Chameleon (23 page)

Moira Lippman put down the tubes she had been holding and laid her hands flat on the bench in front of her. 'My sister in law is one of the infected women,' she said quietly.

'I'm sorry. I didn't realise,' said Jamieson softly. 'How is she?'

'Very ill. They all are.' Moira Lippman swung round in her chair and looked directly at Jamieson. 'There's something crazy going on here,' she said.

'Go on,' said Jamieson.

'It's a Staphylococcus infection this time yet it's behaving in exactly the same way as the Pseudomonas. None of the usual antibiotics are having any effect at all. We are having to run a race to find alternative drug combinations. Two highly drug resistant infections in a row. How can that be?

'Infections that are resistant to treatment are not unknown,' said Jamieson.

'But two in succession? In the same department? There's something not right about this whole affair.'

'If it's any comfort I share your disquiet,' said Jamieson. 'I can't say more than that at the moment.'

Moira nodded and shook her head slightly. She returned to what she was doing.

Jamieson left the lab to return to the residency. As he crossed the courtyard he saw two porters emerge from the side door of Gynaecology. They were wheeling a covered trolley in the direction of the mortuary.

'Can't you sleep?' whispered Sue.

'I'm sorry. Did I wake you?' replied Jamieson in the dark.

'It's all right. What's on your mind?'

'Something Moira Lippman said when I spoke to her earlier. She said that there was something 'not right', to use her expression, about there being two such virulent infections occurring in the same department.'

'You mean the possibility of deliberate contamination has occurred to her too?' asked Sue.

'No I don't think she was going that far,' said Jamieson. 'Moira was talking purely about the organisms involved.'

'I don't see what you are getting at,' said Sue.

'How would you go about contaminating surgical instruments if you had to?' asked Jamieson.

'What a question. I suppose I would just break the sterility seal and expose them to the atmosphere for a while. Maybe drop them on the floor. Spit on them? I don't know really. Something like that.'

'And then they would be unsterile?'

'Yes of course, wouldn’t they?'

'Indeed they would but just think for a moment. Take it a step further. What sort of organisms would they be liable to attract?'

'Oh, I think I see what you mean,' said Sue. 'Your chances of picking up something really nasty are pretty remote?'

'Exactly. I'm not saying it’s impossible but it's not all that likely. If it were, all of us would be sick all of the time. Nasty pathogens are few and far between, thank God.'

'So doing it twice and on two separate occasions would be even more unlikely.'

'Yes,' said Jamieson. 'I think that there's more to it than just breaking the sterile seal on the packs.'

'If the criminal were a carrier of a virulent organism it would be possible for him to contaminate the instruments or dressings from his own secretions,' said Sue.

Jamieson nodded but said, 'Again, the chances of him carrying two deadly organisms are so remote as to be ridiculous. And how would he separate them?'

'I see the problem,' agreed Sue. 'So how did he do it, assuming that there is a 'he'? Any ideas?'

'None,' admitted Jamieson.

'You said that you thought Dr Richardson had some notion about the first organism?' said Sue.

'But he never told me what it was,' said Jamieson.

'Maybe he told someone else?'

'Like who?'

'His wife maybe?'

Jamieson turned and kissed Sue on the cheek. 'Now I know why I love you,' he whispered. 'You're pure dead brilliant.'

Jamieson was surprised to find Moira Lippman in the lab again when he arrived at eight. 'You're back early!' he said.

'I didn't go home. It wasn't worthwhile. There was so much to do last night.'

'You must be exhausted,' said Jamieson.

'I'm OK. I couldn't have slept anyway knowing what Marion is going through.'

'How is your sister-in-law this morning?' asked Jamieson.

'She's very weak and the new drugs are not having much effect.'

'I'm sorry,' said Jamieson. 'Have you looked at the cultures yet?'

'Dr Evans was right. It's a Staphylococcus all right. It's immune to all the penicillins, even the pen'ase resistant versions. Erythromycin is out as well. But I have come up with something.'

'Really? What?'

