Pandora's Helix

Eight

Neef saw that Pereira was looking apprehensive as they entered the main operating theatre where Norman Beavis would carry out neuro-surgery on Thomas Downy.

“Are you sure you want to be present?” he asked. “It’s not for the faint-hearted.”

“I’m fine,” replied Pereira, running his tongue over lips which had gone dry.

The theatre was twice the size of the minor surgical facility that had been used in the morning and was packed with much more technical equipment and people. Beavis, a tall serious looking man who favoured rimless glasses and a severe side parting in his hair that made him look like a Gestapo officer to Neef’s way of thinking, was very much in charge. There was no first name familiarity in his theatre. The ‘Yes Mr Beavises’ and ‘No Mr Beavises’ came thick and fast as he fired questions at the assembled team.

The patient, Thomas Downy, was positioned face down on the table, his small body draped in surgical sheeting and the back of his skull painted near the base with a yellow antiseptic solution in preparation for the first incision. Two technicians were making last minute adjustments to the CT scan equipment.

“Is everyone ready?” asked Beavis.

There was general assent.

“Is anyone not ready?”

Silence.

“Do we have the virus to hand?”

The theatre sister replied, “All ready, sir.” She indicated to a glass vial that sat in an ice bucket by the side of her instrument tray.

“Let’s get started then.”

Beavis cut into the back of Thomas Downy’s head and Neef leaned over to explain to Pereira what was going on. “He’s cutting back a flap of skin to expose the skull.”

Pereira nodded mutely.

Beavis discarded the scalpel in favour of an electric drilling tool which he tested in the air before applying it to the base of Thomas’ skull to start drilling out a plug of bone. The air was heavy with the smell of burning by the time he’d finished. He dropped the plug into a waiting bowl. Neef heard Pereira swallow.

“Will he put that back?” Pereira croaked.

“No,” replied Neef. “He’ll close the skin flap over the opening and in time the hole will fibrose and virtually close itself.”

Beavis inserted a long needle gently through the opening in Thomas Downy’s skull and stopped. “First scan!” he ordered.

The CT scan team moved into action and a few seconds later the image the scan had produced was displayed on a screen. Beavis moved the needle in deeper and repeated his request. The record of the needle’s progress came up on the screen.

“What’s happening?” asked Pereira.

“We can’t use ultrasound for brain surgery and we can’t get a camera inside the patient’s head so we have to take a series of CT scans as the operation progresses.

“You get the picture after the event?” asked Pereira.

“It has to be that way,” said Neef.

“Jesus,” said Pereira softly.

The needle continued its monitored progress towards Thomas Downy’s tumour until Beavis said, “We’re there. Can I have the virus please?”

The theatre sister reached out a gloved hand to pick up the glass vial from the ice bucket. Unfortunately its outside was wet from being in the ice and it slipped from her grasp. It bounced off the edge of the instrument tray and fell to the floor where it shattered. It sent tiny shards of glass everywhere and created a jagged wet splash where the virus had spilled out. Her gloved hands flew to her face in anguish and her eyes above her mask went as wide as saucers. Beavis couldn’t turn his head to see what had happened. His hand was holding the needle steady inside the patient’s skull. “What’s going on?” he demanded.

“We’ve lost the virus,” said Neef. “It’s fallen on the floor.” He stepped forward to put a hand lightly on the shoulder of the hapless sister as everyone else seemed paralysed by shock.

“Is there any danger?” exclaimed Beavis.

Neef looked at Pereira who shook his head.

“No danger,” said Neef. “The virus has been disabled but we better have some disinfectant on it anyway.”

One of the theatre technicians poured antiseptic solution on to the puddle on the floor and then swabbed it up with cotton wool pads. The glass was collected into a small, metal bowl.

“So now we don’t have any virus to inject. Is that right?” asked Beavis. His voice was controlled but the implications to everyone were obvious. The operation had been a waste of time. Beavis still concentrated on keeping the needle steady inside his patient’s head while he waited for an answer.

“There is some more,” interjected Pereira. “There’s a back-up supply in Pharmacy.”

“Will someone please get it,” said Beavis. “Quickly!” There was no mistaking the anxiety in his voice. There was no question of his extracting the needle and then going back in again. The risk of serious brain damage was too great. He was faced with holding the needle in situ until the new virus arrived.

As the minutes passed, Beavis said, “I think my hand’s starting to shake. Could someone please prepare to take over here?” He said it matter of factly but everyone knew the seriousness of what he was saying. There would be danger in the needle changing hands but this would be preferable to the brain damage caused by an involuntary hand tremor. Beavis’ assistant for the operation moved round into place at his elbow. “Ready when you are, sir.”

“The virus has arrived,” announced one of the nurses at the back of the theatre.

