Grounds for Appeal (27 page)

‘What's the problem with this case, doctor?' said the technician, being as insatiable as usual in her search for knowledge.

‘There's a thrombus in the descending branch of the left coronary artery and I'm anxious to know how long it's been there. The family are claiming that the shove in the chest that this poor man suffered was the cause of his coronary episode and hence his death.'

‘And was it?' she demanded, always ready to take the side of the downtrodden masses, even though this particular victim was a rich brewer with a very expensive Alvis motor car.

‘Well, his coronary artery disease certainly wasn't, as it must have been there for years. And I don't think the thrombus was either, as he died within an hour of the squabble. But I'd like to know if his heart muscle was already damaged from lack of blood supply, which is why I've got the heart in this tray.'

Sian looked at the organ phlegmatically, unlike Moira, who though she had got used to typing descriptions of unpleasant things, was not keen to view them in the flesh.

‘Why have you already sliced across it?' she asked.

‘I want to try some new techniques that I've read about in the pathology journals, mainly from the other side of Europe,' he explained. ‘The trouble with conventional histology is that it can't show the very early stages of cell death in the heart muscle, just by staining fixed tissue.'

Sian was already ahead of him. ‘You're into histochemistry, then. But we haven't got the equipment. You need frozen sections and all sorts of fancy reagents.'

He nodded, pleased at her quick mind and wide knowledge of what was going on in the technical world.

‘There are some cut-price methods being tried, where a large slice of tissue, as opposed to little bits for the microscope, can be processed for enzyme content.'

She settled on a stool next to him and put her chin in her hand, prepared to listen to his explanation.

‘We're doing enzymes now in my biochemistry course. But how can that help you with this problem?'

Richard settled back to give a lecture, always ready to impart knowledge to those who wanted to hear it.

‘Muscles need energy and they get this through turning carbohydrates and other nutrients in the blood into carbon dioxide and water, using enzymes, especially the dehydrogenases.'

Sian nodded, in a slightly superior manner. ‘Yes, the Krebs cycle and all that!'

‘Well, those enzymes are inside the muscle cells, but if those get killed or injured by cutting off their blood supply, as with a coronary thrombosis, then the enzymes leak out through the damaged cell walls.'

Again his technician was ahead of him. ‘That's the basis of the SGOT tests we used to do in the hospital. The enzymes became raised in the serum, because they were leaking out of the heart.'

Richard gave one of his impish grins. ‘I don't need to tell you anything, do I, Einstein? So you'll appreciate that if the enzymes increase in the blood, they must decrease in the muscle – and that's where these tests are useful.'

At this point, Angela came in from the office clutching a sheaf of papers, but she diverted to the window area to hear what was going on.

‘I'm getting taught some biochemistry by Sian here,' said Richard. ‘Damned good she is, too!'

The young blonde made a face at him, but she flushed with pleasure at his praise.

‘How's it done, then?' demanded Angela.

As she joined the audience, he explained. ‘As you said, it can be done now on a microscopic scale using live tissue in frozen sections, but we haven't got the equipment. The same can be done using the same reagents on big slices like these, but it's prohibitively expensive to use large volumes of stuff like nitro-BT. However, recently there have been attempts to use cheaper chemicals, which is what I'm going to try.'

Intrigued, Angela wanted to know what they were.

‘According to some chaps in Czechoslovakia and Germany, potassium tellurite and TTC can react with dehydrogenase enzymes and show up deficiencies. I messed about with tellurite a bit just before I left Singapore, but it was too unreliable to be of much use, so I turned to TTC. That's why we've got some here. I brought it back with me.'

‘What's TTC?' demanded Sian, determined to be able to show off the next time she went to her biochemistry session.

‘Triphenyl-tetrazolium chloride,' he replied. ‘A long name, but relatively cheap stuff.' He reached across the table and picked up a small bottle containing white powder and placed it in front of Sian.

