‘
What do you mean by that?’
He
shrugged and changed the subject.
‘
You told me earlier that she was one of the founders of transplant surgery?’
‘
Yes. She carried out some pioneering research here at St Chad’s in the ’sixties.’
‘
Then I wonder why she is still here. I mean, I don’t want to be rude, but —’
‘
Ha
!’
‘
But that unit is pretty small beer,’ he finished. ‘Isn’t it?’
‘
Yes, I suppose it is. Latchvale’s not big enough to have its own transplant unit, not with Birmingham so near, but for some reason, she didn’t want to move away, so the unit stayed. Although it’s subordinate to the one in Birmingham.’
As
we arrived back at ITU, Viv emerged from the air-lock looking slightly flustered.
‘
Jo, could you come and sort out Mr Rogers?’ she said. ‘He thinks he’s dying.’
‘
I’ll be back in a minute,’ I said to Jones as I followed her. Actually, part of me couldn’t help being a little pleased; Viv did have a tendency to make one feel dispensable sometimes.
‘
Sister, you gotta help me,’ said Mr Rogers. ‘Get me a doctor, I’m having another heart attack …’
The
other patients, those who were able, were staring on in morbid fascination.
I
summoned my sunniest smile. ‘No, you’re not, Mr Rogers. Look —’
‘
But I got this terrible pain —’
‘
Yes, I know. Just here, I expect.’ I put my hand on his chest.
‘
Yeah, that’s right, it’s —’
‘
You always get pain there. It’s a sign that the drugs are working; that you’re getting better. Look’ — I pointed up at the cardiac monitor — ‘that’s your heartbeat. See?’ I traced it with a finger. ‘It’s exactly as it should be. Your heart’s doing fine, and so are you …’
Back
in the air-lock, Viv said, ‘I told him exactly the same things, but he wouldn’t listen.’
‘
It could have been the other way round with a different patient,’ I said, but I think we both knew that wasn’t true. Viv was a good nurse, but she sometimes found it difficult to conceal her impatience with time-wasters, as she called them.
‘
You seem to be getting on very well with Mr Jones,’ she remarked suddenly.
‘
How d’you mean?’
She
shrugged. ‘I don’t know. It’s almost as though you knew him before.’
‘
Well, I assure you I didn’t.’
‘
I didn’t think so.’ She hesitated. ‘He is a bit of a dickhead, isn’t he?’
‘
Not as much as you think,’ I said. ‘Not when you get to know him.’
‘
I’ll bear that in mind.’
By
now, we were back at the Duty Room. He was in my office. I don’t know why I’d defended him. It probably wasn’t doing him any favours.
‘
Shouldn’t you be with Dr Cannock?’ I said, glancing at the clock.
‘
I was waiting for you.’
‘
Me? Why?’
‘
I’d assumed you were coming with me. To show me where it is, apart from anything else.’
‘
It’s left down the corridor, then second —’
‘
Besides, I like having you with me, Jo.’
‘
I wish I could reciprocate that sentiment,’ I said pointedly. I did go with him, though.
When
we got to Pathology, his secretary led us past an array of spotless — almost fairground — machinery that emitted hums, buzzes and clicks and was tended by two white-coated figures, to Dr Cannock’s office.
‘
Come in, Mr Jones. Oh, hello, Sister,’ he added as he noticed me.
‘
Sister Farewell’s helping me to compile my report,’ Jones explained.
‘
Oh. Well, do sit down, both of you.’
We
sat down.
‘
Now, you wanted to know about the relationship between Pathology and ITU, I believe?’
‘
That’s right.’
‘
Well, I’m not sure I can be very much help to you there. As I imagine Sister has already told you, the relationship is not as cordial as it might be.’
‘
No, she hasn’t told me that,’ Jones said with a glance at me. I looked down at my hands, surprised, and a little embarrassed that Dr Cannock should have chosen to bring it up.
‘
Doubtless she will,’ he said. ‘We do, of course, perform a considerable number of laboratory tests for them.’
Jones
took out his notebook. ‘How many is considerable?’
He
thought for a moment. ‘Say, fifteen to twenty a day for ITU, although if you include the Coronary Care and Medical wards, that increases to fifty or more.’
‘
What kind of tests would those be?’
‘
Clotting tests and electrolytes on the cardiac cases. Some blood counts. Some microbiology.’
‘
What would they represent as a proportion of your workload?’
‘
Approximately a fifth.’
Jones
looked up from his notebook. ‘So you do a thousand tests a day here?’
‘
It’s not so many. Like most pathology departments, we’re geared for testing large numbers.’
‘
Yes, I noticed all the automated equipment when we were shown through.’
Cannock
smiled. ‘As a chemical pathologist, I’ve worked with automated equipment for a great many years. More recently, the problem has been in processing the large numbers of test results generated by the automation.’ For the first time, his dark brown eyes gleamed with some kind of enthusiasm. ‘And the answer to that problem lies in the complete computerization of the reporting system throughout the hospital.’
‘
I’d certainly agree with you there,’ Jones commented. ‘You obviously know something about computers then, Dr Cannock?’
He
gave a short laugh. ‘You could say that, since I’m on the working party that designed the hospital system.’
