Chameleon

'I see, so you're on the staff?'

'I'm the assistant bacteriologist in the microbiology department.'

'Dr Richardson's department?'

'That's right.'

'Been here long?'

'All of three months.'

Jamieson smiled. He was pleased to have found someone outside of the hospital hierarchy to talk to. 'You must be very much involved in the investigation of the infection problem then?' he asked.

Evans nodded. 'We're doing everything we can but we're not having any success and we're getting the blame for not finding out the cause.'

'Any ideas of your own?' asked Jamieson.

'It's a complete mystery,' said Evans. 'All the swabs we've taken from the surgical wards and theatres — and we've done hundreds — have been negative but Mr Thelwell won't accept this. He thinks we are incompetent and doesn't try to hide it.'

'And what do you think?'

'Dr Richardson is one of the best.'

'And Mr Thelwell?'

'It's not for me to pass comment on a surgeon, not my field I'm afraid.'

Jamieson nodded, pleased at the loyalty and common sense of his visitor.

'When do you think you will be up and about then?' asked Evans.

'Tomorrow,' said Jamieson firmly. 'I'll get the dressings changed in the morning and then I'll get started.'

'Then I'll probably be seeing you tomorrow,' said Evans. He held out his hand to shake Jamieson's and suddenly realised that it still might not be a very good idea. Both men laughed and Jamieson noticed that Evans had what looked like a red burn mark on the back of his right wrist. 'You must have got that from the heater in the bathroom,' he said with concern.'

'It's nothing,' Evans assured him, pulling down his sleeve and getting up from the chair.

'But you should have it seen to,' insisted Jamieson. 'Burns get infected so easily. You must ask one of the nurses to dress it properly.

'Really, it's nothing to worry about,' Evans assured him. It hardly broke the skin.'

Jamieson looked at him doubtfully and said, 'I'm very grateful to you for your help.'

'Don't mention it,' said Evans. 'I'd best be going. I'm on call tonight.'

As the door closed behind Evans, Jamieson lay back on the pillow and looked at his bandaged hands. He reflected on the day. 'What a start,' he murmured. 'What a bloody awful start.'

THREE

Outside in the courtyard between the block where Jamieson was sleeping and the old stone building that housed the Obstetrics and Gynaecology Department the rain continued to fall. Sally Jenkins heard it pattering down on the cobble stones. She had been unable to get to sleep for the pain in her stomach. 'Perfectly natural after any operation, the nurse had assured her. They would give her a pill and she would feel much better in the morning.

Keith, her husband had been equally reassuring. He had spoken to Mr Thelwell and everything had gone well in theatre. The surgeon had located a blockage in her fallopian tubes that had been preventing her from falling pregnant. The big fear that her tubes might have been too damaged to be repaired had been shown to be groundless. Mr Thelwell had successfully cleared away the obstruction and now there was no reason why she should not have children.

She would have a son for Keith, a boy he could take fishing on the canal on Saturdays while she and their daughter — yes she would like a daughter too — while she and Alice would have a nice day at home. They would call her Alice after Keith's mother. Keith's mother would like that. There had always been a frostiness between them, nothing serious, but Sally knew that old Alice blamed her for the fact that she still did not have any grand children after five years of marriage.

Alice would have preferred Keith to have married Stella Gorman, the girl he had been going out with when Sally had first met him. Stella Gorman's father owned a garage business in Trafalgar Street and Alice had already started to pencil in plans for Keith's future when it had all gone wrong for her. As it turned out, Keith had married her and as her father did not own a garage business, or any other kind for that matter, Keith was consequently still working as a mechanic in the council bus depot.

Sally managed a smile in the darkness despite the fact that her pain seemed to be getting worse not better. She did not want to bother the nurses again but it was becoming really bad. Perhaps if she thought some more about children it would take her mind off the pain or maybe even if she concentrated on the sound of the rain outside.

Sally liked the sound of rain. For some reason it always made her think of a time many years ago when she had gone camping with the Girl Guides. They had gone to the Forest of Dean and it had rained non stop for the entire week. They had spent hour after hour lying in their tents just listening to the sound of the rain on the canvas while their leader thought up endless variations on word games to keep them amused.

Sally had been glad to escape the games by being sent each morning to collect fresh milk from the nearby farm. Her wellingtons had squelched through the mud and the rain had pattered on the hood of her anorak just like it was pattering on the awning below her window.

A new stab of pain shot through her and wiped out all thoughts of rain and children. It made her gasp and reach out for the buzzer. Her fingers closed round it like a claw as the pain seemed to seek out the most sensitive nerve ending in her body. Her back arched in a sub conscious attempt to escape it but this only put unfair pressure on the stitches in her lower abdomen. Sally Jenkins added to the call of the buzzer with a scream.

The night staff-nurse in charge of Princess Mary ward called out the duty houseman who was reluctant to come at first for what he felt sure was probably normal post-operative discomfort but the nurse insisted. She won with a veiled threat to call Mr Thelwell directly. 'I think it might be another problem case,' she said.

'But it can't be,' insisted the houseman. 'Mr Thelwell used one of the orthopaedic theatres today. There's never been any trouble with infection in orthopaedics.'

'Well maybe there is now,' said the nurse, putting down the phone as another scream tore the air and wakened the rest of the ward. Sleepy voices were seeking reassurance as she hurried to Sally Jenkins' assistance. 'Nothing to worry about Mrs Elms… It's all right, Mrs Cartwright, we're dealing with it… Go back to sleep Mrs Brown, Nothing to worry about…'

The houseman, white coat pulled on over a hastily donned shirt which still had three buttons undone, arrived within five minutes and ran his fingers through tousled hair while the nurse briefed him. A cursory examination, established that Sally Jenkins' temperature was touching one hundred and two and she was showing all the classic signs of bacterial septicaemia. If this had been an isolated incident, he might have prescribed the normal front-line antibiotics and felt confident of their efficacy but with the current problem-infection in the unit he was reluctant to do this.

If there was a chance that the Pseudomonas was responsible for the infection then penicillin, always the safest drug to prescribe because of its safety and lack of side-effects, would have no effect. On the other hand, none of the other drugs at his disposal had had much effect on the bug in the previous cases. The houseman swithered for a moment, weighing up the pros and cons of seeking assistance. It was now after midnight but the desire to pass the buck on this one was overwhelming. He called Thelwell at home. Thelwell's wife answered.

'I'm sorry to disturb you at this hour Mrs Thelwell but could I possibly speak to your husband. It's Graham Dean at the hospital. I've got a bit of a problem.'

'I'm sorry Graham, Gordon isn't home yet. He's been attending a dinner this evening. Would you like me to give him a message?'

Dean gave Marion Thelwell a brief outline of Sally Jenkins' condition to relay to her husband when he came home and said that he would try to contact Thelwell's number two. After reading the number from the chart on the wall behind the phone, Dean called Thelwell's senior registrar, Phillip Morton and had more luck. He explained the situation to Morton and the buck passed to him. Morton said that he would be there within fifteen minutes. In the meantime, Dean was instructed to start chemotherapy immediately on the assumption that it was a Pseudomonas infection like the others. 'Start her on Pyopen.'