"This is my favourite one," Hannah said as she clicked on another You Tube video on her tablet.
They two of them were sat together in the A&E Department's Triage Room, trying to kill time. It was only ten-thirty in the morning, but it was Christmas Day morning and they'd barely had a handful of patients through the department. The flow of patients would pick up as the day progressed, especially post-Christmas dinner when people came in with chest pains, thinking their severe indigestion was a heart attack. At present, though, they were bored and were watching videos of drunken Santa Clauses on Hannah's tablet. The Trust had blocked access to You Tube on the hospital's computers.
Karl had actually volunteered to work on Christmas Day. Out of the five Nurse Practitioners he was the only one without children, but he had a different motive. His lover Jonah always spent Christmas with his parents, who celebrated with a big family Christmas. Jonah's family was Evangelically Christian, and Jonah was deeply in the closet to them. They still thought of Karl as merely Jonah's flatmate, and Jonah carefully kept it that way.
Jonah would be home on the twenty-eighth, and they would then have their own Christmas together. Working over Christmas was Karl's way of avoiding an empty flat and "family cheer" on the television. This Christmas Day the A&E Department was unusually quiet, he and Hannah were short of work and high on boredom. Hannah, as one of the Department's Senior Staff Nurses, was the day's Triage Nurse, but she was as short of patients as him.
Their watching of the video was interrupted by Germaine, one of the receptionists, sticking her head around the room's door and saying:
"I've got a patient out here for you."
"A customer," Hannah replied. "About time."
"He's called Edward James. Shall I send him in?" Germaine asked. "I've put his details on the system."
"Give me a moment to read his details and then yes," Hannah said.
"Shall I leave you to it?" Karl asked her, as Germaine returned to her reception desk.
"Stay. You haven't got any patients to see and you can probably do his treatment right anyway," Hannah replied.
They both took a moment to read Edward James' details on the computer system. He was a seventy-five-year-old man who was complaining of hallucinations. Apart from high blood pressure, the old man seemed to have no other medical problems. The half dozen lines on the electronic admissions form barely told them anything about him.
The elderly man who entered the Triage Room, in response to Hannah calling for Edward James, was small and extremely neatly dressed, he looked nothing like their usually confused elderly patient. He was short, his body small yet in proportion to the rest of him, as if he had been small all his life, though there was an obvious paunch over his belly. Except for a thin strip of grey hair running around the base of his skull, his head was completely bald, making the features of his face seem small in comparison. He was dressed in a sharply ironed black, pinstriped, three-piece suit, worn over a crisp white shirt and blue tie. The man reminded Karl of a High Court barrister (But his years as a nurse had taught him to never judge on first impressions, they were often wrong).
"Have a seat Edward," Hannah said as the old man walked into the room.
"I preferred to be called Mr James," Edward James replied as he took the seat Hannah had offered him, in front of her and Karl.
Karl felt an edge of distain in the old man's voice. He guessed the old man was used to being the one in charge and was keen to let them know that.
"Right, Mr James, what is the problem?" Hannah asked.
"I need to see a doctor and as soon as possible," Edward James replied, that edge of superiority still plain in his voice.
"I'm the Triage Nurse. I need to do an assessment on you first and from there we can best arrange what treatment you need," Hannah told the old man.
"You're not a doctor then you can't help me. I need a doctor and as soon as possible," Edward James tartly replied, turning his head away from Hannah as he finished his sentence.
"Mr James," Karl said, pushing a tone of authority into his voice. "You have to be assessed by the Triage Nurse before you will be seen by anyone else. She'll decide, on her assessment, who you are most appropriate to be seen by. You can't just walk in here and demand the treatment you fancy."
"I knew I should have gone private," Edward James replied, though the tone of his voice was easing.
"And that's your choice but it’s Christmas Day and none of the private clinics are open, and they don't provide the range of services we do," Karl told the old man.