“I think I’ll be all right,” said Beavis. In the interim, he had piled up a number of surgical swabs under his scalpel hand in order to give himself some support. His assistant moved back round to the other side of the table.

The tray of glass vials was passed through the theatre doors and a nurse brought them to the table.

“Which one?” asked the theatre sister.

Pereira moved in to the table and selected one of the vials. “This one,” he said. “Five millilitres.”

The virus suspension was measured out into the barrel of a syringe and handed to Beavis who attached it to the needle already inserted in Thomas Downy’s tumour. He slowly applied pressure to the plunger until the contents disappeared then permitted himself a slight sigh of relief as he withdrew the needle slowly out of the back of his patient’s skull and dropped it into one of the steel discard dishes. He took a few moments rest during which he flexed his fingers to free them of the stiffness that had developed during the long wait. He nodded to his assistant who took over and carefully sutured the flap of skin back into place over the opening in Thomas’ skull.

“All done,” he said.

“Heavy stuff,” Pereira whispered to Neef, rolling his eyes above his mask.

“We could have done without the drama,” agreed Neef.

The nurse who had dropped the virus was still flushed with discomfort and embarrassment. She moved towards Beavis as he stripped off his gloves and said, “Mr Beavis, I’m so terribly sorry about...”

Beavis stopped her in mid sentence and said, “Don’t worry about it, Sister. It could have happened to anyone. No harm done.”

Neef decided to try and kill off the Gestapo officer image he had of Beavis.

The relief in the nurse’s eyes was obvious to all. One of her colleagues put an arm round her shoulders and as Thomas Downy was wheeled out to the recovery area, it seemed as if the whole theatre suddenly relaxed as tension evaporated.

Neef walked back to the unit with Max Pereira. Pereira had been subdued all day but now he seemed to have perked up again. “There was more to it than I thought,” he confessed. “I thought you could just stick a needle in and that was that.”

“So we medics have our uses then?” smiled Neef.

“I guess I really need you guys to get the vectors in,” replied Pereira, without a trace of humour. “Two more tomorrow?”

“Two more,” agreed Neef. “And then we’re all up and running.”

Neef went straight to the duty room to see Kate Morse. “How’s Charlie?” he asked.

“He’s not good,” replied Kate. “The lab haven’t come up with a confirmation of the Klebsiella diagnosis and he doesn’t seem to be responding to the ampicillin treatment.”

“Damnation,” said Neef. “What are they playing at?” He diverted his eyes so that Kate would not see any signs of the alarm bells ringing inside his head. An atypical pneumonia that wasn’t responding to treatment? It seemed too much like re-visiting a bad dream. He looked sideways at Kate and saw that she was under great strain. It was etched in worry lines round her eyes.

“How was Thomas’ op?” Kate asked in a brave attempt to change the subject.

“He’s fine,” replied Neef. “The operation wasn’t exactly smooth but he came through it OK. Now we’ll have to hope for the best for all of them.”

“Tracy Torrance died in the Randolf Clinic this afternoon,” said Kate. “You were in theatre at the time.”

Neef nodded sadly. “I hope to God her mother doesn’t still believe I wished it on her,” he said.

“I’m sure she won’t,” said Kate. “Once all the pain and grief has gone away and she can think clearly again.”

Neef was happy to see that the leaked story about the Gene Therapy patients at St George’s, ‘New Hope for Cancer Kids’ wasn’t too sensational. Although Mark Louradis had sought the publicity himself, he had apparently played out the role of reluctant academic being interviewed by an intrusive press. He had trotted out the usual platitudes about things ‘being at a very early stage’ and it being ‘too soon to say’ if the patients were going to benefit. He himself was only ‘part of a team’ and a lot of dedicated people were involved. It would be some time before the therapy would be generally available. All mind numbing stuff that the press and public had heard so often before, thought Neef. The press however, did now know what was going on and he could expect their continued interest.

On the evening of the following day, The Citizen ran Eve’s story about the two cancer girls, based on Mr Lees’ complaint to the paper and her own subsequent investigation of the facts. She had waited two days as she promised she would to see if Lennon’s people would come up with anything but they hadn’t and had admitted as much in an interview. The story made the front page. “City Fear as Cancer Killer Baffles Boffins”.

Neef suspected that the Public Health people were not going to be so enthusiastic about being the baffled boffins in question although Lennon seemed to have been quoted fairly enough. Lennon had obviously said much the same to Eve as he had to him in their last conversation and it was unfortunately true that the investigation was going nowhere at present.

Neef thought that the facts had been reported accurately. He wondered what would happen now. He suspected that there were going to be a lot of worried parents out there. There was of course, a chance that there would be no more cases and that the incident would fade away to be written off as just one of these things but if there should be another case, the seeds of panic had possibly been sown by this article.

