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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3. Chapter 3

I sat staring at the monitor in horror.  I was in work early to check my emails before my traitorous snake of a secretary, Colleen had a chance to incriminate me further.  My conscience had woken me ahead of my phone alarm, despite my having spent the rest of the previous evening working myself into a stew of self-righteous bullshit.  I finally went to bed late and slightly drunk, convinced that I was the injured party.

 

I had adopted this early arrival ploy since that first disastrous billet d’amour and so far I had intercepted two more declarations of Katya’s undying love and deleted them both unopened in the hope that she would take the hint.  This latest communication, however, shifted the goalposts completely. 

 

The cause of my alarm was posted on the screen in front of me.  It read:

 

My Dearest Tony,

 

You are perhaps not wishing to answer my emails, but situation is most serious as well as wonderful!  My doctor is telling me that I am expecting a baby from you.  It is most urgent you must talk to me because there is very much we must be thinking of.

 

All my love,

 

Katya

 

I sat back stunned.  This was all getting out of control: way out of control!  A one-off shag at a conference on the other side of the world was turning into a fucking paternity-cum-divorce suit! Real panic gripped me.  I had devoted my whole life to building a successful career and family life, even if I had been prone to jeopardising the latter with my occasional sexual transgressions.  I had no desire to see all that hard work snatched away by some gold-digging tart I had put up the duff!

 

I glanced at my watch.  Bloody Colleen would be in shortly!  I needed to do something quickly.  The first thing was to put this damn woman straight on a couple of things.  I clicked the Reply icon then forced myself to pause and gather my thoughts.  Finally I wrote the following:

 

Hi Katya,

 

Many congratulations on your news.  Unfortunately, I regret to inform you that I cannot possibly be the father of your baby.  If you recall I used a condom at the time even though you assured me that you were using oral contraception.  My reason for doing so was because in this day and age one has to protect oneself against the very real dangers of venereal disease and I am sure you will agree that, despite a very pleasant evening together, we did not know each other well enough to completely rule out such a possibility.

 

However, I did not use a condom to prevent conception, because there was no need.  In February 1993 I had a vasectomy carried out by Mr Vijay Kabir at his private clinic in St John’s Wood, London.  I can forward you written confirmation of this should you wish, simply email back the word ‘Yes’.

 

I will always remember our time together with fondness, but am clearly not the father of your child and have no intention of continuing what I believed to be nothing more than a pleasant interlude.  I would therefore be grateful if you would cease trying to contact me, particularly since this is my work address and your emails are causing me considerable embarrassment.

 

Any further attempts to contact me will be taken as attempts to extort money from me and I will regretfully be forced to make an official complaint to your employers and, if necessary, the Moscow police.

 

I am sorry to have to adopt this attitude, but suggest you devote your energies to identifying the real father.

 

Best wishes,

 

Tony

 

I sat back to consider my efforts.  I did not want to hurt the woman’s feelings, but she had to know I was not messing around.  Goodness knows who had put her in the club, it certainly was not me.  The bit about the vasectomy was true. 

 

I had married Liz because I had fallen in love, not because I wanted kids.  I had finally gone along with Liz’s maternal promptings and succumbed to parenthood, having fought a valiant rearguard action right up to the age of thirty.  My worst fears were confirmed: I had been right to suspect that kids would have a distinctly detrimental effect on the winter skiing and summer sailing lifestyle I had been enjoying up to that point.  Sure enough, my life changed drastically for the worse: goodbye to The Florida Keys and Chamonix, hello to sleepless nights and shitty nappies.

 

In hindsight, I suppose that, although I had played the role of devoted father to a T, I was too selfish or immature to want kids at that time in my life and, when two came along, I persuaded Liz that enough was enough and booked an appointment with my chum Vijay.  Looking back, I imagine I thought this would allow me to return to the good old days, but, of course, it did not.  I now had the responsibility of providing for my family and resented losing the freedom of my youth.  My disregard for my wedding vows was the product of my refusal to grow up, not any dissatisfaction with Liz.