In reply, Edward James simply nodded his head and quietly said:
"Do your assessment."
Karl was surprised at how quickly Edward James' attitude changed, but they were the only option the old man had; now they could just find out what was wrong with him.
"So, what is the problem, Mr James?" Hannah asked.
"This is rather awkward," Edward James said.
"We're all professionals," Hannah said. "We're not going to laugh at you."
"I hope not," Edward James said. He then fell silent for a long moment. What was troubling the old man wasn't the usual physical complaint, Karl reasoned, this was something more personal and the old man felt it. Just looking at him, and knowing the old man's age, Karl assumed the old man was in fairly good physical health.
"I've been seeing ghosts," Edward James said. "For the last four nights I have been visited by ghosts, in my own home."
"Ghosts?" Hannah said.
"The first one was that of my old business partner, Jonathan McCormack. We founded the property company, James and McCormack, thirty years ago, and it has made us very rich. Well me very rich, he died four years ago, on Christmas Eve. He had a taste for male rent boys, who am I to judge, but it was a dangerous and distasteful taste. Christmas Eve, four years, one of those awful rent boys robbed Jonathan; he then collapsed with a heart attack and died. Very unfortunate, especially because we didn't find him until well into the New Year... Well, four nights ago his ghost appeared to me in my very own bedroom. He was weighted down by all these chains and claimed they were due to his selfish life, and that he has to walk the earth in limbo, trying to make amends for his selfish life."
It all sounded very Victorian and very farfetched to Karl, but he kept quiet.
"Then what happened?" Hannah asked.
"Jonathan told me that he'd come back to save me from myself. He said he was sending three ghosts to show me the error of my ways and save my life," Edward James said.
"And you saw the other ghosts?" Hannah asked. Karl could see she too was trying to hide her disbelief.
"Yes. The first one visited me three nights ago. It called itself The Ghost of Christmas Past. It showed me the events of my youth. The terrible, terrible events of my youth. When I was twenty-five, I was engaged to be married to Sara Palaceman, my employer's daughter. At least I thought I was. She was also involved with Gregory Huntington, my rival at the law practice we worked for. When Gregory Huntington got promotion over me, and I was the far more deserving employee, Sara Palaceman broke off our engagement because she was now engaged to Huntington. Huntington! That talentless creep. I lost my temper, there and then, and I choked the life out of that little trollop. I buried her body in Huntington's garden; he barely noticed that he had a garden. Two weeks after she had disappeared, I called the police, anonymously of course, it was so much easier to do that back then, and told them that her body was in Huntington's garden. They dug up his garden and found her body. They convicted him of her murder and gave him life in prison for it. He only lasted six months in prison before he hung himself. He never had any backbone... I had almost forgotten about all that until that damned ghost reminded me of it. Now I can't stop remembering it."
Karl glanced over at Hannah and saw her face fighting not to look shocked. This was an unbelievable story and yet the old man sounded so convincing. Karl turned his face back to the old man, whose face seemed drawn down by the story he was telling, as if his story was costing him so much to tell them.
"Two nights ago, the second ghost visited me. It called itself the Ghost of Christmas Present, though it took a liberal interpretation of it. First it showed me the lives of my tenants, how poor they are and the terrible conditions they live in, but so what. If they don’t want to live in my slum properties then they should work harder, get a better job and somewhere better to live. I did, so they can. Then the ghost showed me the death of Jonathan McCormack, my former business partner. The encounter with the rent boy was sordid enough, but watching him dying alone, in his beautiful home, was deeply unpleasant. I didn't want to know that..."
Karl just stared at the old man. The dry skin flaking off the top of his white eyebrows. The tiny drop of spittle caught in the corner of his dry mouth. The wrinkles in his skin spreading out from the corners of his eyes. This old man was certainly ugly, not just his dry and round little face, yet now Karl found himself fascinated by him.
