Chameleon

by Ken McClure

  'Because I'm pregnant,' replied Sue.

  TEN

  'That is absolutely marvellous!' exclaimed Jamieson enfolding Sue with both arms and holding her tightly. He rested his cheek on the top of her head.

  'You're sure you're pleased?' asked Sue, her voice betraying evidence of doubt.

  'Pleased? How could you think anything else? I'm absolutely delighted! I can't begin to tell you how glad I am,' said Jamieson, letting Sue go and spreading his hands as if appealing for divine assistance. The look on his face now left Sue in no doubt about how he felt and their eyes met in one of these moments when two people in love achieve almost perfect communication. It made Jamieson think momentarily on the last time it had happened. It had been near the end of his time in hospital after the accident. It had been on the day he had realised just what an insufferable fool he had been and he had apologised to Sue for his behaviour.

  For Sue, it had been the moment when she knew she had got her man back. The change in Jamieson's personality had not been permanent as she had feared in her worst moments. The self-pitying, sarcastic monster she had been putting up with for months had vanished. After Jamieson's apology they had looked at each other without saying anything but understanding everything. Sue had cried for the first time since the accident but the tears had been of relief and happiness.

  A knock came to the door and Jamieson opened it. He found Clive Evans standing there.

  'I thought I heard voices,' said Evans.

  'Come in,' said Jamieson. 'Meet my wife. I've just had some wonderful news.' Jamieson's face was creased in smiles. 'I'm going to be a father.'

  'Congratulations,' said Evans warmly. 'Is this your first child Mrs Jamieson?' he asked shaking Sue's hand.

  'Please call me Sue. Yes it is.'

  'What are you hoping for? Boy or Girl?'

  Sue looked at Jamieson and said, 'Well?'

  'Don't care,' said Jamieson putting his arm round Sue again and squeezing her shoulder. 'Mind you, if it should be a boy and if he should play wing three-quarter for Scotland, I can't honestly say that I'd be terribly disappointed.'

  The laughter was cut short when Jamieson noticed the look on Evans' face and he realised that something was wrong. 'Something's the matter?' he said.

  Evans nodded. 'I knocked on your door to tell you that one of the women in ward eight has died and two more are deteriorating fast. The antibiotics aren't working.'

  'This is crazy,' said Jamieson. 'Surely we can't have a second infection immune to treatment. Are you sure it's not the Pseudomonas again?'

  Evans shrugged apologetically and said, 'I can only say what I found on the slide. It definitely looked like a Staphylococcus infection. 'I suppose it's possible that the Pseudomonas is still lurking there. We won't know for sure until the morning.'

  Jamieson sighed in frustration and said, 'I suppose we'll just have to bite the bullet until then.'

  'Fraid so,' agreed Evans.

  Jamieson thanked Evans for bringing him the news and showed him out.

  'What does he do?' asked Sue.

  'Clive Evans? He's the bacteriologist at the moment until they appoint a replacement for Richardson. He has the room next door.'

  'It sounds as if your infection problem is getting worse not better,' said Sue.

  Jamieson nodded and told her about the eight women who had developed infections in the last twelve hours.

  'Eight!' exclaimed Sue.

  'Within hours of each other.'

  'Did they all have their operations on the same day?' asked Sue.

  'I thought of that,' said Jamieson. 'No they didn't and so far I haven't uncovered any other common factor.'

  Sue went through the options that Richardson and the ward sister had already considered and then lapsed into silence for a moment while she tried to think of another idea. Jamieson switched on the electric kettle to make coffee.

  'Why has it taken so long this time for the infection to develop in these women?' Sue asked. 'I seem to remember you saying that the others developed the illness within hours of their operation.'

  'They did,' agreed Jamieson. 'But this time Evans thinks it's another bug to blame.'

  'This isn't a hospital,' said Sue. 'It's a septic tank!'

  'But it's not,' replied Jamieson.

  Sue looked puzzled.

  'Everything is spotlessly clean and sterile and no one can find where the contamination is coming from. That's the real problem. It appears to come out of the blue.'

