Chameleon (21 page)

Jamieson had to work at keeping the anger he felt under control. He said, 'You have just prevented the examination of the surgical instruments in your theatre by spreading them all over the floor. I think that demands some explanation.'

'What the hell are you talking about?' rasped Thelwell. 'That idiot from Microbiology barged right into me. A typical Richardson protégé. Now, if you will be so kind, I have things to do.' Thelwell sat down and started to read his mail. He pretended that Jamieson was no longer standing there.

Jamieson said slowly and quietly, 'I want to know exactly what you did with the instruments you collected from CSSD yesterday.' He watched Thelwell carefully for his reaction.

Thelwell stopped reading, settled back in his chair and let out his breath in a long, slow sigh. 'My, we have been busy,' he said.

Jamieson waited for his answer.

'I brought them back here.'

'Where?'

'Here, to my department.'

'Why should a consultant surgeon play at being a hospital porter?' asked Jamieson slowly.

'Because this consultant surgeon cares enough about his patients to monitor the sterilising of the instruments to be used in their operations and then make sure that they are not tampered with before they are used.'

Jamieson found himself taken unawares by the directness of Thelwell's answer. He had to be careful. He wasn't dealing with a fool. Was the man just clever? Or very clever? Clever enough to pretend that he was investigating the very act that he could see he was about to be accused of?

'Tampered with?' said Jamieson.

'It occurred to me that this was a possibility,' said Thelwell.

'I see,' replied Jamieson. He tried to trap Thelwell by saying, 'So yesterday you brought the instruments up to the theatre from CSSD and put them away in the theatre instrument cupboard yourself?'

'Not exactly,' said Thelwell, walking round the trap. 'I kept them locked away in my desk overnight. I put them in theatre this morning shortly before the operation was about to commence.'

'And the instruments that already were in theatre?'

Thelwell unlocked the cupboard in the left pedestal of his desk and brought out the packs he had substituted. 'I was going to take them back to CSSD for re-sterilising.'

'Have you any reason to believe that instruments have been tampered with?' Jamieson asked.

'Just a precaution,' replied Thelwell. 'But I felt it was warranted. As the same thought has obviously occurred to you, you can hardly argue the point.'

Jamieson stayed silent.

Thelwell said, 'I can assure you that the instruments Evans dropped on the floor were absolutely sterile and had been under lock and key here in my office ever since they were removed from the autoclave in CSSD.'

'I see,' said Jamieson. He had not managed to trick Thelwell into lying or saying anything that might not conceivably be true. 'Perhaps we can compromise?'

'On what?'

'On an agreed procedure for sterilising and storing instruments and dressings,' said Jamieson.

'What do you have in mind?'

'I suggest that instruments are not stored in the theatres at all. I suggest that they are collected fresh from CSSD immediately before they are required.'

Thelwell thought for a moment and then said, 'Agreed.'

'I'll take these back down with me,' said Jamieson nodding to the packs from Thelwell's desk. Thelwell handed them over.

Jamieson returned to his room in the lab after setting up the new procedure for instruments with CSSD and the administration people. Moira Lippman asked if he had a moment to speak. He said that he had but then his phone rang. It was Macmillan from Sci Med.

'Time of death on the murder in Leeds last night has been set at some time between ten thirty and eleven.'

Jamieson thanked him and put down the phone. He had been hoping for a time of death after eleven thirty when Thelwell had returned home but that comfort had been denied to him. He tapped the end of his pen on the desk while he thought. Behind him, Moira Lippman cleared her throat to remind him of her presence.

'Sorry,' he said. 'I was miles away.'

'I repeated your tests on the Pseudomonas,' she said.

Jamieson smiled. 'What happened?'

'You were quite right. There were three significant differences in terms of biochemistry. In fact I did some extra tests and found two more.'

'Five?' exclaimed Jamieson.

Moira Lippman nodded. 'Very strange,' she said. 'In fact one might almost think that ... No, it's silly.'

'What is?'