On the following Monday, Lawrence Fielding reported to Neef that Jane Lees had responded well to steroid treatment and her ‘pneumonia’ was under control. “What made you suspect an immune response?” he asked.

“I wasn’t entirely happy about the original viral pneumonia diagnosis for Melanie Simpson,” replied Neef. “I asked Frank MacSween about it at the time. I thought maybe the underlying cancer had given the appearance of viral pneumonia when it was really some kind of immune response, an inflammatory reaction to the tumours. Frank thought the post mortem appearance was typically viral and I accepted what he said. But when Jane Lees presented with exactly the same symptoms as Melanie Simpson, my suspicions were aroused again. I thought that steroids were worth a try.”

“And you were right,” said Fielding. “Steroids suppressed the lung symptoms.”

“Not that it’s going to do her much good I’m afraid,” said Neef. “Her cancer is too well advanced.”

“No, but at least she’s a lot more comfortable on Antivulon and steroids in the meantime,” said Fielding. “And to quote a source not a million miles from here, ‘If that’s the best you can do... so be it’.”

Neef smiled at having his own philosophy quoted back at him.

When Wednesday came and went without there having been any follow-up to the interview Louradis had given, Neef felt well pleased. The Public Health people were still under daily scrutiny but most of the coverage of that particular day went to Tracy Torrance’s funeral. The Citizen gave it mass coverage with, “Brave Little Tracy Loses Last Battle”, using colour photographs of the wreaths with their poignant messages to wind up second-hand emotion. “Recouping their investment,” as Tim Heaton put it when he called to ask Neef how the Gene Therapy trial was progressing.

“So far so good. The patients start on Gancyclovir tomorrow,” replied Neef. “Then it’s just a question of waiting and seeing.”

“Fingers crossed,” said Heaton. “This could really put us in the big league.”

Neef gave a noncommittal grunt.

“Did you get supplies of your American drug?” asked Heaton.

“Antivulon. We’ve started using it,” said Neef. “It’s a bit too soon to say but one of our patients, John Martin, is coping with it much better than his previous chemotherapy. Thanks for your help in getting it. I appreciate it.”

“Not at all,” said Heaton. “That’s what team work is all about.”

Neef suddenly felt defensive. Heaton was after something.

“I understand from John Marshall that you don’t want any press involvement with the Gene Therapy patients until the trial is virtually over?” said Heaton.

“That’s right I didn’t want any false hopes being built up for the children’s parents. They’re very vulnerable people”

“Oh absolutely,” said Heaton unconvincingly to Neef’s way of thinking. “It’s just that as something did however manage to find its way into the press last week, however regrettable, I was wondering if it might not be a good idea to keep the papers sweet with some more formal announcement of what’s going on? Perhaps a press release composed by John and yourself? Maybe a photograph or two? Put the record straight so to speak?”

“I’d rather not have any press involvement at all at the moment if it can be avoided.”

“That’s the thing,” said Heaton hesitantly. “I’m not sure it can. As the press know about the trial through Mr Louradis’ interview, we really have to answer their questions otherwise they might start assuming the worst and we don’t want that do we?”

“All right,” conceded Neef. “I’ll keep Marshall informed and he can feed them information but I don’t want the press anywhere near the unit.”

“Good,” sighed Heaton. “I’m sure John can keep them at bay while presenting things in a positive light. Anyway, glad you got your American drug all right.”

Neef put the phone down and cursed under his breath. The man was a master at making him feel guilty.

Jane Lees died early on the following Friday evening. Her pain was under control and her end was peaceful. Her mother and father were with her as was the hospital chaplain, Geoffrey Keys. The Lees were not churchgoers but had agreed to Keys being present and luckily took comfort from what he had to say. Neef spoke to both parents afterwards in his office. It was a very different occasion to the last time he had seen them. Mr Lees’ anger had entirely disappeared and had been replaced by grief over his daughter and bemusement at why it had to be her.

“Why?” he asked with tear filled eyes. “Why our Janey?”

“I wish I could answer that,” said Neef softly. “Although in Jane’s case, there will be some kind of an answer. It’s just a question of time before the Public Health investigators find out why your daughter contracted the disease. I’m so sorry.”

Lees shook his head silently. His wife sobbed into her handkerchief. Neef pushed the tissue box nearer to her. A nurse came in and nodded at Neef’s questioning look.

“Nurse Lawrie here has organised some tea for you and I think the chaplain’s going to join you to talk about Jane. I think you’ll find it helps. Don’t hold back. Remember the good times you had together, the family holidays, the Christmases, the fun, the daft things she did. Speak about them. That way, you can go on keeping Jane alive inside you.”