‘If you would be kind enough to make up a one per cent solution in a slightly alkaline phosphate buffer and – if we can borrow space in Angela's incubator for half an hour – we'll see what happens.'

As soon as Trevor Hartnell got back to the police headquarters in Aberystwyth, he sat in an empty office offered by Meirion Thomas and did some urgent telephoning. First, he rang his wife to say he wouldn't be home that night, but would be staying in a bed and breakfast place on the seafront, organized by the local CID. He wanted to be on hand if the forensic report, promised by next morning, added any weight to their enquiries, so it was not worth trekking back to Birmingham, only to have to return. After assuring his wife that he would do all he could to be back home before Christmas Eve, to go shopping for presents for their two kids, he spoke at length to his Chief Inspector in Winson Green. He brought him up to date with the visit to the derelict van and the interview with the former Czech soldier, then asked for some digging into the antecedents of ‘James Brown'.

‘I've got a suspicion that he may have been on our patch towards the end of the war,' he explained. ‘Can you organize a search to see if a Jaroslav Beran shows up anywhere in the records for that time, especially if there's any connection with Mickey Doyle?'

His DCI promised to get some men on to it straight away, and with nothing more he could do that day, decided to go for a bracing walk along the promenade in the chill December wind.

After Sian had made up a fresh solution of TTC and Richard had submerged a centimetre-thick slice of the heart in it, the shallow glass dish was placed in the body-heat incubator and left in peace for twenty minutes.

‘Leave it too long and there can be a non-specific deposition of the tetrazolium all over the tissue,' cautioned Richard.

‘What's the actual basis of the test?' asked Angela, curious about something outside her usual expertise.

‘The dehydrogenase enzymes in the muscle convert the colourless TTC to a red dye which precipitates out on to the surface. If there's no enzyme present – or a marked reduction – then nothing happens in that area and the tissue remains unstained.'

They watched the bench timer, bought in a kitchen sundries shop, and when the time was up, there was a feeling of anticipation, as even Moira, aware of something unusual going on, came to watch. Though earlier she had baulked at the fresh heart lying in the tray, the circle of muscle in its glass dish seemed much less repulsive as Richard laid it on the big table.

‘There's a pale patch there!' exclaimed Sian, proud that her efforts in making up the solution had contributed to success.

‘Yep, just where it should be,' agreed Richard, pointing with forceps at one side of the thick circle of ventricle. ‘Blockage of the descending branch of the left coronary artery would cause an infarct of that part of the heart.'

‘So what's the significance in this case, Doctor Pryor?' asked Moira.

‘It takes some time for the death of the muscle to become apparent. How long depends on the way you look at it . . . just naked eye, with no fancy techniques like this would show nothing for many hours, even a day or two after the blockage. Using ordinary histology would shorten that time, but this is the most sensitive, together with the microscopic techniques that we can't do here yet.'

‘So you feel that this rules out the possibility that the push on the chest caused the death?' persisted Moira.

Richard shook his head. ‘I can't go that far. But it shows that the infarct – the dead tissue – must have been present well before the incident at the side of the road. This was a man with severe coronary disease, who had already suffered an infarct, so that he was in danger of dropping dead at any time.'

Angela joined the discussion. ‘But you can't rule out the possibility that the squabble pushed him over the edge, so to speak?'

‘No, I can't. I'm pretty sure that the physical act of pushing him in the chest, which has not left any mark whatsoever, is not relevant. But anyone in a dispute gets an adrenalin release – the old “fight or flight” reaction. Their blood pressure goes up, their heart rate increases and this could well trigger an abnormality of its rhythm, which in a damaged heart, could cause it to stop altogether.'

‘So where does that leave the lorry driver – and the family?' queried Moira, who was more interested in the legal liability than the pathology.

‘That's a legal matter, not medical. On past experience, I would think that a criminal prosecution would be unlikely, as if it came to trial, the defence would have a field day with the fact that the deceased had already had a recent, potentially fatal myocardial infarct. Still, you never know, there's another legal axiom, which is that “you have to take your victims as you find them”.'

