Page 14 of The Scene of the Crime (Jessica Russell #1)

David Russell sat in the waiting area of his local medical practice, nervously tapping his foot on the floor and looking up at the TV screen on the wall for his name and the doctor’s room number to appear.

A woman in her seventies sitting opposite him leaned forward. ‘Do you mind?’

‘Mind what?’ David asked.

She pointed to his feet. ‘The constant toe-tapping.’

‘Sorry, I’ve had to take time off work to be here. My appointment should have been twenty minutes ago.’

‘That’s par for the course at this practice. Mind you, I’ve been here so many times I’ve got used to it.’ She turned back to Good Housekeeping magazine.

David had been worried all weekend after Doctor Barnes called him on Friday afternoon and requested that he attend the practice on Monday morning so she could discuss his blood test results.

After a previous blood test, all he’d received was a text message informing him the results were satisfactory and that he didn’t need to attend the surgery.

He contemplated telling Jess, but he didn’t want to worry her when she had the stress of starting her new job.

He’d told her he just had a bit of sciatica, but he was actually suffering from leg cramps and was starting to have difficulty gripping and carrying his mailbags.

Over the past two months, he had lost weight and muscle mass, but he couldn’t understand why, as his eating habits and daily routine hadn’t changed.

Feeling anxious about it, he’d looked up iron deficiency anaemia and similar illnesses on the internet.

Although he had some symptoms, he didn’t have pale yellow skin or get headaches when doing something strenuous.

Another sign of anaemia was a rapid heartbeat, which he knew he didn’t have, as he’d bought an ECG smartwatch to monitor his heart rate, blood pressure and oxygen levels.

David looked at his watch. His heart rate was slightly up, but that was probably due to being nervous about his blood test results. Without knowing he was doing it, he started tapping his foot again.

The woman lowered her magazine and frowned. ‘Sorry.’ David apologised then put his hands firmly on his knees to keep them still. He looked up and saw the receptionist walking towards him.

‘David, the doctor is waiting for you in room three,’ she told him. He realised he’d missed his name on the TV screen.

As he walked into room three, Dr Barnes welcomed him with a warm smile. ‘Sit down, David. How are you feeling?’

‘Not too bad, thanks. I’m still getting the leg cramps and feeling run down though.’

‘Did you try the tonic water I recommended? The quinine in it helps against cramps.’

‘Honestly, it hasn’t made any difference. And I’ve been monitoring my weight and muscle mass . . . they’ve both been going down, which has never happened before.’

‘There could be many reasons for that.’ Dr Barnes turned her seat and looked at her computer screen.

‘Your blood test revealed an increase in a substance called creatine kinase. It’s an enzyme that exists in your heart and skeletal muscle.

Any event, like an injury, that causes muscle damage or interferes with muscle energy production can increase creatine kinase levels in your blood.

Even intense exercise can be a cause for the rise. How do you keep fit?’ she asked.

‘I don’t go to the gym and lift weights or anything like that, but I’m a member of a cycling club, and my girlfriend and I cycle together regularly.

I’ve also recently been doing longer hours delivering mail due to a backlog at the sorting office.

It’s made my working days more strenuous, so maybe that’s got something to do with it. ’

‘It’s possible. Kinase levels can also go up after drinking too much alcohol. What would you say your average daily intake is?’

‘Very little during the week. I have to be up for work at five a.m. I might have the occasional bottle of beer, but it’s often an alcohol-free one. I sometimes go to the pub with cycling friends on Saturday night, but it’s not a regular thing.’

‘What about spirits?’

‘I rarely, if ever, have any.’

‘This is a question I need to ask . . . please don’t be offended by it. Do you take any performance-enhancing supplements, such as anabolic steroids or protein powders?’

‘No, but I take multivitamin tablets and cod liver oil daily.’

Dr Barnes smiled. ‘That’s a good thing . . . in moderation, of course. Your work as a postman is obviously very strenuous and could cause a rise in kinase levels. Your symptoms of muscle cramps, aches and weakness could also be symptomatic.’

‘So, there’s nothing wrong with me?’ he said, feeling relieved.

‘I can’t say that for certain, David. You might have a heart condition or a neuromuscular problem causing the kinase levels to rise.’

‘I check my heart rate and blood pressure daily, and they’ve been fine.’

‘Then that’s a positive thing. But I am going to refer you to a neurologist who will carry out some more tests . . .’

