by Ken McClure
FIVE
Jamieson entered the Gynaecology Department through a side door but found the narrow passage leading to the stairs barred by a number of large cartons. Two orderlies stood in front of the boxes waiting for a service lift to descend.
'Won't be a minute,' said one of the men when he saw Jamieson come in. Jamieson nodded and waited. The lift was of the old fashioned type, completely open to view from all sides, more like an iron cage than a modern elevator. Jamieson saw its floor platform appear in the ceiling and then slowly brake to a halt at floor level. One of the men dragged back the concertina doors and the other slid the boxes across the floor for him to stack inside. His way now clear, Jamieson climbed the stairs and followed the signs to Thelwell's office. He knocked once and entered.
'Dr Jamieson?' asked the woman sitting behind a typewriter. 'Mr Thelwell is expecting you. Go right in. She pointed to one of the two dark, wooden doors behind her. G.T. Thelwell said the brass plaque which met Jamieson at eye level.
Jamieson entered to find Thelwell in conversation with Phillip Morton. Thelwell acknowledged Jamieson's arrival with a curt nod and moved in his chair as if to suggest to Morton that their chat was at an end. Morton took his cue and got to his feet. He smiled at Jamieson on his way out. 'How are the hands?' he asked.
'A lot better,' replied Jamieson.
'Take a seat,' said Thelwell.
Jamieson sat down.
'I am afraid our patient, Mrs Jenkins died this afternoon,' said Thelwell when the door closed behind Morton.
'I'm sorry,' said Jamieson. 'She must have gone downhill very fast.'
'What do you mean?'
'A little over a day from the onset of infection,' said Jamieson. 'Seems uncommonly quick.'
'What are you suggesting?' demanded Thelwell.
Jamieson could practically see the hackles rise on the man as he imagined some slur against his department. He kept calm and said, 'I am suggesting that the infecting organism is not only difficult to treat but is also unusually virulent.'
Thelwell realised he had been too quick to condemn and grunted. 'I thought you knew that. In all three cases infection has been followed by generalised septicaemia within twelve hours.
'I see,' said Jamieson.
'Well, what is it you want me to show you exactly?' asked Thelwell.
'Everything. The wards, the theatre, the recovery rooms, the scrub areas… everything.'
Thelwell looked as if he might raise an argument but it came to nothing. He simply got up from his chair and said, 'We'd best get started then.'
As the tour progressed, Jamieson knew he was finding what he had expected to find, a well run, snappily efficient department, as good as any other in the National Health Service, certainly as clean and modern as its budget and the constraints of an old building would permit. He could see no obvious fault at all, either in terms of substance or procedure.
Thelwell outlined the departmental routine as he showed Jamieson around and Jamieson made notes but there was nothing out of the ordinary about anything he heard.
'Where do you store surgical instruments?' he asked as Thelwell finished showing him the gynaecological operating theatre.
Thelwell moved across the floor to a steel cupboard and opened it. There were three instrument packs, each with a CSSD label on it to indicate that they had been through the steriliser. Each one was date — stamped and initialled by the operator in CSSD who had checked them. There was a broad band of autoclave tape on each, its heat-stripe marker turned black, indicating that it had been held at the required temperature in the steriliser for a set length of time.
Jamieson nodded in satisfaction and Thelwell closed the door again. 'When are you operating again?' he asked.
'Tomorrow,' replied Thelwell.
Jamieson was surprised. He said, 'I thought we had agreed that surgery wouldn't recommence until the new recovery ward was made ready?'
'It's an emergency,' said Thelwell. 'But we have taken your wishes into consideration and arranged a side room downstairs as a personal recovery room for the patient.'
'And the case?'
'Ovarian tumour. It won't wait.'
'Orthopaedic theatre again?' asked Jamieson.
Thelwell shook his head and said, 'No, we know the infection has nothing to do with the theatre so I'm moving back in here but to-night this theatre is going to be disinfected from top to bottom including the ceiling just to make sure. All the surgical team were swabbed again today to make certain that no one is carrying the damned organism. After the operation the patient will be taken directly to the room I've just mentioned and specially nursed until she has recovered. The room, like the theatre will be cleaned and disinfected from top to bottom.'
'Well, I can't fault anything there,' said Jamieson.
'How kind of you to approve,' said Thelwell.
Jamieson ignored the jibe and said, 'I would like to attend the operation tomorrow.' He sensed Thelwell's resentment but the thin lips remained tightly closed and the face, apart from the eyes, betrayed nothing for fully ten seconds then he said, 'To what end might I ask?' He enunciated every syllable with meticulous care.
'Just to observe,' said Jamieson. His calmness seemed to annoy Thelwell even more.
'You haven't been swabbed,' said Thelwell.
'Yes I have,' replied Jamieson. 'I had myself tested in Microbiology before I came over here.'
Thelwell swallowed hard and conceded defeat. 'Very well,' he said. 'Be in scrub at ten, assuming your swab is clear.'
'Thank you.'
Thelwell looked at his watch and said, 'Now, if there's nothing else I have a choir practice this evening.'
