He turned away, to face the window; he was not looking at the city below, but at the sky somewhere over Fife. “Norrie had nothing to do with it. I’ve told Stella. It had absolutely nothing to do with him.” He turned to face her. “I give you my word on that, you know. Nothing to do with it.” He paused. “How do I make you believe that? What does it take?”
Nothing more than you are doing at the moment, thought Isabel. Nothing more than the truth that you are so evidently telling me. He was not lying; she could tell that from his demeanour. And she made her decision.
“I believe you,” she said. “All right, let’s say that Norrie had nothing to do with it. But that doesn’t mean that there might not have been others who deliberately altered that data. People who stood to gain from it.”
“Such as?” he snapped.
“The people who made the drugs. The pharmaceutical company.”
He looked at her almost with pity. “Are you one of those people who believe the worst of pharmaceutical companies? Who thinks that everything they do—everything—is selfish, exploitative, wicked? Is that what you really believe?”
She defended herself. “No, I’m not one of those people, as you put it. But you can’t deny that some pharmaceutical companies have played fast and loose with people on occasion. Have tried to get doctors to prescribe useless or marginally useful drugs. Who have charged too much. Who have sometimes concealed evidence that doesn’t suit them. You can’t deny that.”
“Sometimes,” he said, begrudgingly. “Sometimes. But you’re always going to get some rotten apples. That’s human nature. They’re probably no better or worse than any other businesses. It’s called capitalism, Miss Dalhousie. But the real point, surely, is that they invent and make drugs that save lives. Look at AIDS. How long ago was that a sure and certain death sentence? And now? Something you can live with for years and years. And who do we thank for that? The pharmaceutical companies who produce the ARVs. That’s who.”
He looked at her triumphantly, as if challenging her to refute the irrefutable. Isabel merely nodded. “Of course. But what if your case was one where the bad apples were at work? How would you feel if I were to demonstrate to you that they had a role in distorting those figures? And then you took the blame?”
For a while he said nothing. She watched him, and she thought that he looked like a man in the grip of some awful internal struggle. And when he spoke, it became clear that he was.
“You could never demonstrate that to me,” he said. “For a very simple reason. I did it.”
“You told me that already. You admitted that you failed to check the results. You told me that when we first met.”
He became agitated. “Oh no, I didn’t tell you. I didn’t tell you what I did.” He stopped, closed his eyes, and turned away, so that she might not see his face. His hands, Isabel saw, were shaking. “I altered the figures myself.” There was a pause. Had she heard correctly? The words were like the stones of a wall—physical things. And then, “The original reports from the lab indicated relatively small overdoses. I changed them and made it seem that the overdoses had been massive. I did it, and it was very easy. I just tore up the original forms and filled in new ones. Simple.”
He spoke slowly and clearly, enunciating each word. The shock that Isabel felt on hearing this did not stop her from watching his face as he spoke. It was a face that reflected pain in every word of the confession. And again she realised that he was telling the truth.
She was silent for a time after he had finished. Then she said, quite gently, “Why did you do it, Dr. Moncrieff?”
He answered quickly. “Because I believed it was the right thing to do.”
“How could it be? How could it be right to mislead people on this?”
He sat back in his chair and opened his eyes. “Because I really believed in the drug. I thought that the reaction in each case was probably triggered by something that had nothing to do with the drug—especially in the case of the addict. They take God knows how many different things. I thought that those two cases were completely freak events: one caused by a whole cocktail of stuff which an addict had taken; another caused by a nurse who got things dramatically wrong, or a patient who secretly stuffed himself with pills. I thought the drug was completely safe and that this was just nonsense that would set us all back five years. People were dying, remember. I wanted to stop that. That drug was our best hope and the last thing we wanted was a scare over it. We’re never…” He seemed to struggle to find the right words. “We’re never going to get anywhere if we allow this absurd safety culture to inhibit us. You have to take some risks to get somewhere. You just have to. But try telling that to the assorted bureaucrats and lawyers and ethics people, not one of whom, may I say, has ever done anything but inhibit new treatments. Try getting through to that bunch. What about Lister?” He pointed out of the window, in the direction of the Queen Street drawing room where Lister and his friends had taken chloroform at the dining-room table. “Would Lister ever have been allowed to self-experiment like that today?” He laughed. “You can bet your bottom dollar he would not. Health and safety. Informed consent. All that claptrap, all while people are dying.”
He stopped and looked at Isabel. “So there you have it,” he said. “I did it because I thought I knew best. And then…then that poor man died.”
“You didn’t want that,” said Isabel.
“Didn’t want it? Of course I didn’t want it. But I’m responsible for it. If I had blown the whistle on the drug, then it wouldn’t have happened. So what do you want me to say, Miss Dalhousie? That I was wrong? Right, I’ve said it. I was wrong. I was proud. I thought I knew best.”
They sat in silence. It was a curious silence, one that neither felt he or she needed to bring to an end. It was a silence that comes when the worst has been said and there is nothing more to be added.
But Isabel said to herself: If he thought there was no risk, then where exactly was the wrongdoing—in the moral sense? He had not taken a deliberate risk, because a deliberate risk implies knowledge that harm might materialise; he thought that what he did was safe. It was not. He had been arrogant in thinking that he knew better than those who had set in place all the precautions that protected patients. They were right; he was wrong. But he had thought it was the other way round.
“So what now?” he suddenly said.
Isabel said nothing. She was still thinking.
“So you report me?”
