A double door into the older building led to a reception area: country-house scruffy, scratched wooden floors, with a boot rack and coat hooks then a couple of ancient sofas. An open door in the opposite wall showed an office beyond. A middle-aged woman stuck out her head. ‘Can I help?’ She was Scottish, the implacable woman on the phone. Around her neck a lanyard and a pass with a name. Elspeth.
Joe showed his warrant card. ‘We spoke yesterday.’
‘Of course. Joanne is expecting you.’ A couple of teenage girls came through the door. They were dressed in jackets, hats and scarves and they were laughing. It was only when they took off their coats that Joe saw how thin they were, bony and gaunt. He tried not to stare. Elspeth gave them a wave and continued talking. ‘You’re a little early and Mrs Simmons Wright is still tied up with the patients. Can I get you some coffee?’
He was still drinking the coffee when Joanne Simmons Wright came in, bursting through the door so it banged on the wall behind. ‘I’m so sorry to have kept you waiting.’ She was skinny too, but tall and fit. The same age as the receptionist but ungainly, like a tall kid with too much energy. She had short hair streaked with grey. No make-up. She could be a runner and was dressed like one in Lycra leggings and a long sweatshirt. ‘I take the yoga class on a Monday morning, over in the well-being centre.’
‘Yoga can cure anorexia?’
She recognized the scepticism but wasn’t offended. ‘Well, not on its own, but anything that helps patients feel more relaxed and more at ease with their bodies is going to help. Shall we go to my office? It’ll get a bit crowded here when they all come through.’
The office was on the first floor at the front of the house, looking down over the garden to the tarn beyond. There was a desk against one wall, three easy chairs. Joe took one. Joanne was leaning with her back to the windowsill, drinking from a water bottle.
‘You were Lorna Falstone’s doctor?’
‘I’m not a doctor. I’m a psychologist, but I was her key worker.’ Joanne took a seat opposite to him. ‘Poor Lorna. How did it happen? Did she get ill again? Suicide?’
‘No.’ He looked at her face. ‘It was murder.’
There was a stunned silence. He waited for the psychologist to speak, but she turned her head away. ‘You do remember her then?’ he said at last. ‘It was four years ago and you must get a lot of kids through here.’
‘Of course I remember. This isn’t a place where people come for a few days. Some of them stay for months. We have to make sure they’re physically stable, build their weight up slowly, insist on bed rest, before we make a start on any psychological problems. We form relationships here. It’s important. Most anorexics feel entirely alone.’ Still, she saw he was sceptical. ‘This illness has real and distressing physical symptoms. The girls’ periods stop, patients’ hair falls out, such weight loss can even trigger a heart attack. This is more than the self-indulgence of teenagers who want to look fashionable.’
‘And Lorna needed that? The bed rest? The feeding?’
‘She was very ill when she came here. She weighed less than six stone.’
‘Hadn’t her parents noticed?’ Joe was horrified. ‘Why didn’t they do something before?’
‘Anorexia is a sly disease. It creeps up on the sufferer. In the beginning, the parents might have encouraged the exercise, the decision of their child to cut out apparently unhealthy food. Weight can seem to drop away slowly at first. The sufferers are sly too. They hide. Throw away food when nobody’s looking. Exercise in secret. You have to know that this is all about control. Control and compulsion. In chaotic and uncertain relationships, food is the one thing over which sufferers feel they have any power.’
‘You’re saying she was in a chaotic and uncertain relationship?’
‘I’m saying that her relationship with the world was uncertain. She felt friendless at school. I have the sense that her parents’ marriage was shaky. I’m pretty sure she’d never had a boyfriend if that’s what you’re asking.’
‘Why did she need to come here? What was wrong with the NHS?’ Joe’s grandfather had been a miner, a union man. He and Sal might live in a smart house on an executive estate now, but this still felt all wrong. Whatever Joanne might say, he thought these were rich kids who just needed to pull themselves together and stop agonizing over their appearance.
‘I worked in the NHS for ten years. I’d still be there if it had given me the resources to do my job properly. But it didn’t and this is work that can’t be rushed.’ She looked up at him. ‘I still feel bad about leaving. I still feel that I’ve deserted a sinking ship.’ She paused and when she continued her voice was more even. ‘Some health authorities pay for patients to come here. They recognize that ultimately, we provide good value for money. It’s not cheap to keep an adolescent as a long-term inpatient in any hospital and we have a decent rate of success.’
‘Tell me about Lorna,’ Joe said. He wasn’t here to argue politics with a woman who was cleverer than him and knew more about the issues.
‘She was bright. Painfully quiet at first. Her refusal to speak was about control again,
