CHAPTER SIX

SHE DID NOT tell Jamie that she was going to see Marcus Moncrieff the next morning. It was true that he had accepted her involvement, but she suspected that his acceptance was a reluctant one and that he would not really want any further details. Perhaps he had come to the realisation that this is what she did: she became involved, and he had simply decided that he might as well let her get on with it. She wondered whether it was the same as accepting that one’s partner smoked, or drank rather too enthusiastically, or read frivolous novels; bad habits all, but ones with which one might just have to live. She found herself using the word partner against her will; it insinuated itself into her thoughts; linguistic resistance was difficult, and ultimately futile: there was no point in continuing to call Beijing by its long-established anglophone homonym when a whole generation had forgotten that it was once Peking.

She thought that it was a good sign that Jamie was becoming more tolerant of her involvement in the affairs of others; it showed, she thought, that he accepted her for what she was. Isabel had been perfectly self-assured in all areas of her life until that fateful night when she and Jamie had made the transition from friends to lovers. We can be confident in our dealings with the world when what the world sees is the outer person, with all the outer person’s defences: the intimacy of a love affair is a different matter altogether. And who might not feel just the slightest bit insecure under the gaze of a lover—a gaze which falls on birthmarks, on blemishes physical and psychological, on our imperfections and impatience, on our human vulnerability? And how more so when one is older and the lover is younger.

Jamie made everything different, and she was blessed by his presence. But by accepting him into her life she had given a hostage to fortune: he could become bored with her; he could leave her; he could suddenly find her ridiculous. None of which she thought would necessarily happen, but it could. So this sign that he approved of her was important. Yet I am not to think about this, she reminded herself.

Peter Stevenson, her friend whose advice she sought on all sorts of matters, had been explicit. “Isabel, you must stop fussing about this!” he had said, his voice revealing his irritation. “You and Jamie are together. The age gap is a little unusual. But so long as you are both happy, which you are, it doesn’t matter. And Charlie’s arrival has created a bond between you which will last for the rest of your lives. So stop fussing, for heaven’s sake.”

The three of them, Peter, his wife, Susie, and Isabel had been walking along the Water of Leith together, having had lunch in the Dean Gallery, when Isabel had said something about not wanting to crowd Jamie. The Stevensons had asked them to dinner at West Grange House and she had been hesitant in her acceptance.

“I’d love to come,” she said. “Yes, of course.”

“And Jamie too,” said Susie. “We meant both of you. Charlie will settle, won’t he?”

“I’ll bring Charlie,” she said. “I’m not sure about Jamie.”

“But you can choose the evening,” said Susie quickly. “We’ll fit in with you.”

Again Isabel had hesitated. “It’s not that,” she said. “It’s just that…”

Peter had looked at her quizzically. “Doesn’t Jamie want to come?”

They had reached the point where the road dips down to the Dean Village, at the old millpond, and the path along the river begins. High above them were the soaring stone arches of the Dean Bridge, at the end of which a private house, built into the rock, acted as the bridge’s anchor to the wall of the valley. It was one of Edinburgh’s astonishing architectural details; a house which had been lived in for many years by a prominent psychiatrist, who used to joke that since the Dean Bridge had traditionally been the bridge of choice for suicide, like the Golden Gate in San Francisco, his house should have borne the sign LAST PSYCHIATRIST BEFORE THE DEAN BRIDGE. Some had frowned at this, but Isabel had appreciated the joke; doctors needed their moments of dark humour amidst all the human suffering of their day. She looked up. How long would it take to fall—should the psychiatrist’s counsel prove ineffective—and what would one think on the way down? The Roman Catholic Church used to be charitable in such matters and had been prepared to concede that people probably changed their minds on the way down from these great heights, that the desire to die became a desire to live once the descent began. Repentance, then, could be assumed, and in this way one went up rather than down, in the metaphorical sense; once, that is, that one had come down. Did the Vatican still think this, she wondered, or was it no longer necessary to make scholastic distinctions of this nature, if Hell had been abolished in Catholic teaching, as it had been by liberal Protestantism? She had never been able to understand how anybody could reconcile the existence of Hell with that of a merciful creator; he simply would not have embarked on us in the first place in order to send us to some Hieronymus Bosch–like torture chamber or its more modern equivalent (a place of constant piped music, perhaps). Hell might be an airport, she thought, lit with neon lighting and insincere smiles. No, she told herself; she was prepared to accept the possible existence of a creator, in the same way that she was prepared to accept curved space, but he or she would not invent Hell, whatever twists and turns on the subject of free will and choice were resorted to by the concept’s apologists. Why would a creator want us to have free choice in the first place if we were bound, imperfect creatures that we are, to abuse it? And yet, she thought, who amongst us does not want there to be justice; does not relish the idea that when Stalin took his final breath what he was shortly to encounter was at least some measure of punishment for his countless murders, rather than forgiveness? We should be careful, she decided, about abolishing Hell, even if we have no proof of its existence; and yet, and yet…was it not a part of growing up to understand that much as we may yearn for a universe ruled by perfect justice, this was not the way the world would ever be? The wicked got away with their wickedness more often than not, and became incorrigible as a result; the robber barons became richer; the swaggering bullies never met anybody stronger than themselves. The most that many could hope for was that justice had the occasional victory, and that they would see it, and be comforted.