'Some months ago the hospital took part in a clinical trial of a new antibiotic from Steadman Pharmaceuticals; it was called Loromycin. I carried out the lab work for the trial and I still had some of the drug sitting in the fridge. I tried it out on the Staphylococcus and it worked. The medics could use it if they can get some more from the company.'

'Well done,' said Jamieson. Have you told them?''

'I called the ward ten minutes ago. They still have a few dozen injection vials left over from the trial. Mr Morton has started the women on them while Mr Crichton gets in touch with Steadman for further supplies.'

'What a bit of luck,' said Jamieson. 'I only hope it's not too late.'

Moira nodded.

'Did you recover the organism from the dressings?'

Moira Lippman nodded. 'You were right about that. The dressings were heavily contaminated with the Staphylococcus. There's no doubt that they were to blame for the outbreak this time.'

Jamieson admitted that the idea had been his wife's.

'She's a doctor too?' asked Moira.

'A nurse.'

'Smart lady,' said Moira.

'She's here in the hospital,' said Jamieson. 'She arrived yesterday.'

'Not so smart,' said Moira.

Jamieson checked his watch, got up and said that he was going over to CSSD to check on the sterilisation record of the dressings. He met Clive Evans coming into the lab as he was going out and told him that he had been right about the infecting organism. Evans nodded and said that the microscope slides had been clear. Jamieson told him that Moira Lippman had been on duty all night and obviously needed some rest.

'I'll make her go home,' said Evans.

'Did you know her sister-in-law is one of the infected women?' asked Jamieson.

'No I didn't,' confessed Evans.

'She's very ill,' added Jamieson. He told Evans about Moira's success in coming up with an effective antibiotic. 'With a bit of luck, we can beat this damned thing after all,' he said.

'We could do with a bit of luck,' said Evans.

'We deserve it,' said Jamieson.

Once again Jamieson felt the humidity in the air engulf him like an all-embracing cloud as he walked through the swing doors to the CSSD department. It reminded him momentarily of visits to the hairdresser when he was young. Whatever the weather outside, it was always warm and moist inside the little shop in the town. To get to the back shop where the men and boys were dealt with, he had to pass a row of curtain screened cubicles. Gaps in the curtains had afforded him glimpses of women reclining in complicated chairs while their hair was rinsed in white enamel basins. Others had metal umbrellas over their heads.

Charge Nurse Blaney was in the sterilising hall talking to one of the attendants. He stopped when he saw Jamieson approach and waited for him to draw near. He didn't smile.

'I need some more information,' said Jamieson.

Blaney did not say anything. He just nodded and waited for Jamieson to continue.

'A pack of unsterile dressings reached the post-op ward in Gynaecology. Ten 200mm dressings. Here is the reference number I took from it.' He handed Blaney a note of the number.

'That's impossible,' said Blaney, shaking his head.

'It happened,' said Jamieson. 'I want to see the recorder chart from the steriliser run.

Blaney shrugged his shoulders and, still shaking his head he said, 'It won't do you any good.' He went off to his office to return a few moments later with a circular chart in his hand. 'Perfect,' he said. 'See for yourself.'

Jamieson traced the line on the chart and saw that Blaney was right. The steriliser run appeared to have been perfectly normal in every way. 'So it didn't happen here,' he said with a sigh of frustration.

'I told you it was impossible,' said Blaney.

'How are the dressings delivered to the wards?' asked Jamieson.

'A porter takes them up.'

'Always?'

'What do you mean?' asked Blaney.

Jamieson caught the aggression in his voice and knew that his allusion to the Thelwell making his own collection had rankled the charge nurse. 'It's a simple enough question, try answering it.'

The edge to Jamieson's voice put an end to Blaney's own aggression. 'Yes, always,' he said.

'Would it be possible to determine exactly what happened to that dressing pack when it came out of the steriliser?' asked Jamieson.

'Up to a point,' said Blaney.

'Let's do it,' said Jamieson quietly and fixing Blaney with a look that suggested any obstruction on his part might not be such a good idea.

