The Truth Kills – free first chapter from the novel by Vernon Coleman
The Truth Kills
I stood on the porch outside the surgery and heard the two voices becoming louder and louder. They were both shouting and I really didn’t want to be there. I always find other people’s rows deeply embarrassing. I suspect most folk do. I was standing in the porch, as far away from the argument as I could get without going outside. It had been raining all day and now it was raining heavier than ever. The skies were black, the rain was bouncing off the few cars left in the car park and the atmosphere was undoubtedly packed to the edges with invigorating negative ions. The pellets of rain, hitting the thin metal of the cars, sounded like distant machine gun fire. Puddles had already developed on the badly laid tarmacadam and the usual small stream had formed down one side of the car park. We should have made the contractor come back and deal with it but we’d never got round to chasing him and now it’s far too late. I could see my raincoat. It was safe and dry, draped uselessly over the front passenger seat of my rather boring BMW. My brown fishing hat was in there somewhere. I’m one of the few people on the planet who still wears a hat. I still believe the old theory that in cold weather nine tenths of the body’s heat is lost through the head. I wear the thing in summer too, since the brim is just wide enough to provide a little screening from whatever sunshine might manage to struggle through the traditional English summer clouds. The car, the raincoat and the hat were no more than a dozen yards away. But I knew I would be soaked before I could reach any of them. I have another couple of decades to go before I’m officially entitled to retire but I’m desperately out of condition and already have arthritis in my knees and hips. I have patients 20 or 30 years older than me who could beat me in a race for a bus. Damp and cold just make the pain and stiffness worse, of course. I put my black drug bag down beside me and decided to wait a few minutes more.
There were just the three of us left in the surgery. The last patient had gone 20 minutes earlier and Daisy, the evening receptionist, had hurried away moments later.
‘I’ve put the phones through to your mobile number,’ she’d told me as she’d left, grabbing her bag and her coat and rushing to get home before the rain started. ‘I hope you have a quiet night.’ She was the oldest and the kindest of the receptionists and the only one I’ve ever got on with. To be honest she is the only one whose name I can regularly remember. There are eight or nine others, mostly working part-time, and they are as vaguely recognisable, and as indistinguishable, as the staff at the bank or the post-office. They are all women and mostly in their 40s or older. No employer with functioning brain tissue hires women of childbearing age and Jock, who is in charge of hiring our employees does have a modest quantity of brain. He has many faults but he’s not going to hire someone who is going to disappear for a year or more to breastfeed her State supported offspring. And so Daisy, like the rest of the staff, is of an age to be unlikely to demand endless maternity sabbaticals guaranteed by the bureaucrats of Brussels to be funded at someone else’s expense.
I’d been standing in the reception area, dictating referral letters for three patients who needed to see hospital consultants, and I had thanked her and wished her a good weekend. I always feel guilty when I send patients to hospital these days. I know damned well that the appointments they send out are merely times at which patients have to be available so that a nurse can lie and tell them that the consultant hasn’t turned up because of an emergency. He isn’t really dealing with an emergency, of course. Senior hospital doctors don’t deal with emergencies. He’s at his private rooms charging £200 for 20 minutes and another £250 for an X-ray.
I hate being on call; constantly waiting for the telephone to ring. I put my hand into my jacket pocket, pulled out my phone and checked that it was switched on. The battery was low and I realised that I would have to put it on charge as soon as I got home. When I started in general practice I was tied to the landline telephone when I was on call; never daring to go out of earshot of a handset plugged into a socket in the wall. If I went out anywhere I either had to switch the phones through to that number or tell someone where I’d gone. No one could reach me when I was in the car or at a patient’s house. When I was on call for the weekend I didn’t even dare go out into the garden in case the telephone rang and I missed a call. The mobile telephone has made life infinitely easier though, I confess, the most joyful words known to the doctor who is a mobile telephone owner must surely be ‘network search’. I can spend all weekend in the bar at The Bell and no one knows where I am. At nights and at weekends I switch the landline calls to my mobile phone and I can be on call anywhere. Thinking of home, made me think of dinner and I decided that if I called into The Bell I could eat at the bar and have something with chips. Thinking of food reminded me that I’d intended to buy some bread but had forgotten. The stuff I’d used for toast had penicillin growing on it.
Minutes after Daisy had left, the two of them started shouting instead of just raising their voices; they were both almost screaming. I really didn’t want to be there or to know what the argument was about.
