“Rules is rules,” muttered Neef under his breath as he waited. He did not have to wait long.
“Dr Neef?”
“Good Morning, Doctor. I was responsible for having Charles Morse admitted to you last night. I was wondering if you’d had any lab results yet?”
“Not yet, Doctor. Although there were several atypical features, he’s been provisionally diagnosed as Klebsiella pneumonia because of the severity. He’s been put on ampicillin.”
“I suppose it’s too soon to say how he’s responding?” asked Neef.
“We’ve certainly had no encouraging response as yet,” agreed Clelland. “He’s still very ill but as you say, it’s early days.”
“Thank you Doctor.”
Neef put down the phone and reflected on the unpleasant sense of foreboding that had come over him. Maybe he was just hyper-sensitive to the word pneumonia these days but Clelland’s additional qualification of, “atypical” had only heightened his unease. He thought for a moment about the GP who’d called Charlie’s condition, flu and then called Kate Morse’s home number.
“Kate? I hear Charlie’s not so good.”
“Hello, Mike. Good of you to call. He’s really ill. In fact, I think if you hadn’t come out and called the ambulance when you did, he mightn’t have made it through the night. He had to have oxygen in the ambulance. He’s still on it this morning.”
“The ID unit at University College think it’s Klebsiella pneumonia. That would certainly explain why it’s so severe. The ampicillin should get it under control though. He should start getting better soon.”
“God, I hope so, Mike. It gave me a real scare.”
“I’ll bet.”
“I’m on at two. I’ll see you then.”
“Look, Kate, if you don’t feel up to it today, we’ll manage.”
“I’ll be there,” said Kate. “Sitting around worrying doesn’t help anyone, least of all Charlie.”
“As you wish,” said Neef. “I probably won’t see you until after Thomas Downy’s op. We’re going to theatre at two thirty.”
“That had completely slipped my mind,” said Kate. “I hope it goes well for Thomas. He’s such a nice kid.”
Pereira returned from his walk and Neef asked him if he still wanted to attend the next operation.
“You bet,” replied Pereira.
Neef wasn’t convinced but he shrugged his shoulders and suggested they started making their way down to theatre. Mark Louradis was already in scrub when they got there. Neef introduced him to Pereira. “Mr Louradis is our chief surgeon here at St George’s. He is going to inject your virus into Martin Liddle.”
“It’s nice to have the best,” said Pereira, lathering his hairy arms.
Louradis looked sideways at Pereira as if searching for signs of sarcasm but didn’t find any there. Pereira had obviously meant the comment to be taken at face value. How like Louradis to have doubted it, thought Neef. Despite a faultless reputation as a surgeon, Louradis suffered greatly from some unfathomable Mediterranean inferiority complex. Neef sometimes wished he had a fiver for every time he had seen Louradis’ features darken with suspicion over something everyone else present would regard as innocent.
“What a colour!” whispered Pereira to Neef as he saw Martin Liddle’s yellow skin hue.
“That’s the tumour,” replied Neef. “Pancreatic tumours are notorious for being advanced by the time they’re diagnosed. The bile duct gets screwed up as the tumour spreads.”
“This isn’t ultrasound, right?” asked Pereira, nodding at the monitor positioned to the side of the table.
“No, it’s a real video picture. There’s a small camera positioned just to the side of the end of the endoscope.”
Louradis inserted the endoscopy tube and everyone watched its progress through Martin Liddle’s alimentary canal.
“Now we come to the tricky bit,” whispered Neef to Pereira. “He’s reached the duodenum.”
Louradis coaxed the control levers at the head of the tube until he had negotiated an awkward turn and was satisfied with the picture on the monitor. “Almost there, Dr Pereira,” he said. “About here do you think?”
Neef sensed Pereira’s discomfort at the question. He had obviously not been expecting to be asked for his opinion.
“What d’you think, Mike?” Pereira asked.
Neef smiled behind his mask. “Maybe another half inch,” he said.
“Here?”
“Fine.”
Louradis injected the virus and started the process of extracting the tube.
“I need a cigarette,” said Pereira with feeling as he and Neef left the theatre together. “That’s it till two thirty, right?”
“That’s right,” said Neef. “Two down, one to go.”
After changing out of gown and gloves, Pereira disappeared outside for his cigarette and Neef walked back to the unit alone. As he crossed the courtyard past groups of chatting nurses a vehicle parked on the far side caught his attention. It had a press sticker in the windscreen. Two men with notebooks at the ready were standing nearby; they were talking to a man with a camera bag slung over his shoulder. “What’s that all about?” he wondered with an uneasy feeling.
When he got back to his office he called the hospital press officer, John Marshall. “You are remembering our agreement about no publicity for the Gene Therapy trial aren’t you?” he said.
From the first faltering syllable of Marshall’s reply, Neef knew there was something wrong. He closed his eyes in anticipation of hearing something unpleasant.
“It didn’t come from this office, Michael, I promise. But the press got it from somewhere. Mr Louradis is giving an interview about the Martin Liddle case at this very moment.”
“Oh shit,” said Neef. He put down the phone. So this was why Louradis had been keen to carry out such a routine procedure himself. He wanted media attention. He must have set the whole thing up for himself. The man bitterly resented all the press coverage the surgical teams at University College had been getting. He must have seen this as his chance to grab some of the limelight for himself.
Neef’s first thought was to have it out with Louradis and give free rein to the tide of adjectives that were springing to mind but he began to see that what was done was done. It seemed likely they were now going to have to conduct the trial under press scrutiny as University College had done the year before. Nothing was going to change that. He decided not to say anything to Louradis. In the event, Louradis phoned him some twenty minutes later.
“Michael, I’m calling to assure you that I had nothing to do with the press being here this morning. I was a surprised as everyone else.”
“Of course.”
“There were a couple of reporters waiting for me when we’d finished with Martin Liddle this morning. I don’t know how they possibly got wind of it but I felt I had to say something. You know how it is.”
“Quite.”
“I know you didn’t want the press to know about the trial until you knew how it was shaping up but I’m sorry, there it is, there was nothing I could do without being rude. I played it down as much as I could. No hard feelings I hope?”
“Of course not.”
“Good. I look forward to hearing how our young friend progresses.”
“I’ll see that you’re kept informed.”
Neef heard the line go dead and tried out some of his adjectives anyway. Who else would have called the press?
Eight
Neef saw that Pereira was looking apprehensive as they entered the main operating theatre where Norman Beavis would carry out neuro-surgery on Thomas Downy.
“Are you sure you want to be present?” he asked. “It’s not for the faint-hearted.”
“I’m fine,” replied Pereira, running his tongue over lips which had gone dry.