Chameleon

Gordon Thelwell called the hospital at a quarter to one to say that he had just arrived home and understood that his houseman, Dean, had been trying to contact him earlier in the evening. He spoke to the night staff-nurse in charge of the ward where Sally Jenkins lay and was given a report on her current condition and an outline of the treatment prescribed for her by Phillip Morton.

'Appalling!' exclaimed Thelwell. 'This whole hospital is a cesspit of infection.'

The nurse remained silent and waited for Thelwell to continue. He asked her what specimens had been sent to the lab and she told him after referring to the ward lab records book.

'I hope they're not just lying in the collection basket,' said Thelwell.

'They were marked urgent and the duty microbiologist was called out to deal with them sir,' replied the nurse.

Thelwell grunted and asked if Dean was still in the ward.

'No sir,' replied the nurse. 'Mrs Jenkins seems to be stable at the moment sir. Dr Deans left about fifteen minutes ago.'

Thelwell grunted and asked to be informed if there was any change in the patient's condition.

'Of course sir,' said the nurse.

'We'll see how she is in the morning.'

'Yes sir.'

'Trouble dear?' asked Marion Thelwell, sitting up in bed and blinking against the light which her husband had switched on.

'One of my patients. She may have a wound site infection,' replied Thelwell distantly.

Marion Thelwell stopped blinking and looked concerned. 'Not another problem case,' she sighed. I thought you were going to use the Orthopaedic Theatre today?' she said.

'I did use the Orthopaedic theatre,' snapped Thelwell.

'Yes dear.'

Thelwell regretted his sharpness and apologised saying, 'I'm afraid I'm a bit on edge. This business is getting me down.'

'I understand dear. Come to bed.'

'Later.'

'Yes dear.'

Scott Jamieson woke at three in the morning. He usually did when something was troubling him. It was no comfort to know that he was one of thousands in the country who woke regularly at this time. Nature had decreed that three in the morning was the hour when people with problems ranging from the unmanageable size of their mortgage to true manic depression would wake to face their personal hell. Optimism required daylight. Despair thrived in the dark.

He felt alone as he lay in the subdued night-light of the strange ward listening to the sounds of the night. He missed not having Sue next to him. He missed not being able to stretch his arm over her sleeping body to cuddle in to her. He resolved to oppose any possible suggestion in the years to come that they change to single beds. It irked him that he had got off to such a bad start in his new job. Almost subconsciously he flexed the fingers of both hands beneath the bandages to assess how painful they were. It was academic really for he had already decided to start his investigation in the morning however badly he felt. As it happened, they did not feel too bad at all.

His impatience to get on with the job was not entirely due to his inability to come to terms with imposed idleness. It was reinforced with the belief that if he did not get on with the investigation Sci-Med might well feel obliged to send in someone else and that would mean that he had failed, a completely unacceptable state of affairs for Scott Jamieson whatever extenuating circumstance there might be.

As Jamieson closed his eyes and tried to get back to sleep in the ward, the telephone rang beside John Richardson's bed and woke him from a deep sleep. He took a few moments to clear his head and then held the receiver to his ear.

'I'm sorry to trouble you at this hour,' said Clive Evans's voice but I was called out a couple of hours ago for a patient in post-op, one of Mr Thelwell's patients, a Mrs Sally Jenkins. She's being showing signs of wound infection and Mr Thelwell's registrar took swabs for testing.'

'And?'

'Gram-negative bacilli and a positive oxidase test. It looks like it's the Pseudomonas again. I thought you would want to know.'

'Yes, thank-you,' said Richardson putting down the phone. His wife who was awake beside him asked about the call.

'Another post-operative infection in Gynaecology.'

'But I thought Thelwell had closed the Gynae theatre?'

'He did,' replied Richardson thoughtfully. He insisted on moving his scheduled operations to the Orthopaedic suite until we had traced the source of the outbreak.'

'Then it looks like he took the infection with him.'

Richardson looked at his wife and said, 'This is exactly what I have been saying all along. If we can't find the source of infection in the theatre itself then the fault must lie with the staff. It's time we swabbed the whole surgical team again; we must have a carrier among them. It's the only logical explanation. For some unknown reason we must have missed him…'

'Or her.'

'Or her, the first time around.'

Jamieson awoke to the sound of two nurses talking. They were standing in the doorway of his room, one with her hand on the door knob and the other standing in the corridor outside with a steel tray in her hand. As he became fully awake Jamieson could make out some of their conversation.

'They say he cut her to pieces,' said one of the girls.

'That's what I heard too,' agreed the other. I don't understand how no one heard her screams.'

'Maybe they did,' said the other girl. 'They just pretended not to, a sign of the times, I'm afraid. People just don't want to get involved.'

The nurse with her hand on the door handle noticed that Jamieson was awake and cut short the conversation to come into the room and close the door behind her.

'What was that all about?' asked Jamieson.

'A prostitute was murdered in the city last night,' replied the girl.

'I heard about that,' said Jamieson.

'No, this is another one. It happened last night. You're thinking of the first one.'

'Two in two days,' exclaimed Jamieson.

'He cuts them up,' said the girl.

Jamieson grimaced.

'Just like Jack the Ripper, they say.'

Jamieson guessed that 'they' would be the morning papers.

'How are you feeling?'

'Right as rain. I want to leave as soon as I can get the dressings changed.

'I think you should wait till Dr Carew has seen you. You're an important patient.'

Jamieson smiled at the girl's frankness and said, 'I'll take the responsibility.'

'If you say so doctor.'

Jamieson was back in his room in the doctors' residency shortly after breakfast and was pleased to see that the wall behind the bath had been repaired and the heater was back on its mounting. All the same he could not see himself using it again however cold the room might feel. He telephoned the hospital secretary's office and informed him that he was ready to start talking to people.

Crichton was surprised that Jamieson was back in action again so soon and expressed concern over the wisdom of leaving the ward so quickly. Jamieson bore it patiently then asked for help in organising his day.

'Fate has taken a hand Doctor, ' said Crichton. 'A patient that Mr Thelwell operated on yesterday has developed an infection despite the fact that the operation was carried out in a different theatre in a different part of the hospital. We are holding a meeting at ten to discuss the situation. Perhaps you would like to attend?'

'I would indeed,' agreed Jamieson. 'Just one question. Where was the patient taken after her operation?'