by Ken McClure
Porter turned to the two assistants who were waiting to clean up. ‘Be very careful.’
Three days passed without any word from the London lab dealing with the Taylor boy’s samples. Steven was collating paperwork he had obtained from various sources over the past couple of weeks when he suddenly saw something that made his blood run cold. It was the entry in Keith Taylor’s medical notes that recorded his receipt of a bone marrow transplant and that he was receiving immuno-suppressive treatment. He snatched up his phone and called Jim Brewer at Great Ormond Street.
‘Is BCG a live virus vaccine?’ he asked.
‘It certainly is,’ replied Brewer, a reply that made Steven close his eyes. ‘It’s an attenuated form of TB isolated by two French scientists in the Fifties — Calmette and Guerin, hence the name. BCG. Bacille Calmette-Guerin. What’s the problem?’
‘One of the kids I told you about, the ones who were given BCG vaccine at the school camp, was on immuno-suppressive drugs when he was vaccinated.’
‘Jesus,’ said Brewer. ‘I take it they didn’t know?’
‘The kid’s dead,’ said Steven. ‘Necrotising fasciitis — it swept through him like a runaway train.’
‘Jesus Christ, what a fuck-up.’
‘Looks like the medics who gave him the BCG didn’t know about the kid’s background and the medics who treated him in hospital didn’t know he’d been given the vaccine.’
‘I take it the lab grew the BCG bug?’
‘They didn’t grow anything. There are secondary tests being carried out by another lab at the moment.’
‘They might not look for TB,’ said Brewer. ‘It’s a lung disease, not exactly the thing you’d expect to cause a rip-roaring flesh infection.’
‘The first lab said they’d checked for everything,’ said Steven.
‘It might be as well to check with them again. TB grows very slowly in the lab compared to other bugs and it needs a special culture medium. It can take six to eight weeks to grow up while something like a streptococcus grows up overnight.’
‘I’ll do that,’ said Steven. ‘Thanks again.’
Steven felt sick inside. It looked very much as if a mix-up in paperwork had led to Keith Taylor’s death, a mix-up which had also led to his requesting an exhumation and causing the boy’s parents a great deal of stress on top of everything else. It had all the elements of a Bungling Docs story in the tabloids. He called the lab dealing with the Taylor specimens.
‘Nothing yet, I’m afraid.’
‘Have you set up cultures for TB?’
‘Just a moment…’
Steven drummed his fingers on the desk while he waited.
‘We wouldn’t normally,’ came the reply. ‘But in this case, because it doesn’t seem to be one of the usual suspects, we’ve set up cultures on every bacterial growth medium we have, including those for TB. If this bug grows in the lab, we’ll find it.’
Steven hung up before he was asked about his interest in TB. He wanted to talk things over with John Macmillan first. Knowing now that it would take the lab the best part of six to eight weeks to grow up the BCG bacillus, he decided to check with O’Connor, the microbiologist at the children’s hospital in Carlisle. It was he who had told him they’d looked for ‘everything we could think of’ in the Taylor boy’s specimens.
‘We got such a surprise when nothing grew up overnight that I told the staff to inoculate his specimens on every other culture medium we use,’ said O’Connor.
‘Would that include media capable of supporting TB?’ asked Steven.
‘It would.’
‘And?’
‘And nothing. No growth on anything.’
‘Would you just check again for me please?’
O’Connor put down the phone with a clatter. He returned after two minutes. Steven had followed the second hand sweep of his watch.
‘The cultures were discarded as being completely negative after fourteen weeks.’
‘Thank you,’ said Steven without further comment.
He decided not to talk it over with Macmillan until the following morning. He needed time to get things clear in his head. He had been concentrating so much on Keith Taylor’s death that he had lost sight of the connection he was looking for with the other vaccinated children who had developed skin complaints.
He decided to phone the children’s hospital in Edinburgh to ask about the condition of Patricia Lyons.
‘She’s very ill.’