  'No ideas at all?'

  'One,' replied Jamieson a bit reluctantly.

  'Well, I'm waiting.'

  'It could be deliberate,' said Jamieson.

  Sue looked aghast, as if she couldn't believe her ears. There was a long silence before she whispered, 'You can't be serious.'

  'I wish I wasn't,' said Jamieson. 'But if we can't find the source of the infection after all the tests that have been done I have to consider the possibility of deliberate sabotage.'

  'But how?' asked Sue, her mind rebelling against the notion. 'Why?'

  'At the moment I'm considering the possibility that the instruments used in surgery have been deliberately interfered with.'

  'But that is absolutely awful!' exclaimed Sue. 'Surely there has to be another explanation? Who in their right mind would do a thing like that?

  'No one in their right mind,' said Jamieson, putting emphasis on the word, 'right'.

  'You mean someone mentally deranged? On the staff?' Sue asked, her eyes wide with horror.

  'Frankly I don't know what I mean right now but certain things need explaining.'

  'Like what?'

  'Like why does a consultant surgeon take it upon himself to collect surgical instruments from the sterilising department and keep them in his office overnight and why does the same consultant surgeon lie about going to choir practices in the evenings when he is doing no such thing.'

  'You have been busy,' said Sue. 'I take it we are talking about Mr Thelwell?'

  Jamieson nodded.

  'Have you tackled him?'

  'About the instruments, yes'

  'And?'

  'He said he took them to prevent them being interfered with.'

  'Then he thinks the same as you?'

  'Or he is doing the interfering,' said Jamieson.

  'A surgeon?' exclaimed Sue. 'You think that Mr Thelwell is infecting his own patients?'

  'I said that it's a possibility I'm considering,' replied Jamieson. 'I have to and apart from anything else, the man clearly has a problem. He's quite paranoid.'

  'But that doesn't necessarily mean that he's psychotic,' retorted Sue.

  'No,' agreed Jamieson. 'But he is a liar. He's been telling his family that he has been going to choir practises when he's not.'

  'So, he's having an affair,' said Sue. 'I don't see what the missed choir practises have to do with the deaths in the hospital.'

  'They haven't,' agreed Jamieson. 'It was the deaths outside the hospital I was thinking about.

  Sue looked at Jamieson for a moment as if he had gone mad. She searched for words but remained speechless for a long moment until finally she managed to protest. 'You can't mean it! You are talking about the murders in the city?'

  'He's a surgeon. The bodies have been dissected. He is paranoid to the point of being clinically borderline in my opinion and he lies about where he's going in the evenings. He interferes in the supply of sterile instruments to the theatre and the body of the last victim was found in the incinerator of this hospital. Food for thought?'

  'Is he still operating?' asked Sue.

  'No I had to suspend him when Richardson found the infecting organism in his swab but when he gets his final clearance from the Public Health Lab there's nothing I can do to stop him.

  'If you're really serious about this, can't you have a word with the police?' asked Sue.

  'I need something more than bad feelings before I go to the police about a consultant surgeon and pillar of the community,'
said Richardson.

  'But what about these choir practices he says he goes to?' said Sue. 'Where does he really go? '

  Jamieson nodded and said, 'That's something I intend to find out very soon.'

  'You mean you are going to follow him?' asked an astonished Sue.

  'Exactly that. He doesn't know that I know about the choir practice lies. That gives me an edge.'

  'You don't think you're taking this detective bit a little far?' said Sue. 'Maybe the professionals should do this sort of thing?'

  Jamieson nodded and said, 'I know what you mean but it's a simple enough thing to follow Thelwell just once to see where he really goes. If I find out anything, I promise I'll hand the whole business over to the police.'

  Sue smiled. 'All right,' she said. 'Just once.'

