Ken McClure - Wildcard

‘And you say this is quite common?’

‘I read recently in one of the journals that 225,000 heart-valve operations are performed every year in the developed world and 60,000 patients receive replacement valves.’

‘How about post-op problems?’

‘All surgery carries risks, of course, but heart-valve surgery has an excellent success rate. The vast majority of patients make a good recovery and generally feel like new people into the bargain.’

‘And the ones who don’t?’ asked Steven.

‘There’s always a slight risk of stroke, bleeding, infection, kidney failure and, on occasion, heart attack and death; but they’re the exceptions.’

‘Heart-surgery patients haven’t shown up as being susceptible to secondary illness in any way, have they?’ asked Steven cautiously.

‘Secondary illness?’ queried Giles.

‘Viral infections, that sort of thing.’

Giles said, ‘Not in my experience, although it may be true of transplant patients if they’re immuno-compromised because of the anti-rejection measures. I haven’t noticed increased susceptibility in valve-surgery cases and I haven’t heard that from anyone else in the business. We did have a major problem back in the eighties with mechanical failure of one make of replacement valve, the Bjork-Shiley CCHV, which was prone to fracture, but that model was withdrawn way back in 1986, if my memory serves me right.’

‘No, that’s not the sort of thing I was thinking of.’

‘Then I’m sorry, I can’t help,’ said Giles. ‘Valve replacement is one of the most satisfying and rewarding surgeries we perform in terms of improving the quality of patients’ lives.’

Steven nodded and got up to go. ‘Thanks for seeing me at such short notice,’ he said. ‘I appreciate it.’

‘Any time,’ said Giles.

Steven smiled and said, ‘I rather hoped you’d say that. I may have to call on you again.’

When he got back to his hotel, Steven called Sue in Dumfriesshire and told her that it was looking extremely unlikely that he would be able to be there for Christmas.

‘I half expected it,’ said Sue. ‘It sounds as though things are getting worse down there. I’ve been warning Jenny that those poor people may need to hang on to her daddy for a little bit longer.’

‘Thanks, Sue. How do you think she’ll take it?’

‘Your daughter is a remarkably mature young lady for her age. But if you aren’t going to make it, I think you should tell her yourself.’

‘Will do,’ said Steven. He had scarcely put down the phone when it rang. It was the duty officer at Sci-Med. ‘Dr Dunbar? Mr Macmillan would like you back in London at your earliest convenience’ — that being a euphemism for ‘now’.

Steven drove over to Caroline’s house and left her car outside with a note in it saying that he’d had to go to London. He hailed a cab and asked to be taken to the airport. He was in London four hours after receiving the call and in John Macmillan’s office at a quarter to five.

Macmillan smiled and said, ‘I underestimated you: I’d allowed another couple of hours. I’ve called a meeting for seven. Perhaps you’d like to…?’

Something about Macmillan’s demeanour suggested that Steven shouldn’t ask too many questions. He smiled and said that he’d be back for seven. He walked for a bit, enjoying the bustle of the early-evening crowds and the feel of Christmas in the air after the unnatural quiet of Manchester. He found a wine bar which was playing Christmas carols, and had a glass of Chardonnay. He’d have preferred a large gin but remaining alert for the meeting was a priority. Macmillan hadn’t said that Steven would be asked to report on his progress, or lack of it, but it seemed likely.

Back at Sci-Med he found Macmillan alone.

‘The meeting isn’t here,’ said Macmillan in response to his questioning look. ‘It’s in the Home Secretary’s office.’

When they got there Steven was surprised to find two other cabinet ministers in the room besides the Home Secretary himself, who looked a worried man. In all there were eight people present. Steven nodded to each in turn as they were introduced.

‘The truth is, we haven’t been quite frank with you, Dunbar,’ said Macmillan.

Steven remained impassive while he waited for Macmillan to continue, but his pulse rate rose.

‘In the past it’s always been Sci-Med’s policy to pass on every scrap of relevant information to our people as soon as it became available. In this instance, however, we’ve been forced to hold something back.’

‘Well, they say confession’s good for the soul,’ said Steven dryly.

‘The decision wasn’t taken lightly,’ said Macmillan. ‘It was taken at the very highest level and with the concurrence of the people present in this room. When Sister Mary Xavier caught the disease, a woman who had led a sheltered life in an enclosed order, it seemed to us that your search for a common linking factor could not possibly succeed. You don’t have to be an epidemiologist to see that there simply couldn’t be one. The implications of that conclusion were, of course, enormous: that our country is under attack from a lethal virus which can pop up anywhere and at any time, without the need for a continuous chain of infection.’

‘So what was it that you didn’t tell me?’ asked Steven.

‘We told you about Sister Mary but we didn’t tell you about the others. There have actually been fourteen new wildcard cases across the UK. All without a linking factor.’

Steven blanched at the figure.

‘Because of the medical authorities’ vigilance these people were quickly isolated, but if this is the tip of an iceberg we are facing national disaster on an unprecedented scale,’ said Macmillan.

‘And the steps we must take are draconian,’ said the Home Secretary. ‘We are on the verge of declaring a national state of emergency, with all that implies.’

‘Well, gentlemen, it seems to me that you’ve already made your minds up about the virus,’ said Steven.

‘We told you about Sister Mary because we thought you would investigate and reach the same conclusion before reporting back with your findings,’ said Macmillan. ‘That’s why I brought you here tonight. You do agree, I take it, that there is unlikely to be a traceable source of this virus?’

‘No, I don’t,’ said Steven, to the accompaniment of surprised looks around the room. ‘In fact, I think there is one.’

‘But the nun never left the convent.’

‘She did,’ said Steven. ‘She had heart surgery at a local hospital nine months ago.’

‘So she hasn’t been outside the convent in nine months,’ said a man from the British Medical Association testily. ‘Same difference as far as a viral infection is concerned.’

‘The other wildcards, at least the ones I was told about,’ said Steven with a glance at Macmillan, ‘had also had heart surgery recently.’

‘And you think this is relevant?’ asked the Home Secretary.

‘I don’t know exactly how at the moment, but yes, I do.’

The medical experts all travelled the road that Steven had travelled; they protested that there could be no logical connection between having heart surgery and falling victim to a deadly virus. Steven sat through it all patiently, nodding as people pointed out what he already knew about varying geographic locations, different hospitals and different surgeons, the operations having been performed at different times of the year and for different medical reasons.

‘It’s still a fact that all four had heart surgery,’ said Steven when the protests had died down. ‘And it’s the only thing they had in common.’

‘What d’you think, Macmillan?’ the Home Secretary asked.