This was not what he wanted to hear.
‘She has some kind of an infection in the flesh of her burned arm and it’s not responding to treatment.’
‘Some kind of an infection?’ said Steven. ‘What does that mean?’
‘It’s hard to say. The lab hasn’t found anything.’
NINE
The words hit Steven like a body blow. He mumbled a request to be kept informed if and when the lab came up with anything and hung up. He uttered a series of expletives as he thought things through. Surely Trish Lyons’ infection could not possibly be the same as Keith Taylor’s. If it was, it meant that his logical supposition that the BCG bacillus had somehow rampaged through the boy’s body because his immune system had been compromised was wrong. As far as he knew, there was nothing wrong with Trish Lyons’ immune system and for two children to have reacted the way they had to a vaccine that had been safely in use for fifty years seemed highly unlikely. Some other factor was involved, possibly something that Scott Haldane had recognised… and had been murdered to keep him quiet?
Steven spoke to John Macmillan first thing next morning. ‘I’m sorry, there’s much more to it than we first thought.’ He told Macmillan about Keith Taylor being given BCG vaccine when his immune system had been suppressed, something that brought a frown to his face which was quickly followed by a droop to his shoulders when Steven mentioned that Trish Lyons might also be suffering from the same infection.
‘Bad to worse,’ complained Macmillan.
‘There’s more. The lab at the children’s hospital in Carlisle should have grown the bacterium if it had been the BCG bacillus to blame but their cultures were all negative even after fourteen weeks. Trish Lyons’ cultures are also negative to date. There’s a chance that it’s a different infection altogether, a vicious, flesh-eating bug that the kids picked up at Pinetops that we can’t identify in the lab and can’t treat with antibiotics.’
‘Just what we need,’ sighed Macmillan. ‘How exactly are we proposing that the children got this infection — if it should turn out to be the same one?’
‘Actually there are several more children on the green sticker list who are complaining about skin problems.’
Macmillan closed his eyes and rubbed his forehead against the palm of his hand in a slow sideways motion. ‘Bloody hell,’ he murmured.
‘The only thing they have in common is the fact that they attended Pinetops school camp together and that they all received BCG vaccine while they were there.’
‘And of course, the reason they were given it in the first place,’ added Macmillan cryptically.
Steven looked at him questioningly.
‘They were all exposed to possible infection from Anwar Mubarak.’
‘Which was straightforward TB with no clinical problems according to the lab report…’ said Steven, his voice fading as he saw what Macmillan was suggesting.
‘But against which, as your friend pointed out, the authorities saw fit to vaccinate the whole camp — apparently without reference to medical history or background of any of the children,’ said Macmillan.
‘Maybe we should call a Code Red on this one?’ suggested Steven.
Macmillan nodded somewhat reluctantly but said, ‘I agree.’
The change to Code Red signified that a preliminary investigation by a Sci-Med investigator was about to turn into a full-scale investigation with all the powers that entailed. Steven would be able to request help and assistance at any time of the day or night through a special
ly manned switchboard set up at Sci-Med. He would have access to funds through special credit accounts set up in his name. He would have the authority to request assistance and information from the police authority in any area he was operating in with full backing from the Home Office. He could even request that he be armed should he feel that the situation warranted it. None of this would seem to be necessary in his current assignment but it was reassuring to know that everything was in place should he need it — or would be when Jean Roberts was told.
Macmillan pressed his intercom button and said, ‘Code Red on Steven’s assignment, please, Jean.’
‘What do you plan to do?’ Macmillan asked Steven.
Steven thought for a moment before saying, ‘I’m going up to Leicester to visit Anwar Mubarak. I want to see the boy; I want to see the cultures they grew and I want to see the drug sensitivity results from the lab. I need to be absolutely certain we’ve been told the truth.’
‘And if we have?’
