The next morning Jomier travels to Chad’s by public transport: he takes the 94 bus to Holland Park, then the Underground to St Paul’s. There is a delay on the Central Line. Tilly and Jimmy are already with Louisa when he arrives. Jomier kisses his daughter. She smiles – a feeble smile: the effects of yesterday’s transfusion are beginning to wear off. ‘You’re very honoured,’ she says. ‘The great Professor Adams would like to see you. You and Mum.’ She rings a bell. A nurse appears. ‘My father’s here,’ says Louisa.
‘I’ll let them know,’ says the nurse.
Tilly sits on the chair; Jimmy leans against the windowsill; Jomier sits on the edge of Louisa’s bed. Louisa’s huge eyes look from her father to her mother, then her mother to her father: she is content that they are there. Jomier asks if Professor Adams has made any progress.
‘He said it’s like looking for a needle in a haystack,’ says Louisa.
‘That’s not encouraging,’ says Jomier.
‘It’s a horrible thing to say,’ says Tilly.
‘Better no bullshit,’ says Jimmy.
‘Yes,’ says Louisa, ‘it’s better to know where we stand.’
A junior doctor comes to fetch Tilly and Jomier. He escorts them along corridors, up two storeys in a lift, along more corridors, then down some stairs. As they walk he makes some cursory remarks about the rebuilding programme: they hope the refurbishment will be completed by 2011.
They wait in the antechamber to Professor Adams’s office. Jomier feels his odium medicinae awakening within him: the conceit and complacency of these despotic consultants with their courts of houri nurses and fawning registrars when the chances of a cure from cancer in Britain are the worst in Western Europe. Jomier reins in his resentment: he has undertaken to forgive – even the time-serving incompetence of Britain’s NHS. Nor would it be politic to betray feelings to Professor Adams which might distract him from his search for the needle in the haystack.
They are shown in to Professor Adams’s office. It dates from the 1960s: one wall is of plate glass giving a view over east London, the others of unplastered brick. Books and papers are stacked on bracket shelving. On the walls – framed certificates, photographs of grinning children, one a girl on a pony, another of Adams playing golf. He is a medium-sized middle-aged Englishman – lean, brisk, fit. He glances at Jomier and Tilly as if assessing their status: should he stand or should he stay seated? He seems to recall that Louisa is a private patient and so gets to his feet. He comes out from behind his desk, shakes them by the hand, then points towards a hard square-armed sofa set against the wall. He himself sits down on a square-armed armchair. ‘Would you like some coffee?’ Both decline his offer. ‘No, quite right. It’s from a machine.’
Adams has brought a folder from his desk. He opens it and glances down at the papers. ‘As you know, Professor Cochella in Buenos Aires has referred your daughter to me because, while it is clear that she is suffering from a blood disorder, he has been unable to identify the precise type. The normal process of blood cell growth breaks down – we call this haematopoiesis. Sometimes there is an overproduction of a specific type of blood cell in the bone marrow or they produce abnormal cells that malfunction. There are also uncommon lymphoproliferative disorders, myeloproliferative disorders and other uncommon variations – some of them hereditary. If we can identify the type, then we can come up with a treatment but it isn’t straightforward. What I want to confirm with you is that, so far as you know, there is no history on either side of the family of blood disorders of this kind – no hereditary nonspherocytic haemolytic anaemia, or spherocyctic anaemia, no hereditary angioedema, hereditary haemorrhagic telangiectasia . . .’ He hands an A4 sheet of paper to Jomier and another to Tilly. ‘If there have been deaths in the family you may not have been told the cause, but it is worth just looking down the list to see if anything rings a bell.’
Jomier takes up the piece of paper – the haystack in which the needle is hidden – and runs his eye down the list. Aase syndrome, Blackfan Diamond anaemia, Fanconi’s anaemia, Frycht’s anaemia, haemolytic – warm antibody anaemia, hereditary nonspherocytic haemolytic anaemia, hereditary spherocytic haemolytic anaemia, megaloblastic anaemia, hereditary angioedema, antithrombin III deficiency, cor triatriatum, idiopathic oedema, endocardial fibroelastosis (EFE), factor XIII deficiency, congenital heart block, haemangioma thrombocytopenia syndrome, hereditary haemorrhagic telangiectasia, hypoplastic left heart syndrome, hereditary lymphoedema, Maffucci syndrome, perniosis, acquired pure red cell aplasia, pyruvate kinase deficiency, thalassaemia minor and Waldenstrom’s macroglobulinaemia.
‘What is Frycht’s anaemia?’ he asks Professor Adams.
‘We’ve excluded that,’ says Adams. ‘Your daughter has no Austrian blood. You only find Frycht’s anaemia in Austrians – in fact, in one Austrian family, the von Frychts.’
Jomier looks at Tilly. The skin of her cheeks is suddenly flushed. She does not raise her eyes from the piece of paper she holds in her hand.
‘Is this wrong?’ asks Adams. ‘Do either of you have Austrian blood?’
Tilly looks up and glances sideways at Jomier with an expression of terror. ‘No . . . no, I don’t think so . . . I’m sure I don’t.’
Jomier turns back to Adams. ‘My grandmother, Elise Jomier, had a long affair with a man called Ferdinand von Frycht. It is quite possible, even likely, that he was the natural father of my father.’
Adams is excited. ‘That is certainly something worth pursuing. There have been only two or three cases of Frycht’s anaemia this century, but it does crop up every now and sometimes skips several generations.’
‘And if it should turn out,’ asks Jomier, ‘that Louisa is suffering from Frycht’s anaemia, can anything be done?’
‘Five years ago,’ says Adams, ‘I would have said no, but now, yes. Hasemann in Vienna came up with a cure. It helped win him the Nobel Prize.’
Jomier and Tilly walk down stairs, into lifts and along corridors to the private wing of Chad’s Hospital. Tilly is weeping: she chokes and says in a stuttering whisper, ‘I . . . I . . . it was just something . . . in a bubble . . . nothing to do with us. It just happened . . . I mean, I thought, she could have been yours.’
Jomier says nothing. They walk along the corridor in silence. He hides the thoughts going through his head from Tilly. He hides the thoughts going through his head from himself. All thoughts but one. Finally he says: ‘She’s going to live.’
‘Yes.’
They turn a corner. Another corridor. More silence. Then, without looking at his former wife, Jomier says: ‘Did I ever tell you about my grandmother’s affair with Ferdy von Frycht?’
Tilly sniffs. ‘No. No, I don’t think so.’
‘A skeleton in the cupboard.’
‘Yes.’
‘Louisa will be amused,’ says Jomier.
‘Yes.’
‘And Henry? What do you think? A little embarrassed, perhaps, but not ill-pleased. Some blue blood in his veins on his father’s side.’