Pestilence

by Ken McClure

  Chapter Eleven

  Tremaine looked surprised when Saracen walked into A amp;E. He looked at his watch and saw that it was five am.

  “Couldn’t sleep,” said Saracen.

  “Things that bad?”

  “And getting worse. How was the locum?”

  “No problems. He’s just having a cup of tea.”

  Saracen had asked about Malcolm Jamieson, one of two locum housemen appointed to compensate for the loss of Chenhui Tang and Nigel Garten.

  “When does the other chap arrive?” asked Tremaine.

  “Tomorrow, if they let him in,” replied Saracen. He told Tremaine about the Quarantine order on the town.

  “Claire is going to love that,” said Tremaine. “She was planning to go to London for a few days.”

  “Can’t be helped. I’ll just take a shower and then I’ll have a chat with Jamieson.”

  Saracen showered in the locker room under the pitiful trickle that eventually emerged from the sprinkler head after a noisy journey through endless overhead piping. The room, like all the others in the General, was at least fifteen feet from floor to ceiling and tiled with tiles so crazed that they appeared brown. The ventilator fan had been broken for some months so, on days when it rained, the window glass acted as a condenser for the steam and water streamed down it.

  Saracen watched the steam drift up past the metal light shade and hang in a pall round the electrics. “If Legionnaire’s disease doesn’t get you in this place the wiring probably will, he thought. He dressed and returned to A amp;E to speak to Jamieson.

  Jamieson, a tall young man with ginger hair and a serious expression, got up when Saracen came into the Duty Room and seemed uneasy at having been caught drinking tea. Saracen put him at his ease and asked, “Have you had your vaccination?”

  “Dr Tremaine gave me it last night,” replied the houseman.

  “And you know why?”

  Jamieson nodded and said that Tremaine had told him. “This is all a bit of a surprise,” he added.

  “Wishing you hadn’t come here?” asked Saracen.

  “I didn’t say that,” replied Jamieson.

  “No you didn’t,” Saracen agreed. He told the houseman about the isolation order on the town.

  “It’s that serious then?”

  “It could be,” said Saracen, “That’s why I wanted to have a talk to you. Be on your guard at all times. Think plague. Every apparent drunk that you see pewk on the floor. Think first! Every apparent junkie with cramps and cold sweat. Think first! Things might not be what they seem. None of us are too familiar with the disease.

  “I thought that plague could be easily cured these days,” said Jamieson.

  “That’s what the books say but this isn’t the book, this is for real and there’s a problem.”

  “What kind of a problem?”

  “At the moment we can’t treat it.”

  The houseman’s eyes opened wide. “Are you serious?” he asked.

  “Very.”

  Jamieson seemed to pale slightly. He covered his discomfort with an embarrassed grin. “Well, this really is something,” he said, flicking some imaginary dirt from the knees of his trousers.

  “In practise we are going to set up a separate reception area for potential plague cases but the odd one could slip through under the guise of something else.”

  “I’ll be on my guard,” said Jamieson.

  Saracen covered A amp;E on his own until Prakesh Singh joined him at half past seven. There had only been one patient in the interim, a Gas Board worker who had fallen off his bicycle on the way to work and fractured his wrist. The man was leaving as Singh arrived. Saracen gave Singh the same warning as he had Jamieson and satisfied himself that the man had understood before leaving him in charge of admissions. He himself retired to his office to start making plans for the new reception area.

  The immediate problem was to find a route between reception and ward twenty that avoided all contact with the rest of the hospital. His attention was drawn to a room beneath ward twenty itself that was currently being used as a store room for empty gas cylinders awaiting collection. According to the hospital plan there existed a staircase that led from the room up to the ward above. If access were restored then the location of the room would make it an ideal reception area for plague patients. Ambulances would be able to take their patients directly to it. Saracen decided that he would have to check with the hospital secretary whether or not the connecting staircase was wide enough to permit the passage of stretchers. He would do this at the next meeting of the emergency committee which was scheduled for eleven.

  Saracen was surprised when he got to the Lecture Theatre. There were a great many people there that he had not seen before. Two of them were wearing army uniform; the others were introduced by Saithe as being heads of department in Skelmore’s administration.

  “And now,” said Saithe, “I am going to hand you over to Lt Col Beasdale who, from six o’clock this morning, is technically in command of Skelmore.

  The officer smiled and cleared his throat. “Let me begin by saying that this situation gives me no pleasure at all.” He smiled again as if to reinforce his statement but no one smiled back. Beasdale continued. “Nothing would give me greater pleasure than to see an end to this business and the restoration of the town to the proper civil authorities. In the meantime however, my orders are clear and simple. No one is to enter or leave Skelmore without my say-so. Secondly I am charged with the maintenance of law and order.” Beasdale looked round at his audience but no one spoke. He continued, “In practise we would all hope that things would continue pretty much as normal. The civilian authorities will continue to operate as usual and my men will maintain a low profile. They will stay outside the town in fact except for transfer duties.”

  Someone asked what transfer duties were.