‘Assuming the London lab dealing with the Keith Taylor specimens fail to grow anything, we’ll have to accept the possibility that we’re dealing with a new infection — probably viral as it seems to be resistant to antibiotics and nothing’s coming up on bacteriological culture media.’
‘And the first thing to do with a new infection…’ intoned Macmillan.
‘Is to establish the source of it,’ completed Steven.
Steven drove up to Leicester, hoping that at least, by the end of the day, one of the variables would be removed from the investigation, giving him a clearer sense of direction. There were just too many possibilities floating around at the moment: he was beginning to feel as if he’d been dropped in the ocean and wasn’t sure in which direction to swim. The receptionist at the children’s hospital didn’t help much.
‘We have no one here by that name,’ she replied after a brief examination of her screen, apparently not at all concerned that she couldn’t help. Steven wondered what it was about the British that so many people who disliked dealing with the public ended up in jobs entailing constant contact with them. He asked her to check again.
‘Still nothing,’ said the woman, peering over the top of her ornate glasses at the screen.
Realising that Mubarak’s name not being on the admissions register might have something to do with the authorities’ desire for secrecy over the affair, Steven showed her his ID and asked to speak to the Medical Superintendent.
‘Professor Lang is away until tomorrow. He’s at a conference in Geneva.’
‘Well, his deputy.’
The woman sighed and picked up her phone.
Steven was shown to a bright, modern room on the second floor. The name on the door said Dr N. Simmons. ‘Dr Simmons will be with you shortly,’ said the junior assistant who had led him up. ‘Please take a seat.’
Steven sat down, feeling slightly ill-at-ease staring at an empty chair on the other side of the desk. As the minutes passed, he thought about picking up and flicking through the copy of the British Medical Journal that lay there but then thought better of it. It might be construed as an invasion of personal space. As the wait extended to eight minutes, he considered getting up and going over to look out of the window but finding someone wandering about your office could also be intimidating. He sat tight until the door opened behind him and he turned to see an attractive dark-haired woman standing there. She seemed out of breath. ‘Hi, I’m Natalie Simmons, Professor Lang’s senior registrar. I’m so sorry to keep you waiting. My bleeper went off as I was coming along the corridor and I had to go back to the ward.’
Steven smiled and shook hands with the woman. ‘No problem. I’m Steven Dunbar.’
Natalie Simmons plonked herself down behind her desk and pushed her hair away from her face. She took a moment to examine Steven’s ID card before saying, ‘Well, Dr Dunbar, I’m afraid I’ve never heard of the Sci-Med Inspectorate but I’m sure you must have every right to be here and this all seems terribly official so what can I do for you?’
Another push of the hair and a big smile revealing even white teeth accompanied this.
Steven decided that he liked her. Natalie Simmons seemed open, friendly but blessed with beautiful green eyes that also somehow suggested an understanding of just how the world worked — a quality that could ultimately lead to cynicism or, as he suspected in her case, to a comfortable acceptance and amused detachment regarding the workings of the human race. He assured her that she wasn’t alone in not having heard of Sci-Med and told her briefly what they did.
‘I see, and where do we come into that?’
‘I need to speak to someone about one of your patients, a boy named Anwar Mubarak.’
‘Doesn’t ring a bell.’
‘He’s got TB.’
‘Really?’ exclaimed Natalie, sounding surprised. ‘I wasn’t aware we had any TB patients.’
Steven considered, but only for a moment, whether or not he should take Natalie Simmons into his confidence before saying, ‘He’s a recent immigrant. He attended a school camp up in the Lake District before they found out he had TB. The authorities are keen to keep this under wraps.’
‘I can see why — taking our houses, our jobs and giving our kids TB. Well, the authorities seem to have done it very well because I know nothing about this child at all.’
Steven felt that familiar sinking feeling come on. ‘Is there anyone else who might?’
‘I’d be pretty annoyed if there was,’ said Natalie. ‘I’m acting head of the Infectious Diseases Unit while Ralph is away. I’m supposed to know about these things. Bear with me.’
