certainly, but in no immediate danger. I told the nurse to give her a morphia injection, and administered a dose of bromide to the girl, telling her to go to bed and not to do any nursing for the next few days. The following day I overhauled the patient very carefully and found that she was doing even better than I supposed. Her heart was exceptionally strong and steady, she was taking nourishment remarkably well and the progress of the disease was temporarily arrested.

“The niece apologised for her agitation, and said she really thought her aunt was going. I said that, on the contrary, I could now affirm positively that she would live for another five or six months. As you know, in cases like hers, one can speak with very fair certainty.

“ ‘In any case,’ I said, ‘I shouldn’t distress yourself too much. Death, when it does come, will be a release from suffering.’ ”

“ ‘Yes,’ she said, ‘poor Auntie. I’m afraid I’m selfish, but she’s the only relative I have left in the world.”

“Three days later, I was just sitting down to dinner when a telephone message came. Would I go over at once? The patient was dead.”

“Good gracious!” cried Charles, “it’s perfectly obvious—”

“Shut up, Sherlock,” said his friend, “the doctor’s story is not going to be obvious. Far from it, as the private said when he aimed at the bull’s-eye and hit the gunnery instructor. But I observe the waiter hovering uneasily about us while his colleagues pile up chairs and carry away the cruets. Will you not come and finish the story in my flat? I can give you a glass of very decent port. You will? Good. Waiter, call a taxi … 110A, Piccadilly.”