  “Essential goods coming in to Skelmore will be transferred to military vehicles outside the town and delivered by my men. Civilian delivery drivers will not be permitted to enter.”

  “What happens if someone absolutely insists on leaving the town?” asked the County Hospital’s Senior Nursing Officer.

  “My men would explain the position to them and politely turn them back,” said Beasdale.

  “And if they still persisted?”

  “They would not be allowed to leave.”

  “Meaning?”

  Beasdale rubbed his forehead in a nervous gesture of frustration and said, “We would be obliged to use as much force as was necessary to maintain the integrity of the cordon.”

  “Thank you Colonel.” The woman sat down again with an air of self satisfaction that Saracen found hard to fathom for Beasdale did not seem to be an unreasonable character at all. If anything, he seemed to be rather embarrassed by the situation and was deliberately playing down his authority rather than flaunting it.

  Beasdale continued. “This, of course, is not a routine military operation in that the problem is not one of civil unrest but of medical necessity. For that reason all of us concerned with administration of the town will be heavily reliant on medical advice, not just for situation reports but for forecasts as to how things might develop.”

  The more Beasdale said the more Saracen liked him. Never a great fan of the military mind he was relieved to discern in Beasdale a great deal of common sense and that was a rarer commodity than most people imagined. It did not necessarily come with intelligence and you could not be taught it at university or military academy. It had to be innate.

  “Before I hand you over to Doctors Braithwaite and MacQuillan I must just tell you that this will be the last meeting of the emergency committee in its present form.

  “Why?” demanded the nurse who had forced Beasdale into admitting that he would use force if necessary.

  “It has served its purpose,” said Beasdale. “It makes no sense to have the centre of administration here in the hospital, one of the areas most likely to be affected by the problem.”


  “Do you mean you are afraid Colonel?” asked the woman.

  Silly cow, thought Saracen.

  “On a personal level I suppose you could say that I was Miss?…”

  “Williams.”

  “Miss Williams. Like most lay people I know nothing at all about plague save for the horror that the word implies. I depend on you and your colleagues to provide me with more realistic information. But my decision has nothing to do with personal considerations. Should the worst happen and God forbid that it does, Skelmore must not be left like a headless chicken.”

  “So where will your headquarters be Colonel?” asked one of the civilian administrators.

  Beasdale smiled and said, “I am afraid my colleague here has something for you all to sign before I say anything else.” The other army officer took some papers from his briefcase and started handing them out.

  “What on earth?” exclaimed someone in the front row.

  “The official secrets act,” said Beasdale.

  With the formalities over Beasdale said, “Headquarters will be at Skelmore municipal waterworks.”

  The sense of anti-climax in the room was unanimous. Beasdale said, “One or two of you here will already know the reason for this. For the rest of you it will come as a surprise to learn that sixty feet below ground at the waterworks there are a series of well equipped chambers designed as a regional seat of government for the area.” Beasdale paused to let the noise die down.

  “But surely that sort of thing is for nuclear attack and the like?”

  “It does sound a bit overly dramatic I agree,” said Beasdale, “But the powers that be thought that this would be a good opportunity to put the facilities to the test.”

  “So we all meet there in future?” asked one of the administrators.

  “No, not all,” replied Beasdale. “None of the medical personnel will be permitted to enter the administration centre. Instead my men will install extra communication facilities between the waterworks and the two hospitals so that we can communicate at any time and in complete confidence. There will be no need for any of the medical people to come to the centre. Any questions?”

  There were none.

  “In that case I will now hand you over to Doctor MacQuillan for a progress report.”

  MacQuillan got to his feet and switched on the overhead projector. He placed a transparency on it and picked up the pointer. “This,” he announced is an epimid, short for epidemiological pyramid. It is a chart that records the spread of a disease during an outbreak. As you see we have the patient Myra Archer at the top of the pyramid as the source of the outbreak in Skelmore.” MacQuillan slapped the pointer unnecessarily against the name Myra Archer and then slid it down to the next line. “She in turn gave it to Leonard Cohen and he gave it to Moran, the workman on the site, a nice narrow vertical line, just what we like to see. But yesterday things began to change. Moran not only passed it on to his wife he gave it to a woman he was having a fling with and, more importantly, whom we knew nothing about. This woman gave the disease to her children and another child who happened to be staying in her house and the base of the pyramid spreads out.” MacQuillan swept the pointer horizontally along the screen. “To compound an already worsening situation four of the people who attended the original case have gone down with the disease and none of them have been in quarantine.” MacQuillan added lines to the transparency with a felt tip pen and then returned to the screen to run the pointer all the way along the bottom. He said, “Each of these people has a family, a circle of friends and in three cases a class-room full of contacts. The situation is, to say the least, volatile and this is why the quarantine order was invoked.” MacQuillan invited Braithwaite to take the floor and he did.

  Saracen thought that Braithwaite looked tired and drawn as he got to his feet and shuffled to the table. There was little trace of the self assurance, almost arrogance that he had displayed on the previous occasion.