Natalie made a succession of phone-calls, which all ended in negatives. ‘I’m sorry, Dr Dunbar. None of my colleagues knows anything about this either.’
Steven shook his head. ‘Bizarre,’ he said. ‘There seems to have been some sort of misunderstanding but it’s my problem, not yours.’ He got up to go. As a last resort he asked, ‘I don’t suppose Professor Lang could be treating the boy somewhere privately because of the circumstances?’
Natalie made a face. ‘Frankly, I’ve never come across circumstances like this before,’ she said. ‘So your guess is as good as mine. He certainly didn’t mention it to me.’
‘Maybe I’ll call back tomorrow and ask him.’
‘Will that involve you making an overnight stop you didn’t plan on?’
‘I suppose.’
‘Look,’ said Natalie. ‘I have a number for Professor Lang. It’s supposed to be for emergencies but I’ll ring and ask him.’
Steven said he was grateful. He waited while Natalie called Lang but without success. ‘His phone’s turned off. Look, leave me your mobile number and I’ll try again later. I’ll let you know what he says and if it’s not too late you can still get off back to London.’
‘I’m much obliged,’ said Steven.
Steven didn’t know Leicester. He drove around for a while, getting a feel for it before finding somewhere to park and going for a walk. He found it easier to think on the move. He decided to save some time and phone John Macmillan before he left the Home Office for the night. He asked him to double-check on the whereabouts of Anwar Mubarak.’
Natalie called him at 5.30 p.m. ‘I’ve just spoken to Ralph; he was in a meeting earlier. He doesn’t know anything about this boy. At least, I’m pretty sure he doesn’t.’
‘I’m sorry?’
‘My fault, I’m afraid. I didn’t think you’d want me blurting out the question over the telephone in view of its sensitive nature so I got into rather a mess, asking about possible recent immigrant children being admitted with a disease starting with “t” that I didn’t know about but he might.’
Steven had to put his hand to his mouth to avoid laughing.
‘I think Ralph must have thought I was drunk at first but then I told him that it was an inspector from Sci-Med asking the question and he caught on. The bottom line is that he knows nothing at all about it.’
‘Thank you ver
y much,’ said Steven. ‘I’m very much obliged to you.’
‘Not at all. I suppose there must have been some kind of mix-up somewhere?’
‘There’s not another children’s hospital in Leicester, is there?’
‘No.’
‘Would you care to have dinner with me?’ asked Steven, surprising even himself.
‘I’m sorry?’
‘No, I’m sorry. I asked if you’d have dinner with me without thinking. You’ve probably got a husband and children waiting for you at home.’
‘No… I haven’t as it happens,’ said Natalie.
‘Then the offer still stands.’
‘I thought you were anxious to get back to London.’
‘No, you thought I was anxious to get back to London,’ said Steven. ‘I’ve contacted Sci-Med about the confusion. There’s little point in me going anywhere until I hear back from them and that’ll probably be tomorrow — Whitehall goes home at five o’clock.’
‘I see, well, in that case I’d be delighted to have dinner with you.’
Steven booked himself into a small hotel, had a shower and changed, using the ‘just in case’ travel bag he kept in the back of the car. He met Natalie at the restaurant she had suggested, arriving five minutes before she did.
‘This is an unexpected surprise,’ she said. ‘I can’t remember the last time I spent an evening alone with a complete stranger.’
‘Just means there’s so much more to talk about,’ said Steven. And there was.
During the course of the next two hours, Steven learned that Natalie — ‘Tally’ to her friends — had been born and brought up in Bromley, in Kent. She was thirty-five years old and had studied medicine in Sheffield. She’d got married at twenty-seven to Rupert Giles, now an orthopaedic surgeon in London, but they divorced three years later when it was discovered that she couldn’t have children. ‘That wasn’t the only reason,’ said Tally. ‘But it was quite a big factor. Let’s say, it undermined what little foundations we had.’