"Last night the third ghost visited me. This one called itself the Ghost of Christmas Future. It showed me what my future holds for me. I don't know if I really believed it but... But it showed me my own death. It showed me dying at home, sat there in my own filth and mess and incontinence. I had Alzheimer's Disease and I didn't know where I was or what day of the week it was. I was surrounded by low paid care workers, who robbed me blind and left me in my own fifth. I was so disgustingly dirty, it made me feel sick..."
The old man just stopped his story there. He did not seem to peter out, his story just ended as if that was all he had to say. He certainly didn't try to offer any explanation for the events.
"Why did you come here this morning?" Hannah asked, her voice momentarily filled the silence that had slipped over the room.
"Seeing ghosts isn't normal," the old man said, his tone had seemed to have mellowed with telling his story. "I want to make sure I am not going mad."
"Right," Hannah replied, though Karl could read the confusion in her one-word answer.
"Mr James, would you come with me to one of our cubicles," Karl said, jumping in to cover Hannah's confusion.
"Why?" The old man asked, though there was no challenging tone to his voice now.
"I want to run some tests on you and we need to get a specific medic to come and see you," he explained to the old man.
"Oh, good," Edward James said, standing up from his chair.
He escorted the old man down the short corridor into the main body of the A&E Department. There he took the man to the empty cubicle nearest the Nurse's Station. Karl pulled back the cubicle's curtain, the old man walked past him and into it.
"Do I need to undress?" The old man asked him.
"No," Karl replied. "Just wait here. I'm going ask another nurse to come and check your vital signs and take some blood from you."
"Can I lie down? I'm very tired, I haven't slept in the last four nights," the old man said.
"Sure," Karl said as he pulled out the step from under the cubicle's trolley.
Once he'd got the old man settled down on the trolley, Karl returned to the Department's Nurse's Station. There he found Mollie, one the Staff Nurses, sat there, reading a magazine.
"Mollie," he asked her. "I've just put a patient into cubicle two. Can you do a full set of observations on him and take a full blood screen from him? And can you take blood for a full dementia screen?"
"Yeah, no problem," Mollie told him.
“Can you also check his oxygen saturations, get a urine sample off him and test it for a UTI?” Karl added.
"Can you put all those requests on the system?" Mollie asked
"Sure," he replied. “Which radiotherapist is on today? I think he could do with a chest x-ray too, to be on the safe side.”
“Boomer and he’s well into the Christmas Spirit, I warn you,” Mollie said.
“Christmas spirit?” Karl asked. Things were pretty relaxed on Christmas Day but they were still not allowed to drink on duty.
“He’s covered in tinsel, has got a big Santa hat on his head, and he’s wearing a jumper that actually lights up with ‘Ho, Ho, Ho’ on the front. It’s enough to make you lose your breakfast.”
“At least he’s happy. I’ll get the tests and stuff booked on the system.”
When he returned to the Triage Room, he found Hannah staring intensely at her computer screen.
“What’s the matter?” He asked her as he sat down on the other chair at the desk.
“I don’t know if I should refer Edward James to the medics or the Psychiatrists?” Hannah replied, looking at him.
“People can get hallucinations in the early stages of Alzheimer's Disease,” Karl said. “But I didn’t know with him. His hallucinations were very strange and very specific. Refer him to the Psychiatrists, if he isn’t right for them they’ll soon pass him on.”
“Good idea. Who’s the Psychiatrist on call,” Hannah asked.
“Hector, and he’ll be very quick to refer the old man on if his problem is organic,” Karl told her. “I’ve already asked for a full blood screen on him, urinalyses and I’ll book a chest x-ray, that’ll show up anything organic. Maybe I’ll get him an ECG as well, just to rule that out too.”
“Did you believe that stuff about him murdering his girlfriend when he was twenty-five?”
“I don’t know if I believed anything he said,” he told her. “Maybe he’s just completely mad. It’s Christmas Day, we always get the crazy ones in on a Bank Holiday.”