She looked away from the bridge. It made her dizzy to look up, even more so than looking down. I could never live up in the air, she thought, like people who inhabit high apartments, with nothing below them but an almighty drop, with eagles for company.

Peter’s question needed to be answered. “I’m sure that he’d like to come,” she said. “It’s just that—”

There was an edge to Peter’s interruption. “It’s just that what, Isabel?”

It was not easy to explain. She was sure she was right in thinking that Jamie would not want to feel taken over; what young man would? “It’s a little difficult,” she began. “I don’t want him to think that he has to tag along with me.” Even as she spoke, she knew that it sounded unconvincing, and the way that Peter and Susie were looking at her confirmed this. Peter was frowning, in an effort to see what exactly Isabel was driving at; Susie looked sympathetic, but it was evident that she did not agree. And that was when Peter told her to stop thinking about the age difference.

For a while she was silent. They had continued on their walk, leaving the bridge behind them. The river, which was in full spate, was louder now, and she had to raise her voice to be heard above the sound of the water.

“Easier said than done,” she said.

Peter thought about this. “All right,” he said. “Advice is always easy to give. But that doesn’t make it any less relevant.” He looked at her quizzically. “Don’t you realise that Jamie probably feels about you exactly as you feel about him? Hasn’t it occurred to you that he can probably hardly believe his luck—to have found an attractive, intelligent…I could go on…witty woman like you? What would his alternatives be? Any other woman I can think of would be boring by comparison with you, Isabel. So stop it. Right? Just stop it. Subject closed.” He drew a breath. “Except for one final thing. You’re—what are you?—forty-something? Forty-three? That’s still young…ish. And it’s not all that much older than him. Fourteen, fifteen years? So what?”

“So does that mean we’re to come to dinner?” Isabel asked.

All three laughed.

“Yes,” said Peter. “It does.”

They continued with their walk. Then, as they drew level with St. Bernard’s Well, with its small stone temple to Hygena, she saw a figure ahead of them. He had been walking towards them and now he suddenly turned and walked the other way, back towards Stockbridge. She had not been paying attention; there were a few people on the path and he was just one of them. But then she realised who it was. Nick Smart.

She stared after the retreating figure; he was a swift walker. Peter noticed.

“Seen a friend?” he asked.

“No,” said Isabel.

They stopped to admire the temple. Isabel glanced down the path; Nick Smart must have let himself into Moray’s Pleasure Gardens, as he had disappeared from sight. She felt vaguely puzzled. Did he live there, in Moray Place or Doune Terrace? The gardens were private, and one needed to be a key-holder to get into them. And had Jamie not said something about his living over in the Pleasance somewhere, quite a different part of town.

“People used to come and take the waters here,” said Peter. “Apparently the water tasted foul. Full of iron.”

“But that would have been a plus,” said Susie. “Smelly mineral water was always thought to be better for you. More potent.”

Isabel remembered visiting a spa in France where the water was traced with arsenic, and much sought-after for that reason. We like our pills bitter, she thought.

Peter had remembered something. “We visited Vichy once,” he said. “I remember that it was at the end of the season and there was an orchestral concert in the public gardens. The mayor made a speech at the concert and concluded by saying that he hoped to see all the curistes back again next year. Which I thought was rather tactless.”