‘Why can’t you tell me what’s wrong with me?’ he interrupted.

Dr Barnes could see the look of concern on his face. ‘There may be nothing wrong with you, David. I know you must be worried but try not to be.’

‘What sorts of tests?’

‘I’m not a neurologist, David.’

‘But you must have some idea . . .’

‘There are many disorders that affect the nervous system, but there is no risk in having a neurological examination. I will also give you a prescription for some antidepressant medication.’

‘I’m not depressed!’

‘I know, but amitriptyline is also prescribed for fatigue and back pain.’ Dr Barnes printed off the prescription and handed it to David. ‘A receptionist will text you with the date and time of your appointment.’

‘How long will it be before I see the neurologist?’

‘I can’t give you an exact date, but hopefully in a week or two.’

‘Which hospital will it be at?’

‘Guy’s. Please, try not to worry, David. You’re young and healthy, but don’t overexert yourself on your mail round. For now, it would be better if you could do some internal work at the sorting office instead of delivering mail.’

‘I’ll ask my manager.’

‘Good. I will also email you some low intensity exercises you can do to help with the cramp.’

‘Thank you, doctor.’ David folded the prescription and put it in his pocket.

David went to the chemists in Petts Wood to get his prescription.

He knew the doctor was trying to be helpful by telling him not to worry, but he was sure there was something she wasn’t telling him.

While waiting for the medication to be packaged, David looked at the health supplements on the shelves.

He bought some Metatone tonic, Wellman effervescent tablets and magnesium, which, according to the labels, would help him sleep and increase his energy levels.

When he got home, David sat down at the kitchen table with his laptop and started looking up articles on creatine kinase, what a neurologist does and the tests they do.

He knew about CT and MRI scans, but other tests like angiography, myelography and neurointerventional radiology he’d never heard of and sounded scary.

The more he read, the more depressed and worried he became.

*?*?*

Having started work just after three in the morning, it was midday when Jessica said it was time to down tools and have a lunch break.

The exterior crime scene tape had been removed, so Taff organised a pizza delivery to be dropped off by the garden gate on Homer Road.

It was a sunny afternoon, so Taff and Diane sat at the garden table, drinking water and chatting while waiting for the pizzas.

They’d been working non-stop and were glad to be able to finally relax, with their crime scene suits unzipped and the sleeves tied around their waists.

Not wanting to be distracted, Jessica sat at the kitchen table making more notes on her iPad. She reviewed everything she and the team had done and observed, knowing that DCI Anderson would want a detailed analysis of the crime scene and forensic opportunities as soon as possible.

DI Chapman had been in his car, reviewing the house-to-house forms. He called the office and then entered the house to join the others.

On seeing Jessica, who had her back to him, he started to tiptoe across the kitchen floor to avoid disturbing her.

She turned and looked in his direction with a curious frown. ‘Are you all right?’

‘I’m fine, thanks.’

‘Why are you tiptoeing?’

‘I didn’t want to disturb you while you were meditating.’

Jessica rolled her eyes. ‘I was going over my notes. We’re having some pizza in the garden. You’re welcome to join us.’

‘Thanks. I just spoke to Anderson . . .’

‘Wondering why we haven’t found the perpetrator yet, was he?’ she interjected.

‘Actually, he’s more worried about Michelle De Klerk, aka Michelle Belsham, being missing. I told him to request an all-ports warning to see if she checked in on any flights or ferries.’

‘From what I saw at the crime scene, I don’t think she was at the house, but I could be wrong.

Whatever happened, or wherever she is, let’s hope she’s safe and well.

’ Jessica actually felt a bit sorry for Anderson as he was in an awkward position and was taking a risk whatever he chose to do about Michelle’s disappearance.

‘Anderson’s changed the meeting time to three p.m., by the way.’

‘Any particular reason for that?’ she asked.

‘Said he’s got a five p.m. meeting at the Yard with Commander Williams. The truth is, he probably needs to get home to his wife.

I met her once at a colleague’s wedding.

She’s a bit of a battleaxe. He’s under the thumb and does what he’s told.

He’s as quiet as a mouse in her company. Mind you, so would I be,’ he laughed.

‘What’s the address of the station?’ She got out her phone and opened the Waze app.

‘Fleet Road, just off the North Circular. Postcode is IG11 7BG.’