The male voice belonged to Jock Cohen. He’s a few years older than me and since the practice was originally started by his late father he is now the senior partner. He owns the building we practice in. It was built as a house in the late 19th century and for as long as I can remember Jock has been promising to make some basic improvements to the layout in order to make it more suitable for use as a medical centre. The patients sit in what used to be the dining room, the reception staff squeeze into an uncomfortable, partitioned area in the hallway and the doctors ply their trade in what used to be the bedrooms. My consulting room has an old Victorian fireplace and a ceiling that is so high that even with a stepladder none of us can replace the bulb in the ceiling light fitting. For the last seven years I have relied on standing lamps for light. I sometimes think this gives the room a rather unnaturally intimate atmosphere, although there is the advantage that the poor lighting means that the flaking paint is not so noticeable. All of us who work there would be thrilled if Jock organised a lick of paint here and there but there is about as much chance of that as there is of me becoming a world class athlete. Jock’s only concession to the modern world has been to rename the building ‘The Jock Cohen Health Centre’. His father, now a permanent resident at the local cemetery, was also called Jock and our noble senior partner claims that the building is named after him but no one believes this.
Jock senior was humourless, puritanical and unforgiving. He was pompous and self-important and reminded me of George Abbot, an early Archbishop of Canterbury, who in 1605 sent 140 undergraduates to prison for sitting with their hats on in his presence. He liked to think of himself as a general, leading the forces of health and fitness against our arch enemies: disease and death. The trouble was that Jock senior, like his son, wasn’t a terribly good leader. General Baron Kurt von Hammerstein-Equord, Commander in Chief of the German Reichswehr between 1930 and 1934, and an ardent critic of Adolf Hitler, once claimed that all his officers exhibited just two qualities from the following list of four: cleverness, industriousness, laziness and stupidity. The problem with Jock senior was that although he would have doubtless described himself as being clever and industrious, his real qualities were stupidity and industriousness – the most worthless pairing of all.
If I were asked to sum up our Jock, Jock junior, in a single phrase I would have to choose the words ‘careful with his money’. There isn’t much else to say about him, though being of Scottish origin he is, of course, a rabid racist, full to the brim with loathing for anyone who doesn’t own a travelling rug in the clan tartan. His mother is South African and I assume that she must have been the primary source of his wonderful sense of humour for she is quite typical of the endless hearty wits who hail from Johannesburg and Cape Town. His father, as Scottish as sewn up pockets, made Scottish Nationalist and former Prime Minister Gordon Brown look like one of the rampaging Marx Brothers.
The only thing Jock and I have in common is that as white, male, middle aged citizens we are both members of an oppressed ethnic minority. He’s married with two grown up children (neither of whom followed him into medicine) and plays golf with the earnest caution of a man whose Sunday is ruined if he loses a tee, let alone a ball. In the winter months he always wears a blue blazer with gilt buttons and a white shirt with a small crest on the breast pocket. The whole outfit is made ever more glorious by the addition of a tartan waistcoat designed to celebrate his Scottish ancestry and made, presumably, in the Cohen colours. In the summer he wears white trousers with turn-ups and blue deck shoes with white piping and looks like a refugee from the South of France. When he stands he puts his right hand in his jacket pocket, with the thumb hanging outside.
Superficially Jock often seems mean and vindictive (which he is) but somehow he always manages to give the impression that underneath he is kind and generous. ‘Do people hate me because I’m Jewish?’ he asked me once. ‘Are you mean because you’re Jewish?’ I asked him. ‘Of course not!’ he replied indignantly. ‘Then people don’t hate you because you’re Jewish,’ I replied. ‘They just hate you because you’re mean.’
Jock lives a completely stress free life because he never really worries about anything. Most of us become increasingly sad, anxious, angry, bitter and resentful as we become increasingly aware of life’s general injustices, and as life fails to live up to our many expectations. Not Jock. He only ever worries about potential injustices which affect him personally, and those he deals with dispassionately and efficiently. He will probably live to enjoy several birthdays in his 90s though you’d have to wonder why he’d bother.
I believe that medicine is a complex mixture of wisdom (learning from experience), science, art, black magic and intuition. Of all these, intuition, which enables us to access wisdom and experience from our subconscious, is perhaps the most valuable of them all. Jock believes that medicine is a matter of listening to the blandishments of the drug company representative, choosing the most expensive wine at a drug company sponsored dinner, and then prescribing the latest wonder drug without pause or question. I believe that a doctor who is not also a cynic is a dangerous fool. Jock believes that it is not a doctor’s place to think.
