Malpractice

Wealthy, philandering surgeon Tony Stamford seems to have the world at his feet until an embarrassing email from a recent conquest, Katya, proves the final straw for his long-suffering wife. But is she as long-suffering as she seems, and who really is Katya? As Stamford’s life begins to unravel he finds himself lost in a world of mirrors, no longer certain who he can trust and doubting the value of his very existence. Stripped of everything he once owned, he embarks on a battle for his freedom and even sanity which can only end in death. By turns, sharply satirical and disturbingly dark, Malpractice takes a scalpel to the vanities of the medical profession and, in doing so lays bare the deceits and cruelties that desperate people will stoop to. A gripping thriller that reaches remorselessly into the depths of human nature.

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2. Chapter 2

It was an ordinary Tuesday morning in September when Mr Hamish Carmichael first appeared on my radar.  At the time I was working as a General Surgeon at St George’s, Tooting, where I specialised in proctology, specifically colonic cancers.  Like Carmichael, I was therefore, in keeping with the arcane nomenclature of medical tradition, a “Mister” not a “Doctor” and enjoying the trappings of success accorded to a top surgeon in a leading London hospital.

 

He did not arrive in person, preferring to present himself in the form of an inter-departmental memo which read as follows:

 

Dear Mr Stamford,

 

Many apologies for not contacting you earlier but, as a recent arrival in Tooting, I have been a bit snowed under over the last few weeks with the move down to London!  As usual, necessity has become the master of manners and I am now coming to you in the hope of eliciting your opinion regarding a case that is threatening complications.  That said, I am sure we can mix business with pleasure and I wondered if you would be interested in meeting for a drink.  We can say hello and discuss this woman’s colon in civilised surroundings!  I am rather new to the area but, if you fancy venturing out of the immediate vicinity, The Fox and Grapes on Wimbledon Common seems a pleasant enough venue for a lunchtime or early evening pint.

 

If you are amenable, please call Judith my secretary to fix a time.

 

Best wishes,

 

Hamish Carmichael

 

I sat back to consider this innocent little note.  To be honest I felt a little guilty in that, as the more senior surgeon, I had been rather remiss in not introducing myself to him.  I had been excusing myself on the grounds that I had been desperately snowed under with work which, to a certain extent, was true. However, the reason for my exceptional workload was spurious in that, as usual,  taking on extra cases and working all the hours God sent was my escape route when trying to avoid the wrath of my wife Elizabeth, not an exceptional outburst of dedication to my calling. 

 

Suffice it to say that I had been caught with my pants down again following a foolish fling with a lady delegate called Katya at a recent medical conference in Melbourne.  She had emailed me at work on my return to Tooting, demanding to know when I was planning to return to her loving embraces (I was not) and my secretary Colleen had opened it.  Naturally she had felt obliged to share it with her best friend, my wife Elizabeth.

 

Colleen had been my secretary longer than I had been married to Liz.  At first it had been a sort of Bond/Moneypenny, “will-they-won’t they” relationship.  In a rare moment of self-restraint, I had realised that she was more value to me as a secretary than as a lover and, to her ill-concealed frustration, kept things on a purely professional, if flirtatious, footing.  Spinsterhood seemed to overtake her while I pursued my bachelorhood in every direction except hers.  When my marriage to Elizabeth became a reality she could no longer obstruct (she initially applied herself to sabotaging it with the ruthlessness of a female, wartime S.O.E. agent), she appointed herself as Liz’s mole in my network of extra-marital liaisons.  It was a win-win for Liz who had a shoulder to cry on when feeling particularly aggrieved at my latest aberration and a well-placed informant during my periods of penitence.  By the time I decided I had had enough of her treachery, she had too much blackmail material on me to consider sacking her; besides, I rather enjoyed being the centre of so much attention, regardless of the reason for it.

 

In fairness to Colleen, it was her job to sort all my morning post, and it was stupid of me to have got involved with this Katya woman in the first place.  I had been wearing a wedding ring, so the damn woman knew full-well that I was a married man, and I thought I had made it abundantly clear to her that there was no future in the relationship beyond Melbourne. She obviously thought otherwise.