Isabel asked why, and Peter explained. “Because presumably they hoped to be better,” he said. “And if they were better, they wouldn’t need another cure the following year.”

Isabel felt foolish. “I see. Of course.”

Peter looked at his watch and suggested that they walk back to the gallery, where they had left the car. As she walked, Isabel wondered about Nick Smart. Why had he turned round so suddenly? Had he seen her coming? And if he had, then why should he wish to avoid her?

         

STELLA MONCRIEFF had said: “He said that he’ll see you. At first he said no. He was adamant—you know how stubborn men can be. But we can be stubborn, too, can’t we? And I insisted. I begged him. I said that he should see you if only for my sake. And eventually he said that he would.”

Isabel did not particularly like the idea of anybody being forced to see her; the position, she thought, that dentists must find themselves in when a young and nervous patient is led to the chair. Dentists, of course, could console themselves with the fact that the encounter was in the patient’s best interests, whereas she was not so certain that her seeing Marcus Moncrieff would do him any good. She had agreed to the meeting because Stella had pleaded with her and because she felt that it was her duty to respond, but that did not mean that her heart was in it. In fact, right up to the moment that she left the house at eleven o’clock that morning she had hoped that Stella would call and say that the whole thing was off. But she had not, and Isabel had set off on foot for the Moncrieff flat in Ramsay Garden.

The city was preparing for the annual arts festival, which was now only a few weeks away. During that time, for a spell of just under a month, it would become another town altogether—a great open amphitheatre of plays and concerts and opera. Jamie would be busy, both as a player and as a spectator, and they had paged through the programme together, selecting what they wanted to see. Even Charlie had a programme outlined for him: a concert of performing dogs, to be held in a tent, and a magic show described in the programme as being “completely suitable for those under two.” “But everything’s magic for them,” Isabel had said. “Have you noticed how he laughs if you hide your fingers under the tablecloth? He thinks that’s terribly clever.”

For the inhabitants of Ramsay Garden, the Festival brought only the promise of sleepless nights. Their proximity to the Castle Esplanade, on which the military tattoo was performed each evening during the Festival, meant that they had to endure massed pipe bands every night, along with all the pyrotechnics, the fireworks and explosions, that the military, and large sections of an enthusiastic public, consider to be artistic. The final movement of the 1812 Overture, with its cannon fire, was a gift for such an occasion, and was being performed that year, adding to the assault on the senses of those who lived nearby. At least, thought Isabel, as she glanced up at the immense structure which had been erected on the esplanade, at least the modern inhabitants know that the bangs and explosions were not real; earlier inhabitants of that spot would have quaked at such sounds, which would have meant real cannon fire. And the skirl of pipes would have heralded the arrival of troops, and trouble.

She reached the Moncrieffs’ door. A small brass plate said, simply, MONCRIEFF; along the edge of the plate was etched a tiny art nouveau device, one of those curious vines that artists of the period liked so much. The inhabitants of Ramsay Garden were playing the game, keeping in period, just as the inhabitants of the Georgian New Town on the other side of Princes Street were doing their best to maintain a Georgian style. The city encourages actors, thought Isabel, as probably all iconic cities do; look at the Parisians; it must be such an effort being so Parisian. She smiled at the thought, and pressed the bell. She herself lived in a Victorian house, but was not sure how she should respond to that particular challenge. By being stern and disapproving? By clothing the legs of pianos to preserve modesty? If the Victorians had ever really done that, she thought; and she had her doubts. Mind you, had there not been a Victorian librarian who had insisted on keeping books by men and women on separate shelves, unless, of course, the authors were married—in which case the books might properly be placed side by side?

Stella greeted her and gestured for her to come inside. She looked relieved, Isabel decided; as if she had worried that I would not come.

“I’m not late, I hope,” Isabel said. She knew that she was not, but it was something to say.

“Of course not. You’re…well, you’ve come exactly when I expected you.”

Isabel looked about her. They were standing in a generously sized entrance hall. Off to the right, which was the back of the building, there was a door that led into a kitchen, and a short corridor off to further rooms, the bedrooms, she imagined. Then, to the front, another door, attractively panelled in light oak, opened out into a room which, although Isabel could not see into it, she assumed would be the drawing room. That was the room which looked north, which would have the famous Ramsay Garden view, and there was light flooding in from it.