Most of us drift through life, missing opportunities, accumulating regrets and travelling from crisis to crisis, buffeted by fate and her whimsical family. Jock Cohen travels serenely through life, like a swan on a lake but with the big difference that with him the serenity is as real under the water as it is above it. He still lives in the house where he was born and probably still has the silver spoon that was found in his mouth when he was a baby. I doubt if he has ever even had a parking ticket. Fate would not dare be so cruel. It would be a thrill for us all if one of the receptionists walked into his surgery and found him making wild love to one of the nurses, or even a patient damnit, but Jock’s life is dedicated to the accumulation of money and that’s really all there is to him. He has devised a number of ways to hasten this process. He does trials for drug companies, provides second opinions for cash and accepts chunky kickbacks from the consultants to whom he refers patients requiring private treatment.
Jock has a considerable cash income from these various activities. He doesn’t bother declaring any of this to the rest of us, the practice accountant or Her Majesty’s Revenue and Customs but every month he takes the train to London where he visits a stamp shop in the Strand and uses the month’s accumulation of cash to buy rare stamps. I once asked him how he’d explain the collection if the taxman ever discovered it and he told me that he’d simply say that it was a collection he’d been given as a child and that he’d found it in a drawer when clearing out an old piece of furniture. Since the stamps are all old it’s difficult to see how anyone could prove otherwise.
After a rare dinner at his home he once showed me his collection but instead of being able to tell me the history of the individual stamps (as other collectors are usually able to do) all he could do was tell me the prices. I think I’ve only been to the house that one time. His wife turned out to be very mousy and subservient; treating him more like an employer than a husband. We had one of those frozen meals that the supermarkets advertise on television and a single bottle of cheap Spanish red wine. I suspect that more important guests are better fed and better wined.
The other half of the argument, the female voice, belonged to Molly Tranter, our trainee doctor, aka our general medical dogsbody. Molly looks after all the new patients, the mother and baby clinics, the life insurance medicals and the difficult patients who take up too much time for Jock to bother seeing them. She and I also shared the out of hours duty. Jock insisted that we provide a 24 hour a day, 365 day a year, service and said that he insisted on this because it is best for the patients. He was right, of course, but he didn’t share in providing the cover he insisted we provided. He said that at his age he’d done his stint and that it was up to the younger members of the practice to provide cover at nights, weekends and bank holidays.
Our other doctor, Dr Deidre Canterbury, was younger than me but she had two small daughters and said that it wouldn’t be fair to them if she worked at nights or weekends. As a partner, I received a small, extra annual payment from the practice for providing this service. (It was, inevitably, much less than the 6% extra the practice received, and so both Jock and Deidre made money from the out of hours commitment.) Molly, who was salaried, didn’t receive a penny extra. No one ever mentioned it but the practice did well out of Molly and myself covering the out of hours work. Back in 2004, the Government rewrote the GP’s contract and allowed family doctors to stop providing out of hours cover in return for a 6% cut in salary. I cannot imagine what sort of political idiot thought that the extra work was worth just 6% of a doctor’s income. The result, inevitably, was that the vast majority of practices leapt at the chance to give up working at nights and at weekends and happily took the modest drop in pre-tax income. Today, politicians and doctors all seem genuinely surprised that there has been a dramatic increase in the number of patients turning up at Accident and Emergency Departments outside normal working hours. No one seems to suspect that there might be a link between the increase in the number of people dying from routine but serious health problems and the fact that doctors no longer provide 24 hour cover for their patients.
The one advantage of having just two of us look after the nights and weekends was that it was fairly easy to work out the rota. And if one of us needed to change a weekend or a night it didn’t involve a great deal of negotiating. I know a doctor who works in an eight doctor practice in Lancashire. They too have agreed to provide their patients with 24 hour cover. They all share their on call rota equally and they’ve had to have special software designed to enable them to organise their commitments. One of their practice secretaries spends half her life keeping the rota up-to-date and there are constant arguments about the number of bank holidays, Christmases and evenings worked. Molly and I usually managed to work things out pretty amicably.
As I stood in the porch, sheltering from the rain, I cleaned out and lit my pipe and tried to remember why we’d hire Molly Tranter as our trainee. There had been two dozen candidates and she hadn’t been the best qualified in any respect although she had certainly been the smallest. Only the thickness of an envelope more than five feet tall if she stood on tiptoe, Molly was the daughter of a couple who ran a greengrocery business in Wolverhampton. She got the job as our trainee as a compromise. Jock Cohen had wanted to appoint a young rugby playing doctor whose father was a consultant neurologist somewhere in the Home Counties. But the rugby player was a cocky bastard and I think even Jock realised that he would have been a disaster. He’d turned up in a Porsche which he’d left sprawled across three spaces in the car park. I had thought him too far aloof and arrogant for our practice and to my relief Deidre Canterbury, a woman who talks a good deal but usually says very little, and who does not regard tact or diplomacy as having any part to play in her job description, had summarily, and not at all unfairly, dismissed him as a ‘smarmy little git with far too high an opinion of himself’. The young pretender didn’t help his chances by mistaking Deidre for one of the receptionists, handing her his Burberry and telling her to hang it up ‘but make sure you put it on a hanger’. This was a big mistake. Deidre is scarier than Andy Murray’s mother.