 

I certainly was not planning on “playing away” when I arrived in Melbourne, though I suppose, in hindsight, I had not put up much of a fight when Liz announced that she would not be joining me thanks to the commitments of her new job.  I had got chatting to Katya during a lavish banquet laid on by some drugs company or another.  It turned out she was a research scientist at the Immunology and Reproduction Centre in Moscow.  I found this much less interesting than her cleavage which, in my experience was surprisingly shapely for a boffin.  I suppose I had partaken of more of the selection of fine Australian wines than I would normally allow myself, but then I did not have to get up the following morning and perform a rectal examination on an eighty-year-old.  Anyway, one thing had led to another and we had ended up in bed.

 

This, unfortunately, was not the first time I had been abroad in both senses of the phrase and, when Colleen forwarded Katya’s first email to Elizabeth, the explosion could be heard from Wrexham where my beloved was holding a seminar on some new wonder drug her company was launching.

 

Since then I had been avoiding showing myself at home, confining myself to arriving as late as possible and disappearing into my cell, a.k.a. the upstairs back bedroom which, in harmonious times, I used as my study.  I would not have gone home at all if that had not opened up the possibility of further accusations of infidelity.  I was consoling myself with the thought that the frost would eventually melt –abstinence cuts both ways – and a bottle of strategically timed chilled Chablis in due course would undoubtedly help the thaw.  In the meantime, the attitude and procedures of the true penitent had to be observed.

 

Guilt at neglecting my new colleague aside, I was also mildly flattered that he was seeking my opinion.  This was, and still is, by no means uncommon; we surgeons swap notes all the time, but we also have egos that enjoy a gentle massage.  I wondered idly about the nature of these “complications”.  I guessed it was something to do with our professional differences; my speciality was colorectal, or bowel, cancer whilst he had joined the St George’s team thanks to his expertise in dealing with anal cancers.  Perhaps he wanted my thoughts on a post-op complication.  One thing I was sure of was that this was not the real reason for the meeting; these days we discuss patients in our early morning Multi-Disciplinary Team Meetings, not over pints after work.

 

I tried to recall what I knew about Carmichael himself.  I had met him of course at his interview a few months earlier.  Along with my other colleagues, I had been greatly impressed by his suggestion that he transfer to us from the Glasgow Royal where he was attempting to study the recently mooted, if somewhat hard to picture, connection between anal cancers and smoking.   Thanks to the Glaswegian fondness for fags and booze, he was too over-worked to analyse his data.  In fact, he was never out of surgery, so he was offering us hands-on experience well beyond his years; he was still only thirty-nine.  The addition of his talents would make us one of the pre-eminent proctology teams in the UK and arguably beyond.  We almost proposed marriage.

 

The style and tone of his memo carried the same dry, urbane tone that I had noticed in his interview.  His C.V. had shown him as coming originally from Edinburgh, not Glasgow, and I had been struck by the contrast between his rugged appearance and his well-modulated, “Miss Jean Brodie”, Scottish brogue.  He’d gone to school in Edinburgh and done his medical training in the army.  Beyond that I was pretty ignorant about him and his background and therefore a bit intrigued.

 

Furthermore I was getting a bit bored of the penitent bit so it was not difficult to convince myself that a couple of pints with a new colleague after work was well outside the grounds for divorce that I was currently at pains to avoid.  I checked my list of internal extensions and phoned his secretary Judith; as luck would have it we were both free early that evening.

 

*

 

I slipped my Aston Martin DBS 1971 into neutral for the hundredth time.  I ground my teeth as I ground to a halt yet again in the early evening, rush hour traffic.  The roof was still up, despite the spring sunshine, to cut out the traffic fumes, which rather defeated the object of driving a soft-top.  In fairness, a vintage Aston is not the best choice as an urban run-about in this day and age, but marriage and my career had cost me so many of the freedoms and indulgences I had taken for granted in my bachelor years that this was one I was not prepared to give up regardless of cost or inconvenience.

