‘
Mr Jones, I presume.’ I held out a hand. ‘Do come in. These good people have been telling me all about you.’
‘
Oh?’ he said, almost nervously.
Stephen
was staring at him curiously. I said, ‘You obviously met some of them yesterday, but I’ll introduce you anyway. This is Dr Wall, senior registrar …’
‘
Pleased to meet you,’ he said eagerly, offering a hand.
He
simply wasn’t the same man. He’d somehow turned himself into, well, a minor government official, to use his own words — bland and eager to please almost to the point of obsequiousness.
‘
Exactly what sort of information is it you’re looking for?’ Stephen was asking him.
‘
Patient/staff ratios, types of staff, success rates, and perhaps most importantly, how the work of this unit interfaces with the work of other units and departments in this hospital.’
‘
Why?’ Stephen demanded, then smiled. ‘You’re not planning to close us down, are you?’
‘
Oh no, nothing like that, I assure you. The government wants to know how hospital departments interface, so as to ascertain whether there are savings that could be made in that area.’
Masterly,
I thought. Believable for its very vapidity.
‘
I see,’ said Stephen. ‘Well, I hope —’
‘
Telephone, Dr Wall,’ said James behind him and he excused himself.
‘
This is Viv Aldridge, nursing sister,’ I said, continuing with the introductions. ‘And James Croxall and Emma Riley, staff nurses.’ He nodded pleasantly to each of them.
‘
How long will you be here, Mr Jones?’ asked Viv.
‘
A few days at the most. Please don’t mind me. Just carry on working as you would normally.’
He
’d allowed his London accent to become more marked; at the same time carefully enunciating his Hs and Ts, sounding very much the working-class boy made good. It certainly made him seem harmless.
The
doorway darkened and I looked up to see Miss Whittington.
‘
Good morning, Sister, Mr Jones. You’ve managed to find each other, then?’
‘
Yes, indeed,’ said Jones.
‘
Good. Perhaps we could go into your office for a few moments.’
‘
Certainly, Miss Whittington.’ My, we
are
all being polite today, I thought, glad she wouldn’t be able to bring up the subject of the ‘stress’ I’d been under.
Once
inside, I listened respectfully while she told me what I already knew, viz, the ostensible reason for Mr Jones’s visit, fishing as she did for any hidden motive that might affect her. I nodded and said ‘yes’ in the right places, reflecting that it must be her way of keeping on top of things.
After
she’d gone, he said quietly, ‘Is she always like that?’
‘
Yes. I sometimes wonder whether she’s slightly paranoid.’
‘
She’s said nothing more to you about the dead patients?’
‘
No. Not since a few days after I first spoke to her.’ I glanced up at the clock. ‘If I’m to show you any of the ward before the round, we’d better start now.’
‘
All right.’ He stood up. ‘Has anything been said about last night?’
‘
Nothing.’
I
took him to the gowning lobby, where he put on the gown I handed him without any help.
‘
You’ve done this before,’ I remarked.
‘
Yes.’
Inside,
Emma was at the nurses’ station, while James, Armitage and Pete Hadley were sitting with patients. Susan was taking blood from another.
I
glanced at the clock. A quarter-to.
‘
Everything ready for the round?’ I asked Emma.
‘
Yes.’ She nodded vigorously.
‘
No problems?’
‘
None.’
I
took him round the ward, telling him quietly what was wrong with each patient before explaining the functions of the monitors and other bedside equipment, and introducing him to Armitage, Hadley and Susan. They all looked slightly surprised. I don’t usually introduce visitors to them.
‘
What are these rooms, Sister?’ He pointed to the isolation rooms and I explained.
‘
The patients in these two are recovering from renal transplant. They’re on immunosuppressive drugs, which means they’re —’
‘
They’re susceptible to infection,’ he finished for me.
‘
That’s right.’ I acknowledged a wave from Sophie Marsh who was sitting with one of them.
‘
How long will they have to stay there?’ he asked.
‘
Until the transplant’s taken and the immunosuppressives can be reduced. Could be days or weeks.’
‘
Who’s in this room?’ He pointed to the third.
I
glanced round before saying in a low voice, ‘That patient died yesterday in another ward. He’s being kept on life support for organ donation.’
‘
A rather morbid contradiction in terms. A dead patient on life support.’
‘
You know what I mean.’
‘
How long will he stay there?’
‘
Until an organ match is found. Then he’ll be moved to the site of the transplant operation.’
Then
there was a stir and the whole ward seemed to come to attention as Mr Chorley and his retinue filed in.
‘
The ward round,’ I said.
We watched as they approached the first bed and Viv explained something to Mr Chorley. She was looking very much at home, I observed a trifle sourly.
‘
Can you tell me their names?’ Tom said quietly.
‘
The man talking now, that’s Mr Chorley, the consultant. Stephen Wall, you met. The others are Ian Hadmore, senior house officer, Paul Ridware and Jill Newton, house officers.’ I went on to explain how the round was conducted.