 

Any further introspection was abruptly interrupted as Colleen walked through the door.  Shit!  Thankfully she busied herself hanging up her coat.  There was no longer time for any editing so I clicked Send, and then just as quickly deleted both messages.

 

‘Mornin’ Mr Stamford, you’re in early again.’

 

I ignored the underlying sarcasm.

 

‘Morning Colleen, any post for me to look at?’

 

She looked at me as if I had asked her the way to Amarillo.

 

‘The post isn’t here yet.  It comes about ten and you look at it lunchtime,’ she replied with a quizzical look, her tone suggesting that perhaps I had lost the plot.

 

‘Oh yes, of course, what am I thinking of?’  That bloody email had clearly rattled my cage more than I wished to admit.  Unable to come up with a reason for asking her to do the impossible, I shut up and busied myself with some of the previous day’s paperwork.  The words simply swam before my eyes.  I could feel her gaze upon me.

‘A cup of coffee would go down a treat,’ I suggested.  ‘Bit of a late night last night; got caught up in a documentary about the Amazon rain forest of all things.  It was fascinating.’  Why was I lying?  I hadn’t even turned the telly on!  I didn’t need to justify myself to this woman!

 

‘Oh, I stick to me Soaps, me.  There’s real life in them.’

 

‘There’s real life in the rain forest, still I know what you mean.  Each to his own... how’s the coffee coming on?’

 

‘It’s there; I just put it on your desk.’

 

‘Oh, yes, silly me!  I must have been reading.’  This really was not happening.  I glanced at my watch.  ‘Good God, it’s five-past-eight already!  I’d better get a move on.’

 

I grabbed the files she had put on my desk and headed for the door.  For no discernible reason I beat a hasty retreat from my own office.

 

*

 

The room was buzzing with the usual early morning chatter as I backed through the meeting room door to avoid spilling my coffee.  My other arm was full of files, today’s quotient being a fairly reasonable five.  These were new cases that required action after the preliminary investigations, and a couple of old cases that everyone hoped had gone away.  This was the daily M.D.T. or Multi-Disciplinary Team Meeting, where everyone involved in cutting a patient up and putting him or her back together again got together to compare notes and agree on the next procedures.  I scanned the sea of faces and spotted my Senior Registrar, George Hopkins, in the corner where my team usually congregated.  I began weaving my way through the work stations that filled the room.

 

As I got closer I made out Patricia Field, one of the radiologists and an old flame of mine from not long after I arrived at St G’s.  Like me, Pat was married at the time, so discretion finally proved the better part of valour for both parties and we called it a day, although we still managed to remain good friends.  She was busy uploading x-rays of the patients I would be discussing shortly so I passed her with a mimed kiss.

 

‘Good of you to bring me a coffee, Tony, old luv!’  This came from Geoffrey “The Queen” Watson-Smyth, a pathologist whose paisley bow-tie, double-barrelled name, over-familiarity and overweening campness never failed to irritate me.  Today I felt like punching him in his stupid face.

 

‘The machine’s just down the corridor.’  I replied flatly looking around for Jim, one of the nurses who would be in Surgery with me later.  He was not in evidence yet.

 

Off to my left I caught a glimpse of Carmichael’s ginger hair deep in a throng of white coats.  He was obviously busy, and I had enough to deal with myself without a detour to swap niceties, but, in truth, I was relieved at not having to bother.  I was not in the mood for small talk.  Today I was finding the sociable aspects of my job a most unwelcome irritant as I smiled and nodded my way across the room. 

 

Normally I relied on an M.D.T. to wake me up in the morning; planning my up-coming ops was a gentle way to ease into the hurly-burly of the day.  Today I seemed to find getting in focus was a real pain in the neck.  I ran through my usual checks (no one had called in sick etc.), gave myself a stern talking to, and then got down to planning each procedure.

