Pestilence (23 page)

“I know what you are getting at Doctor but, in this case, I think we have to overlook the deposition of the drug in growing bones and teeth and give the children tetracycline too.”

No one chose to disagree.

“What about protection for hospital staff?”

“Anti-plague vaccine and serum is on its way,” replied Braithwaite.

“For my men too?” asked Carradyce.

“Of course.”

“But not the public?” asked Saracen.

Braithwaite screwed up his face still further. “No, not at this stage,” he said. “We don’t want to encourage any unnecessary panic and I feel that this unfortunate incident can be adequately contained without mass vaccination.”

“Then you have established the link between the man who died at the County Hospital and either Archer or Cohen?” said Saracen.

Braithwaite shifted uncomfortably on his feet and cleared his throat once more. “I think we have come as close as we can,” he said. “The man was employed on the development at Palmer’s Green. I think it reasonable to suppose that he must have come into contact with either Mrs Archer or Mr Cohen.”

“It would have to have been Cohen,” said Saracen.

Braithwaite looked bemused; MacQuillan stepped in to save him. “By the incubation time, yes you are quite right Doctor. Mrs Archer has been dead too long for it to have been her who infected the man. The deceased must have been infected within the last six days; that makes it Cohen.”

“Are you taking steps to prove it?” asked Saracen.

Braithwaite was dismissive. “Enquiries will be made but it is purely academic,” he said.

Moss said, “Am I right in thinking that what we are aiming for is six clear days without a case of plague?”

“Better say eight to be absolutely sure,” said MacQuillan. “Eight days without a case and Skelmore will be in the clear.”

“Assuming all the presumptions are right,” said Saracen.

“I don’t think I understand,” said Braithwaite coldly.

“I said assuming all the presumptions are correct and A gave it to B who gave it to C etc.”

“Do you have a better idea Doctor?”

“The point I am trying to make is that we must take nothing for granted with something as dangerous as plague. Every detail must be checked.”

“Very commendable I’m sure,” said Braithwaite. “After only thirty years in the profession I am grateful for your advice.”

Saracen was aware of one of the senior nurses hiding a smile behind her hand and felt embarrassed and annoyed at the put-down.

“What was that all about?” whispered Moss as one of the hospital secretaries changed the subject to ask about ward accommodation.

“I don’t know myself,” confessed Saracen. “I just think they are taking it a bit too lightly. There’s something wrong somewhere.”

“But what?”

Saracen shrugged. “I don’t know. I wish I did.”

“Finally,” announced Saithe. “The Press.” He paused to allow time for groans and head shaking. “I think we must insist that no one outside of our official spokesmen should say anything at all to the newspapers.” There was a murmur of agreement and Moss asked who the spokesmen were to be.

“Both hospital secretaries and Dr Braithwaite as medical officer for the county,” replied Saithe. “But the less we say the better. If we can stall all questions for a week, or eight days to be precise,” Saithe looked at MacQuillan. “We can speak about all this in the past tense.

Saracen returned to A&E and told Alan Tremaine what had been going on.

“I trust we can all sleep safely in our beds now that a committee has been formed,” said Tremaine, tongue in cheek.

“You certainly can,” said Saracen. “The County Medical Officer says so.”

“Then maybe I’ll emigrate,” said Tremaine.

“No respect the younger generation, none at all. Now if you want to give me the report you can go home and get some sleep.”

“Are you serious?” exclaimed Tremaine.

“I’m serious.”

“Then I’m not going to argue,” said a delighted Tremaine. He picked up a clip-board and started to read out facts and figures. “Road accident, two admitted, man with skull fracture, three broken ribs and broken left femur. He’s in ward twelve. Woman, severe facial lacerations, broken left wrist, admitted to ward thirteen. Kid knocked off his bike, cuts and bruises, bad sprain to left ankle. He’s presently at X-Ray but I don’t think it’s broken. One drunk with a four inch cut on his face from a beer glass. Singh is stitching him up in Cubicle four. Lastly a woman with a rash all over her body. It came out while she was eating in a restaurant with her husband. I think it’s an allergy rash, maybe something she ate. She’s responding well to antihistamines.”

“That’s it?”

“That’s it.”

“See you in the morning,” said Saracen. “By the way have all the staff had their tetracycline?”

“To a man. How about you?”

“I’m just about to.”

“Don’t forget,” said Tremaine and with that he left.

Saracen took his tetracycline and then started looking for the day-book. He failed to find it and went to ask Sister Lindeman.

“I put it on Dr Garten’s desk I thought you would be using that room from now on.”

“Of course, thank you Sister,” said Saracen who had overlooked that side of things. He found that Lindeman had moved some of his other books and papers into Garten’s old room and it made him think about her. He had often tried to define what made a good nurse but had never fully succeeded. Whatever it was, Moira Lindeman had it in abundance. She was quite simply the best. Quiet, unobtrusive, competent and smoothly efficient. But there was more to it than that. She had the capacity not only to act but to anticipate what would be required in any given situation. In many other professions she would have been highly rewarded for that quality but here in A&E she was taken for granted.

Saracen finished scanning through the day book and closed it as a knock came to the door and a nurse put her head round. “Dr Saracen? The pubs are coming out. We need you.”

Saracen joined the rest of the team in the treatment room as the first casualties of ‘The Happy Hour’ as Tremaine termed it arrived in A&E. The hour referred to was the hour immediately after closing time when arguments fuelled by booze were settled by violence.

“What happened?” Saracen asked a burly man with blood pouring from a head wound. He was holding a dirty handkerchief against it.

