Jamieson followed the line of Vogel's knife and saw the festering, deformed tissue that had been a healthy uterus only two days before.
'We'll get this to the lab,' said Vogel. 'But there is no doubt in my mind. The Pseudomonas killed her.'
Jamieson left to return to the residency and this time he did not object to the strength of the wind. It would aerate his clothing. He always felt unclean after being in pathology for he knew that the smell of formaldehyde and the hideous odours from the exposed cadavers could cling tenaciously to clothes. He remembered that a long time ago a local cinema back home had started to use the same air freshener as was used in the hospital mortuary. He had stopped going to see films after that. The heavy scent had made him see something quite different on the screen from everyone else.
Jamieson took a warm relaxing bath and then made himself some coffee using the electric kettle that was provided in his room and a sachet of the instant sort he had bought down in the town. He planned to have an early night because tomorrow he would be back in theatre for the first time since the accident. He would not be doing anything other than observe but just being there was going to mean a lot.
As he lay in bed, he thought back to his accident and relived it. On that morning he had been driving in the outside lane of the M6 when a van coming in the opposite direction had swung violently to the right after a tyre had blown. It had mounted the central reservation and flipped over on to its side to tumble right into the path of his own car. There was nothing he could have done. He had careered headlong into it.
Immediately after the impact Jamieson was unconscious but when he did come round he started to remember little details about the moments leading up to the collision. Not all at once because, at first, his mind had been a total blank but gradually and usually when he was least expecting it, latent memory would restore to him a jigsaw piece of the event.
One evening, he suddenly found that he could remember the face of the van driver. It could only have been seconds before his own car had ploughed into the overturned vehicle and the vision could only have occupied the merest fraction of a second at the time but Jamieson could remember seeing fear on the man's face.
The vanman's passenger, a boy in his teens had only time enough to register surprise before death overtook him. The bumper of Jamieson's car had caught him in the midriff and crushed him against the rear stanchion of the cab. His arms and legs were flung out as if he were executing a difficult vault in a school gymnasium. This was another memory that could only have occupied the merest fraction of time but it had been stored in his subconscious as an indelible part of the record of that awful day. These particular visions returned to haunt him regularly.
Knowing that he had to be in scrub by ten, Jamieson got into the Microbiology lab dead on nine to check that his nasal swab was clear of potential pathogens and also to see if the Pseudomonas cultures he had inoculated on the previous day had grown. He was satisfied on both counts and Moira Lippman told him that she would be happy to prepare the biochemical reagents for the tests he wanted to do while he was in theatre. It was an offer that Jamieson was glad to accept but once again he reminded Moira that he did not want to interfere with her routine lab work.
'No problem,' smiled the girl. 'I can fit it in. Besides,' she added, 'I have a vested interest in seeing an end to this infection.'
'Tell me,' said Jamieson.
'My sister in law is due to come into Kerr Memorial next week for an op.'
'I see,' said Jamieson.
The nurses in the scrub area for the Gynaecology theatre had to make special arrangements for Jamieson. The bandages on his hands could not be removed to permit washing so they added more sterile dressings to them and sealed them inside sterile inspection gloves. They sealed the cuffs with sterile tape. One of them helped him adjust his mask to sit more comfortably over his face and he was ready to enter theatre.
'Good morning,' said Jamieson as he entered.
Thelwell, watching the preparation of the patient looked up at him but did not reply. Phillip Morton, who had been detailed to assist, said Good morning as did the theatre sister.
A nurse asked, 'Music sir?'
'Mozart I think,’ replied Thelwell. 'Unless anyone objects?'
No one objected. Heaven help them if they had, thought Jamieson.
The strains of Eine Kleine Nachtmusik began to fill the theatre affording it the ambience of an aircraft during boarding.
Phillip Morton supervised a junior houseman in the final preparation of the area where the first incision would be made. The green sheets were re-adjusted to display only the operating site and Morton said, 'Ready here sir.'
Thelwell looked to the anaesthetist and said, 'Well Dr Singh. Is she sleeping comfortably?'
'Like a baby sir,' replied the Indian.
Thelwell began with a preamble for the benefit of the junior houseman and two medical students who had been permitted to attend. A nurse turned down the music a little and Thelwell spoke to punctuating beeps from the monitor.
'Mrs Edelman is twenty nine years old. She is the wife of a German engineer who is based here in Britain with the car company he works for.'
'BMW,' said Phillip Morton but Thelwell just frowned and continued. 'Mrs Edelman has one child, a boy of three years but a later pregnancy was miscarried at eighteen weeks. She had a second miscarriage last year, again at around eighteen weeks and she and her husband decided not to try again. A few weeks ago she developed severe pain in her lower stomach and was referred to us by her GP. The scans we did show a sizable growth on her right ovary. We fear it may be malignant and today we are going to have a look and decide with the aid of the pathology department just what to do.'
Jamieson had been watching the theatre sister lay out the instruments in order. She knew what Thelwell would ask for first and held it in readiness while a more junior nurse waited behind her ready to replace instruments as they were used.
Once again Jamieson saw what he expected to see. Thelwell was a competent surgeon. He could not be faulted on anything as he performed what was a delicate though fairly routine operation. The discipline in the theatre was excellent and the team functioned with the efficiency of a group who knew each other well.
'How is she?' Thelwell asked the anaesthetist as the entire theatre waited for the pathology lab's verdict on the tissue that Thelwell had removed from the woman's ovary.
'Quite stable. No problems,' answered the man sitting at the head of the patient.
Thelwell looked at the clock again and tutted. 'They seem to take longer each time,' he muttered.
No one spoke for they knew that Thelwell always said that at this point in the proceedings. It was never true. The pathology lab was always efficient when it came to emergency sections.
The swing doors opened and a green clad figure came in to join them. 'I'm sorry, it's malignant,' she said.
'Thank you,' said Thelwell matter of factly then turning to the anaesthetist. 'Is she still all right?'
'No problems.'
'Might as well get on with it then.'
Thelwell detailed the extent of the tissue he would have to cut away for the benefit of the houseman and students and then proceeded to do it while Phillip Morton assisted. Jamieson admired the business-like way Thelwell went about the remainder of the operation. There was no hesitation, no pause for second thoughts or discussion of alternatives. He made his decisions as soon as they were required and then acted on them. The operation was over with laudable speed and Phillip Morton was left to carry out the final stages before the patient was allowed to begin a controlled ascent to consciousness.
'Thank you everyone,' said Thelwell, stripping off his gloves and leaving the theatre. Jamieson joined him outside for gown and mask removal.