‘
Do any of them carry out invasive treatments on the patients?’
‘
Mr Chorley, very rarely. The others, yes, although it varies.’
We
watched a little longer, then he said he’d seen enough for the moment, we de-gowned and I showed him round the rest of the unit.
We
’d seen the pantry and sterile preparation room, and were in the relatives’ room, which was empty at the moment. He said, ‘I noticed that a lot of the patients had a nurse actually sitting with them — is that usually the case?’
‘
Much more so than in an ordinary ward. Each patient has a nurse with them at least half the time.’
‘
Is it always the same nurse?’
‘
Usually, although not necessarily. For instance …’ I told him about Emma and Mr Phillips.
‘
So the same nurse would also always give the patient an injection, or any other such treatment?’
‘
Same answer — usually, but not necessarily.’
He
thought for a moment. ‘So wouldn’t that make it rather difficult for a nurse, or a doctor, to just go up to a patient and say:
It’s
time
for
your
such
-
and
-
such
,
Mr
Bloggs
, and inject him with something that killed him?’
It
was my turn to think.
‘
It would make it more difficult, yes. But it would depend on who they were, on their authority and how well they knew the system.’
‘
But surely it would be risky? I mean, if Mr Bloggs was your patient, and you went in and saw another nurse giving him an injection, wouldn’t you want to know why?’
‘
Yes, but if they said:
Because
Dr
Brown
told
me
to
, that would answer it.’
‘
Still too risky. Too easily checked.’
‘
I suppose so …’
‘
We’re looking for somebody, or something, that would obviate that risk.’ He took a breath. ‘Where d’you keep your fluids for drips and suchlike?’
‘
In the store, just across the corridor.’
That
was empty as well. I showed him the drip sets, which were sealed in tough plastic bags.
‘
Are these ever opened in here?’ he asked.
I
shook my head. ‘Each bag contains four sets, so we take two or three bags at a time into the ward and open them there.’
‘
But it would be quite easy for a doctor, or nurse, to smuggle an unused set out of the ward?’
‘
Er — yes, I suppose it would. But surely it would be obvious if one had been tampered with?’
‘
Would it? Can I open one of these?’ Without waiting for an answer, he took out his penknife, slit one of the bags open and pulled out a set. ‘You lift the label so,’ he said, gently sliding the point of the knife underneath the label on the plastic pack and twisting the blade. ‘You inject your poison, then stick the label back down with glue. Who would know?’
I
shook my head. ‘Where did you learn that?’
He
smiled, rather sadly. ‘I’ll tell you some other time.’
‘
You think that’s how it was done?’
‘
It’s a possibility. It would certainly overcome the problem of being spotted giving an illicit injection.’
‘
But how would the killer know which patient was going to —? Oh … I see what you meant now about whether the killings are planned or random. But how are we going to work out which?’
‘
The patient records on computer might help us there. You did say all treatments are recorded?’
‘
That’s right.’
‘
Shall we go and look at them?’
‘
If you like. I thought you said yesterday you wanted to see the Coronary Care ward?’
‘
I did, didn’t I? Shall we do that quickly first?’
Coronary
Care is a bit more like most hospital wards —about twenty patients, with a much lower staff/patient ratio, not so much high-tech equipment and no gowning air-lock. Mr Chorley and his caravan had just started their round there.
I
introduced Tom to the sister in charge, quickly pointed out the ward’s features, then we returned to ITU.
‘
And that’s where a patient would be transferred when their condition had improved in ITU?’ he said when we were in the corridor.
‘
Yes. Or perhaps the Medical ward.’
He
lowered his voice. ‘Easier to kill someone in there, I’d have thought. Not so many nosey nurses to worry about.’
‘
True.’
‘
And yet only two of your group of eight died there. I wonder why? Opportunity? Something else we haven’t thought of?’
‘
I don’t know,’ I said slowly. ‘Although, because of its nature, there are more deaths anyway in ITU than in other wards …’
‘
So a sudden death wouldn’t be so unexpected …’ he said. ‘Like the wood and the trees. It took half a dozen sudden deaths before you spotted anything, and even then, nobody else believed you.’
We
arrived at ITU and went through to my office. Viv was in the Duty Room.
‘
Everything go all right?’ I asked her.
‘
No problem. I enjoyed it.’ She grinned. ‘How long did you say you’d be here, Mr Jones?’
‘
Mm? Oh, only a few days.’
‘
There’s no rush. Don’t hurry on my account.’
‘
Oh, I wouldn’t do that,’ he said seriously. Viv made a face as we went into my office.
As
soon as I closed the door, he said, ‘Is it reasonably soundproof in here?’
‘
Reasonably. If we keep our voices down.’
‘
Are we likely to be disturbed?’
‘
It’s a possibility, since I am supposed to be the sister in charge. Although people usually knock when they see my door’s closed.’
‘
Then shall we have a look at the record of one of the patients who died?’ He indicated the computer terminal. ‘If anyone does come in, you’re just showing me how the system works.’