When Karl had finished ordering all his tests for Edward James, on the computer there, he’d leaned back in his chair, and listened as Hannah bleeped the on-call psychiatrist, but he couldn’t get comfortable. What the old man had said had left him feeling uncomfortable. Where they just the fantasies of a mind starting to be taken over by Alzheimer's Disease, was the man mentally ill and this was part of his illness, or was he a fantasist who was bored being on his own on Christmas Day? Karl used to pride himself that he could stop the fakers, those pretending to be ill to get some attention, years of experience had taught him that, but this old man was different. His story was completely fantasist yet his tone had been serious, it was as if the old man did believe everything he had told them. Karl knew that he should relax and let the on-call psychiatrist decide about the old man, but he couldn’t stop thinking about the old man and his story. He couldn’t put his finger on what was wrong.
“Excuse me,” Germaine’s voice broke into his thoughts.
Karl looked up and saw her standing in the Triage Room’s doorway, nervously moving from one foot to another.
“I’ve got three people who’ve turned up looking for Edward James,” Germaine said. “I’ve put them in the Relatives’ Room. They were really insistent they wanted to see him.”
“I’ll speak to them,” Karl said, standing up again.
The three people waiting in the Relatives' Room could not have looked more different. There were two men and a woman. The first man, probably in his late forties, was tall and dark haired. The second man was in his late twenties, he certainly gave off a boyish vibe with his nervous energy and head of thick, light brown, curly hair. The woman, Karl guest, was in her mid-twenties, petite and very blonde. Her skin was pale, seeming made paler by her very blonde hair, which she wore in a tight ponytail sprouting out of the back of her head. Her face was carefully made-up, as if she had spent more than an hour carefully applying it to all her features, matching her carefully coordinated out-fit of dark jumper and soft flowing skirt. The first man was far more causal, his dark hair ruffled and falling down the back of his neck, his strong-featured face was graced with a day’s growth of stubble. He wore an old, black leather jacket, over a blue checked shirt and black, neatly ironed pair of jeans. The second man was standing, whereas the other two sat on the plastic chairs there, and was walking to and throw, across the back of the room. His body was thin, seeming to be all arms and legs, hanging off a narrow chest and no visible stomach. He was wearing jeans and a hooded top, over a pale green linen shirt, though with a closer glance all those clothes looked expensive. His curly brown hair framed a round and open face, dominated by large green eyes and a wide, red lipped mouth. Here were three people who could make any head turn on any street, Karl thought as he surveyed the room.
“Hello, I’m Karl, the Nurse Practitioner on duty today. How can I help you?” He said, introducing himself.
“I’m Sara Palaceman, Mr James’ granddaughter,” the woman said.
“And I am Jonathan McCormack, his nephew,” the first man said.
“Oh, and I’m Gregory Huntington, Greg. I’m the old man’s other son,” the second man added.
Before he could stop himself, Karl felt the surprise jumping onto his face.
“God, he’s told them those bloody stories!” The woman, Sara Palaceman, protested.
“He bloody has,” the Jonathan McCormack added.
“What?” Karl asked.
“Daddy is barking mad, I told you lot this ages ago,” Gregory Huntington said.
“Greg! My mother took my grandmother’s maiden name when she left my father,” Sara Palaceman said, directing the second part of her sentence to Karl. “I’m named after my grandmother. Six months ago, my grandfather started to tell this bloody awful story about murdering my grandmother before they were married. They were married nearly fifthly years before she died two years ago.” Distress flooded her voice as she spoke, though she sharply held herself in check.
“I’m not my uncle’s business partner who died after being beaten up by a rent boy,” Jonathan McCormack said. “My uncle’s business partner, David Kramer, retired ten years ago. He lives in Southern Spain with husband.”
“And I’m the result of daddy’s affair with his secretary, twenty-nine years ago,” Gregory Huntington said, smiling at Karl. “Daddy never married mummy, that’s why I haven’t got his surname either. I only found out he’s my father two years ago.”