 

I took an air-conditioned breath and turned my thoughts to the forthcoming encounter with Carmichael.  The choice of venue would not have been mine.  I have always found “Wimbledon Village” faintly absurd and the Fox and Grapes even more so.  Faux country pubs in quasi country villages, populated by city dwellers in green wellies and four-by-fours, are not my thing.  I like cities with concrete buildings to work in, and countries with untamed wildernesses to play in.  At public school, and then at medical school, I despised the rugby, brawn and beer crowd and loathed the huntin’, shootin’ and fishin’ types.  I went sailing in the summer and skiing in the winter.

 

I dismissed the thought with a mental shrug; Wimbledon Village was not an unnatural place for a St George’s surgeon, newly arrived from Scotland, to land up in.  The local estate agents would have pounced with a ruthlessness unheard of in the back streets of The Gorbals.  The traffic thinned as I wound my way up through the back streets to Wimbledon High Street and out onto the common.  I bagged a parking space not too far from the main door of the pub and walked into the front bar. 

 

Carmichael was there ahead of me, seated at a country kitchen-style table by a leaded window, gazing out onto Wimbledon Common’s manicured countryside.  In fact he was probably gazing at the Aston because he turned around and rose to greet me as I walked through the door.  He walked forward and held out a hand as I registered him.  His grip was firm to the point of being challenging and his smile was friendly enough, but chilled by his calculating, pale blue eyes.

 

‘What can I get you?’ he enquired as he released my hand.  ‘By the way my friends call me Ham; it trips off the tongue a bit smoother than Hamish.’

 

I nodded my acceptance of this breaking of the ice.

 

‘Mine call me Tony; I think I’ll have a gin and tonic, please.’

‘Fine, Tony.  Would that be a large one?’

 

‘No, no thanks, I’m driving; just ask for plenty of ice.’

 

‘Far to go?’

 

‘No, only back over to Wandsworth Common, near the station.’

 

‘You're losin’ me there; I’m the new boy in town.’

 

‘Of course, I’m sorry.  It’s a few miles from here towards Clapham Junction.’

 

By this time we had reached the bar and Ham was trying to catch a bar person’s eye which spared me any further attempts to explain London geography and gave me a chance to inspect him more closely.  He had a sportsman’s build though shorter and stockier than mine; a sort of boxer to my fencer.

 

He ordered a gin and tonic for me and a large, straight, single malt for himself.  He paid and returned to his window seat which had stayed empty, reserved by a half-drunk pint and an empty spirit glass.  My colleague clearly liked a tipple.

 

We exchanged a few pleasantries about how he was settling in and my few skiing trips to the Highlands which clearly were of limited interest to him.  It transpired that he was living in a flat in the Village for its proximity to Wimbledon Town Football Club which he had recently adopted as his home side.  He informed me that this was a bit of a come down from Partick Thistle, whom I had never even heard of, though I nodded polite agreement and suggested he might like to try Fulham as more in keeping with his professional status.  This was based on my knowledge of property prices rather than any familiarity with “the beautiful game”.  The topic died there; it rapidly transpired that my interest in football matched his interest in skiing.

 

Things were getting slightly awkward and it did not help when I recalled that his C.V. said he was married and enquired as to whether his wife would be joining him in London.  He hesitated for a moment, and then shrugged.

 

‘I guess it will come out sooner or later,’ he replied guardedly, ’Maggie and I are no longer, as you might say, an item.  We were seeing a marriage counsellor when I wrote my C.V. and I still had hopes we could work something out.  We couldn’t.  She has never had my ambition and flatly refuses to move away from home.  She says she has to nurse her sick mother who, in my professional opinion, is as fit as a fiddle.  She has been like a lead weight throughout our marriage and, thanks in no small part to her scheming, fucking mother, this last move brought matters to a head.  She will be staying in Scotland.’

 

This was said with a finality which thankfully invited no further enquiry – I am not the “agony aunt” type and chose the life of a surgeon partly to avoid the wearisome patient contact that my colleagues in General Practice and Psychiatry are expected to endure.  Unfortunately, glad as I was to avoid the minefield of marital problems, particularly given that I had enough of my own, I was left stumped for conversation.  This was further exacerbated by his apparent unwillingness to help make the running.  I took an unwanted swig from my gin and tonic then drew out the task of topping it back up with the remains of the tonic water in the little bottle.  I became aware that those cold, blue eyes were studying me with the same steady lack of emotion he would have employed to examine a biopsy.

