The Nursing Home Murder, Ngaio Marsh (Roderick Alleyn #3). New York: Felony & Mayhem, 2011 (originally published in 1935).

Summary: The Home Secretary collapses of acute appendicitis during a speech on a key bill against radicals and is taken to a private hospital of an old doctor friend for emergency surgery, dying under suspicious circumstances soon after the operation.

Spoiler notice: The review includes a plot summary, without giving away the conclusion.

The Home Secretary, O’Callaghan, has put the final touches on a bill against anarchists and the Prime Minister’s cabinet is ready to press it forward. It will be dangerous for O’Callaghan, who will lead the effort. People have been assassinated for less. But O’Callaghan is fighting enemies on other fronts. He is suffering from the symptoms of appendicitis but is trying to gut it out until passage of the bill. Then there is the woman he’d had a sexual liaison with. Both were approaching it with a progressive attitude, except the woman, Jane Harden, cannot. She has fallen in love and written both touchingly and threateningly in several letters. Then a doctor friend, Sir John Phillips, who runs a private hospital nearby (the “nursing home” of the title) visits, not knowing O’Callaghan is ailing, and confronts him about the affair with Jane Harden, who is his theater nurse, and with whom he is in love. Jane will not consider him, having “given herself” to O’Callaghan. The meeting concludes unsatisfactorily, Phillips warning him, “You do well to keep clear of me” and threatening if he has the opportunity to “put him out of the way.”

His hypochondriac sister Ruth tries to help, pressing on him various patent medicines from her pharmacist friend as he tries to ignore the pain and get the bill through. Lady Callaghan remains more distant, not unsympathetic but letting him do what he must. But when he gets up to make a major speech on the bill, he collapses and under Lady O’Callaghan’s direction, unaware of the recent confrontation, is taken to Dr. Phillips hospital. He diagnoses a burst appendix, requiring immediate surgery. He wants to get another surgeon but Lady O’Callaghan insists he operate.

Dr. Philips is assisted by Dr. Thoms, an eccentric anesthetist Roberts, Sister Marigold, the head nurse, Nurse Banks a gruff nurse active in communist agitation and outspoken in her antipathy for O’Callaghan, and Nurse Harden. Various injections, including hyoscine, used for abdominal pain, are given. Phillips personally prepares the hyoscine injection and administers it. The operation comes off but O’Callaghan’s pulse is weak, his condition worsens and he dies shortly after.

It was thought this was due to the neglect of the appendicitis but Lady O’Callaghan suspects foul play, having come into possession of the letters from Jane Harden and learned from O’Callaghan’s personal secretary, Jameson, that Phillips had spoken threateningly to O’Callaghan. She speaks to Alleyn, who had been handling security on a discrete basis for the Home Secretary, and he is persuaded there is credible cause for an autopsy and inquest. The coroner finds he’d received on overdose of the hyoscine, enough to easily kill him.

Beyond the obvious suspect, Dr. Phillips, Alleyn must consider a host of possibilities. Jane Harden certainly had motive. Nurse Banks hated what O’Callaghan stood for and was active in the communist party. Was she part of a plot to kill him? Roberts was also at the party meeting. Dr. Thoms happened to talk about the lethal dose of hyoscine. Was Ruth an unwitting accomplice in his death? What was in the patent medicines mixed by the pharmacist, who also happened to be part of the local communist party?

In addition to the intrepid Fox, Alleyn draws upon the help of his newspaper friend Bathgate and his girlfriend Angela, who help with a bit of undercover work at a party meeting. None of this seems to bring him closer to the killer, although Alleyn has growing suspicions, until a fluke event exposes the killer.

This is classic Marsh–a host of suspects, an effort to follow movements to see who really had motive, means, and opportunity, with a lot of cogitating with Fox and Bathgate. It can seem a bit formulaic at times, although I’ve always liked the books with Bathgate. But formulas can be like recipes, it’s the little “extras” that keep the dish from being ho-hum. The batty siater, Ruth, the crusty communist, Nurse Banks, the eccentric Roberts with his crazy theories, and the noble Roberts who we so want not to be guilty and to find love with Nurse Harden, that makes it all interesting.