Chameleon (10 page)

'Cystitis. I'm taking ampicillin.'

For a moment Jamieson could not see what the girl was so upset about. Cystitis was a common enough complaint in young women, perhaps correlated with sexual activity and often attracting the adjective, 'honeymoon' but in this day and age this was hardly a matter for either secrecy or embarrassment. Then he realised what the problem must be. 'You didn't go to your doctor?' he said.

The girl shook her head.

'You took the drugs off the ward?'

Marion Fantes nodded.

Jamieson let out his breath in a long sigh then he said, 'You do realise that taking any drugs off the ward is an offence that renders you subject to instant dismissal?'

The girl nodded and said, 'Of course. It was a stupid thing to do. I suppose I just didn't think at the time. I quite often get cystitis and my doctor always gives me ampicillin. I suppose I just thought that this time wouldn't have been any different so I didn't bother with the trip across town and the forty minute wait in the waiting room. It's so depressing.'

'How long have you been a nurse?' asked Jamieson.

'Nine years.'

'Any thoughts of marriage?'

The girl gave a bitter laugh and said, 'It's ironic really. I got the cystitis after a week's holiday with my boy-friend in the Lake District. At the end of it we broke up for good and now this.' She looked at Jamieson with an air of resignation and asked, 'What happens now?'

Jamieson looked at the sorry figure in front of him and considered his options. The official line was easy to take. He should report the girl and she would be dismissed. End of matter. But there were more things to be considered in the circumstances. The girl was thirty-one? Thirty-two? She had lost her boy-friend and she wasn't the most attractive girl he had ever seen. What would happen to her if she lost her job as well, not only her job, but her career? He could see the threat of embittered spinsterhood looming large on her horizon. Her record said that she was an excellent nurse. Was it really right to destroy all that? The rules said that it didn't matter what drug was stolen or for whatever purpose.

Jamieson decided to disagree. Any girl who had spent eight years of her life working in institutions like Kerr Memorial and living in places like the Thelma Morrison Nurses' Home deserved personal consideration and it wasn't heroin she had taken, just ampicillin, an antibiotic that graced half the bathroom cabinets in the land. Jamieson took a deep breath and said, 'Nothing.'

'I don't understand,' said Marion Fantes looking puzzled.

'To-night you take a trip across town and you wait for forty minutes in the waiting room along with the screaming kids and the coughing bronchitics. You read old copies of Punch and What Car until the buzzer sounds for you and then you tell your GP that you've got cystitis. That is the way - the only way - you get ampicillin in future. You never ever take anything from the ward again. Understood?'

Marion Fantes looked as if she could not believe her ears. Her face lit up like a sunrise as she fought for words to express her gratitude. 'I'll never be able to thank you enough,' she said.

'Hop it,' said Jamieson. He looked at his watch again. It was time to go and see Thelwell. He wasn't looking forward to that. As he left the nurses' home, the singing porter was aiming for the top note of
Nessun Dorma
. He missed.

FIVE

Jamieson entered the Gynaecology Department through a side door but found the narrow passage leading to the stairs barred by a number of large cartons. Two orderlies stood in front of the boxes waiting for a service lift to descend.

'Won't be a minute,' said one of the men when he saw Jamieson come in. Jamieson nodded and waited. The lift was of the old fashioned type, completely open to view from all sides, more like an iron cage than a modern elevator. Jamieson saw its floor platform appear in the ceiling and then slowly brake to a halt at floor level. One of the men dragged back the concertina doors and the other slid the boxes across the floor for him to stack inside. His way now clear, Jamieson climbed the stairs and followed the signs to Thelwell's office. He knocked once and entered.

'Dr Jamieson?' asked the woman sitting behind a typewriter. 'Mr Thelwell is expecting you. Go right in. She pointed to one of the two dark, wooden doors behind her. G.T. Thelwell said the brass plaque which met Jamieson at eye level.

Jamieson entered to find Thelwell in conversation with Phillip Morton. Thelwell acknowledged Jamieson's arrival with a curt nod and moved in his chair as if to suggest to Morton that their chat was at an end. Morton took his cue and got to his feet. He smiled at Jamieson on his way out. 'How are the hands?' he asked.