She glanced at the furniture, at the walls. It was typical of an Edinburgh flat of a well-heeled professional couple, which she assumed was what the Moncrieffs were—or had been: this was a house that had seen social disaster, she reminded herself.

“Marcus is through there,” said Stella, gesturing to the drawing room. Her voice was lowered; the hushed tone one might use outside a hospital room.

She led Isabel into the room. At first, after the comparative gloom of the entrance hall, the light seemed overwhelming. It suffused the room, flooded it, and made Isabel blink.

“Facing north,” she said, “and yet this is so bright.”

Stella muttered something about the windows, but Isabel did not catch what she said. Her attention was now focused on a man sitting in a chair by the large expanse of window at the front. He turned his head as they entered and rose to his feet.

“Marcus,” said Stella, her voice raised slightly, as if she were talking to a child. “Isabel Dalhousie has arrived.”

As Marcus rose to greet her, he was dark against the glow behind him, a chiaroscuro effect that created what felt, Isabel thought, like an annunciation scene. She moved towards him, towards the light, and they shook hands.

“The view…,” said Isabel.

They both turned to look out. “Yes, that’s a view, isn’t it?” said Marcus. “I sit here and see something different virtually every moment.” He gestured towards Fife, where the hills, dark green and solid, were sharply outlined against the sky, like sections of a collage. “The sky over there changes constantly. Constantly. It shifts from blue to white to purple—just like that. It’s very bright right now, for some reason.”

But Isabel was gazing downwards, to where the flanks of the Castle Rock descended almost vertically to the douce order of Princes Street Gardens, the railway line, the floral clock, the benches. Her gaze drifted beyond that, over the tops of the buildings, the crude, grey architectural mistake of the New Club, the ridges of chimneys, the stately stone pediments, to Trinity in the distance, and then the silver band of the Forth. The heart of a country, she thought; the heart of this place.

There was a chair opposite his, and Marcus invited her to sit down. As she did so, she cast a quick appraising eye over him. He was a man somewhere in his fifties—the younger end, she thought—tall, just beginning to grey, and with one of those slightly angular faces that spoke of intelligent determination. It was a face which would have looked good on a banker, or a senior lawyer, but would do well for a doctor; a trustworthy face. And not at all aggressive, she thought. This was the face of a kind man.

His voice was soft, the words clearly articulated, each syllable given its value, and each r given more. It was what she would have described as an old-fashioned Scottish professional voice. Of course he was innocent; that cardiologist was right—she could not imagine his doing anything underhanded.

“You know, I’m not sure whether Stella should have bothered you with my troubles,” he said. “This wasn’t my idea, you know. This meeting of ours. Not my idea.”

“I’m here only because I want to be,” said Isabel. “I assure you.”

He smiled, a quick, wistful smile. “That’s good to know. I’m not sure whether I’m here because I want to be. I rather think I’m not.”

Here in what sense? Isabel wondered. At this meeting with her, or here in this room, rather than elsewhere—at work, in a hospital or clinic? And there was a final possibility: here on this earth.

“When your wife…when Stella spoke to me, I doubted if there was anything I could do to help you. I told her that. But if there is anything…well, it’s sometimes useful to have somebody else go over things and see if there is anything that can be done.”

He watched her as she spoke, a slight smile playing about his lips. “It’s very kind of you,” he said. “I wouldn’t want you to think me ungrateful, but frankly I don’t really see any way out of my…misfortune. It’s happened. That’s it.”

Isabel felt his sense of defeat. There were times when the acceptance of defeat must seem the only option and an intelligent person in such circumstances might well become resigned.

“Would you be able to tell me—very briefly—what happened to you?”

He sighed. “Very well. I was a doctor. I still am, I suppose. Although, as you can see, I’m not actually practising anymore. I’m an infectious diseases specialist.” He had been looking at his hands as he spoke; now he raised his eyes to meet hers. “There was a time when everybody thought that they wouldn’t need us much longer. People thought that they’d won the battle against the microbe—but were we in for a little surprise on that front! Everything has come back with a vengeance: TB is the least of it, perhaps. The real nasties—Ebola, Marburg, and the rest—are lurking, and of course all sorts of new ones—avian flu and so on.”