 

He suddenly broke the silence as if he had come to some conclusion about me, but saw no need to share it:

 

‘Are you married, yourself?’

 

I nodded, avoiding the need to give a direct answer by taking another swig of my drink.

 

‘D’ya have kids?’

 

‘Yes,’ I replied, relieved at a diversion in this strangely uncomfortable exchange, before realising that my current relationship with my off-spring needed judicious editing.  Our son, Pete, was studying Maths and Computing at Stirling University (probably in order to put as many RAC Online miles as possible between himself and the distinctly frosty atmosphere at home), whilst, at home, our daughter Annette was spending as much of my cash as possible, whilst pursuing an unending post-graduate diploma in Uber-Modern Urban Art or some such crap.  I suspected that this was her way of spiting me for the wrongs she felt I had done her mother.  The two of them had always been thick as thieves, and now they were solidly united in their contempt for my latest infidelity.

 

‘Yes,’ I repeated, ‘both more or less grown up.  My youngest Pete’s up in your neck of the woods at Stirling, doing maths and mucking about with computers.  God knows what Annette’s up to, but it doesn’t involve earning a living yet – kids, eh.’ He acknowledged this token explanation with a slight lift of the chin.  He was clearly not interested in pursuing this line of enquiry any more than I was.  He picked up his whisky glass and drained it, replacing it firmly, even pointedly, back on the table.

 

‘Can I get you another?’ I enquired, taking the hint.

 

‘Aye, that would be nice; I think I’ll have another pint of that Directors bitter if you don’t mind.  I’ll pass on the whisky this time.’

 

I drained my glass and collected his as I rose and began working my way through the “after work” crowd now thronging the bar.  As I waited to be served I wondered what was troubling me about my companion.  I certainly found his chilly gaze and his abruptness unsettling, but that was no doubt just his manner, and I was not so clever when it came to small talk myself.  We certainly did not seem to have much in common beyond work.  Perhaps I should try that next.  He certainly had a taste for the booze that I did not share.  He had already put away two large scotches and a pint of beer to my knowledge.  Directors is the strongest of Courage’s regular draught beers so I was not overwhelmed by his abstemiousness just because he was passing on another large scotch.   Still, he was not the only surgeon I knew with a taste for the booze and drinking habits north of the border are notoriously macho, as are the drinking habits of rugby players.  As far as I was concerned, provided it did not affect his work, it was none of my business.

 

I returned from the bar.  He was staring out of the window at the flat expanse of Wimbledon Common again.

 

‘Missing the mountains?’ I enquired, slightly flippantly.

 

‘No,’ he replied flatly,’ I was admiring your car.’  He paused, as if choosing his words very carefully.  ‘That is a beautiful machine.  That machine is fuckin’ beautiful.’

 

‘Thanks, I, er, I’m glad you like it...’ I replied lamely, taken aback by the intensity of his expression.’

‘Where d’you get it?’ he asked, as if I had not spoken.

 

‘Chelsea Cars in Wandsworth.  I was driving past one day and fell in love.’

 

He nodded thoughtfully.

 

‘I’m not surprised.  Can I take a look?’

 

‘Sure.  Why not?  I guess we’d better take our drinks with us; this table will go the second our backs are turned.’

 

‘Aye, come on, let’s go.’  Without further ado he picked up his glass and headed for the door.  Apparently, without becoming soul mates we had found something to talk about.

 

*

 

‘Okay,’ I said, ‘are you sitting comfortably?’

 

‘Go on,’ he said, with the nearest I had yet seen to a real smile.

 

I dropped the car back into second and floored the accelerator as I swerved out from behind the car in front of me.  The cars that had been gaining rapidly in my wing mirror suddenly began to recede as the Aston charged across and forward into the outside lane of the A3.  I glanced across and grinned to see Carmichael’s head slammed back against his headrest as we hit eighty within seconds.  I immediately eased off the accelerator to avoid upsetting the speed cameras and police cars that jostled for position on the hard shoulder.  I had made my point.

