Sacrifice

'What is it? It is all right?' came her voice from behind the screen.

Gifford took the baby to the Kennedys, allowing them a few moments to cuddle and greet their son before the weighing and testing would begin. My job was to take care of the mother.

Over at the paediatrician's table, Gifford was calling out numbers to the midwife, who was recording them on a chart.

'Two, two, two, one, two.'

He was checking the baby against the Apgar score, a test devised to check the health and fitness of the newborn. Baby Kennedy had scored nine; the test would be repeated twice more but I didn't need the results. I knew he was pretty much perfect.

I couldn't say the same for the mother. She'd lost a lot of blood, more than we were able to replace and the bleeding was continuing. Immediately after delivery the anaesthetist had given her Syntocinon, the drug routinely administered to prevent post- partum haemorrhage. In most cases it worked. In a very few it didn't. This was going to be one of the few. I delivered the placenta and then called my boss over.

'Mr Gifford.'

He crossed the room and we stood a little back from the Kennedys.

'How much blood would you say she's lost?' I asked. Glancing to the left, my eyes were on a level with his shoulder.

'Couple of units, maybe more.'

'We have exactly one unit in stock.'

He cursed under his breath.

'She's still haemorrhaging,' I said. 'She can't lose any more.'

He stepped closer to Janet and looked at her. Then at me. He nodded. We walked round the screen and stood facing the Kennedys. John was holding his son, joy beaming out of every muscle in his face. His wife, on the other hand, did not look well.

'Janet, can you hear me?'

She turned and made eye contact.

'Janet, you're losing too much blood. The drug we've given you to stop the bleeding hasn't worked and you're getting very weak. I need to perform a hysterectomy'

Her eyes widened in shock.

'Now?' her husband said, his face draining pale.

I nodded. 'Yes, now. As soon as possible.'

He looked at Gifford. 'Do you agree with this?'

'Yes,' said Gifford. 'I think your wife will die if we don't.'

Pretty blunt, even by my standards, but I couldn't argue with him.

The Kennedys looked at each other. Then John spoke to Gifford again. 'Can you do it?'

'No,' he said. 'Miss Hamilton will do it better than I can.'

I somehow doubted that, but it wasn't the place to argue. I looked over at the anaesthetist. She nodded at me, already set up to administer the general anaesthetic that would be needed for the procedure. A nurse arrived with the consent forms and John Kennedy and his son left the theatre. I shut my eyes briefly, took a deep breath and got to work.

Two hours later, Janet Kennedy was weak but stable, the wind had dropped and the blood she badly needed was on its way. She was probably going to be OK. Baby Kennedy, now named Tamary, was fine and dandy and John was dozing in the chair by his wife's bed. I'd showered and changed, but felt the need to stay at the hospital until the blood arrived. I phoned home to check messages but Duncan hadn't called. I had no idea if the police were still there or not.

Gifford had stayed in theatre throughout the hysterectomy. He might have pretended absolute confidence when speaking to the Kennedys but he'd kept a pretty close eye on me throughout. Only once had he spoken: a sharp 'Check your clamps, Miss Hamilton' when my concentration had slipped a fraction. He'd left the theatre without a word when the operation was over, at least trusting me to close by myself.

I really wasn't sure whether he'd been satisfied with me or not. It had all gone pretty smoothly, but there'd been nothing slick, certainly nothing polished about what I'd done. I'd looked like what I was: a newly qualified and very nervous consultant, desperate not to put a foot wrong.

And now I was annoyed with him. He should have said something; even criticism would have been better than just leaving. I may not have been brilliant but I'd done OK and now I was tired, a bit weepy and rather in need of an encouraging word and a pat on the back. It's a part of myself that I really don't like, this constant need for approval. When I was younger, I assumed it was something I'd eventually grow out of; that self-assurance would come with greater experience and maturity. Just lately, though, I've started to have doubts about that, to wonder if maybe I'll always need the reassurance of others.

I was standing at my office window, watching people and vehicles move around in the car park below. I jumped as the phone rang and rushed back over to my desk, thinking the blood had arrived sooner than expected.

'Miss Hamilton, this is Stephen Renney'

'Hello,' I said, stalling for time, thinking, Renney, Renney, I should know that name.

'I heard you'd been called in. If you're not too busy, there's something you can help me with. Any chance of you popping down?'

'Of course,' I said. 'Anything I need to bring?'

'No, no, just your expertise. Call it professional pride, even professional conceit, if you like, but I do want to hand over a complete report when the big boys get here. I've got a suspicion which could be important and I don't want a couple of smart-arses from the mainland waving it in my face tomorrow morning like some big discovery.'

I had no idea what he was talking about but I'd heard it all before. So reluctant were the islanders to be thought in any way inferior to their mainland counterparts that they created a climate of excellence, even over-achievement, as the norm. Sometimes it actually got in the way of doing the job; sometimes good enough was really, honestly, all you needed. When I was in a bad mood and some bolshie registrar was giving me a hard time, I called it the Collective Chip on the Shetland Shoulder.

'I'm on my way,' I said. 'What room are you in?'

'103,' he replied. A room on the ground floor. I put the phone down and left the office. I made my way along the corridor and down the stairs, past radiology, paediatrics and accident 6c emergency. I followed the corridor, counting off room numbers as I went. I couldn't place room 103 and had no idea of Stephen Renney's field. I saw the number and pushed open the door.

On the other side, totally blocking the corridor were DI Dunn, DS Tulloch and Kenn Gifford, still in scrubs but having lost the mask and hat. Also a small, bespectacled man with thinning hair who I knew I'd seen before. I guessed he was Stephen Renney and, feeling like a complete idiot, I finally remembered that he was the hospital's locum pathologist.

Room 103 was the morgue.

3

THE SMALL MAN CAME FORWARD, HOLDING OUT A BONY hand. There were traces of eczema around his wrist. I took it, trying not to shiver at how cold it felt.

'Miss Hamilton, Stephen Renney. I'm so grateful. I've just been explaining to the detectives that, in the interests of completeness, I really do need-'

The doors opened again and a porter wheeled in a trolley. We all had to stand back against the wall to let him past. Gifford spoke and, away from the tension of theatre, I realized he had one of those deep, educated Highland voices that, prior to my moving here and hearing them on a regular basis, had been guaranteed to put a tickle behind my knees and a smile on my face. One of those 'oh, just keep talking' voices.

'Why don't we go into your office for a moment, Stephen?'

Stephen Renney's office was small, windowless and absurdly tidy. Several pen-and-ink drawings hung on the walls. Two orange plastic chairs were placed, too close together, in front of his desk. He waved his hand at them, glancing from DS Tulloch to me, then back to the detective sergeant. She shook her head. I remained standing too. With a tight smile, Renney lowered himself into his own chair behind the desk.

'This is entirely inappropriate,' Tulloch said to her inspector, gesturing towards me. She was probably right, but I don't like being described as inappropriate; it tends to put my back up.