Moira's smooth brow wrinkled in puzzlement at this.

‘I don't really follow that, doctor.'

Richard did his best to illustrate the point.

‘Look, if someone hits another on the head with a blow that normally would not be expected to kill him, but that person has an abnormally thin skull and dies of a brain haemorrhage, it's not a valid excuse to claim that the attacker did not know of the thin skull. Actually, in practice, it's a good point for the defence in mitigation, but the principle is the same as someone with a heart condition.'

Angela, also familiar with many legal dilemmas, pointed out to Moira the difference between criminal and civil actions.

‘The standard of proof in a criminal trial has to be “beyond reasonable doubt”, but in a civil action for damages, it only has to be a “balance of probabilities” which means that it only has to be proved that it was more likely than not that the outcome was due to the alleged cause. So if the police don't take any action, maybe the family will sue the driver.'

Their secretary was looking bemused by now, but found it all fascinating. ‘I'll have to go away and think about this,' she said with a sigh. ‘I wish I knew a lot more about these things.'

As she went back to her typewriter, Richard went off to telephone the Hereford coroner to give him much the same opinion as he had offered to Moira.

NINETEEN

O
n Thursday morning, Trevor Hartnell was sitting in Meirion Thomas's room when a phone call came through for him from Birmingham. His DCI, a gaunt Scotsman nearing retirement, had news for him about Jaroslav Beran.

‘We've turned up something about him from way back in 1944. He's never actually been convicted of anything serious up here – just a few drunk and disorderlies and a couple of minor assaults – but he was pulled in a couple of times for questioning on bigger stuff, then released for want of evidence.'

‘What sort of thing was he involved in?' asked Trevor, giving a thumbs-up sign to the Welsh DI sitting across the desk.

‘He was suspected of being the driver in a smash-and-grab on a jeweller's in Aston, but the main witness conveniently vanished before trial. Then there was a big black-market meat investigation that he was certainly involved in, but again it all fizzled out for lack of evidence. That one was almost certainly a Mickey Doyle enterprise, as it was known that it was he who had put the frighteners on some of the witnesses. Oddly enough, some of the lamb and mutton involved was known to have been rustled from Wales.'

‘Anything else known about him?'

‘His background was very dodgy. He was virtually kicked out of the Czech Free Forces after deliberately injuring himself, though again they couldn't prove it. He turned up in Handsworth in forty-three, but after the black-market case, he vanished from the scene altogether.'

Trevor Hartnell shifted the receiver to his other hand, as he made some notes on a pad.

‘Does anybody actually remember him from those days, boss?'

His DCI told him that a couple of older uniformed officers from Handsworth recalled ‘this Czech bastard', as they called him. ‘A real hard case, they said. Heavy drinker and violent at the drop of a hat, often involved in punch-ups with other toerags. One of them says he used to frequent the Barley Mow pub, which is interesting, as it was one of Doyle's hang-outs.'

There was nothing more the DCI could pass on, but he promised to keep a couple of men asking around about Jaroslav Beran. When he had rung off, Trevor repeated what he'd heard to Meirion Thomas.

‘Sounds as if he was a low-level crook up in your place,' was the Welshman's response. ‘A getaway driver and an enforcer, presumably working for this Doyle character.'

‘Odd that he suddenly disappeared from Birmingham and turned up in Aberystwyth. His convictions for receiving were since he came down here, according to the probation people.'

Meirion leaned back in his chair and looked out at his favourite view, the cold sea now choppy in the winter wind.

‘Maybe things were getting too warm for him in Birmingham – or perhaps this Doyle wanted him as a sort of lookout man down here. A lot of the country house thefts were in Mid-Wales and along the Marches.'

‘You never got a whiff of him in your sheep stealing cases, did you?' asked Trevor. ‘It seems he was involved in the black-market meat racket up in B'rum.'

The stocky DI shook his head. ‘I never knew he existed until this week. He's kept his head down pretty well.'