“Then it must have been a mistake,” said Mma Ramotswe. “Does the doctor drink over lunch?”
“He never drinks,” said Boitelo. “He says that he does not like the taste of alcohol, and he also says that it is far too expensive. Water is cheaper, he says.”
There was a brief silence as Mma Ramotswe and Mma Makutsi contemplated the possibilities. Neither was sure about the significance of the misreading—if that was what it was. It sounded important, but what did it mean? Doctors made mistakes all the time—as everybody did—and why should this make the nurse so anxious? It seemed that an important part of the story was yet to come, and this was what Boitelo now provided.
“I was puzzled by this,” she said. “As you said, it could have been a mistake, but now there was something that was making me wonder if something strange was going on. It seemed odd that the doctor should be so determined that I should not take blood pressure and then that he himself should go and make such a mistake. So I decided to carry out a little investigation myself. I have a friend who is a nurse too. She works in another clinic, and she had once told me that there was some old equipment lying about in a cupboard there. I asked her if there was a sphyg, and she said that she would look and see. When she reported back that there was one, I asked her if I could borrow it for a few weeks. She was a bit surprised, but she agreed.
“I hid the sphyg in my drawer at work. And then I waited for my chance, which eventually arrived. I had been paying attention to the medical records now, and each time I got them out for the doctor I looked to see whether it was a high blood pressure case. There were many of them, I noticed, and I began to wonder about them. All of them were on the same drug, which is quite an expensive one. We give them supplies of it from the clinic.”
Mma Ramotswe sat up, almost upsetting her cup of cold tea as she did so. “Now, Mma,” she exclaimed, “I think that I can already see what is happening here. The doctor is giving false blood pressure readings. He tells patients that they have high blood pressure when they really do not. Then he makes them take the expensive drug, which he provides for them. It must be a very good business for him.”
Boitelo stared at her. “No, Mma,” she said flatly. “That is not what is happening.”
“Then why did he enter the false reading? Why did he do that?”
“It must have been a genuine mistake,” said Boitelo.
Mma Ramotswe sighed. “But you said that you yourself were suspicious of it. You didn’t think it was a mistake.”
Boitelo nodded. “I didn’t,” she said. “You are right, Mma. I did not. But now I do. You see, I did two further tests. In each case it was while the doctor was busy with somebody else and there was one of these blood pressure patients in the waiting room. I took their blood pressure and then I compared the results I got with the results that the doctor later noted on their records.”
“And?”
“And they were the same.”
Mma Ramotswe thought for a moment. She was no statistician, but she had read Clovis Andersen on the subject of unusual occurrences.The fact that something happens once , the author of The Principles of Private Detection had written,does not mean that it will happen again. And remember that some events are pure one-offs. They are freaks. They are coincidences. Don’t base a whole theory on them. Clovis Andersen was probably right in general, and if he was also right in this particular case, then there was nothing untoward occurring. But if that were so, then why had Boitelo come to see her?
“You are probably wondering what happened,” said Boitelo.
“I am, Mma,” said Mma Ramotswe. “I am not very sure where this is going. I thought I did, but now …”
“Well, I will tell you. I shall tell you what happened. One of our patients had a stroke. It was not a serious stroke, and he recovered very well. But he had a stroke. And he was one of the ones with high blood pressure.”
Mma Ramotswe nodded. “I have heard that this is a danger from high blood pressure.” She shifted in her chair. That was why that doctor had told her to lose some weight. He had talked about heart problems and strokes, and it had all made her feel most uncomfortable. What use, she wondered, was a doctor who made people feel uncomfortable? Doctors were meant to provide reassurance, which of course made people feel better. Everybody knew that.
“Yes,” Boitelo went on. “High blood pressure can lead to strokes. And this patient ended up in hospital for a few days. I don’t think that there was any real danger, but the doctor became quite agitated about it. He asked me to get out the patient’s records and he kept them with him for a while. Then he gave them back to me for filing.”
“And you looked?” asked Mma Makutsi.
Boitelo smiled. “Yes, Mma. I was nosy. I looked.”
“And did you see anything unusual?” prompted Mma Ramotswe.
Boitelo spoke slowly, seemingly aware of the dramatic effect that her words were having. “I found that the figures for a blood pressure reading had been changed.”
A large fly landed on the table in front of Mma Ramotswe and she watched it as it took a few steps towards the edge. It hesitated and then launched itself into the air again, its tiny buzz just audible. Boitelo had been watching it too, and she swatted ineffectively at it.
“Rubbed out?” asked Mma Ramotswe. “Were there marks on the page?”
“No,” answered Boitelo. “There was no sign of that. It must have been done very skilfully.”
“Then how could you tell?” challenged Mma Makutsi. “How did you know?”
Boitelo smiled. “Because the patient was the first one whose blood pressure I had taken in the waiting room while the doctor was busy. It was the same person. And I had written down my reading on a scrap of paper which I had put away in my drawer. I remember comparing those figures with the ones which the doctor put on the card that day. They were the same. But now, that very same figure had been changed. A high reading had been changed to a low one.”
Boitelo sat back in her chair and looked at Mma Ramotswe. “I think, Mma,” she said, “I think that this doctor is doing something very wrong. I went to see somebody in the Ministry of Health and I told him about it. But he said that I had no proof. And I don’t think that he believed me anyway. He said that from time to time they had complaints from nurses who did not like the doctor they worked for. He said that they had to be very careful, and until I could come up with something more concrete I should be careful what I said.”
She looked at Mma Ramotswe defensively, as if she, too, would pour scorn on her story. But Mma Ramotswe did not do this. She was noting something down on a piece of paper, and she did not react in any way when Boitelo went on to explain that she had brought this matter to the attention of the No. 1 Ladies’ Detective Agency out of a sense of public duty and she hoped that in the circumstances there would be no fee, which she would be unable to pay anyway.
CHAPTER THIRTEEN
BLUE SHOES
MMA RAMOTSWE KNEW that she should not have left the office that afternoon. She now had rather more to do than she wanted, and none of the problems which had landed on her desk appeared to have any answer. There was a series of issues, each of them demanding to be resolved but each curiously resistant to solution. There was Mokolodi, which she should do something about sooner or later; there was Mma Tsau and the blackmailing letter; and then there was the question of Mr Polopetsi’s mean uncle and his favouritism towards Mr Polopetsi’s brother, for whom he had bought a car. She thought about that. No, there was nothing that she could do—just now—about that. The world was imperfect, and there were just too many claims. One day, perhaps, but not now. So that came off the list, which left one remaining item, the most difficult of course: the doctor. She admired Boitelo for coming to see her; many people would just have given up in the face of a wrong which they could not right, but she had brought the issue to her. And Boitelo had been correct, Mma Ramotswe thought, about civic duty. It was her duty not to stand by in the face of evidence of medical wrongdoing; and it was Mma Ramotswe’s civic duty to do something now that the issue had been brought to her attention. But it was difficult to think what to do, and, as she often did in such circumstances, Mma Ramotswe decided that the best thing to do would be to go shopping. She often found that ideas came to her when shopping, halfway down the vegetable aisle in the supermarket, or when trying on a skirt—which would inevitably be just a little bit too tight—she would have an idea and what had previously been a log-jam would gradually begin to shift.