  Braithwaite said, “My staff have been working all night to isolate known contacts of the patients admitted to hospital yesterday. We hope that we have got them all in time but we can’t be sure.”

  “What exactly do you do when you get to them?” asked Beasdale.

  “In the case of families we simply instruct them to say indoors and wait for further instructions. The social services see that they get everything they need in the way of supplies. It’s just a matter of keeping them out of circulation. Our biggest headache of course has been the school. We’ve had to close it and quarantine all the families of children in one particular class.”

  “How long will the quarantine be maintained?”

  “Eight days. The incubation time for the disease plus a safety margin.”

  “So we wait and see.”

  “Yes.”

  “Supposing any of the contacts do develop the disease. Does that mean we are in real trouble?”

  “Not necessarily,” interjected MacQuillan. “It’s rogue contacts we really have to worry about, people that we don’t know about like Moran’s woman friend. These are the people who can spread the disease all over the place before we get to them. If that happens the base of the pyramid will broaden until we can no longer hope to trace and isolate contacts.”

  “And if that should happen?”

  “Then we close all factories, schools and non-essential shops and tell people to stay home.”

  There was a long pause before Saracen asked, “Has the protective clothing arrived?”

  “This morning,” replied MacQuillan. “The staff on ward twenty already have it. Everyone else should have it by lunch time.”

  “The army too?” asked Saracen.

  “My men do have it,” replied Beasdale, “But, as a matter of policy, will not don it unless the situation deteriorates markedly. The sight of soldiers in space suits is not one to encourage public optimism.”

  “The same goes for my men,” said Chief Superintendent Carradyce.

  The meeting broke up and people began filing out of the lecture theatre until there were only a handful left; Saracen was among them. He leaned forward in his seat and rested his elbows on the wooden rail in front of him while he looked at MacQuillan’s epimid which was still up on the screen. MacQuillan noticed him and came over. “Well, what do you think?” he asked.

  “You’re the expert,” Saracen smiled. “What do you think?”

  MacQuillan kept his voice low. He said, “There are too many imponderables to be able to say with any certainty what is going to happen. We are riding a roller coaster that isn’t secured to the rails. Whether we stay on or fly off is entirely in the lap of the gods.”

  “Maybe we should co-opt a vicar?” said Saracen.

  “Or an astrologer,” replied MacQuillan.

  Saithe closed the door of the lecture theatre and said to the members of the General’s staff who had stayed behind, “Is there anything we should discuss before we go about our duties?”

  “Admission arrangements for plague cases,” said Saracen. He made his suggestion about the room below ward twenty.

  “Sounds eminently suitable,” said Saithe. “What is it being used for at the moment?”

  Saracen told him and voiced his one qualm about the suitability of the stairs for stretcher bearers.

  “There’s no problem. They are wide enough,” said Jenkins, the hospital secretary, a small, dapper man with gold rimmed spectacles and a penchant for wearing shirts with collars in contrasting colours. Today’s was dark red with a pristine white collar.

  Saithe asked Jenkins to see to the room’s conversion. MacQuillan asked about ambulance access.

  “That’s partly the reason for choosing it,” replied Saracen. “It fronts on to the courtyard; ambulances can drive right up to the door.”

  “What about ambulance crews?”

  “Two crews have volunteered for special duties and have been equipped with respirator suits. Two vehicles have been taken out of routine service and will be used exclusively
for the emergency. They will be decontaminated after every call.

  “Sounds fine,” said MacQuillan getting to his feet to leave. “Up to the number of cases that two ambulance crews, two vehicles and a handful of volunteer nurses can deal with…”

  Saracen returned to A amp;E and phoned Jill on ward twenty. He had to try twice before he finally got through and asked to speak to Staff Nurse Rawlings.

  “Who is speaking?”

  Saracen recognised the voice; it was Sister Lindeman. I might have known it, he thought, Lindeman in the thick of things as usual. “It’s James Saracen Sister,” he said.

  “One moment Doctor.”

  “James?”

  “Hello, how are you?” Saracen asked softly.

  “Not so good. It’s all so hopeless,” replied Jill. “There’s so little we can do for them.”

  “How is Nurse Travers?”

  “Mary died two hours ago.”

  “God I’m sorry. You really shouldn’t be on duty.”

  “There’s no point in sitting around moping about it when I can be more use up here. I just wish there was something more positive we could do other than try to make people more comfortable while they wait to die.”

  “They’re all bad then?”

  “Without exception. The three kids died in the early hours of this morning then Mary died and the others will die before nightfall. If there are no admissions today the ward will be empty by tomorrow. All dead.

  “What are the duty arrangements for the nurses?”

  “We have divided into two twelve hour shifts. We have been given our own quarters in the side rooms outside ward twenty where we can watch television and play Scrabble. You know the sort of thing.”

  “I’ll come up later on.”

  Jill paused before saying, “That’s probably not a good idea.”

  “Why not?” said Saracen.

  “As yet you haven’t been exposed to the disease. In the interests of what could conceivably happen in this town perhaps we shouldn’t take any silly chances?”