“It were this other bastard see, it were all his fault. There I was, mindin’ me own business when this…”

Saracen switched off. He had heard it all so many times before. He concentrated on stitching the cut but just before he started the man put a hand on his arm and asked thickly, “Is this gonna hurt?”

“Hope so,” said Saracen.

There was a welcome lull between one and two in the morning when the town had settled its differences and settled to sleep. Saracen grabbed the chance to drink tea and eat digestive biscuits that had gone soft through lying too long on the plate. In the quiet of the small hours he started doing the Guardian crossword and was pencilling in the word ARCHIMEDES when the phone rang; it was Dave Moss.

“The woman died and we’ve had four more admissions.”

“From where?” asked Saracen.

“From the Maxton estate. A woman and three kids.”

“Known contacts?”

“Don’t know yet. Braithwaite’s people are investigating but there’s more to worry about at the moment; I’ve got the lab results back.”

“And?”

“It’s plague all right. They’ve isolated Yersinia pestis but there’s some kind of problem with the drug tests.”

“What kind of a problem? MacQuillan assured us that the treatment was cut and dried,” said Saracen.

“Well, the lab think so too but they are not too happy with the readings they’ve been getting. They’d like Porton Down to check them out.”

“What’s to check? The strain is either sensitive or resistant to tetracycline and plague is always sensitive. MacQuillan said so.”

“I know that’s what MacQuillan said and that’s what the book says too but the lab found that, although tetracycline slowed the bug down, it didn’t kill it.”

“Maybe some problem with the potency of the drug used in the test,” suggested Saracen.

“Maybe,” said Moss hesitantly

“So what drug do we use meantime until they check it out?” asked Saracen.

There was an uneasy pause before Moss said, “Trouble is…all the drugs the lab tested behaved in the same way. They slowed the bug down but they didn’t kill it.”

Saracen’s head reeled with the implications of what Moss was saying. “But that means we can’t treat it,” he said finally.

“Yes it does,” agreed Moss.

“If tetracycline slows it down what are the chances of the patient’s own body defences coping?” asked Saracen.

“That’s the big money question,” agreed Moss. “We won’t know until we’ve tried it. So far all the patients have been well into fever before we’ve seen them; they probably would have died anyway. The only people treated with tetracycline have been the staff and the known contacts and they seem all right so far, touch wood.”

“When will we hear from Porton Down?” asked Saracen.

“Two days they reckon. It has top priority.”

“So we just sit tight and hope,” said Saracen.

“Nothing else for it,” agreed Moss.

Saracen put down the phone and sat staring into space for a moment. Sister Lindeman interrupted him. “I’m sorry. We’ve got a right mess coming in,” she said.

“Tell me,” said Saracen wearily.

“Glue sniffers. Four kids. The Police found them on a building site.”

Saracen could smell the solvent on the breath of the children. Like a lot of other things, tar, petrol, disinfectant, it was not unpleasant in small doses but when you put the stuff in a polythene bag and clamped it over your nose and mouth as the four in front of him had been doing it was a different story. He looked at the blistered mouths and rolling eyes and shook his head as he examined each in turn.

One of the four, a street-wise youngster in grubby Tee shirt and jeans and with a mop of curls, seemed less affected than the others so when things were under control Saracen came back to him and asked some questions. He asked the boy his age.

“Twelve,” came the sullen reply.

“Why do you do it?”

“Nothing else to do around here.”

“Crap!” said Saracen.

The boy seemed taken aback. “It’s true,” he mumbled.

“And I’m telling you it’s crap! Don’t you think I’ve got enough to do without dealing with a bunch of cretins who stick plastic bags on their heads?”

“You can’t say that! You’re a Doctor!” protested the boy.

“I just did” said Saracen. Where did you buy the glue?”

“Ain’t sayin’”

Saracen looked at the police constable who had brought the boys in but the man shrugged his shoulders. “I asked you a question,” said Saracen turning back to the boy.

“And I said I ain’t sayin!” replied the boy aggressively.

Saracen eyed him up for a moment and then said, “In that case my son I think a nice enema is called for.”

“What’s that?” demanded the boy.

Saracen leaned over and whispered in the boy’s ear. “First the nice nurse will take this big tube and then…”

The explanation had the desired effect. The boy’s eyes opened wide and aggression changed to panic. “No one is gonna do that to me,” he spluttered.

Saracen nodded gravely. “Oh yes they are,” he said. “And with ice cold water too…”

The boy began to shrink away but was restrained by the constable’s hand.

“Now perhaps if you were to answer my question I might just be able to reconsider your treatment,” said Saracen calmly looking at his fingernails.

The truth dawned on the boy. “This is blackmail!” he stammered.

“I believe it is,” agreed Saracen.

The boy gave in. “Bartok’s in Weaver’s Lane,” he said. “He said we weren’t to tell anyone.

“I’ll bet,” said Saracen quietly. He looked at the policeman and asked, “Mean anything?”

The officer nodded and said, “We know old Bartok. Tight as a cat’s arse.” Realising too late what he had said the policeman began to colour and offer his apologies to Sister Lindeman. “We’ve heard worse,” said Lindeman.

“You’ll have a word with him?” asked Saracen.

“We’ll lean on him a bit but he’ll swear blind that he thought the kids were building model aeroplanes.”

“See what you can do anyway.”

The constable got to his feet and replaced his helmet. “Can I take it these four rogues are going to be all right?” he asked Saracen.

Saracen nodded and said, “This time.”

“Are you keeping them in?”

“These three better stay overnight, this one can go home,” said Saracen lightly shaking the shoulder of the boy who had provided the information.