Scorpion's Advance (2 page)

'God, no,' said Anderson. 'New drugs have to be proven safe long before they ever reach hospitals. We give them to volunteers for much less dramatic reasons, to look for minor side-effects - If you give a new drug to a patient and he starts to feel dizzy you can't be sure if it's the drug or his illness, but if you give it to twelve healthy students and they all feel dizzy, it's the drug. Again, with a new drug we have to work out the correct dose to give so we give it to volunteers and then collect samples of blood and urine to see how much gets into their system.'

'Neil?'

'Yes?'

'You’
re boring me.'

Anderson switched off the light and snuggled down beside Angela in the darkness. He put his hands down on to her buttocks and pulled her into him. '
Now, where were we?’

Angela giggled.

Anderson got into the lab just after nine. Before doing anything else he examined the cultures he’d put up the night before from the Klein case. There was no sign of bacterial growth on any of them. They were still perfectly sterile. At nine-thirty the internal mail system delivered a directive that all personnel connected with the trial of the antibiotic Galomycin should present themselves at ten-thirty prompt in the medical superintendent's office.

Anderson spent the intervening hour on the project he was most concerned with at the moment: the problem of why so many infections in the hospital were failing to respond to standard treatment. This morning's lab cultures had yielded two more strains of bacteria that had app
arently developed immunity to first-choice antibiotics. That made a total of eight in the last twelve days. He set up tests to establish alternative treatment for the patients.

Anderson left the lab at twenty-three minutes past ten and crossed the courtyard to the hospital. He made his way along the corridor in an easy slalom between trolleys bearing patients and trolleys carrying stores and stopped as he passed the main staircase when he heard his name being called. Ma
ry Ryle, the hospital pharmacist, was hurrying after him. She was a thin, spinsterish woman in her late thirties whose life had been dedicated - and wasted in Anderson's opinion - to the care of her aged mother. She seemed relieved to see Anderson. 'Thank goodness,' she twittered nervously, 'I thought I was going to be late.'

Anderson smiled at the idea. Mary
Ryle was the last person on earth to turn up late for anything. 'We still have a few minutes, Miss Ryle.'

'I must say, this is all very mysteriou
s’.

Anderson did not bother to explain why the meeting was being called for they had reached the medical sup
erintendent’s office. They went inside to find the other four already there. James Morton, the medical superintendent; Nigel Lennox-Adams, consultant physician; John Kerr, consultant bacteriologist and Anderson's chief and Sister Linda Vane, in charge of the ward where Galomycin was under test.

Linda Vane mad
e sure that everyone had coffee then Lennox-Adams cleared his throat loudly to make sure he had their attention.

'I won't beat about the bush,' he said. 'One of the student/staff volunteers we have been using for the
Galomycin trial is dead.' He paused while Mary Ryle injected a few variations of 'how awful'. 'There is, of course, no suggestion that taking the drug had anything whatever to do with it but, statistically, it is absolutely imperative that we establish the exact cause of death.'

'Does that mean that you don't know why he died?' asked James Morton.

Lennox-Adams told him of the circumstances surrounding Klein's death.

'I see,' said Kerr.
He turned to Anderson. 'You found nothing in the slide?'

'Zilch
.'

'And the cultures?'

'Negative this morning.'

'You've arranged a post-mortem?' Kerr asked Lennox-Adams.

'Two-thirty this afternoon. Quite frankly it's down to lab tests now. Fearman said that the patient presented as a typical bacterial meningitis when he came in. When I saw him it looked like the final stages of rabies. I think that means that, as physicians, we simply don't know.'

Anderson walked back to the lab with Kerr, pausing to let Kerr light his pipe. After a few rapid puffs to verify that it was alight, Kerr said, 'I want you at the Klein PM this afternoon. Take the specimens yourself, everything you can think of.'

'Very well,' said Anderson without much enthusiasm. He decided to give lunch a miss.

The Pathology Department was in the basement of the medical school. It had originally been sited there so that horse-drawn hearses could use the back door to
collect or deliver their cargo out of sight of curious eyes. The reason still held good, only the horses had gone.

Anderson asked the reception technician about the Klein post-mortem.

'Number five,' he said, inclining his head to the left.

Anderson followed his direction and went through the green swing doors marked with a white '5'. He found himself alone in the changing-room but could hear voices coming from the post-mortem suite beyond. They had already started. Anderso
n changed into gown and Wellingtons and joined them after a brief pause to steel himself for the sights and smells of Pathology.

The pathologist looked up from the table as Anderson entered and regarded him through half-framed spectacles.

'Anderson, Bacteriology, to take specimens.'

'
Gelman,' said the pathologist.

The mortuary attendant adjusted the water supply to the table so that it settled down to a steady gurgle as it sluiced through the drainage channels.

Anderson looked at the face of the corpse and saw again the mask of terror that he had seen in the early hours of the morning. If anything, the yellow-white pallor of dead flesh made the spectacle even more horrible.

'An unpleasant death,' said
Gelman, noting the look on Anderson's face. He opened up the cadaver with a strong sweep of the knife.

Gelman
removed the internal organs, examining them visibly then weighing them before recording his findings on tape. At intervals Anderson would ask him to pause while he moved in with scalpel and pipette to take samples of tissue and body fluids and deposit them in small, sterile glass bottles for transport back to the lab. The head was done last; the air filled with the smell of burning bone as Gelman trephined round the skull and removed it as a complete cap.