The discussion about whom to appoint had gone on for over a week, though I had kept it out of it all as much as I possibly could. I’m pretty sure that Molly had been the only one none of us disliked enough to veto. In a way this was surprising since Jock has a strong dislike of women doctors. He said that having Deidre working in the practice was more than enough of a nod towards feminine supremacy. When there were no women within hearing distance he used to be fond of quoting Noel Coward who apparently once said that women should be beaten regularly, like gongs. Jock stopped quoting Coward when a midwife overheard him and, instead of accusing him of political incorrectness, laughed at him for quoting an ‘old poofter’.
Suddenly, a door burst open and I heard it slam into the wall. We used to have those little rubber door stopper things to prevent the doors hitting the walls but over the years marauding, thieving children have unscrewed them and stolen them so now when a door is thrown open with enthusiasm the doorknob tends to crunch into the plaster. The voices were much louder now and half of the row, the feminine half, was heading in my direction. I had just decided that the rain was the lesser of two evils when Molly Tranter joined me in the porch. Her cheeks were red with anger and she was shaking. She looked out of the door and up at the sky and swore quietly.
I said something banal about the rain looking set in for the night and Molly agreed with me. Quite unexpectedly she then burst into tears. She was still in her twenties and I remember thinking that she looked too young and inexperienced to be a student nurse, let alone a doctor. She always dressed casually, never wore make-up and wore her hair in a short page-boy cut. She was so skinny she looked as if she needed nailing down on windy days.
I’ve been told I have a reputation among our less discerning patients as a kind and sympathetic listener, but I’ve never been good with women who aren’t showing me lumps and rashes or describing their symptoms. I muttered something intended to be soothing. Molly pulled a packet of tissues out of her pocket, took one out and blew her nose. She then took out another tissue and dabbed at her eyes. ‘Life’s all about money to him,’ she said, clearly having taken my calming murmur as an invitation to confide in me and share her pain. ‘He’s a mean, grasping, thieving crook. He doesn’t give a damn about the patients.’ She paused. ‘I told him all that,’ she said defiantly.
‘He has to look after the practice,’ I said, feeling I had to offer a half-hearted defence of Jock who is, after all, our senior partner. ‘Expenses are constantly going up. Staff costs. Stationery. Health and safety. Heating bills.’
‘Oh bugger you!’ Molly cried. ‘Why do you always have to be so damned reasonable and sensible? This isn’t about making enough money to pay the gas bill, this is about making enough money to pay for his farmhouse in the Dordogne and the third car and the boat in Dartmouth.’ She was right about that. Jock still believes that having good time means spending money he doesn’t have on stuff he doesn’t need and probably doesn’t even really want. He hasn’t yet worked out, and probably never will, that real luxury is space, light, peace and quiet.
Molly started crying again. ‘I hate crying,’ she said. ‘I’m only crying because I’m so damned angry.’ She blew her nose. ‘Why do you put up with him? Why do you defend him?’
‘I’m too tired to fight anyone,’ I told her, too weary to feel embarrassed by this admission. ‘I’m just worn down by daily rubbish. The last time I filled in a form where they asked for my occupation I put: ‘Filling in forms and dealing with crap’.’ The truth was that I didn’t know where it had gone, or when it had disappeared, but all the righteous passion I’d had as a young man had faded away. ‘Without cowards and failures like me there would be no courageous, successful people and the courageous, successful people would have no one to look down on. How can I end that sentence without a preposition?’ Molly looked at me but said nothing for a while. I pulled out my pipe and puffed at it even though it had gone out long ago.
