Death Watch

— Shaw sensed this was a person who dealt in certainties, or sought them out. But the eyes, an extraordinary luminous

‘What have you done already?’ he asked.

‘I’ve notified the Human Tissue Authority, Lynn Primary Care Trust, and the Department of Health. A team from HTA will undertake an audit of our tissue and organ bank within the next forty-eight hours. In the meantime I’ve had it closed. The locks are sealed. No one is to enter without my written approval. The press office have prepared a release, but it won’t go out until I say so.’

Any note of resentment at Shaw’s hijacking of the inquiry had disappeared from her voice. He sensed a woman whose self-confidence was robust, and anything but fragile.

‘Good. That’s prompt. Thank you. I’m sorry — two points. I need to sign that approval as well — for entry to the organ banks. Can you make that change? And the press office needs to sit on the news until I say so. I don’t want this aspect of the inquiry made public.’

She nodded.

‘Now, please,’ said Shaw. She flicked through a plastic internal telephone directory and made the calls.

When she’d finished she held the directory in her hand, shaking her head. Then she sat with it on her lap. ‘I’m sorry,’ she said, running a hand into her black hair until it stuck, the fingers lost in the thick plush locks. ‘This is really stupid of me. Stupid of all of us. One of your officers was asking if any of us recognized the initials — MVR.’ She put an unvarnished fingernail on one of the telephone entries, stood, and showed Shaw. Motor

‘It’s OK,’ said Shaw. But it wasn’t, and sorry was the most overrated word in the language. They could have had a forensic team in the garage while Judd’s body was still smouldering; now the chances of finding relevant evidence were slim. He stood, walked to the glass wall of the office, and rang Valentine on his mobile, telling him to get over to MVR with back-up. Then he took his seat again.

‘The kidney that we’ve found on the incinerator belt,’ he said. ‘To what degree can we be sure a crime has been committed here? What’s the best-case scenario, and the worst?’

Without knocking, Dr Gavin Peploe joined them. He let a smile begin on one side of his lopsided face and slide to the other, shaking Shaw’s hand. A crumpled figure, in a?500 suit, he folded himself easily into a chair, the crossed legs and folded arms revealing not a trace of anxiety.

‘Gavin, thanks,’ Mrs Phillips said, adroitly reinforcing her authority by making it clear she’d summoned him. ‘DI Shaw’s first question is a good one, if he doesn’t mind me saying so. Could this be nothing — a one-off?’

Peploe’s small feet did a little shuffle. ‘I’ve been thinking about that,’ he said. ‘At this moment we don’t have any other evidence of illegal traffic, unauthorized procedures, or organ or tissue retention against anyone’s wishes. Our records are complete for the disposal of tissue and organs from both live patients and cadaveric supplies.’

‘So. Here’s a scenario. What if the kidney is diseased — I think the pathologist is still doing tests — it could be something very difficult to detect in an organ which has been partly incinerated. Glomerulosclerosis, for example. What if an earlier bureaucratic error left such a kidney in the system which could not — retrospectively — be matched to documentation? All the NHS theatres run at near full capacity — everyone makes mistakes. We’ve completed nearly two hundred kidney transplants within the trust this year. Organ and tissue disposal is a priority, but it’s only human nature if people spend a bit more time on caring for the living patient. So — an error. Someone panicked, forged the tag, or switched a bag, and tried to slip it onto the incinerator belt.’

‘And what are the chances that actually happened?’ asked Shaw.

‘Nil,’ said Peploe, smiling, his teeth very white against the expensive tan. ‘One in a billion. Organ tracking is the surgeon’s responsibility, then the theatre manager’s. Senior professionals in both cases. If there’d been an earlier error they could just have reported it. It’s a misdemeanour. Why risk a career by trying to cover it up? It doesn’t make sense unless it’s a panic reaction. The one thing experienced theatre staff don’t do, Inspector, is panic.’

‘Worst case?’

Phillips stood and walked to her filing cabinet, leaving Peploe to answer. Shaw noticed for the first time there was a picture on the top in a gilded baroque wooden

‘The world,’ said Peploe, spreading his hands, ‘is divided into the rich and poor. The poor supply human organs, and the rich receive.’ He tossed a thick file onto the floor beside Shaw. ‘In 2002 the Washington Post reported from a small village in Moldova that fourteen of the forty men had sold body parts. We’re talking liver parts, kidneys, lung, pancreas, colon, corneas, skin, bones, and tissue such as Achilles tendons — even marrow.

‘This is a worldwide trade. The poor selling to the rich. A Turkish peasant can get two thousand seven hundred dollars for a kidney he doesn’t need. Someone who does need one will pay a hundred and fifty thousand. Note the profit margin. In 2000 eBay auctioned a kidney and reached one hundred thousand dollars before the FBI stepped in. There is also plenty of evidence that children were sold for body-part harvesting out of eastern Europe and Russia — largely through orphanages set up to feed a burgeoning black market.

‘There are darker corners of this market,’ he added, laughing again. ‘An entire human body is worth about a quarter of a million dollars. It did not take the market long to realize that if people wouldn’t donate parts, or sell them, then systematic murder would provide one source of supply. Tissue brokers, who supply the major bio-med companies, may not be as punctilious as they should be when checking the provenance of body parts.’

‘And one other sophistication…’ added Peploe. ‘The Chinese government uses prisoners on death row as a source for harvesting tissue and organs. Prisoners may undergo several operations before they are deemed of no more use. Until that point they are effectively kept alive to provide fresh body parts. They’re farmed, with regular harvests. Then they are executed. This happens. There is fragmentary — anecdotal — evidence it happens elsewhere, too.’

Somewhere, a hundred feet below, they heard a car alarm sound.

‘I need to read about this,’ said Shaw, picking up the file.

‘That’s all I could download this morning,’ said Peploe. ‘UN report, some background stuff from the HTA, and a few case studies from Organ Watch — a pressure group. If you want any more, let me know. It’s my specialist subject — at least, it’s going to be.’

‘If we’re talking illegal operations, could they be taking place here? At the Queen Vic?’ asked Shaw.

‘It’s unthinkable,’ said Phillips, leaning against the filing cabinet.

Her voice had been sharp, too sharp, and she knew it. She took a deep breath. ‘It is not possible for an illegal organ transplant to be completed in an NHS hospital without being detected.’ She gave Shaw a list. ‘This is a roll call of all surgeons working within the trust. There are twenty-eight names here. Any one of them could perform this operation. But, as I say, I find it impossible to believe it happened here.’

Peploe steepled his fingers. ‘Well, a lot easier than it was. New drugs mean you don’t need a blood match, or a tissue match for that matter. And the chances of organ rejection are significantly lower. Plus, you’ve got keyhole surgery for the removal now, so the donor can be up and about in hours. By the way — so you know — when you give someone a new kidney you don’t take out the old one. So if this is a transplant, we’re not missing the diseased organ. The new organ goes in here…’ He indicated a spot in his groin. ‘Joined to the urethra.’

‘Well, we have to begin somewhere,’ said Shaw, holding up the paper Phillips had given him. ‘We’ll start by interviewing everyone on this list.’

Shaw stood. ‘For the record, I am going to have to ask both of you this question. Do either of you have anything to do with illegal organ removal in this hospital, or with the death of Bryan Judd?’

There ensued what might have been a stunned silence. ‘I’m sorry, but I need an answer,’ said Shaw.

‘Nothing.’ They said it together, in perfect unison.