 

First up was a woman with a carcinoma of the mid-rectum.  I took a look at slides of the biopsy and was pleased to see no liver metastases on the C.T. scan.  The M.R.I. scan showed the tumour to be confined within the meso-rectal fascia, which made life a lot easier.  We all agreed that chemo would serve no useful purpose and listed her for the knife.  The second and third were, with variations, equally routine. 

 

It was not until the penultimate case, a re-admission for a secondary tumour Watson-Smythe reckoned he had spotted on a recent biopsy, that a horrible thought struck me.  What if that bloody woman had received my email and, instead of taking “no” for an answer, had sent some sort of reply?  Jesus Christ!  Why hadn’t I thought of that before?  Colleen would be onto that in a flash.  It was conceivable that Liz might forgive another fling – she had forgiven enough in the past – but the claim that I had made another woman pregnant, true or not, was more than I could see her standing for now or ever.  It imposed a physical reality that words like “fling” or even” infidelity” simply did not convey.

 

My alarm must have shown in my face:

 

‘Are you okay, sir?’  It was Pammy, a middle-aged anaesthetist who never took her eyes off me.

 

‘Yes, yes, thank you Pammy, I’m fine...really.  It’s just that I, er...’  I was not just groping for an answer that would explain my expression; I needed an answer that would get me out of there to check my emails.  It popped up out of nowhere.  ‘Liz’s away at the moment and it just hit me I think I’ve left the front door unlocked.’  I turned to the rest of the gathering.  ‘Look everybody, I think we’re just about done here.  Would you mind if I shoot off now to sort this out so I can get back in time for morning clinic?’  There were general nods and shrugs as I gathered up my files, and people turned to the next case.

 

‘Would you like me to let Colleen know where you’ve gone?’  It was Pammy again trying to create a relationship that was never going to happen.  She could not have chosen a worse way to go about it.

 

‘No!’ I snapped with unintentional abruptness.  ‘I’ll call her from the car, thank you,’ I added, in an unconvincing attempt to soften my tone, as I turned on my heel and headed rapidly for the door.

 

*

 

Having said I was going home I felt obliged to be seen to do so, but did not have time to spare.  I contented myself with driving half a mile up Blackshaw Road and parking in the anonymity of the crematorium car park.  I needed somewhere quiet to think.  I pulled out my phone and Googled my email address.  To my relief, I had had no further glad tidings from Katya.  Thank God!  If she was going to react dramatically, she would have done it by now.  She was probably considering her next line of attack or, God willing, had actually taken my advice and set out in pursuit of the real father.

 

Fine, but that sounded, even to my coloured judgement, like wishful thinking.  What if she persisted?  Where did I stand legally, particularly given the national barriers involved?  When it came to defamation the internet was no respecter of borders.  It began to dawn on me that I might need some serious advice. 

 

I cancelled Google and called my solicitor Roger Caraway in Richmond.  Roger and I were old pals from our schooldays back in Dulwich where we discovered a mutual enthusiasm for skiing in the sixth form.  After school I had headed for Oxford to do medicine while Roger went to Bristol to do law, but our skiing and our friendship survived the separation.  So did our need for each other’s professional skills.  He did the conveyancing on the houses I bought and I made sure he avoided waiting lists.

 

I normally went through the office switchboard as a matter of courtesy, but I had to get back to work and, by now, I was convinced that I was dealing with a matter of some urgency.  I called his mobile.  To my relief he picked up after a couple of rings:

 

‘Hi Tony, what can I do for you?’

 

‘Hi Roger, I’m sorry to call unannounced, are you free to talk?’

 

‘Sure, I’ve got an appointment due in at ten; we’ve got a few minutes.’

 

‘Good, good, listen I need to put something past you, though I suspect it’s not really your field.’

 

‘Sure, but I probably “know a man who does”, eh?  What’s the problem?’

