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Authors: Andrew Puckett

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Chapter 19

 

Jo had waited in the loo until she was sure Fraser and Helen had gone, then gathered up the samples from the bed and taken them to Tom. She told him about Rose Parker.

“Who gave her the first doses of antibiotic?” Tom asked, “Was it Carrie Tucker?”

“According to the chart it was Sophie Rogers, but I don’t know who was with her.”

“Can you find out?”

“I’ll try,” she said. “But Tom, there’s another problem - if it
is
Carrie doing it, she’s only on duty eight hours a day, so the rest of the time, Rose would have been getting the real thing.“

“Unless these are all bogus as well.” He nodded at the drug samples she’d brought. “And they look all right to me.“

“And as Fraser said, it would’ve been noticed if none of it was working.”

“Mm.” He got up and walked over to the window before turning back to her, “Is it possible,” he said slowly, “That if Rose was given bogus antibiotic, say for the first three doses, that the real one would fail to work later?”

“I
think
so,” she said, “You’ll have to ask Fraser. Although the way Rose was, I’d have thought the ampicillin I gave her would’ve worked.”

“All right, I’ll talk to him.” He paused. “Is he over his wobbly now?”

“Yeah - I think Rose’s death shook him as much as me.”

He nodded, said, “I’ll get all these samples off to the lab – maybe they’ll be able to tell us something.” He sighed. “It’s a bugger, isn’t it?”

“Yes,” she agreed sadly, thinking of Rose. “It is.”

Later, when she was back on duty, she engineered a chat with Sophie Rogers, and on the pretext of asking her about the onset of Rose’s pneumonia, discovered that Carrie hadn’t been with her when she’d given her the first two doses of ampicillin.

*

Taking Helen out was a chore that Fraser didn’t look forward to, and yet was hardly ever as bad as he thought it was going to be.

It wasn’t bad this Monday. They went to a pub and she laughed when he described the Trust meeting and his wayward guts. Then he told her about the Trust’s debts and the money spent on the Euro preparations.

“Yes, it’s appalling,” she said, referring to the Euro, “When you think of all the misery that money could relieve. I’m surprised someone hasn’t gone to the papers about it.”

“Why don’t you, if you feel so strongly?”

“I couldn’t,” she said, shaking her head. “I know it sounds stupid, but if you’ve been trusted with confidential information, you can’t somehow. I can’t, anyway.”

It was then that he decided she probably had nothing to do with the killings. He told her about Armitage’s reaction, or lack of it, to the news of the lifting of the Grade II listing of St James’, and his strange mood afterwards.

“He’s got a lot on his mind at the moment,” she said.

He asked her what. She said vaguely,

“Oh, Ranjid … “

“Why Ranjid?”

“Well, you’ve seen what he’s been like lately – and there’s also Fleming, whom he cares for no more than you do.”

“Why is that?” he probed. “He can’t have much effect on Philip, can he?”

“He holds the purse strings. It’s what administrators do, why they can make life difficult for those under them.” She obviously didn’t want to talk about it anymore, so he didn’t press her.

She didn’t ask him in when he dropped off either, and he drove away feeling guilty that he was so relieved. In a pally platonic sort of way, he’d rather enjoyed her company, but he couldn’t feel any more for her than that … exactly what
did
she feel for him, he wondered? She seemed to want to go on seeing him, and yet she was two-timing him with Ranjid …

*

The next morning, Tuesday, Gavin in Glasgow came back to him with his figures: deaths there were 28% from pneumonia, 25% Cancer, 18% heart conditions, and the pneumonia deaths were recorded as such. Not much different from Wansborough’s –
as
they
stood

With an eye on the door, he worked out what he thought were the numbers of pneumonia deaths recorded at Wansborough as something else, then adjusted the figures to take account of it. Now the figure for pneumonia came out at over 40% percent of the total. Far too high ...

The figures from Bristol came an hour later. They were much the same as Glasgow’s. He went down to Tom’s hotel at lunchtime and showed him.

“Does this put your mind at rest?” Tom asked.

He nodded. “Aye. It was anyway, after Rose – if you can call it that.”

Tom asked him whether the real antibiotic could have failed if she’d been given a dummy one first. “Jo seemed to think it was possible,” he said.

“She’s right, any infection can get to a point of no return where it’s too late for any antibiotic, however good.”

“Could
that
be how it’s being done?”

Fraser hesitated, “If it were, we’d see some of them getting better.”

”Yeah, Jo said that as well.” He sighed. “Maybe the results from the lab’ll tell us something. Anything else?”

Fraser told him about the Trust meeting, the Euro and the lifting of the Grade II listing St James’ –

“Hang on,” said Tom, reaching for his notebook, “Let me try and get this into some sort of context … “

So Fraser described the St James’ scandal and how the committee had been formed to find a way out of it.

*

Over the next few days, Fraser and Jo kept watch on the patients at risk as best as they could. Of the five, they thought Shirley Norman was the most likely, because of her immobility - she wasn’t responding to treatment and was getting depressed about it.

Tom acquired some cefataxin for them and on Wednesday, Fraser thought he was going to have to use it when Stanley Forbes, who wasn’t on the list, went down with a chest infection, then he realised it was another false alarm.

Jo, meanwhile, had a couple of domestic problems to deal with.

On Wednesday, Debbie, one of the HCAs, came looking for her: “Jo, Mrs B’s at it again … “

Jo strode determinedly into Room Four – “What is it this time, Mrs Bailey?”

