by Ken McClure
'What unit's that then?' asked the boilerman.
'The… A amp;E team.' replied the man after a moment's hesitation.
'I could have sworn I knew all the porters in A amp;E,' said the boilerman but I don't think I've seen you before. You sound a bit posh to be a porter. You're not one of them medical students are you? Playing at being a worker?'
'No.'
'You'll have to sign this,' said the boilerman, handing over a record sheet. It was clipped to a dog-eared piece of board. A blunt pencil was attached by a length of string. 'Print your name on the left, sign on the right. In between, write down what you put in the fire and who authorised it.'
The man accepted the board and wrote quickly and untidily. He handed it back.
'You've still got your mask on,' said the boilerman as he tried to read what the man had written. He tilted back his head so that he could look through the lower portion of his glasses as he held the paper up to the light. 'I'm beginning to think I've got a personal hygiene problem.' He looked at the man and caught his stare. The mask stayed put. 'I can't read the authoriser's name. What does it say?'
'Dr Mullen.'
'Dr Mullen isn't on duty this evening,' said the boilerman quietly. 'I saw him go off at five.'
Again came the stare over the mask. There was no firelight to blame this time. There was something evil about the look in these eyes. 'Who are you?' whispered the boilerman, taking a step backwards and reaching up the wall for the telephone. 'What's your game?'
The fist landed perfectly on the boilerman's chin and the man in white reached out to catch the falling man before he hit the ground.
He laid out the prostrate figure gently and looked about him. He would have to get this exactly right. He was approximately the same height as the boilerman so he could use himself as a measuring aid. He planted both feet apart on the ground in front of the furnace and measured the distance between his feet and the fire door by stretching out his body and moving himself forward with his hands on the ground. When his head reached the fire door he marked the ground with the toe of his left foot and stood up. Next he laid down a fire rake at the spot he had just marked. Someone his height tripping over the rake at that particular spot would pitch forward and hit their head off the iron door.
The man dragged the unconscious body of the boilerman over in front of the furnace and angled it before the fire door. It would have to be done with one blow. He brought the body up into as near a kneeling position as he could manage and held the head in both hands before bringing it back slowly and then slamming it forwards against the iron door with all the strength he could muster. There was a sickening crack and he felt confident of success. He felt for a carotid pulse and was alarmed to detect a faint beating but it grew weaker by the second until suddenly it stopped altogether and the boilerman was dead. The man arranged the limbs of the corpse in keeping with a trip over the rake and a subsequent accidental blow to the head on the furnace door. He checked that everything else was in order, collected his trolley and left silently.
There were two police cars parked near the hospital front office when Jamieson left the residency to walk to the microbiology lab in the morning. He asked Moira Lippman about them when he got in.
You didn't hear about the accident last night?' asked Moira.
'No. Tell me.'
'Archie Trotter, the night-shift man in the boiler house had an accident last night. He fell and hit his head off the furnace. He was dead when they found him this morning.'
'Poor man, there seems to be a jinx on this place,' said Jamieson.
'Don't say that,' exclaimed Moira. 'My sister in law is being admitted for her operation today.'
'Sorry. I'm sure she'll be OK.
'How did your tests turn out?' asked Moira, seeing that Jamieson was examining the tubes he had inoculated the day before.
Jamieson shook his head and said thoughtfully, 'I'm not sure. There seem to be a number of unusual results.'
'How unusual?'
'Three of the biochemical tests don't seem match the text book response.'
'It's not that unusual to come across the occasional one,' said Moira.
'But three?'
'That's a bit much,' agreed the girl.?Any ideas?' asked Jamieson.
Moira smiled and said, 'Dare I suggest… experimental error?'
'You mean I mucked up the tests?' said Jamieson with a wry smile. 'Maybe you're right. I'm a bit of an amateur at this sort of thing.'
'Would you like me to repeat them for you?' asked Moira. 'Give you a second opinion?'
'You're serious?'
'Of course. It's no trouble really.'
'You're an angel,' said Jamieson.
'Problems?' asked Clive Evans coming into the lab and seeing the two of them with the test tubes.
Jamieson told him.
'That's nothing to worry about, happens all the time,' said Evans. 'Sometimes I think if I ever come across a bug that matches the text book in every response I'll give a sherry party for the lab.'
'I thought it was me,' said Jamieson. 'Moira said she'd repeat the tests for me.'
'Relax. I'm sure your tests worked fine. There are lots of atypical strains around.'
'I thought three differences were a bit much Dr Evans,' said Moira.
'It's not common I'll grant you but I have seen it happen before,' replied Evans.
Moira shrugged and silently deferred to Evans' greater experience.
Harry Plenderleith was none too happy about working out his shift in the place where a man had died less than twelve hours before. He did not have to imagine where they had found the body for there was still a chalk mark on the floor that the police had left and a brown stain in the concrete where the blood had collected in a puddle. It all made him very unsettled and he whistled a lot to cover the fact that he was nervous. He had never liked the dead man. Trotter and they had never seen eye to eye about anything. Now that he was dead the possibility that his spirit was still hovering around played with Plenderleith's imagination as he checked that number two fire had been completely extinguished.