‘
Really? That can have been no mean task. How did you manage to fit that in with running Pathology?’
‘
The two aren’t as incompatible as you might think. You know about the Medicines Control Agency and the Accreditation of Pathology Departments?’
‘
Some, yes.’
‘
Well, what the MCA is demanding for path labs today, they’ll be demanding for hospitals tomorrow. A totally comprehensive and secure computer system. We decided to begin work on it before being ordered to.’
‘
I see. So what was your part in it?’
‘
The formulation of standard operating procedures, especially with regard to the use, and abuse, of passwords.’
Jones
chuckled briefly. ‘In my experience, that’s virtually impossible to prevent.’
‘
Oh, there are ways.’
‘
For instance?’
‘
Well, if a member of staff uses the password of another who is on leave, then the system can flag this up.’
‘
That
is
comprehensive. And you’ve got that working here?’
‘
On a pilot basis only.’ He glanced up at the clock as he spoke. ‘I’m sorry, I don’t want to be rude, Mr Jones, but I did say this would have to be brief, and I do have another appointment shortly.’
‘
Of course.’ Jones closed his notebook and stood up. ‘Well, thank you for giving us your time at such short notice.’
‘
I’m only sorry I couldn’t be more help.’
‘
No, that was just the sort of information I was looking for.’
When
we were back in the corridor, I said, ‘Were you really interested in all that stuff about computers?’
‘
Certainly.’
‘
Why? It all seemed a bit creepy to me. Big Brotherish.’
‘
It was rather, but that could be useful to us.’
‘
How?’
‘
You’d be amazed at the amount of information you can extract from a computer, especially a nosey one.’
‘
I don’t doubt it,’ I said drily. ‘But it scares me … it’s not what hospitals and medicine ought to be about.’
‘
Perhaps not.’ He paused. ‘What did Cannock mean about the relationship between ITU and Pathology not being a cordial one?’
By
now, we were back at ITU, so I said, ‘I’ll tell you in the office.’
Viv
was on the phone in the Duty Room, which was otherwise empty.
‘
I was surprised he brought it up,’ I said, when I’d shut the office door. ‘It came about because a lot of ITUs have their own mini-labs with a lab worker to do the urgent tests. Mr Chorley wanted one here, but Dr Cannock wouldn’t have it.’
‘
Why not?’
‘
He said he wanted all laboratory tests to be carried out under one roof — for purposes of quality control. He arranged for us to have exclusive use of a phlebotomist instead, so that urgent samples could be taken straight back to the lab. It still left a lot of bad feeling, though.’
‘
So the girl who takes the blood samples is part of Pathology?’
‘
Yes, either Susan or Pat are with us or in Coronary Care or the Medical ward most of the time. Usually Susan.’
‘
Is there really enough work to keep them busy all day?’
‘
In all the three wards, yes. Some patients need testing several times a day.’
He
said slowly, ‘What’s to stop them putting something in rather than taking it out?’
‘
I suppose that might have been possible,’ I replied after a pause, ‘when we still used conventional syringes. But we don’t, not any more.’
‘
Oh? What do you use?’
‘
Vacutainers. They’re sample bottles that are manufactured with a vacuum in them, so they take the exact amount of blood required. There’s absolutely no way anyone could use them to inject anything. I’ll show you, if you like.’
I
went into the Duty Room, and was looking for a set in Susan’s cupboard when she came in.
‘
Can I help you, Sister?’ she asked.
‘
Yes, I think you can,’ I said, standing up. ‘Were you about to take a sample?’
‘
I think so.’ She picked up a couple of request forms from the tray. ‘Yes.’
‘
Would you mind if we watched you? Mr Jones and myself?’
‘
Of course not.’
‘
Mr Jones,’ I called, and he came to the door. ‘Susan’s about to take a blood sample, so you can see how it’s done.’ He stopped short. ‘What, now?’
‘
Yes. Is that a problem?’
‘
No. No, not at all.’
I
didn’t notice how pale he was until we’d gowned up and were at the bedside. Susan set out three tubes in a rack, then screwed one end of the double-ended needle into the plastic barrel of the set. Then she applied a tourniquet to the patient’s arm.
‘
Could you clench your fist for me please, Mr Hughes?’ she said, and Mr Hughes duly obliged.
She
felt his arm until she found a vein, then unsheathed the second needle of the set and quickly punctured the vein with it.
I
glanced at Jones — he was deathly pale and actually trembling slightly, and a frisson of
Schadenfreude
rippled through me as I remembered something from the previous night. So the great Mr Jones had a weakness — he was needle-shy!
Susan
took a tube from the rack and pushed it into the open end of the barrel. The rubber cap of the tube was penetrated by the needle inside the barrel and the vacuum drew in the required amount of blood. She slotted the tube in the rack and then filled the other tubes in the same way.
‘
Have you seen enough, Mr Jones?’ I inquired sweetly.
‘
Yes, thank you,’ he replied thickly. I thanked Susan and we left.
‘
You should have told me you were needle-shy,’ I said as we de-gowned.
‘
It wasn’t the needle, it was the blood,’ he said, after a pause. I didn’t say anything, just looked at him, and he went on, ‘If you must know, my brother was a haemophiliac and the sight of blood always made me feel ill. Can we leave it at that, please?’