'No, really. It isn't worth mentioning.' With that Moira Lippman turned on her heel and left Jamieson alone again.

Jamieson reflected for a moment on how much he hated when people did that.

The first indication that all was not well in the post-surgical care ward in the Gynaecology department, came at three thirty when Hugh Crichton called Jamieson and said, 'You did ask to be kept informed of any other surgical infections breaking out in the hospital?'

'Yes.'

'It's beginning to look as if several women in surgical gynaecology who had their operations within the last ten days have developed fever and signs of wound infection.'

Jamieson closed his eyes for a moment then said, 'Go on.'

'There's not much more to report really. Samples are on their way down to the lab for bacteriology. I just thought you should know.'

'How are the women?' asked Jamieson.

Crichton cleared his throat nervously before replying, 'They are rather ill actually. It all happened very suddenly and their condition has been worsening all the time.'

'Thanks for telling me.'

Jamieson put the phone down and cradled his head in his hands for a moment while he thought. More infection and again in Thelwell's unit. If the damned Pseudomonas strain was responsible again the whole place would have to be closed down. There was no alternative. He went to talk to Clive Evans.

'I've just heard,' said Evans when Jamieson entered. 'The specimens will be here at any moment.

'So you will know by tomorrow morning if it's the Pseudomonas to blame?'

'Tomorrow for sure but we can do a few microscope slides on the specimens directly. We should be able to get an idea from them.'

'How long?'

'Half an hour.'

'Let me know as soon as you have a result, will you?'

'Of course.'

Jamieson was trying to call Sue for the fourth time that day and still without success when Clive Evans came into the room. Jamieson could see that he had the results of the primary tests. He replaced the receiver.

'I've just had a look at the stained slides,' said Evans.

'And?' asked Jamieson anxiously.

'I don't think it's the Pseudomonas.

'You don't?' exclaimed Jamieson.

'They're Gram positive cocci rather than Gram negative rods.'

'So what do you think?'

'All the indications at the moment are that it's a Staphylococcus infection,' said Evans.

'A different infection?' said Jamieson sounding bemused.

'It seems to be, but we won't know for sure until the morning when the cultures have had time to grow up.'

Jamieson turned away, wresting inside his head with the implications of what Evans had said. 'Another outbreak of post-operative infection in the same unit but caused by a completely different bug?' he murmured.

'That's how it looks,' said Evans. He could see that Jamieson was deep in thought so he said, 'If you'll excuse me, I've got things to do.'

'Thanks,' said Jamieson absently.

Jamieson walked over to Gynaecology at six thirty. The condition of the infected women in had worsened and there had been speculation that some of them might actually die before morning if the right antibiotic was not found. The choice of antibiotic treatment had already caused disharmony between Thelwell and his team. They were all agreed that penicillin was proving ineffectual. This was not too surprising because most hospital strains of Staphylococcus had become resistant to the drug over the years but Thelwell's insistence that Cephalosporin should continue to be used and Morton's insistence that it was having not having an effect either was causing tight lipped anger all round. Jamieson intervened to suggest that they treat the women with more than one antibiotic at the same time. After a brief discussion they agreed on a regime of three drugs with close monitoring of the patients' condition so that the regime could be altered if it was proving ineffectual.

Jamieson took the ward sister to one side and asked her about the infected patients. 'How many patients do you have in the ward Sister?'

'Seventeen.'

'And of these only eight have become infected?'

'So far,' said the sister.

'Do the eight have anything in common?' asked Jamieson.

'I don't understand.'

'I'm looking for the reason why eight of the seventeen patients have developed wound infections and the other nine didn't. Did they all have their operation on the same day? In the same theatre? Were the operations performed by the same surgeon? That sort of thing.'

'I'll check for you.'

Jamieson followed the woman to the ward duty room and waited while she checked the records. He became aware that his presence at her shoulder was making her uncomfortable so he turned away and looked at some post-cards pinned up on the wall until she had finished. Two were views of sun-splashed beaches in the Mediterranean; the rest were saucy sea-side cards almost invariably featuring large bosomed nurses and captions of the 'Blimey Nurse!' sort.