  At Hugh Crichton's suggestion, Jamieson and Sue moved their things to a second floor room in the residency rather than have her move out into the apartment that Sue's father had arranged for her. Ostensibly this was so that Jamieson could remain on hand in the hospital at all times and still be with his wife but Jamieson's slight resentment of Sue's father's involvement in their lives had played a part in the decision. This was not mentioned. As yet, Jamieson had never openly complained to Sue about her father's constant involvement in their marriage because he knew that it would sound ungrateful after all Sue's father had done for them during his long stay in hospital but the potential for trouble in the future remained.

  Clive Evans gave them a hand with their luggage. 'No more heavy lifting for you,' Jamieson said to Sue.

  'It's a bit early for that,' smiled Sue.

  When they had moved everything upstairs and Evans had left them Jamieson noticed that Sue had become much more subdued. 'What's up?' he asked.

  Sue looked up at him from the chair she was sitting on and said, 'I suddenly feel ridiculous.'

  'Why?'

  'It seemed the right thing to do to come here to be with you but now that I am here I feel like a silly schoolgirl. I should have stayed in Kent.'

  'No you shouldn't,' said Jamieson softly. 'Its lovely having you near me. We belong together. But it's not going to be much fun for you. I've got to get to the bottom of this business.'

  Sue suddenly burst into tears and put her head on Jamieson's shoulder. 'Oh dear,' she said. 'Does being pregnant mean behaving like this all the time?'

  Jamieson held her and shushed her gently. 'Dry you eyes,' he said. 'We'll go out to dinner. The three of us.' He patted Sue» s stomach and she smiled.

  They were half way through dinner when Sue suddenly laid down her knife and fork and looked at Jamieson, wide eyed.

  'What's wrong?' asked Jamieson.

  'The women weren't infected during their operations at all,' said Sue.

  'I beg your pardon,' said Jamieson, taken aback at Sue's sudden statement.

  'The infected women in the ward,' said Sue. 'They didn't pick up the infection during surgery at all.'

  'Go on,' said Jamieson, putting down his knife and fork.

  'The infection was caused by something in the post-op ward.'

  'It's been cleaned and disinfected,' said Jamieson.

  'I didn't mean that.'

  'Then what?'

  'Their dressings,' said Sue.

  'Their dressings?'

  'The chances are that the women all had their dressings changed during the same ward round. That's when the infection could have set in.' That's why they all developed the illness together. The bug was in the dressings.'

  'Contaminated dressings?' said Jamieson quietly. 'God, you could be right.' He left the table to phone the hospital from the public phone at the side of the bar. He watched Sue play idly with her cutlery while he waited for the hospital to answer. It seemed to take an age.

  'Kerr Memorial,' said the voice.

  'Surgical gynaecology,' said Jamieson.

  'They're engaged at the moment. Will you hold caller?'

  Jamieson said that he would through gritted teeth. He shrugged as Sue caught his eye.

  'Surgical, Sister Roache speaking.'

  'This is Dr Jamieson, Sister. I need some information about the application of surgical dressings in the ward.'

  'What exactly do you want to know?' asked the nurse.

  'Tell me everything. I want to know your routine for changing them. I also want to know when you do it and the order in which they're done. I need to know who does them and how often the routine changes. Everything.'

  'Let me see now,' said Sister Roache. 'New patients are treated on an individual basis so for them, it could be any time. After a couple of days on the ward patients would have their dressings changed after morning ward rounds, say some time from ten thirty onwards. It would be done consecutively.'

  'All of them?'

  'Yes.'

  'But you have seventeen patients in the ward at present if I remember rightly?' said Jamieson.

  'Seventeen, yes.'

  Jamieson cursed under his breath. If all of the women had had their dressings changed consecutively why had only eight developed wound infections?

  'Size!' whispered Sue who had come across to eavesdrop on the conversation. 'Ask about the size of the dressings!'

  'What size of dressings were used in the changes Sister?' Jamieson waited while she went to check.

  There was an excitement in Sister Roache's voice when she came back to the phone. 'I think you may have your common factor Doctor,' she said. 'The eight infected women were given 200mm dressings the others had various other sizes used on them.'

  'Were the 200mm dressings all from the same pack?' asked Jamieson with baited breath.

