intellectual challenges, problems to solve, games to win or lose in the struggle to advance a career.
‘I take it this means that we’ll not be getting her home in the near future?’ said Kate.
‘Out of the question,’ said Grayson.
Kate looked down at the floor and clasped her hands, twisting her fingers as she listened to Grayson continue.
‘The fact is, I’m sorry to say, that Amanda is one of these patients for whom dialysis just isn’t good enough. It isn’t working. She really needs a transplant.’
‘Or she’ll die,’ said Kate in a flat monotone.
There was an agonized silence in the room before Grayson said quietly, ‘That is a possibility, I’m afraid.’
Sandy saw that Kate had stopped fidgeting. Her hands lay still in her lap and her face was perfectly calm. It unnerved him. He reached across and laid his hand on top of Kate’s. They were ice-cold. The tightness in his throat still made talking difficult but he asked Grayson, ‘Surely there must be some kind of priority given to such cases?’
‘Of course. Amanda will be given urgent status on the transplant register,’ agreed Grayson.
‘What does that mean in practice?’
‘It means that she will be allowed to jump the queue if a suitable organ should become available, but of course we’ll still be constrained by considerations of tissue type. The organ has to be a good match for her.’
‘What about us?’ asked Kate.
‘I was about to suggest that,’ said Grayson. ‘It’s possible that either you or your husband might prove to be a suitable donor and we’ll certainly check your tissue type, but I don’t think you should bank on this. It happens less frequently than people imagine. A brother or sister would be a better bet and a twin would be ideal, but of course Amanda is an only child.’
‘So if neither of us matches her type we’ll just have to wait and hope?’
‘That’s about the size of it.’
‘How much time have we got?’
‘Impossible to say, I’m afraid,’ replied Grayson curtly.
‘Doesn’t it concern you at all?’ said Sandy, his patience with Grayson’s apparent callousness finally giving out.
‘I beg your pardon?’
‘Our daughter’s plight. Aren’t you concerned — as a person, I mean?’
‘Of course I am,’ replied Grayson, obviously flustered by the question.
‘You could have fooled me,’ replied Sandy flatly but Kate put a restraining hand on his arm to stop things going any further. He and Kate got up to go.
Clive Turner, who had been silent throughout, followed them outside. ‘I’m sorry,’ he said when the door had closed behind him. ‘Dr Grayson’s a bit of a cold fish. I’m sure he means well, but he doesn’t always come across that way.’
Sandy nodded. ‘How soon can we be tested for tissue type?’ he asked.
‘We can do it before you leave,’ replied Turner. ‘But as Dr Grayson said, I don’t think you should build your hopes too high.’
Sandy’s look suggested that this was the last thing he wanted to hear.
‘Look, why don’t we all go and get some tea?’ suggested Turner. ‘There’s something I’d like to talk over with you.’
Sandy’s first inclination was to decline the invitation but he changed his mind when he saw that Turner wasn’t just being polite or mounting a damage-limitation exercise on behalf of his boss. The man looked as if he really did have something to say. ‘All right,’ he said. ‘I think we could all do with some.’
The visitors’ tea room smelt of strong tea and plastic. The tall windows looking out on to the courtyard were misted over, thanks to a tea urn with a faulty thermostat which bubbled constantly and sent wafts of steam up into the air. Here and there a cleared patch on the glass permitted views of the rain speckling the puddles in the courtyard below. At Turner’s suggestion, Sandy took Kate across to one of the red-topped tables and sat down with her while Turner got the tea and brought it over on a brown plastic tray. There was a slight hiatus while he righted the cups in their saucers, placed them around the table and poured out the tea. As he sat down, he said. ‘This must be a nightmare for you.’
‘It all happened so quickly,’ said Sandy, searching for something sensible to say in reply. ‘She was as right as rain one moment and then suddenly she’s in here and…’
‘She’s dying,’ said Kate.
Turner’s silence was worse than anything he could have said at that moment, thought Sandy.
‘What was it you wanted to speak to us about?’ he asked, determined to end the silence.
Turner rested both forearms on the table and leaned forward as if to impart a confidence. ‘We have to think ahead about what to do for Amanda if neither of you should prove to be a suitable donor.’
‘I thought we’d just have to wait,’ said Sandy.
‘I don’t know how you’ll feel about this,’ said Turner, ‘but I thought there was one possibility we might explore together for Amanda. It’s only a possibility, mind you, and it might come to nothing, but I think it’s worth considering.’
‘What is?’ asked Sandy.
‘We had a circular from the Scottish Office recently concerning the Medic Ecosse Hospital here in Glasgow. Apparently, because of some political agreement reached between the hospital and the government over funding, they’re taking on a number of NHS patients recommended to them for specialist treatment. They’ve done this occasionally in the past but it was only out of the goodness of their hearts. Now it’s been put on a more formal basis. I suppose it’s still a PR exercise but the fact remains that a patient accepted by them under the new scheme will be treated as one of their own patients and completely free of charge.’
‘How does this affect us?’ asked Sandy.
‘It just so happens that Medic Ecosse has a world-renowned transplant facility.’
‘You mean you think they might accept Amanda as a private transplant patient?’
‘As far as I could see, there was no qualification about what kind of patient could be referred to them. If a case could be made out that a patient would clearly benefit from their expertise or facilities, then the criterion for referral would be met. That, I have to say, may be wishful thinking on my part but on paper there’s no bar.’
‘Do you think Amanda would benefit from such a referral?’ asked Sandy.
‘I think…’ Turner paused as if considering his words carefully. ‘I think that Amanda might conceivably get her transplant quicker at Medic Ecosse than here in the unit, and in her case time is of the essence.’
‘But how, if there’s an international register and a waiting list?’ asked Kate.
Turner paused again, then said, ‘I suspect there may be several international registers, not all of them available to NHS-funded hospitals.’
‘I don’t think I understand.’
‘I’m afraid that where there’s any kind of demand there’s always a supply based on currency rather than need,’ said Turner. ‘The international trade in donor organs is no different from any other commodity in short supply.’
‘How awful,’ said Kate.
‘But even if that were so,’ said Sandy, ‘surely they couldn’t admit to that and accept Amanda on those grounds?’
‘No indeed,’ smiled Turner. ‘But in addition, and this is important, they have the most modern dialysis equipment available anywhere in the world. I think a case could be made out that Amanda would benefit greatly from that alone. What she needs most right now is time. The Medic Ecosse unit could give her that. If they can come up with a kidney for her too, so much the better.’
‘How do we go about asking Medic Ecosse?’ asked Sandy.
‘The referral would have to come from here. I’ll speak to Dr Grayson if you like.’
‘Would you?’ said Kate, gratitude obvious in her voice.
‘Maybe I shouldn’t have rattled his cage,’ said Sandy ruefully. ‘I was pretty rude.’
‘Don’t worry about it,’ said Turner. ‘He’s too thick-skinned to have taken it to heart. He’ll have put it down to your being upset. Insensitive people always put it down to a misunderstanding on someone else’s part. I’ll get back