'Only two had their operations on the same day,' said the sister. 'Some operations were carried out by Mr Thelwell others by Mr Morton. Some were done in Gynae; three were done in the Orthopaedic theatre. No obvious common factor.'

'There must be one,' maintained Jamieson. 'If they all became infected at the same time there must be one.'

'I can't think,' said the sister.

'Nor can I at the moment,' agreed Jamieson, racking his brain. 'But there has to be a common link. There are just too many for it to be chance wound infection with an airborne bug.'

A nurse came into the duty room and apologised for interrupting before saying, 'Sister, it's Mrs Galbraith. She's very ill.'

The ward sister left the room. Jamieson could hear cries of pain coming from the ward. He left and returned to the residency.

As he climbed the stairs Jamieson thought he heard a slight sound on the first landing as if someone were standing there. He paused but now could hear nothing. Normally this would not have merited any consideration at all but his nerves were taut. There was something strange going on in this hospital, maybe even something evil. The knowledge brought fear and suspicion with it. He continued up to the head of the stairs but was cautious about turning the corner. The thought that someone was lurking there had become almost unbearably strong. He made noise with his feet to suggest that his next step would bring him round the corner and then drew back his right fist. An arm emerged from the shadow and Jamieson prepared to let fly. He only just managed to stop himself in time when he caught a glimpse of the wrist and realised that it was a woman's.

'What the hell!' he exclaimed grabbing the figure by both wrists and pulling her out of the shadows.

'Steady on!' said Sue. 'Why so jumpy?'

Jamieson was speechless with surprise and dismay at what had almost happened. 'What on earth!' he exclaimed. 'I nearly laid you out.'

'I can think of better welcomes,' said Sue. 'Why so nervous?'

'What are you doing here?' exclaimed Jamieson. 'I've been trying to contact you all day.'

'Do we have to speak on the stairs?'

Jamieson opened his door and they both went inside.

'I was feeling guilty about how I treated you on the phone yesterday so I thought I would come up and say I was sorry. The people in the gate-house told me where you were staying. I saw you start to cross the courtyard when I came in the front door so I thought I would give you a surprise.'

Jamieson shook his head and took her in his arms to hold her close. He was still upset at what had happened. 'You're crazy,' he murmured.

'Some welcome.'

'I'm sorry. It's lovely to see you but ...'

'Relax. I don't intend interfering in anything. Daddy has arranged accommodation for me in the town so I won't be in your way.'

'Your father?' said Jamieson.

'Don't go all cold on me,' said Sue. 'He doesn't interfere a lot in our lives and you know it. He has money and he likes to see me happy so where's the harm? I wanted to be near you especially right now.'

'Why right now?' asked Jamieson.

'Because I'm pregnant,' replied Sue.

TEN

'That is absolutely marvellous!' exclaimed Jamieson enfolding Sue with both arms and holding her tightly. He rested his cheek on the top of her head.

'You're sure you're pleased?' asked Sue, her voice betraying evidence of doubt.

'Pleased? How could you think anything else? I'm absolutely delighted! I can't begin to tell you how glad I am,' said Jamieson, letting Sue go and spreading his hands as if appealing for divine assistance. The look on his face now left Sue in no doubt about how he felt and their eyes met in one of these moments when two people in love achieve almost perfect communication. It made Jamieson think momentarily on the last time it had happened. It had been near the end of his time in hospital after the accident. It had been on the day he had realised just what an insufferable fool he had been and he had apologised to Sue for his behaviour.

For Sue, it had been the moment when she knew she had got her man back. The change in Jamieson's personality had not been permanent as she had feared in her worst moments. The self-pitying, sarcastic monster she had been putting up with for months had vanished. After Jamieson's apology they had looked at each other without saying anything but understanding everything. Sue had cried for the first time since the accident but the tears had been of relief and happiness.