'Actually there is,' said Jamieson making Thelwell stop in his tracks. 'I want to discuss your own swabs. I want you to explain two completely negative nasal swabs in the last two staff screenings.'
'I don't understand,' stammered Thelwell but Jamieson could sense that he did. He waited for something more and Thelwell gave in. He said, 'I always make a practice of using Naseptin cream in the interests of my patients. That's why my swabs were completely clear. It's a hard habit to break and I must have forgotten not to use it on the days swabs were taken.'
Jamieson let Thelwell dangle on the hook for a moment before stating the obvious. 'But the object of the staff screening exercise was to establish whether any of the staff might normally carry organisms that might be dangerous to the patients. If everyone sterilised their nasal passages before the test there would be no point in doing them…' Jamieson knew that Thelwell was writhing in discomfort behind the apparently bland exterior.
'As I said,' said Thelwell, 'I must have forgotten to stop the cream on the days of the tests. I have a lot on my mind at the moment.'
Jamieson continued to stare at Thelwell, wondering if there was any more to come. His silence bore fruit. Thelwell said, 'All right if you must know, I did not want to give that idiot, Richardson any opportunity to embarrass me with his incompetence. That man would probably say he found typhoid in my naso-pharynx.'
Jamieson found it hard to maintain his composure. Was this a hospital or a lunatic asylum he wondered? Thelwell's paranoia must be bordering on the clinically significant but for the moment he had to keep things in perspective. He had to consider that Thelwell might be telling the truth about using the cream routinely. He said, 'Perhaps after tomorrow you might submit another screening swab to the lab?'
'Of course,' murmured Thelwell, embarrassed and anxious that this line of conversation should end.
'Enjoy your practice,' said Jamieson. 'A local choir?'
'Yes… yes,' stammered Thelwell, uneasy with the change to social chit chat. 'St Serf's Church. We are doing the Te deum.'
'Nice,' said Jamieson inappropriately.
The man stood in the shadows of a shop door and watched what was happening down the road. The sluts were still there, flitting in and out of the darkness in their imitation leopard skin and leather but they didn't fool him. Half of
them had warrant cards in their handbags and the Ford Orion that was parked in Clarion Street might just as well have a blue light on its roof instead of two clods eating sandwiches and looking at their watches. Did they think he was a complete idiot? Did they really think that he would try exactly the same line of attack? Walk into their puny little trap like some mental defective? There was no anger in the man's thinking. He was just surprised that they could be so stupid. Talk about bolting the stable door…
A bus loomed up from his right and pulled to a halt in front of him. He pulled up his collar and got on board. He would concentrate on other things this evening and the fact that the police would be out all night in the cold made the prospect all the more pleasant. Anyone who protected these filthy creatures deserved all the discomfort that was coming to them.
The bus stopped on the far side of the circle and the man got off, carrying his briefcase and pressing his hat a little more firmly on to his head. It had started to rain but it was only a short walk back to the basement flat and then he could get on with the evening's work. He turned into the lane that separated the main road from the street where the flat was situated and passed along it, carefully avoiding the piles of cartons and waste paper that had been bundled out for collection on the following morning.
The location of the flat was ideal for his purpose because all the surrounding buildings were in use as offices. At night there was rarely anyone about. The windows of the entire street were in darkness save for one upstairs light in the surveyor's office across the road from the flat. This was so unusual that it made him stop briefly in the shadows at the end of the lane and look up at it. He was curious. No one had ever worked late there before. His natural caution made him consider all possible implications.
As he watched, a young woman appeared at the window. She was laughing and, as she reached up to the cord for the blinds, a man came up behind her and slid his arm round her waist. The man in the shadows watched as the man in the window slid his hands up on to the woman's breasts and buried his face against the side of her neck. 'Fool!' he hissed, his eyes burning with anger as he watched the woman laugh again and reach up her hand to stroke her companion's hair. 'Can't you see she's trying to trap you?'
The venetian blinds snapped shut and the two figures were eclipsed leaving the man at the corner of the lane still staring up at the window. He swallowed twice and regained his composure. There was work to be done. He descended the basement steps and opened the door extra quietly. He did not want to give the couple across the street any occasion to look out of the window, not that that was likely he conceded. That poor fool would have other things on his mind. But, as ever, caution was of the essence.
He closed the door silently and pulled the curtains across the window before switching on the light. A spider scuttled up the lifeline of its web having been exposed against the whitewash of the walls but the man ignored it. He opened the door of a small metal cupboard and examined what was inside. Excellent, he thought, it was all going well. When the time came for a change he would be ready and it could begin all over again.
He closed the door of the cupboard and went through to the kitchen to switch on a small metal-shaded lamp that sat in the middle of the kitchen table. A dull, purple glow came from the lamp at first but it grew brighter as the minutes passed. The man returned from the bedroom wearing white overalls and a full plastic face visor. He checked that his gloves were fitting properly, that the cuffs of his overalls overlapped them and the tunic was fastened up to his neck. There were to be no more slip ups. After more checking and preening he seemed satisfied with the state of his protection and got to work.
