Ken McClure - Chameleon

'I'm sure it will be fine,' said Jamieson.

'If there's anything you need you only have to ask.'

Clive Evans took off his jacket and donned a white lab coat. As he rolled back the cuffs of his shirt sleeves Jamieson again noticed the red burn marks on the back of his wrist and asked him about them.

'Oh it's absolutely nothing,' insisted Evans, 'No problem at all.'

'What happened?' asked Richardson.

'Dr Evans burned himself while helping me escape electrocution yesterday,' Jamieson explained.

'Really?' exclaimed Richardson, obviously concerned at his colleague's injury. 'Have you seen about it Clive?' he asked. 'Maybe you should have a dressing on that.' He leaned forward to examine it more closely but Evans again insisted that it was nothing and pulled down his sleeve. He turned to Jamieson and said, 'If you like I'll show you around the lab.'

Jamieson followed Evans round the cubicles of the first floor while Evans explained what happened in each of them then he led the way downstairs to the cold, fluorescent light of the basement and a long low room. 'This is the Preparation Room,' he said. 'All our glassware and equipment is cleaned and sterilised here.

Jamieson noted the three women working at large stainless steel sinks and noted the steam steriliser that was currently on an operating cycle. A relay clicked to allow more steam to enter and maintain its temperature.

'As you see, we have one large autoclave, working on the hospital's direct steam supply. We use that to sterilise all specimens once we've finished with them. In addition we have three hot air ovens and several small pressure cookers for individuals to use if they have to sterilise something in a hurry.

'Do you sterilise anything for other wards or departments?' Jamieson asked.

'No. All general sterilising is done down in the central facility at CSSD.'

'I see,' said Jamieson. He noticed that the sweat was running off the women as they worked at their sinks and looked up at the ceiling for an extractor fan.

Evans read his mind and said, 'I'm afraid there's no air conditioning. Dr Richardson has been asking for it for a long time I understand but with no success. Too many other priorities. It's not so bad when the steriliser isn't running.'

'But pretty awful when it is,' added Jamieson.

The two men moved on through the basement corridor with Jamieson having to duck his head to avoid hitting it on an array of pipes that ran along the underside of the low ceiling. Evans, a couple of inches shorter than Jamieson, did not have the same problem.

'This is my lab,' said Evans opening a door to a square room that was slightly bigger than any of the others Jamieson had seen with the exception of Richardson's room. 'And this, I am afraid, is yours for the duration.' Evans opened a door on the other side of the corridor and Jamieson looked in to a small, narrow room that reminded him of a walk-in wardrobe. It had a desk, a telephone and an anglepoise lamp and not much else. There was no room for anything else. There were two cardboard folders lying on the desk.

'These files contain the information you asked for,' said Evans. 'If there's anything else, I'm just across the corridor.'

Jamieson thanked him and took off his jacket to hang it over the back of his chair. He sat down and looked at the walls that enclosed him. If he reached out he could touch all of them. Above him there was a thick, glass grating that allowed the merest suspicion of daylight to enter, slightly less than the greyest of dawns, Jamieson reckoned. 'One hundred and five North Tower,' he whispered switching on the anglepoise lamp. He opened the folders and got to work.

After a good two hours study, Jamieson could find no fault in the procedures followed by the Microbiology Department in trying to trace the source of the infection. According to the records, all recommended, standard procedures had been carried out with meticulous care and all tests appeared to have been carried out more than once, often three or four times. But the result had always been the same. No sign of the bug that was plaguing the practice of surgery in the Gynaecology department.

Jamieson went through the results of the staff tests again, just looking for anything at all out of the ordinary. His finger stopped moving as he found something. One nurse and one member of the surgical team had proved to be completely negative on each of the two separate occasions they had been tested. He found that puzzling. Most people carried bacteria of some sort in their nose and throat and on their skin. Usually it comprised a variety of harmless bugs but in a few cases people carried organisms which could cause disease in others in certain circumstances. It was naturally unwise for these members of staff to be near patients with open wounds.

There were a number of possible explanations for a completely negative test and Jamieson considered them in turn. If the person was on some kind of anti-bacterial treatment then the normal bacterial flora of the body might have been destroyed. Alternatively, antiseptic creams might have been applied to the areas to be swabbed before the test but that would demand some explanation. Jamieson made a note of the two reference numbers from the result sheet and resolved to pursue the matter further when he had finished reading the paperwork. He finished going through the staff reports and changed to reading the lab report on the infecting organism.

The cultural characteristics of the bug were recorded and its identity had been established beyond doubt. It was only when he saw the results of the antibiotic tests against it that he saw where the real trouble lay. The organism seemed to be immune to every known antibiotic on the standard treatment list. There was simply no way of treating such an infection. 'No wonder they died,' he said quietly.

For bacteria to become resistant to antibiotics was nothing new. It happened all the time and, perversely, especially in hospitals. With so many drugs around it was merely a case of natural selection at work. Spontaneous mutations arose all the time in bacterial populations so when an antibiotic was injected into a patient the occasional mutant able to resist its action would survive and multiply. It would become the dominant form of the infection and if not detected and destroyed might survive long enough to affect other patients.

The Pseudomonas bug that was causing all the trouble started out with the advantage of being naturally immune to many antibiotics. The acquiring of a few more through living in a hospital environment could make it a very dangerous customer indeed. Despite that, Jamieson still found the virulence of the Kerr strain surprising.

Clive Evans put his head round the door and asked how things were going.

'I know a bit more now than I did earlier on,' replied Jamieson.

'Good. Can I show you where the staff restaurant is?'

Jamieson looked at his watch and was surprised to see that it was after one o'clock. He said. 'Can I ask a couple of questions first?'

'Of course.'

'There are two members of the surgical team who had two successive negative results from their swab tests. Was this followed up?'

'No, I don't think I noticed that,' confessed Evans.

'It might be an idea to check them out.'

'We've just done another swabbing this morning but you are right, we should have caught on to that. Who were the two?'

'I can't give you names. They were only numbers were on the sheet you gave me. These ones.' Jamieson handed Evans a sheet of paper with the reference numbers on it. Evans put it in his pocket and said he would check. 'What was the other question?' he asked.

'Have you had the Pseudomonas checked for the presence of Resistance Transfer Factors?'

'No we haven't,' replied Evans. 'Dr Richardson didn't think there was much point in it. If the bug is resistant to antibiotic treatment it's resistant. It was his view that it doesn't matter much to the patient why it's resistant.' Evans saw the look on Jamieson's face and quickly added, 'Well, that's what Dr Richardson said.'