Isabel nodded. “I suppose we’ve created exactly the right conditions for this,” she said. “Too many people. Too much travel. Environmental degradation.”

Her comment seemed to cheer him: she knew what she was talking about. “Exactly,” he said, his voice becoming enthusiastic. “Global warming is going to wreak havoc with health. Malaria in Europe and North America. And that will be just the beginning.”

She brought the conversation back to his case. “But I was told that you were working on MRSA when this…this thing happened.”

His enthusiasm visibly waned. “I was. I was very interested in a new antibiotic that had just been licensed. I knew the people who made it—one of the smaller drug companies, a bit of an outsider. They had a veterinary preparation and an antifungal cream—and then this very clever bit of chemistry. It was like finding oil for them.

“Anyway, any cases of MRSA infection in Scotland were more or less referred to me and I monitored the use of this drug. Everything was fine. Then, by highly unlikely coincidence, two cases turned up in Edinburgh, one after the other, when patients who had taken the drug experienced fairly serious side effects. Heart issues. I was asked by the Scottish government health people to look into it. The chief medical officer was concerned.

“I did it. I got hold of the records and had blood samples sent back for analysis. I tried to find out what happened.” He paused. “Are you following me?”

Isabel smiled. “So far. You’ve been very clear.”

He ignored the compliment, turning to stare out of the window. “We looked at the two patients. There was an interesting thing about one of them. He was a drug addict. He had got hold of our antibiotic from some pusher who said that it was a new drug that would give an unusual hit. How the pusher got his hands on it is beyond me, but it was probably theft from a pharmacy somewhere. These people will steal anything, sell anything, and take anything. As long as it’s a pill. And then word gets out on the street that something works and you have all sorts of people overdosing on the most peculiar substances. Laxatives even. Vitamins.

“I spoke to this patient and asked him how much he had taken. He gave me an answer which worried me, as it was not all that much in terms of an overdose. Ten times the therapeutic dose, in fact, but that was well within the limits of tolerance of that particular drug. Those limits are pretty large.”

He looked back at Isabel. “I don’t know if you’ve had any dealings with addicts. Have you? Do you know what they’re like?”

Isabel thought. There had been a student in her college at Cambridge who stayed in bed all day and made no sense most of the time. There had been a person in the apartment next to hers when she had been on that fellowship in Georgetown. He was an addict, she had been told, but he appeared perfectly inoffensive. A bit thin, perhaps, but inoffensive. I have had a sheltered life, she thought.

“No. I can’t claim vast experience.”

“Well, I’ll tell you something about them,” said Marcus. “Everything they say has to be distrusted. Everything. And so although I was worried, I thought that the chances were that he was lying. So I got hold of the blood that had been taken from him when he was admitted and sent it off to the lab for reanalysis. And when it came back, the result showed an overdose of about one hundred and fifty times the therapeutic dose. So this patient had swallowed a whole carton of the drug. But then that’s what they do. When they’re desperate, they pump the stuff in with reckless abandon.”

Isabel wondered what happened to the patient. She could not see him in her mind’s eye, for some reason. He was just a story.

“He recovered,” said Marcus. “He was discharged and went back to wherever he came from. Fife, I think. He’s probably overdosed on something else since then. Poor man. He won’t be long for this world, I suspect. But no sooner had we sorted him out than another one turned up. In this case the patient had been given a dose of the drug by a nurse here in Edinburgh. The nurse swore blind that the dose had been the normal one, but again the blood showed a massive overdose. Not as big as in the addict’s case, but pretty massive. Nobody could work out how on earth it happened, as the patient sided with the nurse and confirmed her story.”

“So somebody was lying?”

He thought for a moment. “Not necessarily. Errors can be made in how things are written down. Inadvertently move a decimal point one place in either direction and you get very different results, don’t you? But something had gone spectacularly wrong. Again, we were able to sort things out and the patient recovered reasonably well. She was a nice young woman, actually. A student at one of the universities, as I recall.”

“So you wrote up these results?”

“Yes. I made a report to the chief medical officer. I effectively gave the drug a clean bill of health. Then I wrote the two cases up as a case note for one of the medical journals. They published it. It was just a couple of paragraphs describing what had happened.”