 

‘Right, well it’s like this...’  We were the sort of friends who did not have secrets, and he knew about my chequered sexual history, but even so I was groping for words.

 

‘Who have you shagged this time?’ he prompted helpfully.

 

‘A woman I met at a conference in Melbourne; she’s a research assistant at a leading Moscow hospital,’ I added lamely, as if that made any difference.

 

‘I see, and presumably she claims that you have got her pregnant?’

 

‘How did you know?’

 

‘Because I and my colleagues throughout the legal profession have a growing queue of male clients who are all experiencing similar claims on their paternity.  It’s one of the most popular cyber scams doing the rounds at the moment.  What did she say her name was?’

 

‘Katya.’

 

‘Hmm, well you will probably be surprised to learn that Katya does not exist.’

 

‘What d’you mean “does not exist”?  I fucked her for God’s sake!’

 

‘Sure, then she had a shower, so you had a shower and, while you were doing that she went through your wallet and found a business card.  That’s more than enough for her employers to find your email address.  You fucked a high class hooker with an above average acting ability who took the opportunity to sell your identity to the Russian mafia.  Then again, it could have been a Chinese Triad - the triads are fond of pretending to be Russian to confuse things.  The likelihood is that these emails are a phishing scam coming out of somewhere in the Far East.  Your girlfriend will turn out to be some greasy little Chinese junkie who sits in front of a monitor day and night to keep his heroin habit fed.  Did you answer any of the emails?’

 

‘No, er, yes, I did.  I answered the last one, but I denied all responsibility...’

 

‘Damn!  That’s it; I’m afraid you could have problems, mate.’

 

‘What do you mean?  I offered to send her proof...’

 

‘Let me explain again; “she” does not exist.  You replied to a computer program written to send out an increasingly demanding series of emails designed to provoke a response.  The moment you reply they’re in.  They will send you an email containing a Trojan virus that will hack your computer and take you for everything you’ve got.  If it’s really clever, it will attack your bank accounts and credit cards, and, if it’s not so sophisticated, it will simply give them access to your social network history, porn sites you visit and all your correspondence.  They will be looking for blackmail opportunities to sell.’

 

‘Liz knows about my misdemeanours...’

 

‘Fine, but you don’t think the tabloids would be interested in a story about what a “sexy surgeon” gets up to at conferences?’

 

‘Jesus, what should I do?’

 

‘Do you and Liz have joint bank accounts?’

 

‘No.’

 

‘Not even savings accounts?’

 

‘Well, we have an account for paying bills and standing orders.’

 

‘Okay, well you need to close that and every other financial account that has got your, or your and Liz’s, name on it.  That includes credit cards, oh and tell your stock broker to keep an eye out for new instructions.’  His tone softened.  ‘It’s not as traumatic as it sounds, these people are used to dealing with customers who have lost their cards and need to cancel them.  You want to do that straight away.’

 

‘Surely that’s all protected by passwords...’

 

‘Of course, and most passwords can be cracked within minutes.  People are lazy so they choose something familiar and frequently sentimental like a loved one’s name, and if they are asked to include numbers they tend to opt for permutations of one, two, three.  A good password involves an exercise in lateral thinking and the time needed to memorise the result.  Anyhow, the faster you do that the better and I cannot overstate the urgency.  You can get the Lost or Stolen number off your bank’s website.  Call me straight back when you’ve done it.’

 

There was a click and a hum as he rang off.  I sat for a few moments gazing unseeingly at the mourners who were filing solemnly into the crematorium.  With an effort I forced myself to focus on Roger’s instructions.  I Googled “Lost or Stolen Bank Cards” and called the idiot-proof number.  The helpful young man at the other end sorted out my bank cards with the easy calm of someone who dealt with panic for a living, then referred me on to Barclaycard to go through the same process again.  Finally, after a check through my wallet, I cancelled the Amex Platinum Card I had been persuaded to carry by a particularly nubile sales girl at an airport.  With the plastic sorted, I phoned my stock broker, Stoughton and Jakes of Bond Street, to warn them not to sell any shares without my personal say-so.

