Chapter 9

What have you done to Mrs Gold?’ George Edwards asked Andrew.

They were sitting in the Consultant’s lounge having coffee. They were alone. It was half an hour before the clinical meeting was due to start and both had finished their morning commitments earlier than expected.

‘She now insists on seeing me in my rooms,’ he continued. ‘Refuses to go back to the follow up clinic. She kept going on about a glass eye, said you mixed her up with another patient. I couldn’t make any sense of it.’

Andrew felt foolish. What must Dr Edwards think of him? In the short time he’d been back he had already managed to alienate a patient. He doubted that George Edwards was impressed. Reluctant as he was to discuss the matter, he felt he had no choice. He owed Dr Edwards an explanation. As briefly as he could he told Dr Edwards about the glass eye on the initial MRI scan which was no longer present on the more recent scan. He was quick to add that Howard Bell had reassured him that it was just a labelling error which had been corrected but by that time he had already lost Mrs Gold’s confidence.

And without waiting for George Edwards to reply and for no particular reason, he told him the story of Daryl Morgan and the septum cavum pellucidum which had also disappeared on a subsequent scan and for which he had not yet had a satisfactory explanation.

He hoped that somehow this all made sense to Dr Edwards and would go some way to reassuring him that he, Andrew Marshall was not totally incompetent.

Dr Edwards said nothing for a minute or so and then, in a soft voice said, ‘Do you know the small pub on Humphrey Street, The Royal?’ Andrew nodded.

‘I’ll meet you there at 5.30.’ Without another word, George Edwards put down his cup, stood up and left the lounge, leaving Andrew sitting there, completely mystified.

The afternoon went smoothly and Andrew managed to stay on time so that by 5.35 he was seated across from George Edwards at The Royal Hotel. Dr Edwards had arrived a few minutes earlier and was sipping a beer when Andrew sat down, slightly breathless from rushing.

‘What can I get you Andrew? It’s on me.’

‘A scotch, neat, would be great. Thanks.’

Five minutes later George Edwards was back with Andrew’s scotch. By the look of it he had ordered a double. He let Andrew take a sip and said,

‘Very interesting what you told me this morning. Don’t worry about Mrs Gold, I’ll sort her out. Let me tell you a story.’

Two and a half years earlier, Dr Edwards had a patient who had been referred to him with carpal tunnel syndrome. She was a forty year old woman who had developed the condition as a result of years of typing eight hours a day, five days a week. The symptoms were driving her mad and she wanted surgery, only the woman was not a great surgical candidate. Obese, a chain smoker who became breathless after walking ten metres. Nevertheless, the anaesthetist cleared her for surgery which he had performed uneventfully.

On waking from the general anaesthetic she complained of dizziness and when this persisted, the over-anxious Surgical Registrar ordered an MRI scan of her brain for later that day. By then the dizziness had settled but the scan still went ahead. To everyone’s horror, it showed a right temporal glioma, totally unexpected and discovered purely by chance.

Dr Edwards was notified immediately. He reviewed the scan himself and noted the tumour which was fairly small but looked aggressive. He also noticed the arachnoid cyst in the anterior temporal fossa on the other side, an incidental and clinically insignificant finding. The Amaradine trial was still running and Dr Edwards arranged for the woman to be enrolled and he presumed she received the active drug and not the placebo, as her repeat scan four weeks later showed that the tumour had completely disappeared, as had the arachnoid cyst. This latter finding puzzled Dr Edwards and he went to see Dr Howard Bell who two days later came back to him with the explanation that the initial MRI scan had been mislabelled and the correct scans, both before and after treatment were now in the patient’s X-ray bag, correctly labelled.

‘I did not think much of it at the time Andrew. I mentioned it in passing to Jeffrey who dismissed the whole thing but said he would have a word with Howard Bell to make sure that the Radiology Department took greater care in labelling their X-rays. To be honest, I forgot about the whole thing until this morning when you told me about Mrs Gold and the other patient, I’ve already forgotten his name.’

‘Daryl Morgan,’ Andrew said.

‘Yes, Daryl Morgan. That makes three patients, at least three that we know of. Either our Radiology Department is very sloppy or something else is going on.’

George Edwards stopped. He let that last statement hang in the air. Andrew’s brain was racing. Should he tell Dr Edwards about Roger Marsden. The poor guy’s probably already in Jeffrey Harris’ bad books, he did not need George Edwards on is case as well. But something wasn’t right. He felt sure of it and without thinking, relayed to George Edwards what Roger had told him.

‘I’ll get us another drink,’ was all Dr Edwards said.

He was back a few minutes later, this time with two scotches, both doubles. This time Andrew drank the whole glass in one long gulp. He could feel the scotch going to his head. He doubted that he would have had the courage to say what he said otherwise.

‘George. Is it okay for me to call you George?’

George Edwards nodded.

‘There is something else going on. I’m sure of it now and I think you are sure of it too.’

He paused. George Edwards said nothing.

‘The trial was going to be negative. Roger Marsden told me. Then suddenly, out of nowhere twenty more patients turned up and the results turned out positive. Coincidence? I don’t think so. I bet if you look into it, our three patients would have been among those twenty. Those scans were mislabelled alright. They weren’t their scans.’

Andrew stopped. The enormity of what he was implying dawned on him.

‘Let’s be clear about what you are saying Andrew. You are saying that patients who did not have brain tumours were told they had and then cured of their non-existent brain tumours. That is what you are saying Andrew, isn’t it?’ George Edwards spoke calmly as he always did.

‘I can’t believe I’m saying it, but yes George, that is what I’m saying. And it’s worse than that. They would have had to have had biopsies of those non-existent tumours to get them into the trial. It’s mind boggling. They had unnecessary, invasive surgical procedures which could have potentially killed them or caused brain damage.’

‘But that never happened Andrew. I was very closely involved in the trial. All the biopsies were stereotactic and we did not have one death and no significant complications.’

‘That doesn’t make it right,’ Andrew protested.

‘I know it doesn’t Andrew. I’m not excusing any of it. But if it did actually happen, I’m sure no one came to any harm at least.’

‘What do you do now George, what’s our next step?’

‘Are you asking my advice Andrew?’

‘Yes I am, George. I’m out of my depth here.’

‘My advice, dear Andrew is to do nothing. It’s in the past. No one came to any harm. This has been an extraordinary medical breakthrough Andrew. Do you really want to jeopardise that? I’m near the end of my career. Yours is just beginning. You have a bright future. You are putting all that at risk. And for what? You can’t undo what has been done. If this really happened and it came out, the department would be finished. Jeffrey would be finished and all the good works being done by so many people will come to an end. Surely you can’t want that?’

‘Of course I don’t George. As you said, if it happened. We don’t really know that it did. There may be a perfectly innocent explanation. I really want to believe that. But I need to find out. I won’t involve you, I’ll do it on my own. And once I know, I can decide what to do then. I’m sure I will need your help at that time.’

‘Fair enough Andrew. Feel free to discuss this with me at any time. I think it’s best we keep the information just between the two of us, don’t you?’

There was nothing more to say. Andrew offered to buy another round of drinks but Dr Edwards declined. He was taking his wife out to dinner and had to get home. Andrew left at the same time and headed home, his head spinning.