“Then?”

Marcus was silent for a while. Isabel noticed that his hands, clasped together in his lap, were white at the knuckles. His voice, when he spoke again, sounded strained.

“A month later a man in Glasgow was admitted to hospital. He had been treated with the antibiotic. He…I’m sorry to say that he died from heart complications. He had not received an overdose—that was established. The press got hold of the case and they asked how somebody could die from taking a licensed medicine. Well, I could have given them an answer to that, but they were not in the slightest bit interested in a rational explanation about inevitable risk. They put pressure on the minister and they took another look at my report. They discovered that the doses I had described did not match a new set of lab reports on the blood. The figures were way off. And they also discovered that I had not declared a conflict of interest when I published that case note. I should have told them that I had received a research grant from the company that made the drug. And they were right: I should have done that. I don’t know why I didn’t. It was some years ago. It must have slipped my mind.

“There was an internal enquiry and I was censured. They said that I had been negligent in not checking the blood results when they were so obviously exceptionally high. They said that a prudent doctor would have had the samples tested again. They censured me, too, for not disclosing the conflict of interest and the journal published a withdrawal of my case note.”

He stopped and looked at Isabel. The air of defeat had returned. He seemed flattened, almost as if the breath had been knocked out of him—winded.

Isabel felt that she needed to think. She rose to her feet and stood before the window, looking out over Princes Street below. A train had emerged from the tunnel underneath the National Gallery and was moving slowly west. She looked at her watch. That was the Glasgow train, which left every fifteen minutes.

“So what they did,” she began, “is to conclude that you were negligent. Is that it? They didn’t conclude that you had deliberately falsified anything?”

Her question seemed to unsettle him. He looked down at his hands for a few moments before he replied.

“There was no falsification,” he said. “There was an error in the transcription of the results somewhere along the line. It’s possible that it was a slip by a medical student who was attached to my unit at the time. They accepted that. They said, though, that I should have rechecked and should not have relied on a medical student. They said that I was careless. That was the actual word used: careless.”

“And do you think you were?” asked Isabel.

He closed his eyes. She noticed that his right eyelid was twitching. “Yes. I should have checked. And I should have declared the conflict of interest. I failed to meet the standards expected of a doctor of my experience.”

There was something that Isabel was unsure about. Was this failure directly linked with the Glasgow case? She asked him this, and again he took a little while to answer.

“According to the press it was,” he said. “One or two of the papers went so far as to accuse me of…” He faltered. “Of killing the patient in Glasgow. They said that if I had done my work properly, safeguards would have been put in place. The drug would not have been given to somebody with a history of heart problems—which that man had. They blamed me for his death.” The next words were chiselled out. “Publicly. Unambiguously.”

Isabel reached out and put her hand on top of his clasped hands. “But you weren’t responsible for that,” she said. “Somebody made a mistake. That’s all.”

But there was something she still needed to know. Why had he not checked the results, if they were so out of line with what might have been expected? She asked him.

His answer came quickly, and Isabel thought that it sounded rehearsed. But then she realised that repetition may have the same effect as rehearsal. He would have had to explain himself a hundred times before, sometimes, perhaps, even to himself; of course it would sound rehearsed. “It didn’t cross my mind,” he said. “It didn’t occur to me that the results could be wrong. I took them on face value.”

They spoke for a few more minutes. Isabel asked him the name of the assistant who had worked with him, and he gave it to her. But he added, “It was definitely not his fault. It really wasn’t.” Then Stella appeared, hovering anxiously about the door. Isabel said good-bye to Marcus, who had sunk back in his chair and started to stare out of the window again.

Glancing behind her, Isabel whispered to Stella. “He looks very depressed,” she said. “Has he seen a doctor?”

“He won’t,” Stella replied. “I’ve tried. I’ve tried everything.”

“All right,” said Isabel. “Give me a week. Maybe ten days. Then telephone.”

Stella reached out and briefly held Isabel’s arm. “You’re a saint,” she said.

The compliment surprised Isabel. She did not conceive of herself in those terms at all; it simply would never have occurred to her to do so. A saint with a young boyfriend, she thought. And a taste for New Zealand white wine. And a tendency to think uncharitable thoughts about people like Dove and Lettuce. That sort of saint.