“We were all happy to heard that news too,” Sara Palaceman said, not looking at Gregory Huntington as she spoke. Karl detected another awkward family dynamic here.
“And I’ve been looking after him ever since,” Gregory Huntington said.
“If you had done a better job then we won’t have to be here today, on Christmas Day too,” Sara Palaceman said, still not looking at Gregory Huntington.
“I’m entitled to a lay-in on Christmas Day. I didn’t know the old man would go wondering will I was catching a few zz’s” Gregory Huntington protested.
“Will you two knock it off,” Jonathan McCormack snapped at the other two. “This nurse doesn’t need to know how dysfunctional our family is!”
“Does Mr James have Alzheimer's Disease?” Karl quietly asked, deciding to pull the conversation back to his patient.
“We haven’t had a firm diagnosis but a doctor he’s seen says he might,” Jonathan McCormack said. “But my uncle denies it every time.”
“He’s very good at hiding his Alzheimer's Disease,” Sara Palaceman added, the distress seemed to have eased from her voice. “But if you spend any time with him, you’ll realise he does.”
“He’s got the memory of gnat,” Gregory Huntington said. “I spend most of my time reminding him what day of the week it is and that he’s already had his breakfast.”
“My colleague and I were questioning whether he does,” Karl said.
“Oh, thank God for that,” Sara Palaceman said, relief filling her words.
“I told you, I told you,” Gregory Huntington said, staring at her.
“Can we see my uncle?” Jonathan McCormack asked.
“Of course,” Karl replied. “We’d still like to run some tests on him.”
“Naturally,” Jonathan McCormack said, “But we would like to take him home as soon as possible.”
“I’ve got him a full Christmas Dinner waiting for him there, well when I cook it,” Gregory Huntington added.
“Of course. I’ll take you to see him now,” Karl said.
It took him only a few moments to escort the three of them from the Relatives’ Room and around the corner into the Department, and over to Cubicle Two. He pulled back the cubicle’s curtain and found Edward James lying, curled up in the foetal position, on the cubicle’s trolley. The old man was obviously asleep.
“He’s sleeping,” Sara Palaceman quietly said.
“Yeah, he’ll do that all day long and be wide awake all night. It’s driving me nuts,” Gregory Huntington said.
“We’ll wait with him until he wakes,” Jonathan McCormack said.
“Of course,” Karl replied as he walked away. He’d already decided to go back to the Nurses’ Station and arrange an ECG for the old man.
When he reached the Nurses’ Station, he found Mollie and Paul, the Causality Doctor on duty, staring at a website on the desk’s computer screen.
“Surfing the web at work?” Karl said jokingly, as he sat down next to him.
“We’re checking out our new patient,” Paul said.
“He’s led a pretty colourful life,” Mollie added.
“How colourful?” Karl asked.
“Well,” Mollie began, “when he was in his twenties he was involved in the murder of his girlfriend. She was seeing two men at once and the other man was convicted of her murder but everyone thought he was the real killer, but that was fifty years ago. They didn’t have DNA and all that back then. There’s also one of his business partners, this is just as bad. It was four years ago. His business partner had a thing for rent boys and, on Christmas Eve, one rent boy beat him up and robbed him. The business partner had a heart attack, a massive MI. He rang Edward James for help but James didn’t answer his phone to him because he wasn’t at work. The business partner kept ringing James for help all over Christmas but James just ignored his calls, he wasn’t at work. They found the business partner in the New Year but he was dead and very messy.”
“Are you sure?” Karl asked.
“Hell yes,” Paul added. “There’s a truck load of articles on the web about him. Like this one.” Paul moved the mouse and clicked on another website. The computer screen was filled with text, a large banner headline, and black and white photographs dominating the page.
