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
