Williams furrowed his brow. ‘You know, I don’t rightly know. I was informed by telephone of the situation.’
‘By whom?’
‘A Department of Health official, I think he called himself, snooty bugger as I remember. I guess the kid must have had tests before he or she came here and the results caused the shit to hit the fan.’
‘I suppose,’ agreed Steven who had noticed that Williams had not given away whether the child was male or female. Was this because he didn’t know?
‘What happened to the boy?’ he asked.
‘I’ve no idea.’
‘But it was a boy?’
‘I don’t know.’
Steven looked surprised in order to provoke further comment.
‘I suppose he or she was taken off to hospital but I wasn’t asked to make any of the arrangements so I didn’t see it happen. I was just asked to organise the other kids for vaccination.’
‘Do you know which school the child was attending?’
‘I don’t think they said,’ said Williams. ‘Does it matter? What could I have done?’
‘You’re right,’ agreed Steven, backing off. ‘The medical authorities seem to have had everything in hand and you had another hundred kids to worry about. Can you remember how long after the initial phone-call the other children were vaccinated?’
‘Next day,’ said Williams. ‘The team was here at ten sharp next morning and we had the kids ready and waiting. I remember we had a late start that day to outdoor activities.’
‘Well, no untimely delays there,’ said Steven. ‘Sounds like a very efficient operation.’
‘Maybe you’d like to see round the camp, see the clinic for yourself?’ asked Williams, who clearly wasn’t at all sure what Steven’s interest was in all of this.
Steven said that that wouldn’t be necessary, congratulated Williams on having such an enviable job and left. Deciding that he felt hungry — he had missed out on lunch — he drove along the shore to Ambleside and found somewhere advertising all-day-food.
He had to admit that he hadn’t come up with anything about the handling of the situation at Pinetops that could have upset Scott Haldane although he did feel a bit puzzled about the apparent secrecy surrounding the identity and movement of the sick child while at the camp. It was understandable after the event and the reasons given by the authorities to Macmillan and relayed by him had seemed valid enough. Anything to do with race relations issues and possible problems affecting them had to be handled with kid gloves — but the more he thought about it, the odder it seemed that Williams, and presumably his staff, knew nothing about the child. He was chewing his way through a particularly tough gammon steak when another thought struck him. How did the Department of Health know about the child so quickly? Williams had told him that it was someone from DOH who had phoned him. How did the ‘snooty bugger’ know so quickly?
‘Is everything all right for you?’ asked the waitress.
Steven nodded. ‘Fine.’ It wasn’t but it was hard to break the habit of a lifetime. Surely, he reasoned, a sick child with lung problems would be seen by his or her GP and referred to a local hospital for X-rays and tests. It was they who would make the diagnosis and arrange for the child to be admitted to hospital. There would have been no need to involve the DOH. Steven paid and left. He walked down to the edge of the lake and threw a couple of pebbles into the water while he continued to follow his line of thought.
TB was a notifiable disease, which meant that the hospital would be obliged to report any incidence of it, but notification would almost certainly be to the local health authorities in the first instance. DOH would be involved in collating national figures but surely not in individual cases and certainly not in the practical aspects of vaccinating contacts.
Maybe he was making a mountain out of a molehill, he conceded as he started to walk back to the car, but there was something not quite right about how things had been handled at official level and he wanted to know what. It preyed on his mind all the way home. There was a message from Jenny on his answering machine when he got in.
‘Daddy, I’m ringing to say I’m sorry about what I said but you’re not there. Auntie Sue says I can stay up till nine o’clock if you want to call me back. Love you.’
Steven looked at the time. It was 2 a.m. ‘Shit,’ he murmured as he poured himself a nightcap. It was impossible not to imagine Jenny’s face when 9 o’clock had come and gone. It was an image that reappeared at intervals during a restless night. He was up early to call her before she left for school.
‘Hello, nutkin, I’m sorry I was out when you called last night. I was working. I was driving home at the time but it was lovely to hear your voice when I got in.’
‘You work very late, Daddy.’
‘Sometimes I have to, nutkin.’
‘Auntie Sue says that’s why you can’t look after me and not because you don’t love me.’
‘Auntie Sue’s right, Jenny. I love you very much. We all do.’
‘That’s what Auntie Sue said.’
‘Auntie Sue’s very wise.’
‘Are you coming up at the weekend, Daddy?’
‘You bet.’
‘Can we go swimming?’
‘Of course we can.’
Steven put the phone down and let out his breath in a long sigh of relief as the tension he had been feeling over Jenny left him. He felt in a good mood as he set out for Great Ormond Street Hospital. He wanted to have a word with an old friend before he went in to the Home Office. Jim Brewer and he had gone through medical school together. Brewer had pursued a more traditional career path and was now a consultant physician, married to Linda, a radiologist who worked at another London hospital. Steven had last seen them both at the christening of Gerald, their third child, some two years ago. He noticed that his friend’s reddish fair hair had become thinner in the interim and his waistline thicker as he headed for his forties but he seemed relaxed and at ease with the world. A round peg in a round hole, thought Steven. Can’t ask for better than that.
With the pleasantries over, Brewer asked, ‘Well, Action Man, what can I do for you?’
‘I need some advice,’ said Steven. ‘I’d like you to imagine that you have a hundred or so children living together at a school camp and one of them is confirmed as having tuberculosis… what happens next?’
Brewer rested his elbows on his desk and made a steeple with his fingers. ‘Well, let’s see. The child would have to be admitted to hospital for assessment and the start of treatment. Assuming that it wasn’t a problem strain — resistant to one or more of the front-line drugs — he or she would be started on triple chemotherapy — streptomycin, PAS and isoniazid. They’d be kept on that regime for at least six months but they could be released from hospital once their sputum had gone negative and they weren’t infectious any more. Does that answer your question?’
‘What about the other children?’
‘Close contacts would be screened for the disease, as would family members of course. Depending on the outcome of the tests they would be vaccinated or even put on treatment themselves if they were showing signs of infection.’
‘How about non-close contacts, say, children at the camp but from another school group?’
‘Skin tests.’
‘I take it it’s still the Mantoux test we’re talking about?’ asked Steven.
Brewer nodded. ‘Nothing much has changed in the last fifty years.’
‘What would you think to the idea of vaccinating the whole camp immediately?’
‘With BCG?’
Steven nodded.
‘Without skin testing first?’
Another nod.
‘Sounds way over the top,’ said Brewer. ‘Unless of course there was some good reason for doing it.’
‘Like what?’