Plenderleith put on his protective face mask and started to rake out the ashes creating clouds of dust as he did so. He had scarcely begun when the rake caught something heavy and it clattered out into the ash can making him put down the rake for a moment and reach into the ashes to recover the object. It was a long bone. He dusted it off and examined it by holding it against his person in various ways until he decided that it had come from an upper leg. 'Poor bugger,' he whispered under his breath and resumed raking the floor of the furnace. More bones clattered into the can and Plenderleith grew uneasy. He had come across the occasional bone before when these sealed sacks from surgery had been brought down from the theatres but this seemed all out of proportion. His unease finally peaked when the last artefact rolled out into the can and lay there in the ash.
Plenderleith didn't make much sense on the phone and the hospital telephonist had to tell him to calm down.
'But there's been a bloody murder I tell you!'
'Start again, you found some bones while you were cleaning out the furnace?'
'Human remains! That's what they are!'
The telephonist, who had turned aside for a moment to consult with someone, came back on the line and said, 'My supervisor says that that is not unusual. You should have been told about amputation waste when you were given the job.'
'Amputation waste!' exclaimed Plenderleith. 'You mean they amputated this bugger's head?'
'So the fall didn't kill him?' asked Chief Inspector Ryan.
'Only if he fell at eighty miles an hour,' replied the police pathologist.
'What are you saying?'
'The indentation on his head is too deep for an accidental fall but it matches the cast of the fire door so either someone took the door off its hinges and hit him with it or else they slammed his head against it to make it look as if it were an accident.'
'Thank you Doctor.' s
aid the policeman. He was about to say something else when he was interrupted by another man who had come into the room. They spoke in a huddle for a few moments before the policeman said to the pathologist. 'I'm afraid we've got something else for you.'
'Never a dull moment,' replied the man laconically.
'A pile of bones from the furnace our late friend here was tending. A body was cremated in it.'
'Never rains but it pours.'
'The jigsaw puzzle is on its way over.'
Jamieson was still in the lab when he heard that the accidental death of Archie Trotter had become murder. Moira Lippman told him. She had heard the rumours at lunch time in the staff canteen. They had started to fly when a police incident 'room' was set up in the grounds outside the boiler house.
'What about motive?' asked Jamieson.
'That's the really grisly bit,' said Moira. There's a story going around that they found some human bones in the incinerator this morning.'
'That doesn't necessarily mean that…'
'But it was a whole body.'
Jamieson adopted a suitable expression. He was pretending to be an outsider to all that he was hearing but the suggestion of murder in the hospital made him look for a suitable excuse to return to his room and call the switchboard. He got through to Sci Med in London and told them that he wanted to be kept discreetly informed of all developments in the case. He was assured that the local police would be informed of his interest and instructed accordingly.
Moira was on the phone when Jamieson returned. He heard her sound relieved and thank someone before putting down the receiver. 'I was just checking on my sister in law,' she said.
'Everything OK?' Jamieson asked.
'Yes but she's not sure when they're going to operate yet. There's a bit of a back log.'
'Where's Dr Evans?'
'He's in Dr Richardson's office,' replied the girl.
Jamieson left Moira Lippman and came along the corridor to climb the stairs up to the ground floor. As he reached the top of the stairs he heard a clap of thunder and paused to look out of one of the corridor windows at the darkening sky. A figure on the other side of the courtyard caught his attention. It was Thelwell. He had just come out of the door that led to the Central Sterile Supply Department.
Jamieson frowned as he wondered what a consultant surgeon was doing there. He reflected that this was the second time he had had occasion to wonder this of Thelwell. The first time was when he had seen him in the vicinity of the lab on the night that Richardson died. The function of the CSSD was to sterilise dressings and surgical instruments. What possible reason could Thelwell have had for being there? After a couple of minutes consideration Jamieson decided that he would have to satisfy his curiosity. He would make it his business to find out what Thelwell had been doing there.
The heavens suddenly opened and rain began to hammer mercilessly against the window, all but obliterating his view of the courtyard outside. He paused in the shelter of the front door and waited until the deluge had stopped. His reasoning that such heavy rain could not last long was proved right when after three minutes the sky started to lighten and the rain eased off sufficiently to let him sprint across the courtyard to the entrance of the Central Sterile Supply Department.
Jamieson felt the humidity in the atmosphere hit him and saw the moisture condensing on the tiled walls as he opened the front door of the CSSD and walked along the thirty metres or so of corridor that led to a pair of heavy swing doors equipped with brass handles. STERILISING HALL said the sign above them. The humidity increased even more as Jamieson pushed open one of the doors and turned left as instructed by the arrow. He was forced to run his finger round the inside of his collar as he approached the figures in white.
'Who's in charge here?' he enquired, raising his voice to be heard above the hiss of steam and also to compensate for the fact that the man he was asking was wearing a full face visor. The man pointed to a green door and Jamieson followed his direction and knocked.
'Come.'