'A lot better,' replied Jamieson.

'Take a seat,' said Thelwell.

Jamieson sat down.

'I am afraid our patient, Mrs Jenkins died this afternoon,' said Thelwell when the door closed behind Morton.

'I'm sorry,' said Jamieson. 'She must have gone downhill very fast.'

'What do you mean?'

'A little over a day from the onset of infection,' said Jamieson. 'Seems uncommonly quick.'

'What are you suggesting?' demanded Thelwell.

Jamieson could practically see the hackles rise on the man as he imagined some slur against his department. He kept calm and said, 'I am suggesting that the infecting organism is not only difficult to treat but is also unusually virulent.'

Thelwell realised he had been too quick to condemn and grunted. 'I thought you knew that. In all three cases infection has been followed by generalised septicaemia within twelve hours.

'I see,' said Jamieson.

'Well, what is it you want me to show you exactly?' asked Thelwell.

'Everything. The wards, the theatre, the recovery rooms, the scrub areas ... everything.'

Thelwell looked as if he might raise an argument but it came to nothing. He simply got up from his chair and said, 'We'd best get started then.'

As the tour progressed, Jamieson knew he was finding what he had expected to find, a well run, snappily efficient department, as good as any other in the National Health Service, certainly as clean and modern as its budget and the constraints of an old building would permit. He could see no obvious fault at all, either in terms of substance or procedure.

Thelwell outlined the departmental routine as he showed Jamieson around and Jamieson made notes but there was nothing out of the ordinary about anything he heard.

'Where do you store surgical instruments?' he asked as Thelwell finished showing him the gynaecological operating theatre.

Thelwell moved across the floor to a steel cupboard and opened it. There were three instrument packs, each with a CSSD label on it to indicate that they had been through the steriliser. Each one was date - stamped and initialled by the operator in CSSD who had checked them. There was a broad band of autoclave tape on each, its heat-stripe marker turned black, indicating that it had been held at the required temperature in the steriliser for a set length of time.

Jamieson nodded in satisfaction and Thelwell closed the door again. 'When are you operating again?' he asked.

'Tomorrow,' replied Thelwell.

Jamieson was surprised. He said, 'I thought we had agreed that surgery wouldn't recommence until the new recovery ward was made ready?'

'It's an emergency,' said Thelwell. 'But we have taken your wishes into consideration and arranged a side room downstairs as a personal recovery room for the patient.'

'And the case?'

'Ovarian tumour. It won't wait.'

'Orthopaedic theatre again?' asked Jamieson.

Thelwell shook his head and said, 'No, we know the infection has nothing to do with the theatre so I'm moving back in here but to-night this theatre is going to be disinfected from top to bottom including the ceiling just to make sure. All the surgical team were swabbed again today to make certain that no one is carrying the damned organism. After the operation the patient will be taken directly to the room I've just mentioned and specially nursed until she has recovered. The room, like the theatre will be cleaned and disinfected from top to bottom.'

'Well, I can't fault anything there,' said Jamieson.

'How kind of you to approve,' said Thelwell.

Jamieson ignored the jibe and said, 'I would like to attend the operation tomorrow.' He sensed Thelwell's resentment but the thin lips remained tightly closed and the face, apart from the eyes, betrayed nothing for fully ten seconds then he said, 'To what end might I ask?' He enunciated every syllable with meticulous care.

'Just to observe,' said Jamieson. His calmness seemed to annoy Thelwell even more.

'You haven't been swabbed,' said Thelwell.

'Yes I have,' replied Jamieson. 'I had myself tested in Microbiology before I came over here.'

Thelwell swallowed hard and conceded defeat. 'Very well,' he said. 'Be in scrub at ten, assuming your swab is clear.'

'Thank you.'

Thelwell looked at his watch and said, 'Now, if there's nothing else I have a choir practice this evening.'

'Actually there is,' said Jamieson making Thelwell stop in his tracks. 'I want to discuss your own swabs. I want you to explain two completely negative nasal swabs in the last two staff screenings.'