“This food, it isn’t fit for pigs.” Mrs B was a scrawny, vinegary woman who’d come in with a broken arm. “It in’t just me you know – “ she looked round – “We all feel the same, don’t we girls?”

Mrs Sherlock, whom Jo thought weak in the head, nodded in agreement. One or two of the others mumbled.

Then Lily Stokes said, “Don’t you go including me Daisy Bailey, I think it’s fine.”

Mrs B shot her a look of pure poison.

Jo said, “It’s exactly the same food that we all have, Mrs Bailey. All the patients, all the staff.”

Mrs B snorted. Jo went on:

“If you really don’t like it, you can always ask a friend to bring you some in.”
If
you’ve
got
any
friends
, she added silently.

She looked round. “Anyone else have anything they wish to say?”

They didn’t. One or two were clearly having difficulty in hiding their
schadenfreude
.

Then on Thursday, she was accosted in the corridor by a big, red haired nurse.

“I hear you’ve been asking about me,” she said, “Carrie Tucker.” Which, being construed, meant something like:
What’s
your
caper
then
,
missus
?

“That’s right,” said Jo, who’d recognised her from Fraser’s description. She explained her interest in the pneumonia cases and how she simply wanted to talk to someone who’d seen them.

Carrie heard her out impatiently. “Yeah, so what is it with you and pneumonia, then? Jackie said you had a thing about it.”

Gee
,
thanks
Jackie
… “It’s an interest of mine, always has – “

“So why didn’t you ask me to my face about it?”

“I am, now.”

They eyeballed each other a bit longer, then Carrie backed down. “So what d’you want to know, then?” she asked sulkily.

Yes, she agreed after Jo told her, both cases had developed very quickly and by the time anyone had thought of adding another antibiotic, it had been too late. “It does happen, you know,” she said defensively.

Jo reported this to Tom. “The trouble is,” she said, “I can’t ask any of the others now if she was with them on the drug round - it’d be bound to get back to her.”

Tom thought for a moment. “What’s your gut feeling?” he asked. “Is she involved?”

“I disliked her intensely,” Jo said slowly. “But I don’t think she’d have been so in your face at me if she was.”

“Then leave it,” said Tom. “In fact it might be an idea to keep your head down for while before anyone else starts wondering about you.”

Bit
late
for
that
, she thought.

So she and Fraser kept watching, like good shepherds both, but nothing happened. She had, she realised, begun to feel a bit like a shepherd in the responsibility and yes, the fondness she was feeling for these particularly vulnerable members of her flock. Especially Lily Stokes.

On Friday, Mrs Bailey, whose bed was next to Lily’s, called Jo over.

“Can’t you do something about them kids?” she demanded, pointing at Lily’s grandchildren.

Payback time for Lily. However, the children were being rather noisy, so Jo asked them to calm down.

They immediately looked mutinous and Jo was drawing breath to get heavy when Lily intervened.

“Now look what you’ve done,” she said to them. “The nurse’ll have to make you go away, which means I won’t see you so often. If that happens, I won’t get better so quickly, and if
that
happens, you won’t be able to come and stay at my house, will you?”

It wasn’t so much the words themselves, Jo realised, but the way she used them … Anyway, it worked, much to the annoyance of Mrs B.

*

“So
now
what do we do?” Marcus demanded irritably ...

It was Saturday morning at the hotel, a beautiful day, which was maybe part of the reason they were all feeling so jaded. They’d held over the meeting from Friday evening so that they could see the results from the forensic lab, which had just been faxed through.

There was nothing wrong with any of the ampicillin. The blood Fraser had taken from Rose Parker showed no sign of any poison or drug overdose, other than a high level of ampicillin, and the swabs he’d taken had grown virulent pneumococci that were completely resistant to it.

“Can I see it, please?” Fraser said, and Tom passed it over.

“With all due respect, Fraser,” Tom said, not sounding particularly respectful, “This does rather suggest to me that these patients
are
somehow being deliberately infected.”

“Maybe it does - to you,” Fraser murmured, not taking his eyes from the report, “But I thought you’d taken me on for my medical expertise and I’m telling you – “ now he looked up – “That it can’t be done.”

“Yes, you’ve told us that several times,” Marcus said, his voice acid smooth, “Do you think you might see your way to explaining why not?”

Realising that Marcus was a tick away from ignition, Fraser concentrated his thoughts. “If this organism was somehow being used to give people pneumonia, it would have to be sub-cultured, and that would destroy its virulence.”

“That doesn’t leave me any the wiser.”

Fraser tried again: “To isolate the organism, you have to grow it on an agar plate from an infected patient, then keep it alive by passing it to further plates, sub-culturing it. And that’s the problem - sub-cultured pneumococci very quickly lose their virulence, their ability to cause pneumonia.”

There was a brief silence, then Tom said, “How quickly is
very
?”


Very
very. One, maybe two sub-cultures at the most.”

“But exactly
how
does it lose its virulence?” Marcus asked. “I mean, it’s the same bug, isn’t it?”

“Aye, but with one important difference. On agar, it loses its capsule, and its capsule is essential for it to remain virulent.”

“All right, what’s its capsule?”

Just that, Fraser explained, a capsule made of a jelly-like substance which surrounded each individual bacterium and protected it from being engulfed by white cells. “You can squirt as many cultured, non-capsulated pneumococci into someone’s lungs as you like, but they won’t get pneumonia. The white cells get them first.”

“And if they
are
capsulated?”

“Then that person will probably get pneumonia and die. But as I said, you can only get capsulated pneumococci by taking them straight from someone who’s already infected.”

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