Jamieson entered to find a large, well built man seated at a desk so small that it seemed to emphasise his bulk. He held a pen in one of his fat podgy hands and was ticking off items on a list. Like the others, he was wearing white cotton trousers and a white surgical tunic top with a vee neck. Dark chest hair reached above the centre of the vee. There was a strong smell of aftershave in the room, not expensive, just strong.
'I understand that you are in charge here?' said Jamieson.
'Who wants to know?' asked the man.
Jamieson said who he was.
'Charge Nurse Blaney,' said the man, leaning across the desk and offering his hand. Jamieson shook it and noticed how soft and flabby it was.
'How can I help you?'
'Mr Thelwell was here a few minutes ago,' said Jamieson.
'Yes.'
'What did he want?'
Blaney’s expression changed to one of suspicion. He said, 'I don't think I can discuss…'
Jamieson had been prepared for the response. He interrupted by saying. 'If you call Mr Crichton on extension 2631 he will tell you that I have the right to ask these questions.
'I'll take your word for it,' said Blaney. 'Mr Thelwell likes to collect his own instrument packs.'
Jamieson felt his throat tighten. He had to clear it before asking, 'What exactly does that mean?'
'Mr Thelwell insists on picking up the instruments that go to his theatre himself.'
'Has he always done this?'
'Just for the past couple of months.'
'He just comes down here and takes away his instrument packs?' asked Jamieson.
'He does more than that,' replied Blaney. 'He likes to monitor the sterilising process.'
'What exactly does he do?' asked Jamieson.
'He checks the temperature and pressure gauges during the autoclave cycle, monitors the graph recorder, waits till the instrument packs come out then takes them up to his theatre.'
'Did Mr Thelwell say why he does this?' asked Jamieson.
'A safety precaution,' replied Blaney.
'A safety precaution,' repeated Jamieson thoughtfully.
'That's right,' said Blaney. 'Is something wrong?'
'No… nothing,' said Jamieson but his mind was turning cartwheels. The revelation that Thelwell was an intermediate in the chain of events that brought sterile instruments from the supply department to the theatres was something that he hadn't reckoned on.
'Mr Thelwell is a very conscientious man. He leaves nothing to chance,' said Blaney. 'Even though Dr Evans puts these machines through their paces every week and the graph recorders are always spot on, he likes to see things for himself.'
'Does Mr Thelwell just collect his own instruments?' asked Jamieson, trying to make it sound like a casual inquiry.
'No, he takes all the packs for gynaecology,' replied Blaney. 'There's nothing wrong in that is there?' he added in a slightly aggressive response to the frown on Jamieson's face.
Jamieson said that there wasn't but his mind was working overtime.
'Perhaps you would like to see the routine?' asked Blaney.
Jamieson looked at Blaney, smiled and then said, 'Why not.'
Blaney gave Jamieson a conducted tour of the sterilising hall, stopping at intervals to explain things when he thought it necessary.
'Do you always use the same steriliser for the instruments?' asked Jamieson.
Blaney nodded and pointed to one of the autoclaves. 'That one,' he said. 'All sterile supplies for Gynaecology go through that one.'
Jamieson looked at the dials on the front. He said, 'What would happen if the steam supply should fail?'
'The machine would reset itself and refuse to proceed with the cycle.'
'What if it should fail half way through a cycle?'
'Same thing. It would reset itself and the graph recorder would show the failure.'
'Is there a manual over-ride?' asked Jamieson.
'I don't understand,' said
Blaney.
'Can you convince the machine that it has completed its sterilising cycle when it actually hasn't?'
'But who would ever want to do that?' asked Blaney.
'Can it be done?'
'No,' said Blaney. 'The automatic timer will not start until the temperature has climbed to a pre-set value and if at any time during the cycle the temperature should fall below that value, the timer would reset itself and refuse to start until the temperature had climbed again.'
Jamieson looked at the chart recorder on the front of the machine and said, 'Do you keep these charts?'
'Every one,' said Blaney.
'So if I were to ask you for the chart from the run Mr Thelwell has just been watching you could show it to me?'
'Of course.'
'I'd like to see it,' said Jamieson.
Blaney shrugged and asked Jamieson to wait while he fetched it from his office. He returned with a circular piece of graph paper. 'This is it,' said Blaney. 'Dated and initialled.' He traced the blue line on the paper with his forefinger and said, 'As you can see, it was a normal run. The temperature climbed steadily as the steam entered the machine and at 131 degrees centigrade the timer was triggered.' The finger traced a plateau on the graph. 'The temperature held steady until the timer cut out and here…' Blaney's finger began to drop with the blue line. 'is where the steam was shut off and the temperature started to fall.'
'Thank you,' said Jamieson. He made a mental note of the reference number on the graph before asking, 'How often is the machine checked?'
'Dr Evans checks it out every week, sometimes twice.'
'You couldn't ask for more than that,' said Jamieson.
Blaney smiled modestly and said, 'We do our best.'
Jamieson returned to the Microbiology department to pursue his original intention of going to see Clive Evans but his mind was now almost totally preoccupied with the fact that Thelwell was removing surgical instruments from CSSD and holding them in his personal possession before they were used. Why? Why? Why?
He found Evans in what had been John Richardson's office. He was sifting through some papers.