‘Staff briefing,’ he whispered. ‘We have one every morning. I’ll let John finish.’
Dunbar nodded and listened with interest to the briefing. There were seven patients in the unit. The current condition of each was discussed in turn and staff were asked for any observations they might have. Updates were made to all their charts and all staff were made aware of plans for each patient for the day. Again, Dunbar was impressed. This was a well-run unit.
‘Any questions?’ asked the man Ross had called John. There were none.
Ross stood up and said, ‘Just before you go everyone, I’d like you to meet Dr Steven Dunbar. He’s been assigned to the hospital by the Scottish Office to keep an eye on us, but he tells me he’s not such a monster once you get to know him.’
There was polite laughter. Dunbar saw that Ross was popular with his staff. He was introduced to each member of staff in turn, starting with the theatre sister, Trudy Sinclair, and ending with John Hatfull, who had been giving the briefing.
‘John is my surgical registrar,’ explained Ross. ‘Also my right-hand man.’
Hatfull was slightly shorter than Ross, brown-haired and hazel-eyed. He had an air of intensity that Dunbar often associated with highly intelligent people. It was as if they radiated energy. It was hard to imagine them relaxing. He shook hands with Hatfull.
‘Did I hear James say you were a doctor yourself?’ Hatfull asked.
Dunbar nodded.
‘What speciality?’
‘Field medicine,’ Dunbar replied.
Hatfull looked surprised then amused. ‘From field medicine to accountancy? Quite a change. I suppose you were looking for more excitement.’
The others laughed. Dunbar smiled dutifully, but offered no explanation. He didn’t want anyone thinking too much about the unlikelihood of such a switch.
‘Well,’ said Ross, ‘I’ll show you round. Or maybe you’d care to do that, John, if you have the time?’
‘My pleasure,’ replied Hatfull. ‘Anything in particular you’d like to see?’
‘Anything and everything,’ said Dunbar. ‘I just need to get a general feel for the unit. I need to relate its size and facilities to the figures I see on the balance sheets.’
‘Of course.’
As they started the tour Dunbar sensed that Hatfull was on his guard. He thought he’d try a little flattery to see if he could soften him up. ‘Dr Ross seems to rely on you a lot.’
‘He’s a very busy man,’ replied Hatfull.
‘Of course,’ said Dunbar. ‘He has research interests too. Are you involved at all in that?’
‘No, I’m just a work-horse. I leave research to the clever people.’
‘As a transplant surgeon in this unit, you’re not exactly among the intellectually challenged of the world,’ countered Dunbar with a smile.
‘One does what one can.’
‘The withdrawal of research funding must have been quite a blow to Dr Ross?’
‘Must have been.’
Dunbar didn’t ask any more. He accepted he wasn’t going to get anywhere with Hatfull.
The tour of the transplant unit took about thirty minutes, including the time taken by Hatfull to answer questions as monosyllabically as possible. Dunbar reverted to asking the kind of questions he thought he should be asking. They related to length of patients’ stay in the unit, numbers of staff involved in preoperative and post-operative care, in fact, anything he thought an accountant might be interested in. He made notes in a small leather-bound book he took from his inside pocket. There was very little to ask about the equipment and accommodation. The facilities were simply the best. When he’d asked everything he thought he should, they were re-joined by Ross, who asked if he’d enjoyed his tour.
‘Very interesting,’ replied Dunbar. He thought he’d risk trying a different tack and asked, ‘What actually happens when you hear that an organ has become available for one of your patients, Doctor?’
‘Quite a lot,’ smiled Ross. ‘And all at the same time! The procedure usually starts with a computer alert that a matching organ is available. We first double-check that this is the case and then contact the hospital or clinic holding the organ to establish personal contact and agree terms of transfer. A lot depends on where the donor organ is and how long it’s going to take to get here. At the same time, we alert our patient to the possibility of an operation and arrange for him or her to be admitted if they aren’t already in hospital. The operating teams are put on stand-by, round the clock if necessary. Time is always of the essence where live tissue is concerned.’
‘Of course.’
‘Apart from the actual theatre teams, we also need lab support and a supply of blood from the transfusion service available at exactly the right time. A lot of people are involved in a successful transplant. It’s a team effort and there are so many things that can go wrong. A flight gets delayed, a traffic jam, a driver takes the wrong turning. So many things, so many links in the chain, and all of them important.’
Dunbar nodded and pushed his luck. ‘And do they?’ he asked.
‘I’m sorry?’
‘Do they go wrong?’
‘Very rarely,’ said Ross with a smile and a touch-wood gesture. ‘There have been a few close calls as regards time but we’ve always managed to get the job done.’
‘That’s interesting,’ said Dunbar. ‘I suppose the clock starts ticking as soon as the donor organ is removed?’
‘Absolutely. There’s only a finite time before it becomes useless for transplant purposes.’
‘I suppose the ideal thing would be to keep the donor on a life-support system until everything was ready?’
‘In a cold, clinical sense, yes,’ agreed Ross. ‘But of course the moral implications of such a procedure dictate that hospitals can’t actually do this — well, not overtly. There’d be a public outcry.’
‘Of course. So with time ticking away, and traffic jams and airline delays all playing their part, you must have to get the organ into your patient almost as soon as it comes through the door?’
‘Almost,’ agreed Ross. ‘The theatre staff are usually prepped and ready.’
‘No time for any last-minute checks on the organ itself?’ said Dunbar, feeling as if he’d just jumped into water without knowing the depth.
There was a tense pause before Ross said, ‘I don’t think I’m quite with you. What sort of checks are you referring to?’
‘Oh, I don’t know,’ said Dunbar, trying to appear off-hand and casual. ‘The usual things, blood group, tissue-typing, AIDS, Hep. B screening, that sort of thing.’ He had slipped his real question in at number two in the list, hoping it would nestle there without arousing suspicion. A glance at Ross as they proceeded along the corridor made him doubt whether he had succeeded: the smile had gone from his face.
‘All these things are usually done at the donor hospital,’ said Ross.
‘Of course. That would make sense,’ said Dunbar. ‘I just wondered whether, with an international donor network, standards might vary from country to country.’
‘All hospitals in the network work to the highest standards,’ said Ross.
‘I see,’ said Dunbar.
‘But when we have time to spare, we do carry out our own screening,’ said Ross.
‘I felt sure you would,’ said Dunbar.
‘And here we are back where we started,’ said Ross as they returned to the unit’s foyer. ‘Is there anything else we can show you or help you with?’
‘Your research labs,’ said Dunbar. ‘I didn’t see them.’
‘No, you didn’t,’ agreed Ross. ‘My labs aren’t actually in the hospital. As you’re not funding them any more, I didn’t think they’d come within your remit.’
Dunbar detected resentment in Ross’s voice. He decided on a conciliatory response. ‘You’re absolutely right. I was just personally interested. Did you manage to get alternative funding for your work, Doctor?’
‘Enough to keep going for the moment,’ replied Ross. ‘Medic International have been generous.’
‘I’m glad. It was all very unfortunate.’