He opted for the rigours of life in the Parachute Regiment and had been extensively trained, first as a soldier and then in field medicine. The next few years brought all the physical challenges he could have ever dreamed of as he served with units of the regiment and occasionally on secondment to Special Forces. It was, though, a lifestyle that couldn’t continue indefinitely, and when the time came for him to stop he knew and accepted it. The big question had been what to do next.
The army ran courses for officers returning to civilian life but Dunbar wasn’t included. He was a doctor; it was assumed he’d be returning to medicine in civvy street. Luckily, he had confided in a fellow officer that he had no wish to continue in medicine, for a while at least. This had led to a suggestion through a friend of a friend that he might be suitable for a job with the Sci-Med Inspectorate. Now, after four years with Sci-Med he felt settled and content.
No two assignments were ever the same; each was demanding in its own way and, being concerned exclusively with problem areas in medicine, he was obliged to keep abreast of the latest advances in his profession. His readiness to move to assignments at a moment’s notice was part of the job, wherever they happened to be in the UK.
The only real drawback to his lifestyle was that he was seldom in one place long enough to establish relationships. At thirty-five he was still unmarried.
Dunbar flipped open the slim file on Amy Teasdale. She had suffered almost continual renal problems from birth. Various treatments had been tried in a variety of hospitals while she waited for a suitable organ to become available, but her condition had deteriorated until, after a period of particularly severe illness, she was admitted to Medic Ecosse. The team there managed to stabilize her long enough for a suitable donor organ to be found.
Unfortunately the story had not had a happy ending. Amy’s body had rejected the organ almost immediately, despite the computerized match being good in terms of tissue compatibility. A copy of the Medic Ecosse comparator sheet was included. Cause of death was given as severe immune response to the presence of foreign tissue, despite satisfactory in vitro compatibility. As the compatibility rating of the donor organ was given as 84 per cent, Dunbar thought Staff Nurse Fairfax’s complaint that Amy had been given the wrong organ did not sound too convincing.
He turned to the file on Lisa Fairfax herself. In view of what had gone before, it was possible that the nurse’s claim might have stemmed from her having been deeply fond of young Amy Teasdale and correspondingly upset by her death — always an occupational hazard for staff in children’s wards. She obviously believed that the immunological reaction she had witnessed in her young charge had been caused by the child receiving an incompatible organ, but her reaction could have been inspired by grief and the inherent need to explain away an emotionally unacceptable happening.
Despite assurances from the hospital authorities that there had been no mix-up and that Amy had received an entirely compatible kidney, as shown by lab analysis, Lisa Fairfax had persisted in her claims and she and the hospital had parted company. It looked like a classic case of a nurse allowing herself to become too involved with her patient, thought Dunbar.
He closed the file. It seemed straightforward on paper, although the question of why Staff Nurse Fairfax had persisted with her allegations until Sci-Med became aware of them puzzled him. People did tend to make wild claims and accusations when they were deeply upset, but after a period they usually recovered and, in many cases, were embarrassed about things they had said under stress. Maybe he should arrange a meeting with her, to see if there was more to her than had come through in the report.
He looked to see if there was any more about her and found a one-page personnel file. It included her address and some background material, including the fact that she had worked for three years as a theatre nurse and for a further three specializing in transplant patient care. This made Dunbar think again. He had been ready to dismiss her as emotionally vulnerable, but perhaps he was wrong. You accumulated a lot of nursing experience in six years. Lisa Fairfax must have seen a lot of transplant patients come and go in that time. He decided that, in fairness, he would definitely have to arrange a meeting.
The file on Sheila Barnes’s complaint was skimpy. A young patient named Kenneth Lineham had, like Amy Teasdale, died after rejecting a transplanted kidney. The organ had been deemed highly compatible with his own tissue type but, again like Amy Teasdale, he had undergone immunological rejection of the organ after the operation. Sister Barnes, like Lisa, had maintained that there had been a mix-up somewhere along the line and he had been given the wrong organ. A preliminary investigation of her allegation failed to find any evidence of this and she had resigned in protest.
Dunbar could certainly understand why the Sci-Med computer had drawn attention to the situation. The two nurses had made almost identical claims about two different patients almost three years apart, and both were experienced transplant-unit nurses. But, it had to be said, there was a total lack of scientific evidence in both cases. The women’s assertions seemed to have been based on gut feeling and very little else.
Dunbar wondered if there had been any other cases of apparently severe immune rejection in patients receiving organs classed as perfectly compatible by lab testing. This was something he could check on the computer. He had access to the main Sci-Med computer through the IBM notebook he carried with him. All he needed was a convenient telephone line, and the hotel was equipped with telephone points for modem connection.
He logged on to the London computer through his access number and password and started asking questions about kidney-transplant records. There were plenty of them; kidney transplant had become an almost routine operation over the past few years. He had to narrow down the data available to that pertaining to unsuccessful transplants in the last two years. Asking the right questions was always the key to a successful computer search. Having access to all the data in the world was no use at all unless you knew exactly what to ask.
A lot of thought had gone into the systems design of the Sci-Med service. He further narrowed down the information to patients who had died within two days of their operation, as had Amy Teasdale and Kenneth Lineham. He then asked how many of them had been given kidneys with an 80 per cent compatible rating with regard to host tissue. The answer was none.
Dunbar stared unseeingly at the screen for a few moments. He was thinking about the result. Only two patients in the UK in the last three years had died within two days of their operation after receiving highly compatible organs, and both had been patients at Medic Ecosse. Coincidence? That couldn’t be ruled out, he supposed. Two wasn’t a large number, maybe statistically insignificant. Perhaps there were more cases just outside the 80 per cent compatibility figure. He asked the computer the same question with a less stringent figure on compatibility, reducing by first 5 then 10 per cent. The two Medic Ecosse patients were still the only ones. He then looked at cases in which the patient had died within the first month after transplant. There were ten, and without exception there had been other circumstances involved in their deaths. The two Medic Ecosse deaths remained out on their own. They were a puzzle.