 

I called Roger back and went through what I had done.

 

‘Good.  Can you lay your hands on five grand in cash?’

 

‘Five grand?  No, not without going to the bank.’

 

‘Hmm, and they would find a withdrawal like that pretty suspicious given that you’ve just cancelled your cards.  You don’t keep an emergency fund in a shoe-box under your bed?’

 

‘No, and I don’t draw my water from a pump in the back yard.’

 

‘Fair enough, I’ll stick it on your account and send one of the girls out to the bank.’

 

‘Hang on, what are you spending five grand of my cash on?’

 

‘I’ll tell you when we meet.  You’ll have to trust me on this.  There’s someone I think you need to talk to.  Can I call you back on this phone in the next ten minutes?’

 

‘Sure, I’m not due in clinic for another twenty minutes.  If you can, try to make it before then - call me anyway if you can’t.

 

*

 

I started the car and headed back to St George’s on automatic pilot.  I did not know whether to feel relieved or frightened.  If Roger was right, at least I had not fathered some Muscovite sprog because that really would have taken some explaining to my darling wife.  I had never acknowledged it to myself before, but it struck me that I rather liked the power that, up until recently, my philandering had bestowed on me.  I enjoyed the sin/penitence cycle, secure in the knowledge that Liz and the kids were ultimately dependent on me for their cosy lifestyles.  It was Sod’s Law that all this should have happened just as Liz seemed to be flexing her muscles on the independence front. 

 

Still, with a bit of luck, I could spin it.  If I stuck to my guns, who could prove that I was not simply the victim of a trumped-up blackmail scam – my identity could have been stolen without any naughtiness occurring!  As Roger pointed out “Katya” need never have existed!  Admittedly, my past record rather militated against the plausibility of this defence, but it was still my word against an email from God knows where.  Where were the photographs and witnesses M’lud? 

 

As quickly as my optimism had surged forward, it receded.  As defences went it was as thin as Katya’s panties – I was not in a Court of Law where evidence and rational argument prevailed, at least not yet.  This defence was going to have to withstand the fury of a woman scorned and, as we all know, not even Hell can match that.

 

Still, there was not much I could do about it.  My thoughts turned unwillingly to these bloody Triad people.  Who the hell were they and, more importantly, what could they do to me?  The young man at the bank had assured me that he could see no suspicious transactions on screen and so had the girl at Amex.  That was a relief, but then it dawned on me that losing the money that was currently sitting in our accounts was hardly the end of the earth.  Nobody likes being robbed, but it could only happen once before the accounts closed and I appeared to have avoided that.  We had assets like property and shares, and next month’s salaries to fall back on, and my credit rating as a senior doctor was through the roof.  No one was going to starve.

 

How vulnerable to extortion or blackmail was I?  If Roger was right, they had access to everything on my work computer, and presumably my home computer given that I regularly sent myself documents from one to the other.  What did they contain that could be used against me? 

 

I had parked up and was back in the hospital when my phone rang.  It was Roger.  I took it as I hurried down the corridor.

 

‘Hi Roger.’

 

‘Hi Tony.  Listen, I’ve spoken to the chap we need to meet and he has given you an appointment at four-thirty.  It’s in Docklands so we need to allow at least an hour...’

 

‘Four-thirty when?’

 

‘This afternoon of course.’

 

‘This afternoon?  You’re joking aren’t you?  I’m in surgery all afternoon.  You’ll have to tell this chap of yours I can’t make it.  It’s just not possible.’

 

‘Well it’s up to you, but you won’t be offered another time.’

 

‘Come off it!  At five grand a go?  Money talks; of course I will.’

 

‘No you won’t.  It’s a seller’s market.  Five grand is only the deposit; you could be looking at adding a nought to that.’