 

‘Wow,’ was his only comment.

 

I indicated and began working my way quickly back across the traffic we had overtaken before I missed the Guildford turn off.  It had taken that far for us to find a suitable gap in the tail-end of the rush hour traffic.  I had a feeling from the look on Carmichael’s face that, as far as he was concerned, it had been worth it.

 

The traffic back into London was mild compared to the rush- hour mêlée we had just battled through.  As a result, I was able to spend time showing off my baby’s abilities to better effect and talk in more detail about its technical specs.  The run out had been devoted to the narrow escapes I had suffered in it on German autobahns and the like.  He was particularly entertained by my account of the day I had spun out on a mountain road in Austria racing a friend’s Bugatti.  I had ended up with the back wheels over a cliff edge, too scared to open the door in case it toppled; a bit like the ending of The Italian Job, except I didn’t have a ton of stolen gold in the back.

 

It was not until we had turned off at Tibbet’s Corner and exited the roundabout onto Parkside that he popped the question:

 

‘So when can I have a go?’

 

Why I had not anticipated this I cannot imagine; too much English reserve, maybe – I had been brought up to wait until I was asked or something like that.  Anyway it left me groping for an excuse.  If you have never owned a classic sports car you may not appreciate why I needed one.  If so, try to imagine how you would feel if someone asked to borrow your newly born child, then double that feeling on the basis that newly born children are relatively cheap and easy to come by, certainly from the male perspective.  I played for time.

 

‘Well, er, have you ever driven anything like this before?’

 

‘Not exactly, but the day after I passed my test me and the boys shot over the Forth Road Bridge for a day out at Knockhill race track thrashing one of their old Formula Fords.  I almost lived there for a couple of years before med school.  About then I saved up and bought a second hand three litre Capri S, the sort Bodie and Doyle used to drive when I was a kid watching The Professionals with my dad.  Boy could that thing shift!  We tuned it up and took it road racing down in the Southern Uplands.  I earned enough prize money to keep it on the road.’

 

‘What roads did you race on?’

 

‘Just the ordinary hill roads at night – like Rebel without a Cause in the rain.’

 

‘What did the police think?’

 

‘They never caught us.’

 

‘So would you be planning on taking my pride and joy here on some sort of illegal rallying spree around Wimbledon Common?’

 

‘No, no, of course not; I’ve grown up a bit since then...’

 

‘What about insurance?’

 

‘I’m fully comp on any vehicle, it’s just the current vehicle is a Porsche 911 Turbo which is locked in a bloody garage in Edinburgh while the lawyers argue over its resale value.’

 

I found myself nodding in sympathy; given Liz’s ire regarding my latest misdemeanour, it was not inconceivable that my “pride and joy” could soon be suffering a similar fate.  I paused, groping for any other obstacle I could throw in the way without appearing neurotic.

 

‘So what d’you say?’ he prompted.

 

‘Okay, on one condition,’ I conceded.  ‘I hope you don’t mind me saying, but back in the pub I saw you polish off at least a pint and a couple of scotches in about twenty minutes.  If you drive this car you do it dry, agreed?’  As I said this I turned to look him briefly in the eye; he was already looking at me to gauge my reaction.

 

‘Why, of course, man.  I never would drink and drive, particularly not in another man’s car.’  For the second time his face broke into a smile that looked like it was not used to being there.  ‘No way, scout’s honour.’

 

*

 

 I dropped him back at the Fox and Grapes where he said he had left his briefcase.  I suspected a few more pints would cross the bar before he took it home, but I was not particularly interested in finding out.  I am a fairly private man and selective about my friends.  Hamish and I had done enough bonding for one day.

 

It was still only just after eight which was a lot earlier than I had recently been returning home.  To kill a bit more time I stopped off at the Indian Ocean on Trinity Road.  I shoved lumps of Chicken Dhansak around my plate with pieces of torn-off chapatti for a while, but gave up.  My appetite had gone; my thoughts had turned to matters matrimonial.

