Ken McClure - Pandora's Helix

“That goes without saying.”

“I still think you should make sure she understands all the implications.”

“It may not come to that,” said Neef. “I won’t decide anything until I’ve seen the story in the Citizen this evening. She said she was going to do her best to back-pedal on it.”

“I think you have to consider...”

“What?”

“Ms Sayers may have decided to get herself a story about a child oncology unit. She may be using Neil to get on the inside, so to speak.”

Neef nodded and said, “To my shame, I thought of that too. I even considered that the whole apology scenario was part of some con.”

“The safe course...”

“Is to say, no. I know, Kate. “It’s just that I’m not sure. She may be entirely genuine and to dismiss her intentions unfairly...”

“Would be unforgivable and not you at all,” smiled Kate. “Up to you.”

“Let’s forget it for the moment. I am sure there are more pressing things to consider?”

Kate Morse nodded, adjusted her spectacles and opened her day folder. “Lawrence suggested we have the meeting you wanted at four this afternoon when he comes back on duty?”

“Fine.”

“We have an admission at eleven this morning, a twelve year old boy with a brain tumour, referred to us by Dr Sleigh at the Infirmary.”

“Yes, I remember. He phoned me. There’s some indecision about whether surgery is possible or not.”

“That’s the one,” said Kate. “Thomas Downy. And of course, Tracy Torrance. Will you be here for the hand-over?”

“Yes,” said Neef, without hesitation. “I think I’d better be.”

“They’re coming at two. We can expect a media circus outside, I suppose.”

“I don’t doubt it. Do we have Thomas Downy’s notes?”

“I put them on your desk.”

Neef walked round the unit before going to his office. He preferred this informal approach to ward rounds, rather than the traditional scenario of consultant followed by entourage of juniors, still favoured by many of his colleagues. Or maybe that was being unfair to them. The special nature of his own unit permitted a different approach. In a high turn-over general ward it was probably necessary for consultants to be continually briefed on who they were seeing and what was wrong with them. The population in his own unit was more stable. He knew all his patients well and liked wandering round on his own.

By ten thirty, Neef had made a thorough examination of Thomas Downy’s case notes, his X-rays and CT scans. He understood the problem. Here was a borderline case for surgery with a cerebellar tumour in such an awkward position that attempts to remove it might well cause irreparable damage or even death on the table. He would have to pass the buck entirely to the neuro-surgeon. In the meantime, he would assess the boy’s physical condition when he was admitted and get some MRI scans done just in case the surgeon decided to take the chance. He called Ann Miles on the desk intercom and asked her to contact Norman Beavis, the neuro-surgeon contracted to the Trust.

There weren’t enough neurosurgical cases in St George’s to warrant the full time services of a neuro-surgeon so the Trust had contracted for the part time services of Norman Beavis FRCS. Ann Miles called back to say that Beavis’ secretary had been informed. Mr Beavis was operating this morning but would return his call this afternoon.

The Downy boy was admitted at eleven and made welcome and comfortable by the nurses before the two housemen examined him and ran preliminary tests. Neef was in attendance but took a back seat. He was pleased with the way the new housemen were shaping up. They both chatted to the boy, disguising the clinical nature of their task with talk of football. On finding out that Thomas Downy was an Arsenal supporter, good natured rubbishing of his allegiance broke out with Samuels favouring Manchester United and John Duncan, who came from Glasgow, rooting for Celtic. Neef noticed the boy smile for the first time as Samuels and Duncan argued with each other in true pantomime fashion.

Neef ate lunch in the hospital restaurant. He was feeling slightly nervous about the afternoon encounter with the Torrances and this had dulled his appetite. He opted for a cellophane wrapped salad from the self service counter and a cup of tea. He was joined at the table by Frank MacSween.

“I called University College about the Simpson lassie,” said MacSween.

“You told them about the tumours?”

MacSween smiled wryly and said, “I think at first they thought I was complaining about the patient not being sent here in the first place. They were at great pains to assure me that no one had realised she had cancer. She was admitted as an ID case with pneumonia.”

The University College Hospital Trust and the St George’s Trust had a set of agreements about what kind of patients they could deal with. Infectious diseases went to University College, child cancer cases came to St George’s”

“Probably your Scots accent,” said Neef. “They’ll be expecting a bill.”

“I shall treat that with the contempt it deserves,” said MacSween. “Anyway I explained that the Public Health people would have to be informed as the cause of the cancer would have to be identified quickly. They said they’d be quite happy about that so I did, this morning.”

“Good.”

“Public Health are sending someone over this afternoon to take a look at the pathological material and then they’ll get on to it. University College also sent Melanie Simpson’s notes over this morning just in case the PH people want them.”

“Anything interesting?”

MacSween shook his head. “Not a thing. Bairn’s hardly had a day’s illness in her life and then, zap, she’s dead.”

Neef played with his fork thoughtfully. “You said the bugs lab failed to find any evidence of bacterial pneumonia so they were assuming it was a virus?”

“That’s right.”

“Are you happy with that?”

“I think so; it’s always a bit iffy when a diagnosis has to be made through a process of elimination but the bilateral consolidation was classic so I wouldn’t argue against it. Why do you ask?”

Neef shook his head as if dismissing some vague notion he had no wish to expand on and said, “Just a thought.”

“Well, we’ll see what the virology lab has to say and then we’ll get a clearer picture,” said MacSween.

Neef and MacSween looked at each other and broke into grins. “No, we won’t,” they both intoned together.

“They’ll find half a dozen everyday viruses of the cold and flu variety and invite us to pick one as the cause,” said Neef.

MacSween nodded. Viruses were always much more difficult to pinpoint than bacteria.

Neef looked at his watch and rose from the table. “They’re coming for Tracy Torrance this afternoon,” he explained. “She’s going to the Randolf Clinic.”

MacSween nodded. “The show must go on,” he said.

“Keep me informed about the Simpson case will you?”

“I will. Betty wants you to lunch on Sunday. Bring a friend, if you have any left when the newspapers are finished with you.”

“And with that happy thought...” said Neef, getting up. He smiled his good bye.

At five minutes to two, Neef straightened his tie and put on his jacket. He went over to his office window and saw activity around the front gate. A television camera crew were in place and technicians were milling around with their hands in their pockets. He saw a woman holding a microphone look at her watch and then primp at her hair with her free hand. A few minutes later a black Ford Granada swept into view and turned in through the gates. It stopped outside the front door and Mr and Mrs Torrance got out, accompanied by a tall, fat man with thinning hair which he kept plastered across his scalp with the palm of one hand. In the other, he carried a brief case. He shepherded the Torrances inside and turned to face reporters alone. He was standing on the second step leading up to the front entrance. The reporters below him looked like seals waiting to be fed, Neef thought.