At length
Gelman stood back from the table and stripped off his gloves. 'Well,' he said with some resignation, I hope you lot can come up with something. I've just cut up a perfectly healthy twenty-two-year-old boy.'

Anderson took the last of the samples he wanted before joining
Gelman in washing up at the sink. 'Dr Lennox-Adams thought it might be rabies,' he said.

'Doubt it,' said
Gelman. 'No bite marks on him.'

'But rabies can have a very long incubation period, can't it?' said Anderson, knowing that it could but not wishing to offend the senior man.

True,' said Gelman, drying his hands. 'But I still doubt it. Death followed too rapidly after onset . . . more like toxic shock.'

'So poisoning is a possibility?'

'I think it has to be, but God knows which one. That's something for the labs.'

Anderson returned to the Bacteriology Department and washed again, despite having just done so. He scrubbed his hands and arms till he was satisfied that no trace of the smell of the post-mortem room remained on them. He sluiced warm water over his face and gargled with cold water from the fountain before spitting it out into an adjoining basin with satisfying accuracy. 'Sweet Jesus,' he growled under his breath, finding that the disposable towels were inserted the wrong way up in their dispenser. 'A fifty-fifty
chance and she never gets it bloody right . . .'

Anderson asked one of the junior technicians to take some of the specimens back to the Virology Department before getting down to work on setting up his own tests. It was well after seven before he had the racks of culture tubes and plates safely in the incubator. He met John Kerr on the way out; they were the last to leave the building.

'Get everything you needed?'

'All set up.'

'I see you reported two more cases failing to respond to treatment in the wards,' said Kerr.

'It's a mystery,' said Anderson. The patients were responding well to antibiotic treatment then suddenly they stopped getting better and relapsed.'

'Did you come up with alternative therapy?'

'Yes. But I'd still like to know what the hell is going on.'

Kerr nodded. 'Any ideas at all?'

'Not yet. You?'

'No. We must talk.'

It was five days before the
Galomycin group met again, five days during which Anderson had failed to find any evidence of bacterial infection in the specimens taken from Martin Klein at post-mortem. He knew that the Virology Department had come up with a similar blank, although they had managed to eliminate rabies from the running. Lennox-Adams announced similar reports from Pathology and Biochemistry with an air of barely suppressed irritation.

'Five days of investigation and we have discovered precisely nothing. Damned annoying. If anything is to be taken from the lab reports at all, it is that death was probably caused by some powerful toxin. As Biochemistry have failed to identify it, my own personal view is that it was probably bacterial in origin.'

Anderson heard the ball plop into his court, with some surprise. He scraped together a lob. 'I found no evidence of bacteria being involved, sir.'

'Are you saying that you found no bacteria at all in Klein's body?' Lennox-Adams asked with affected incredulity.

Anderson bit his tongue and held his temper in check. He said, 'No, sir, I found the normal organisms you’d expect to find in the human gut. I meant that I did not find any evidence of disease-causing bacteria.'

'Perhaps Dr Kerr might care to take a look at the cultures,' said Lennox-Adams dismissively, adjusting his glasses and flicking through his papers.

Anderson bit his tongue again.

'I have
complete confidence in Dr Anderson's ability,' said Kerr.

'Nevertheless . . .'

'Nevertheless, I have confidence in Dr Anderson's ability,' repeated Kerr coldly.

'Of course,' said Lennox-Adams with an unconvincing little smile. He changed the subject to bring them up to date with the overall progress of the
Galomycin trial. 'To date, we have treated thirty-six patients with the drug and all of them have showed remarkable progress with, I think I'm right in saying, no side-effects?' He looked around the group with raised eyebrows.

Kerr said, 'One developed thrush but that's par for the course with any antibiotic.'

'Excellent. What about the blood levels in volunteers, Dr Anderson?'

'It's very good. I think we could cut the dose to, say, two hundred and fifty milligrams instead of five hundred.'

'Very well. See to it, Miss Ryle, will you?'

'Yes indeed, Dr Lennox-Adams, right away,' said Mary
Ryle, barely avoiding genuflection in her anxiety to please.

Anderson left the meeting with John Kerr. 'Thanks for standing up for me in there,' he said, while Kerr fumbled in his pocket for matches.

'That's all right,' said Kerr, having once more achieved pipe ignition. 'Mind you ... I want to see those cultures

Fearman
was cooking spaghetti when Anderson got in. 'Want some?'

'No thanks.' Anderson flung himself down in a chair. 'Christ, what a day.'

'Problems?'

'Tell me. Is Lennox-Adams a natural son of a bitch or does he work at it?'

'What's he done?'

'Suggested that Kerr check my results like I was some kind of ... fucking
school kid!'

'Oh dear,' said
Fearman, stirring his spaghetti and stifling a smile.

'One day I'll snap his bloody double-barrelled name in two and stuff half up each nostril.'

‘That's what I like about the Scots . . . such a gentle race.'

'And your spaghetti up yours!'

'C'mon,' soothed Fearman. 'Don't take it personally. He's like that with everyone below the rank of senior registrar.'

Anderson closed his eyes and rested his head on the back of the chair. 'Suppose you're right,' he conceded. 'On top of that I've had half the medical staff on the phone today asking me what I'm playing at.'

'What d'you mean?'

'I recommend a course of treatment. Three days later the patient relapses; the infection has become resistant to the antibiotic. It's happened ten times in the past few weeks.'

'And you don't know why?'

Anderson shook his head.

'What does Kerr think?'

'We're both in the dark.'

'Well,' said Fearman, finishing his spaghetti and getting up with his plate. 'I've got lives to save.'