Two hours passed before he decided that he had done enough for one evening. He switched off the lamp and removed his visor. The cold air of the basement felt damp against the thin film of sweat on his forehead and made him shiver slightly as he got to his feet and started clearing up. With everything safely away inside the metal cupboard he sighed in satisfaction and looked at his watch. A last check on the thermometer protruding from the top of the cupboard and there was no more to be done this evening.
As he switched off the room light before opening the outside door he became aware of voices in the street above and stopped in the darkness behind the door to listen. A man and a woman were talking but he could not make out what was being said. As the minutes passed he became more and more impatient. Standing motionless was making him acutely aware of the cold and damp. Very slowly he turned the Yale lock on the back of the door, keeping his full weight against it in case it should move against the jamb and make a noise. With painful slowness he inched the door open until he could hear what was being said.
As he listened, he came to realise that the voices belonged to the man and woman he had seen in the window across the street. Their illicit liaison in the office was over and they were now leaving. Where had they done it in the office? Across a desk? Writhing on the floor like animals? Against a wall perhaps with the bitch egging him on. There was no limit to the ingenuity of the sluts. That was why he himself had to be equally devious if he were to redress the balance.
The woman was insisting that there was no need for the man to run her home. He was late already and that would only cause more trouble at home. She was quite happy to get the bus; the stop was only round the corner and she would be home in fifteen minutes.
'If you're sure,' said the man.
'Absolutely,' said the woman.
There was a long silence and the man in the basement deduced that the pair must be embracing. A look of disgust crossed his face in the dim yellow light that filtered down from the street.
There were a few whispered good-nights and then the click of high heeled shoes on the pavement that said they had parted. A car moving off a few seconds later said that it was now safe for him to leave. But the seeds of an idea had been planted inside his head. He had not planned it but could he turn a chance like this down?
Care! He must take care! There was always danger in unplanned action. Spontaneity could spell disaster but on the other hand, if the opportunity should present itself he must not turn down the chance of ridding society of another of these creatures. He closed the door again and once more shut the curtains before switching on the light. He went to the bathroom and took down the rubber apron from the line across the bath and folded it quickly before stuffing it into his briefcase. The instruments were ready on the side of the sink. He wrapped them up quickly in the velvet cloth.
This would be the first test, he thought as he closed the basement door quietly behind him. If the bitch was standing at the bus stop when he got there it would be a sign that fate was on his side. If she was not, he would return to the flat and abandon the entire notion.
He caught his foot against the edge of a cardboard box in the lane as he hurried along it and almost went sprawling but recovered his balance in time to remind himself to take more care. He paused at the end of the lane to compose himself, smoothing the front of his coat and adjusting the angle of his hat, before rounding the corner to approach the bus stop.
She was still there! The bitch was standing there, her skirt hugging the line of her buttocks, the slit in the back revealing a triangle of white underskirt, the line of her jacket designed specifically to enhance the curve of her breasts. She turned to look at him as he joined her at the stop but her face registered nothing. That was the way the bitches always looked at him, as if he weren't there. He stared at the back of her neck and then at the slight haughtiness of her profile as she turned slightly. Who did she think she was kidding with her air of respectability? Did she really imagine that he could not see through the sham! Through to the dirt and the evil!
The bus arrived and the woman climbed aboard. She had difficulty in mounting the high first step due to the tightness of her skirt and had to reach down to hitch it up a few inches. Behind her the man felt the pressure behind his eyes increase as he realised that this must be for his benefit. She was trying to distract hi
m from his task by flaunting her evil charms. She was using the very weapons that had caught him out before! He felt the hardness stir and tiny beads of perspiration broke out along his upper lip. He fought the feeling. He must not be swayed.
The woman asked for a thirty-five pence fare and the man, after a suitable delay while he pretended to search for change in his pocket, asked for the same. He collected his ticket from the dispenser but, as he did so, he banged his briefcase against the base of the machine and the instruments inside rattled free from their wrapping.
'What you got in there mate?' asked the driver. 'The Crown jewels?'
The man managed a smile but it was strained and unnatural. With an outward air of calm he moved into a seat at the back of the bus. There, he would be free from curious eyes. He was four rows behind the woman and inside his head he was furious with himself. He had thrown away his chance! He could not now go ahead with the plan. The driver would remember him getting on the bus at the same time as the deceased. The incident with the instruments rattling free would ensure that he wasn't forgotten. Why hadn't he taken the time to pack the instruments properly!
The bus turned into a brightly lit street where the local pubs were turning out their clientele in compliance with the law. It was noisy and disorderly and the man grimaced involuntarily as he saw a crowd of youths respond to the sight of the bus by running towards the stop. The doors slid open and two of them had an argument in the doorway as they both tried to board first. The driver remonstrated with them and received a torrent of abuse in return. He said no more as they dropped their money into the tray and continued to push and shove each other.
There were five in all. They lifted the hat off an old man as they moved inside the bus and let it fall again so that it dropped over his eyes. His protests were met with loud derision.
'What's wrong, granddad? Gone blind?'
They turned their attention to a teenage girl who flushed in embarrassment as they started to discuss her appearance.