Karl lent forward and stared at the webpage, and something tight caught in his throat. The first black and white photograph was of a young, blonde haired woman, her hair piled up on her head in an elaborate nineteen-sixties style. The face in the picture was that of Sara Palaceman, the woman who claimed to be the old man’s granddaughter.
“Who’s the picture of?” Karl asked, indicating the photograph on the screen.
“That’s the murdered girlfriend, Sara Palaceman,” Mollie replied.
“Is there a picture of the man they convicted of her murder?” Karl asked, his mouth and throat suddenly feeling dry.
“Yes, here,” Mollie replied as she scrolled the webpage down until it reached the next picture.
The black and white picture showed a man with a haunted and trapped expression pulling down at his face, a still handsome face, and his hair was cut into a slightly unrulily short-back-and-sides style, which reminded Karl of the hairstyle his father had insisted he had as a child, but otherwise it was the face of the man who’d introduced himself to Karl as Gregory Huntington, only half an hour ago.
“And what was the name of the business partner?” Karl asked, his mind racing ahead of him.
“Jonathan McCormack,” Mollie answered him. “Why do you want to know to?”
“Have you got a picture of him?” Karl asked, ignoring her question as he felt panic rapidly rising within him.
“Here,” Paul replied, reaching other and clicking the computer’s mouse on another website. “But it’s from when he was younger,” Paul added.
Another website flashed up on the computer’s screen. On it was a colour photograph with its subject staring straight out of the picture. It was the same face, the same hairstyle, even the same growth of stubble; it was the man who had claimed to be the old man’s nephew.
“Christ!” Karl cried out and leap out of his chair.
It only took him a moment to run over to Cubicle Two, but all the while the panic now pounding in his head. He snatched open the cubicle’s curtain, making several of its hooks jump out of its track, and stared into the cubicle. There was only one figure in there, the old man, still lying in the foetal position on the trolley. The woman and two men were nowhere to be seen. Karl strode up to the trolley but he didn’t need to examine the old man to know he was dead. His eyes and mouth were both open, though his body was unnaturally still. All the same, Karl reached forward to check the old man’s carotid pulse, his finger’s sinking into the flesh of the old man’s neck. The old man’s skin was dry and cold, already beginning to stiffen with rigor mortis, and there was not even a glimmer of a pulse under his fingers.
Karl pulled his hand back. The old man was cold and stiff, he'd was far too gone for CPR to be of any hope. The old man must have been dead for three or four hours, far longer than he had been in their Department. Karl began to back away, slowing walking backwards out of the cubicle, though he couldn’t take his eyes off the body of the old man.
“What’s happened?” Mollie asked, her voice coming from over his shoulder.
“He’s dead,” Karl said. “The old man is dead.”
“Quick, start CPR!” Paul shouted rushing past him.
“Too late,” Karl replied but Paul had already rushed up the trolley. Paul, though, froze in his tracks when he took hold of the old man’s arm.
“He’s been dead hours,” Paul mumbled, the colour draining from his face, as he dropped the old man’s arm back onto the trolley.
“How can he be dead for hours? I only took his blood a few minutes ago and he was alive then,” Mollie said.
Karl turned around and saw Mollie’s face, which was filled with shock.
“I left two men and a woman in that cubicle. Did you see anyone walk past the Nurses’ Station?” He asked Mollie. There were only two exits from the Department, but to get to both of them you had to walk past the Nurses’ Station.
“No one passed us. The only one who passed the Nurses’ Station has been you,” Mollie replied.
“Oh God,” Karl muttered and walked passed her. He didn’t know where he was going but he knew he didn’t want to stay staring at this cubicle. His body felt numb, a cold numbness seeping from his limbs, as his mind raced with different and confusing thoughts. He didn’t know what had just happened but he needed to get away from it.
As he again walked passed the Nurses’ Station he was greeted by Hannah rushing towards Cubicle Two.
“What’s happened?” She asked him, her voice as animated as she was.
“The ghosts got Edward James,” he replied and then carried on walking passed her.