A pipe is a very useful toy. I always puff on it when I don’t have anything apt or witty to say and so I puff on it a good deal. In fact, although I’d never admit this to anyone, I don’t smoke because I enjoy the taste of the tobacco but because I rather like the process and the paraphernalia. Like most pipe smokers I have quite a collection of pipes, stored on a rather fine mahogany rack at home. Nearly all of them are really large, with huge bowls, because I never inhale the smoke and am perfectly happy for it to float up into the air around me. It may not be politically correct but my idea of political correctness is putting a cross in the right place on a ballot form and I rather like wandering around in my own private cloud of blue smoke. One of the receptionists, the stout, middle-aged one who has an undiagnosed thyroid condition that I have never found the courage to mention and who spends so much time on her sunbed that she must surely be a dead cert for multiple basal cell carcinomas, once said that I live in my own piece of foggy, Victorian London. I think it was meant as an insult, but I took it as a compliment. My pockets are full of pipe smoking stuff: a leather tobacco pouch, a three in one silver gadget for poking and cleaning pipes and a packet of old-fashioned pipe cleaners with which I sometimes make small animals to entertain fractious child patients. Their mums think I do this because I love children but I’m afraid I do it because I hate children crying. And besides you can’t examine a child who’s screaming. If it takes a small giraffe to shut him up then I’ll sacrifice a pipe cleaner and make a small giraffe. I once told Jock, in mock seriousness, that the practice should pay for my pipe cleaners and that they ought to be tax deductible. He can never tell when he is being teased. He said that I ought to take it up with the accountant and ask him to consult our local tax inspector.
‘Do you think he’ll fire me? I don’t care if he does. He’s even got personalised number plates on both his cars. How vulgar can you get? They’re the middle class equivalent of having your name tattooed on your arm.’
‘They aren’t very good personalised number plates.’
‘How can a personalised number plate not be very good?’ she demanded.
‘It took me three months to realise that the letters and numbers were anything other than an ordinary number plate,’ I explained. `I had to squint at it and use my imagination to realise that it sort of made up a dyslexic version of his name. There’s a number 4 making up the last letter of ‘Jock’! ’
Molly smiled and sort of nearly laughed and stuffed her used tissues into her coat pocket. She looked terrible. ‘I’ll buy you a drink,’ I told her. ‘You aren’t fit to drive so we’ll go in my car. I’ll bring you back here to pick up yours afterwards.’
‘I don’t drink much,’ she replied. ‘Hardly at all. Hardly ever. It makes me too tiddly and gives me a sort of hot flush.’
‘You have to drink something or your kidneys will pack up,’ I told her. ‘I’ll buy you a glass of water. You can have it with or without bubbles but I suggest you live dangerously and have it with bubbles.’
Twenty minutes later, soaked from the short run to my car, we were sitting at the bar in The Bell Hotel. To save time, and to avoid the town’s impenetrable one way system, designed by a maniacal pedestrian with a hatred of motorists or some sort of deal with the oil companies, I’d taken the ‘short’ route which involves heading out of town onto the motorway, slaloming between the cones and warnings put there to give the authorities an excuse to make oodles of money out of enforcing speed limits, and then driving back in again at the next junction. This had the added advantage of enabling me to purchase a few gallons of petrol for the car. The stuff they sell on the motorway is expensive but at least it is available. Most of the petrol stations in the town centre have been converted into ‘Hand Car Wash And Valeting Centres’ manned by hard working and enthusiastic East Europeans who must make a fortune out of their polishing and buffing. I wonder how much of it is passed onto the Chancellor of the Exchequer. We will all be in real trouble when the motorway service stations have been taken over by the red fingered men with plastic buckets and sponges.
Even though Molly and I had travelled no more than a couple of miles on the motorway we still drove past two broken down vehicles. Now that people can’t afford to have their cars serviced this happens more and more often. The stranded motorists, including one mother holding a young baby, were standing on the grass behind their cars. It was still bucketing down and they must have been drenched to the skin. The idiots who answer emergency calls always tell people to get out of their cars. I bet more motorists die of pneumonia than die of being squashed in their parked cars. It’s the same with aeroplanes and airports. They are staffed almost exclusively with leering, bullying layabouts who have a collective IQ lower than a ballerina’s shoe size and who would never notice if a team of terrorists with tea towels draped over their heads went past them carrying sacks full of Semtex. No one dares complain because they’re frightened of being arrested for aiding and abetting terrorism. The Nazi storm-troopers at airports take nail clippers off octogenarians in order to prevent hijackings but the aeroplane owners recycle dirty air to save money and, as a result, far more people die of infectious diseases caught on aeroplanes than have ever died because of terrorist attacks. I haven’t been on an aeroplane for years and with any luck I’ll manage to keep off them in whatever years I have left until the Good Lord gives me wings or a toasting fork.
End of chapter one
Copyright Vernon Coleman
This short extract is taken from The Truth Kills, a novel by Vernon Coleman
The Truth Kills is available as an ebook on Amazon.