She knew immediately why he was there. ‘Over here,’ she said, beckoning him to follow her. ‘We made a little corner for one of our own.’
‘Good,’ said Steven.
She led him to the back of the nave to a corner behind one of the two main supporting stone pillars. Caroline lay on a camp bed along the back wall. Above her were a stained-glass window depicting the resurrection, and a board citing the names of those of the parish who had fallen in two world wars. Caroline’s eyes were closed but she was moving her lips as if they were dry so Steven guessed that she wasn’t sleeping. He knelt down beside her and laid his hand gently on her arm.
She turned her head to him and opened her eyes. Steven smiled at her through his visor. ‘How are you doing?’ he asked.
‘Just fine,’ she replied, as if giving a joke answer to a joke question. ‘It’s nice to see you.’
Steven patted her arm. ‘I had to go to London,’ he said. ‘You probably didn’t see the note I left in your car.’
She shook her head. ‘No, I thought you’d done a runner.’
‘I came back as soon as I heard. I’ll be here if you need me — I plan to be with you every step of the way. You can beat this, I know you can.’
She smiled wanly and squeezed Steven’s hand limply in lieu of a reply.
‘Get some rest,’ he said, smoothing her hair back from her forehead. ‘I’ll be back later.’
He found Kate Lineham again and asked, ‘What do you think?’
She shrugged apologetically. ‘Impossible to say. The statistics are against her, but if tender loving care can do it she’s got it made.’
Steven nodded, grateful for an honest answer, then made for the exit and a shower. When he got outside his phone rang.
‘Where the hell are you?’ asked John Macmillan.
‘Manchester.’
‘May I ask why?’ said Macmillan with barely suppressed irritation.
‘There’s more of the virus here than anywhere else,’ replied Steven. ‘Apart from that, one of my friends has just gone down with it.’
‘I’m sorry,’ said Macmillan, the testiness disappearing from his voice. ‘We know now that all eighteen wildcards received human-tissue valves, but getting the information on the donors is proving difficult. Organs and tissue are distributed through a central register in response to computerised requests from hospitals and clinics. The hospitals themselves aren’t usually given personal details of the donors.’
‘The names aren’t going to make much difference, anyway,’ confessed Steven, ‘but I would like details of the register. Maybe someone could e-mail what you’ve got?’
‘Of course. What are your plans in the meantime?’
‘I need to talk to a heart surgeon again. There must be something I’m missing in all this.’
Steven was desperately in need of sleep but he arranged to see Martin Giles again at the City General at two. He kept awake with constant cups of coffee and thought he was doing well until the surgeon greeted him with, ‘God, you look rough.’
Steven made light of it and asked for more details about hear-tvalve replacement and how choices about the options were made.
‘Basically, tissue valves are best,’ said Giles, ‘and human ones if you can get them, though only if they are a good match in terms of tissue type, of course. Ideally, we prefer repairing the patients’ own valves using their own tissue. That way there are no problems with rejection and therefore no need to put them on immunosuppression therapy, which almost always leads to problems. Mechanical valves, made of metal, plastic, carbon fibre or whatever, are okay but the flow through them isn’t nearly as good as through a tissue valve because of restricted opening angles. The patients also usually have to be on anti-clotting agents for the rest of their lives. Age is also a factor. We’d give a tissue valve to a middle-aged patient, but probably fit a mechanical valve to an older one.’
‘Can we just go back a bit there?’ said Steven. ‘You said that tissue valves are the best, human ones if possible.’
‘Yes.’
‘That implies that there’s an alternative to human tissue?’
‘Treated pig valves are also used.’
‘Pig? What about foreign tissue rejection?’ asked Steven.
‘That’s why I said “treated”,’ said Giles. ‘They treat the pig valves with a chemical called gluteraldehyde to make them more acceptable. The valves themselves tend to be a bit weak and it’s often necessary to give them an auxiliary scaffold — “stenting”, they call it. They’re not nearly as good as compatible human valves but they’re used quite a lot, and with a pretty good success rate, all things considered — although there can be problems if, for instance, the patient’s Jewish!’
Steven smiled. ‘I take it tissue valves are screened for potential problems like AIDS, hepatitis, CJD, things like that.’
‘Bet your life they are,’ said Giles fervently. ‘Litigation we can do without.’
Steven thanked him again for his help and drove back to his hotel. He lay down on his bed and slowly felt his limbs appear to double in weight as the prospect of sleep finally became a reality. His mind, however, was still troubled by conflicting arguments. Logic insisted that the replacement heart valves must be the cause of the outbreak, because they were the only common factor among the wildcard patients, but eighteen replacement valves could not possibly have come from one infected human heart. As he spiralled down into a deep sleep, the last image he had was of the driver saying, ‘Maybe you only think it’s impossible.’
Only four hours later he was jolted awake when a chambermaid in the corridor dropped what sounded like a metal tray laden with the crockery from a royal banquet. He lay staring at the ceiling for a while before acknowledging that he was not going to be able to get back to sleep. He got up and showered, then ordered an omelette and a salad from room service. He turned on his laptop and downloaded his e-mail while he waited.
Skipping an apology for not yet having details of the donors’ names, he read through the general details of how transplant organs and tissue were made available and how they were requested and allocated through a central register. It occurred to him that the register itself was a common link. All the replacement valves must have passed through it in terms of paperwork if not in substance. He asked Sci-Med to contact the operators of the register and request that they check their records for any factors common to the wildcard patients.
An hour and a half later he got his reply. There was another apology for still not having details of the donors but this one came with an explanation. The co-ordinating officer at the central register who was dealing with the request had been taken ill and sent home. Unfortunately, he had taken with him the computer disk with details of the donor files on it. People were trying to contact him urgently. With regard to Steven’s request that the wildcards be screened for common factors, one common factor had already appeared. The wildcard patients had all been found heart valves by the same co-ordinator, Greg Allan, and he, by a curious coincidence, was the man who had just gone sick.
‘Well, well, well,’ murmured Steven. ‘Strikes me, I’d better take Mr Allan some grapes.’
He called Sci-Med and asked for Greg Allan’s address as a matter of urgency. He was called back four minutes later by the duty officer, who said, ‘I’ve got it but it won’t do you much good. He doesn’t seem to be there at the moment.’
‘I thought he went home sick?’
‘That’s what his colleagues thought, and they all say he looked ill when he left. But when they tried to contact him about the disk they discovered he wasn’t at home and his wife hadn’t seen him since he left for work this morning.’
‘Give me the address anyway,’ said Steven and wrote it down; it was in Leeds. For once, luck was on his side. He was closer to Leeds here in Manchester than he would have been had he stayed in London. He could be at Allan’s place in an hour; the question was, would Allan be there when he arrived? He told the duty officer of his plans and asked that Sci-Med contact the local police and ask them to put an immediate trace on Allan’s car. ‘Give them my mobile number and ask them to contact me the moment they find him.’