 

To be honest I was worried in a way I had never been before.  Since this latest fling in Melbourne the chill in the atmosphere at home would have had Captain Scott reaching for his thermals, but I was used to that.  So what was troubling me?  What made this aberration any different from my past misdemeanours?

 

I must admit my track record when it came to the “And forsaking all others” part of the marriage vows was not good.  I am a child of the Sixties/Seventies and, while I have never been an advocate of free love, I have never bought into the notion of blind, unthinking fidelity.  I suppose I have always seen sex and love as two entirely separate things.  I have never had sex with a woman I did not feel loving towards, but that does not mean I was in love with her.  I was in love with Liz from the day we met and that, for me, was never diminished by the occasional fling that presented itself along the way.  Unfortunately, Liz was a home-maker as well as a career woman and such liberal notions were thrown back over her shoulder along with the wedding bouquet.

 

Suddenly, it struck me.  I had been sneaking home late to an unlit house and creeping out first thing in the morning to have breakfast in the hospital canteen.  I had not seen her for several days.  For all I knew the house had been empty!  Had she left me?  The notion was so bizarre, so contrary to my assumption of her long-suffering forgiveness that I nearly choked on a dry piece of cold chapatti I was trying to swallow.  I took a swig of water as I struggled to get a grip.  I told myself not to be so absurd, but the thought refused to go away.  I abandoned the remains of my curry and went to the till to pay the bill rather than wait while they faffed around with hot towels and mints.

 

By the time I reached Thurleigh Road, on the other side of the Common, I had calmed down somewhat.  The house was indeed deserted, but there were no signs that anyone had moved out.  I checked the wardrobes and drawers in Liz’s (formerly “our”) room and the majority of her clothes were still there.  Annette’s room looked like it had been burgled by the Visigoths, but I got the overall impression that she was still in residence.

 

I checked the calendar in the kitchen, the dining table part of which Liz used as a semi-office.  She had blocked off the days from the nineteenth to the twenty-third of September with arrows and the word “Manchester”.  It was now the eighteenth.  That was it!  I recalled with some relief an icy comment, tossed over her shoulder, about a sales conference she was attending at some Holiday Inn or the like near Sale.

 

So what was troubling me?  The answer was there all around me; the emptiness.  For the best part of the last two decades I had been used to being greeted by Liz and the kids as I returned home.  Even when I was in the dog house, there was a meal waiting for me in the fridge; not anymore it seemed.

 

Alright, if Liz was pissed off at my latest infidelity, why didn’t she talk about it instead of fucking off on some bloody sales conference?  Fair enough if she wanted a bit of independence now the kids were flying the nest, but didn’t twenty years of marriage count for something?  For Christ’s sake she knew what I was like!  We all have a weakness of one sort or another, mine just happened to be women.  So what!  Hadn’t I always come back?  Hadn’t I always provided for her and the kids and, indeed, shown her a lifestyle and degree of comfort she would have been very lucky to find elsewhere?

 

To an outsider, Liz and I were the perfect medical couple.  My star had risen steadily through the surgical firmament, whilst Liz had recently been made Marketing Director of a big American medical services group that had opened up in Surrey.  Quite how she had moved from being an English Midwife to being an international Marketing Director was a mystery to me, but, like many of my profession, I liked to view the business world with  a certain distain.  On reflection, I could not even recall the name of the company she worked for...What the hell was it?  One of those corny puns the yanks love.  Medi...medi...MediCal International, that was it!  Based in California - very clever with that capital C stuck in there to make a play on the place name.  No doubt some smart little marketing executive had been dining out on that one for weeks!

 

Sadly, this patronising little burst of amnesia did nothing to make me feel any better.  Truth be told, I knew perfectly well who she worked for, but I did not like to admit it because that involved admitting that my role as bread-winner was diminished.  It had never occurred to me, and it did not then, but, in hindsight, I had always used the fact that I came from a wealthy, if highly dysfunctional family, plus my substantial earnings as a successful surgeon, to control my wife.  Now the kids were grown up and making their own way in life, and my wife was busy carving out a successful career of her own.  In a moment of uncharacteristic self-awareness I realised that I did not like this unexpected shift in my marital and parental status.  In fact, I did not like it one little bit.

 

 

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