 

‘Right now, I’m not planning on adding a nought to anything!’ I snapped, resorting to the angry tone I used when things were not going my way.  This was getting alarming.  For one thing I did not like parting with substantial sums of money without knowing exactly what it was to be used for.  At a deeper level, I suppose I did not like this uncustomary feeling of lack of control.  My world was suddenly threatening to crumble and my ability to control it seemed to be slipping out of my hands.  I had spent much of my career surrounded by people from whom I could expect pretty much instant obedience and a readiness to comply with my timetable.  I did not like being at someone else’s beck and call.

‘Suit yourself,’ replied Roger, calmly - he had always been the more level-headed member of our friendship.

 

‘What d’you mean “Suit yourself”?’ I demanded, angrily.

 

‘What I say; in your shoes I would put a pretty high price on my professional reputation, but it’s up to you.’

 

‘Alright!  Alright!  I’ll call you back.’  I cut the call, struggling to regain my composure as I opened the door to my office.

 

Roger’s final remark had shaken me sufficiently to make me take a hard look at my afternoon list as soon as I sat down at my desk.  I was down for a couple of hernias and a right-side hemicolectomy starting at one-thirty.  I was needed for the hemicolectomy, but could trust the hernias to my registrar.  Even allowing half-an-hour to change and scrub-up, and assuming no unexpected complications, I reckoned I could be out of there by three o’clock.  That would allow an hour-and-a-half to get there through non-rush hour traffic.  I called Roger back and agreed that he would pick me up at three-fifteen.

 

*

 

‘Okay George, I reckon that’s about it.  I’m sorry but I’m going to have to leave you to finish off.’  I had just finished suturing together the ends of what was left of the patient’s ascending colon and according to the relentlessly accurate display of the surgery’s chronometer I had run out of time.

 

My ever-reliable Senior Registrar George Hopkins shrugged angrily, but not because of my early departure.

 

‘Bloody students,’ he muttered, nodding across the recumbent form of our latest right hemicolectomy towards the knot of youngsters who had wasted so much of our time eagerly ingesting the art of anaesthesia.  George was an impatient individual at the best of times, and the delays caused by the educational needs of trainee anaesthetists was always guaranteed to wind him up.  I usually contained my own impatience by laughing at his, but this afternoon I was not laughing either.

 

The op itself had gone smoothly enough, though the size of the cancer had ruled out laparoscopy, which therefore made the whole thing a bit messier and more time consuming.  I had anticipated that, but not my annoyance at the students; they had really got on my nerves.  That was not usual. 

 

When I was in an operating theatre other people rarely troubled me except in cases of gross stupidity, clumsiness or incompetence; in other words behaviour which intruded upon the world of absolute immersion that it was my function in life to inhabit.  Compared to the old-school tyrants and egotists I had been tutored by, I was positively saintly to work with.  The theatre was my stage, my sanctuary and even my play-ground; a place where the cares of the world disappeared, blown away by the combination of concentration, ingenuity and dexterity demanded by my craft.  I maintained a benign dictatorship and, as long as my colleagues observed the pecking order, my feathers generally remained unruffled.

 

Sure, the on-the-job training of anaesthetists was an on-going irritant amongst us surgeons, but, like it or not, we needed them to stop the patients screaming when we cut them open, so I had always been much more phlegmatic than George in this regard. 

 

Not today, however.  Today, I could not focus properly on the surgery and this was virtually unheard of for me.  It was an awful feeling; a bit like drifting off on the motorway then jerking back into focus, unable to recall the last ten miles.  Guilt and panic at what you may or may not have done seize you, although you and the car are still in one piece and there are no angry fellow motorists shaking fists at you.  I glanced round several times at my colleagues to check I was not attracting sideways glances, but then that became a distraction in its own right.  I was glad to get out of there.

 

It was only as I stood waiting for Roger at the Main Entrance that it struck me.  The students were gone, but the feeling was not.  I was accustomed to keeping a firm grip on my life and suddenly that grip felt much less secure.

 

 

 

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