“That’s certainly one explanation. She had some liver scarring. I think the valve may have been to bypass some blood around the liver, which normally has a huge blood flow. When the liver gets scarred from damage, usually cirrhosis, it restricts blood flow through it. The back pressure causes damage to other organs, especially the heart, leading to oedema – fluid collecting under the skin, around the legs, possibly in the lungs, which can be similar to drowning.
“A bypass valve would relieve this back pressure and prevent these symptoms. Before the operation, the patient might be taking diuretics, which cause the kidneys to produce more u
rine by reducing the amount of fluid in blood vessels slightly, hence reducing the back pressure of blood; or antihypertensives, which dilate blood vessels so that they can accommodate more volume of blood: that would also reduce back pressure.
“So, if you fit a bypass valve around the liver, it takes all this blood straight to the venous side and back to the heart, and therefore there is no blood backing up to cause high blood pressure or heart failure or any of those symptoms. Unfortunately, the liver’s job is to manufacture proteins and other necessary biochemicals distributed through the bloodstream, and make safe any toxins from either metabolism or what is ingested already existing in the bloodstream. None of this can happen if the liver is bypassed completely. So it may only work for either a short time, or if the liver is only partly damaged.”
“Hence the tablets,” said Reilly.
“But what we’ve just discussed did not cause her death,” offered Gardener. “Or the severe bruising we’ve seen.”
“I don’t think it would,” said Fitz. “I was simply pointing out something I’d found that may or may not have a bearing on what happened.”
“Could the blow have caused the valve to stop working?”
“It could have damaged the valve enough for it to partially work, or, as you say, stop it working altogether.”
“But it wouldn’t cause the damage Jane Carter had been subjected to,” persisted Gardener. “We need to try and find out how she was killed, and who killed her. Was the mark on her abdomen clear enough to identify any tread pattern from the footwear?”
“No.”
Chapter Twenty-seven
Gardener was the last person through the door. Despite the late hour the team were enthusiastic, huddled together in small groups, discussing what they’d learned during the day. He was hoping for positive results.
With the door closed, signalling the start of the meeting, he strolled down the left side of the room, noticing Maurice Cragg had once again pulled out all the stops. On top of one table they now had an old tea urn with a number of empty cups and saucers lined up. There were bottles of water and the usual leftovers from the bakery – most of which had been snaffled by the others. There was, however, one chicken salad wrap, which had his name on; he scooped it up as he passed, along with a bottle of water.
Cragg had updated the whiteboard with all the information discussed in the previous meeting, and more photos had been added.
Before starting, Gardener realised he wasn’t last. One of his team was missing. “Anyone seen Colin?”
Most shook their heads.
“Not since this morning,” said Rawson.
“Anyone heard from him?”
“Come to think of it, no.”
Gardener found it very unusual that Sharp hadn’t shown. He glanced at the clock on the wall. It said eight-thirteen.
“Okay, let’s crack on. We have a lot to get through tonight, and if any of you have had the kind of day Sean and I have had, we’ll be here forever. We spoke to Jane Carter’s solicitor today, as well as Fitz. Both had some interesting things to say, but I’ll fill you in later.”
Gardener pointed to Dave Rawson first. “How did you get on with Carrie Fletcher?”
“Sorry, boss, couldn’t find her.”
“What do you mean?”
“She wasn’t home.”
“Why don’t I like the sound of this?” Reilly asked.
“I went straight away after you called me,” continued Rawson. “Knocked on the door a few times, went round the back – no answer. There was no car on the drive, and from what I could see, it wasn’t inside the garage.”
“Did you speak to her neighbours?” Gardener asked.
“Yes, one on each side. They hadn’t seen her for a few days, ‘since that nasty business’ was how they put it.”