'I don't understand,' stammered Thelwell but Jamieson could sense that he did. He waited for something more and Thelwell gave in. He said, 'I always make a practice of using Naseptin cream in the interests of my patients. That's why my swabs were completely clear. It's a hard habit to break and I must have forgotten not to use it on the days swabs were taken.'

Jamieson let Thelwell dangle on the hook for a moment before stating the obvious. 'But the object of the staff screening exercise was to establish whether any of the staff might normally carry organisms that might be dangerous to the patients. If everyone sterilised their nasal passages before the test there would be no point in doing them ...' Jamieson knew that Thelwell was writhing in discomfort behind the apparently bland exterior.

'As I said,' said Thelwell, 'I must have forgotten to stop the cream on the days of the tests. I have a lot on my mind at the moment.'

Jamieson continued to stare at Thelwell, wondering if there was any more to come. His silence bore fruit. Thelwell said, 'All right if you must know, I did not want to give that idiot, Richardson any opportunity to embarrass me with his incompetence. That man would probably say he found typhoid in my naso-pharynx.'

Jamieson found it hard to maintain his composure. Was this a hospital or a lunatic asylum he wondered? Thelwell's paranoia must be bordering on the clinically significant but for the moment he had to keep things in perspective. He had to consider that Thelwell might be telling the truth about using the cream routinely. He said, 'Perhaps after tomorrow you might submit another screening swab to the lab?'

'Of course,' murmured Thelwell, embarrassed and anxious that this line of conversation should end.

'Enjoy your practice,' said Jamieson. 'A local choir?'

'Yes ... yes,' stammered Thelwell, uneasy with the change to social chit chat. 'St Serf's Church. We are doing the
Te deum
.'

'Nice,' said Jamieson inappropriately.

* * * * *

The man stood in the shadows of a shop door and watched what was happening down the road. The sluts were still there, flitting in and out of the darkness in their imitation leopard skin and leather but they didn't fool him. Half of them had warrant cards in their handbags and the Ford Orion that was parked in Clarion Street might just as well have a blue light on its roof instead of two clods eating sandwiches and looking at their watches. Did they think he was a complete idiot? Did they really think that he would try exactly the same line of attack? Walk into their puny little trap like some mental defective? There was no anger in the man's thinking. He was just surprised that they could be so stupid. Talk about bolting the stable door...

A bus loomed up from his right and pulled to a halt in front of him. He pulled up his collar and got on board. He would concentrate on other things this evening and the fact that the police would be out all night in the cold made the prospect all the more pleasant. Anyone who protected these filthy creatures deserved all the discomfort that was coming to them.

The bus stopped on the far side of the circle and the man got off, carrying his briefcase and pressing his hat a little more firmly on to his head. It had started to rain but it was only a short walk back to the basement flat and then he could get on with the evening's work. He turned into the lane that separated the main road from the street where the flat was situated and passed along it, carefully avoiding the piles of cartons and waste paper that had been bundled out for collection on the following morning.

The location of the flat was ideal for his purpose because all the surrounding buildings were in use as offices. At night there was rarely anyone about. The windows of the entire street were in darkness save for one upstairs light in the surveyor's office across the road from the flat. This was so unusual that it made him stop briefly in the shadows at the end of the lane and look up at it. He was curious. No one had ever worked late there before. His natural caution made him consider all possible implications.

As he watched, a young woman appeared at the window. She was laughing and, as she reached up to the cord for the blinds, a man came up behind her and slid his arm round her waist. The man in the shadows watched as the man in the window slid his hands up on to the woman's breasts and buried his face against the side of her neck. 'Fool!' he hissed, his eyes burning with anger as he watched the woman laugh again and reach up her hand to stroke her companion's hair. 'Can't you see she's trying to trap you?'

The venetian blinds snapped shut and the two figures were eclipsed leaving the man at the corner of the lane still staring up at the window. He swallowed twice and regained his composure. There was work to be done. He descended the basement steps and opened the door extra quietly. He did not want to give the couple across the street any occasion to look out of the window, not that that was likely he conceded. That poor fool would have other things on his mind. But, as ever, caution was of the essence.