  'It would appear so,' replied the nurse.

  'Are there any left from that pack?' asked Jamieson.

  'I'd have to check.'

  'If there are put them to one side. Don't let anyone near them. I have to get them to the lab.'

  'Very good.'

  Jamieson put down the phone. 'You were right,' he said to Sue. 'You're a genius. It was the dressings. An unsterile pack of dressings'

  'But how did they get to be unsterile?' replied Sue.

  Jamieson shook his head as a black cloud swirled around inside his head.

  When they got back to the residency Jamieson went immediately up to the Gynaecology Department and spoke to Sister Roache. She handed him a dressing pack with only two remaining in it. Jamieson was careful not to touch either of them.

  'Staff Nurse Telfer says that this was the pack that was used,' said the sister. 'She and student nurse Barnes applied them.' Jamieson said that he would take them to the lab and asked about the condition of the infected women.

  'Not good. I've never known such a virulent outbreak of wound infection before.'

  Jamieson didn't tell her that this was an entirely new infection but he thought about it on the way over to the Microbiology Department. That two completely different organisms had caused such havoc in the same department only reinforced his growing suspicion that the contamination was not due to a quirk of fate. Something much more sinister was behind it.

  Jamieson saw a light on in the microbiology lab and found Moira Lippman there. 'I didn't know you were on call tonight. 'This is a bit of luck,' said Jamieson.

  'What can I do for you?' asked Moira.

  Jamieson thought the girl sounded a bit distant but let it pass. He asked her about setting up some microbiological tests on the dressings.

  'Of course,' said Moira Lippman. 'Just leave them there. I'll do them in a moment.'

  The girl turned back to the bench to continue with the specimen she was dealing with and Jamieson felt compelled to ask, 'Is something wrong Moira?'

  Moira Lippman put down the tubes she had been holding and laid her hands flat on the bench in front of her. 'My sister in law is one of the infected women,' she said quietly.

  'I'm sorry. I didn't realise,' said Jamieson softly. 'How is she?'

  'Very ill. They all are.' Moira Lippman swung round in her chair and loo
ked directly at Jamieson. 'There's something crazy going on here,' she said.

  'Go on,' said Jamieson.

  'It's a Staphylococcus infection this time yet it's behaving in exactly the same way as the Pseudomonas. None of the usual antibiotics are having any effect at all. We are having to run a race to find alternative drug combinations. Two highly drug resistant infections in a row. How can that be?

  'Infections that are resistant to treatment are not unknown,' said Jamieson.

  'But two in succession? In the same department? There's something not right about this whole affair.'

  'If it's any comfort I share your disquiet,' said Jamieson. 'I can't say more than that at the moment.'

  Moira nodded and shook her head slightly. She returned to what she was doing.

  Jamieson left the lab to return to the residency. As he crossed the courtyard he saw two porters emerge from the side door of Gynaecology. They were wheeling a covered trolley in the direction of the mortuary.

  'Can't you sleep?' whispered Sue.

  'I'm sorry. Did I wake you?' replied Jamieson in the dark.

  'It's all right. What's on your mind?'

  'Something Moira Lippman said when I spoke to her earlier. She said that there was something 'not right', to use her expression, about there being two such virulent infections occurring in the same department.'

  'You mean the possibility of deliberate contamination has occurred to her too?' asked Sue.

  'No I don't think she was going that far,' said Jamieson. 'Moira was talking purely about the organisms involved.'

  'I don't see what you are getting at,' said Sue.

  'How would you go about contaminating surgical instruments if you had to?' asked Jamieson.

  'What a question. I suppose I would just break the sterility seal and expose them to the atmosphere for a while. Maybe drop them on the floor. Spit on them? I don't know really. Something like that.'

  'And then they would be unsterile?'

  'Yes of course, wouldn’t they?'

  'Indeed they would but just think for a moment. Take it a step further. What sort of organisms would they be liable to attract?'

  'Oh, I think I see what you mean,' said Sue. 'Your chances of picking up something really nasty are pretty remote?'