Blaney led the way to his office and started leafing through a pile of papers. He pulled out a yellow sheet of paper and matched it against the chart he still held in his hand and said, 'This is the commissioning form that went with that particular steriliser run. There are three signatures on it. John Hargreaves because he was the attendant who loaded the dressing packs into the autoclave and who started the run, Dr Evans' because this was one of the monitored safety check runs and mine because I checked the chart afterwards and passed the load fit for distribution to the wards.'

'Then what?' said Jamieson.

Blaney read some more from the form and said, 'The load was held in the clean store until the following Friday when it was signed out and taken to Gynaecology.'

'By whom?'

'One of the general porters. I don't know who but the dressings were signed for by Staff Nurse Kelly on arrival in the ward.'

'On the same day?' asked Jamieson.

'Yes.'

So there had been no delay between the dressings leaving CSSD and them reaching their destination, thought Jamieson. If they had been interfered with it must have been in the three day period before they were used when they had been stored on the ward or alternatively at some time in the two days they had lain in the clean store in CSSD. The latter was something he had not considered before. Supposing the instruments and dressings had been contaminated before they had even left CSSD? The thought chilled him. He looked at Blaney's eyes and saw nothing but sullenness.

'Who looks after the clean stores?' asked Jamieson.

'I do,' said Blaney.

'I'd like to see them.'

Blaney shrugged non-committally and led Jamieson to a long narrow room filled with free-standing metal racks bearing instrument and dressing packs. There were no windows in the room and above them a fluorescent light tube buzzed intermittently. Blaney stood mutely in the doorway while Jamieson walked up and down the narrow gangways. Jamieson had not expected to find anything amiss. He had merely wanted to observe Blaney's reaction to his being in the store. He was alert for any sign of nervousness but Blaney remained inscrutable throughout.

'Will that be all?' Blaney asked when Jamieson had finished his inspection.

'For the moment.'

Jamieson obtained Claire Richardson's telephone number from Hugh Crichton and called her just after half past eleven. He said that he would like to have a chat with her if at all possible.

'What about?'

'About your husband.'

There was a short pause then Claire Richardson said with more than a trace of bitterness in her voice and a slight slurring. 'Now there's a novelty. I got the impression that everyone in that damned place was pretending that John never existed. Apart from Clive Evans and Moira Lippman no one even turned up at his funeral. Bunch of bastards. Clive gave twenty years to that damned slum.'

'I'm sorry,' said Jamieson and meant it. He had liked John Richardson.

'What do you want to talk about?'

'I'd rather tell you personally.'

'What the hell,' said Claire Richardson. 'When did you have in mind?'

'Would lunch be out of the question?' asked Jamieson tentatively. To his surprise he heard Claire Richardson laugh. She said, 'It's quite a long time since anyone asked me to lunch. I accept.'

They arranged to meet at a restaurant in town at one o'clock.

Jamieson had been waiting for only five minutes when Claire Richardson arrived. They shook hands and despite her smile, he noticed the air of sadness about her. She did not wear her grief like a badge but her eyes held a remoteness and detachment which told Jamieson that she had not yet come to terms with her loss. There was however, a basic intelligence and humour about the woman that was evident during the course of the meal and Jamieson decided that he liked Claire Richardson a lot. He guessed that she and John Richardson had been very happy together. They would have been good for each other.

Jamieson had feared that conversation might be difficult but this proved far from being the case and he enjoyed the meal from start to finish. When the waiter finally brought coffee Claire lit up a cigarette and said through a puff of smoke, 'Now, what was it you wanted to know?'

'Did John speak to you about his work much?' asked Jamieson.

'He told me everything.'

'Then you know all about the infection problem in Gynaecology at Kerr Memorial?'

Claire Richardson threw back her head and gave a humourless laugh. 'Know about it!' she exclaimed. 'I lived through every hellish moment of it with John. The agonies he went through over not tracing the source of infection, his elation when he found Thelwell was carrying the bug and then ...'

'Then what Mrs Richardson?' asked Jamieson leaning forward slightly as a sudden cloak of sadness came over Claire Richardson and she stopped talking.

'I don't know. John began to have doubts. He seemed very troubled and clammed up totally which was so unlike him. We always shared everything. He locked himself away in his study and then ... well you know the rest.'