As the couple stood up to follow the nurse out of the room, Mr Lees blew his nose loudly and turned to Neef. “I’d just like to thank you for all you did for Janey, Doctor. I think I was a bit out of order the last time we spoke. None of this was your doing and I was too angry to thank you properly. I didn’t really know what I was saying. We’re both grateful, Martha and I.”

“I wish it could have been more,” said Neef.

Neef watched the door close behind the Lees. He stared at it for a few moments, grateful for the silence in the room as he considered what he still had to do before going home. There came a knock. Eve Sayers put her head round the door. “Can I come in?”

Neef nodded.

“I came to see Neil. I couldn’t make it earlier this afternoon. I saw Mr and Mrs Lees out there,” said Eve. “Is it what I’m thinking?”

“Jane Lees died a short time ago,” said Neef.

“The second victim,” said Eve.

Neef gave her a look that questioned her choice of phrase but then considered it justified. “Yes, the second victim.”

“Do you know what really worries me? There’s something out there killing these kids and everyone in authority seems to be sitting around on their backsides waiting for number three to happen.”

“I’m sure that’s not true,” said Neef.

“So what exactly are Public Health doing?” asked Eve.

Neef looked at her dispassionately and shrugged as if he had no heart for an argument. He was still thinking of Jane Lees.

Eve realised that she was kicking a man when he was down. She looked up at the ceiling as if seeking divine guidance. “I’m sorry,” she said. “I didn’t think. I’ve been getting the run around from the Public Health department all day and I just didn’t stop to think. You’ve had a bad day too, probably a lot worse than mine.”

Neef shrugged philosophically. “I’ve had better,” he said.

“You’ve only had one of my three recipes. Want to try for number two?”

Neef relaxed a little and gave a weak smile. “It’s my turn. Why don’t I take you out to dinner? It’ll have to be out. I don’t cook.”

“Neither of us really feels like going out to eat,” replied Eve. “Come home with me?”

Neef seemed reluctant then nodded his assent. “All right. Thank you,” he said.

When they got to the car park, Eve said, “Leave your car. I’ll drive you home later.”

Neef did not offer any argument. He felt strangely detached from what was happening, as if he had tripped out some emotional overload switch. He was a spectator to what was going on rather than a participant.

They did not speak as Eve negotiated the traffic and drove expertly across town, using the Golf GTi’s acceleration to advantage when small gaps appeared in the traffic ahead. They still didn’t speak as they stood on opposite sides of the elevator as it took them up to Eve’s apartment but they looked each other in the eye rather that at their feet or the floor indicator above the doors. It didn’t feel uncomfortable. Eve’s gaze was positive, Neef’s was slightly puzzled.

Eve unlocked her door. She kicked aside the mail that was lying behind it and led Neef to the drinks tray where she poured him a large gin and tonic. “Drink that,” she said.

Neef downed the gin without question.

“Come.”

Eve led Neef to the couch where she pushed him gently backwards on to it and took off his shoes. “Now relax,” she whispered. “Nothing awful is going to befall you. I’ve been watching you, Michael Neef and quite frankly, you are a fake. You gave me a lecture on how to handle the mind destroying amounts of grief your job entails when the truth is, you can’t handle it yourself. You’ve been pretending. It really does get to you, doesn’t it? I suddenly saw it in your eyes back there. You can’t go on like this indefinitely, bottling it all up inside you, you’ll make yourself ill. You need to talk it out. It’s too much to carry all on your own.”

Neef stared up at the ceiling for a few moments. He said simply, “It used to be Elaine. I could tell her when the going got tough.”

“Elaine?”

“Elaine was my wife. She died four years ago.”

“I’m sorry.”

“I still miss her,” said Neef. It sounded so pathetically inadequate, he thought, to distil all that loneliness and pain into four little words. “She was always there when I needed her and then suddenly, she wasn’t. I’ve learned to cope with most things but occasionally, just occasionally, I find myself in a situation where...”

“You can’t cope.”

“I can’t cope,” agreed Neef slowly.”

Neef closed his eyes and rested his head on the back of the couch.

“Well, I’m not Elaine,” said Eve softly, “But you’re a nice man, Michael Neef and if you need a shoulder to cry on, feel free.”

Neef opened his eyes and nodded with a slight smile. “Thanks,” he said. “I appreciate it.”

“Don’t appreciate it,” said Eve softly. “Use it. Talk to me. What got to you today? Jane Lees?”

“No...” Neef began hesitantly. “I know what’s going to happen to the kids and I can cope with that. I’m prepared. It’s their parents who sometimes get to me. It’s their parents’ grief I can’t handle”

“Go on.”

“It’s as if it’s infectious. More often than not they’re nice ordinary people who can’t understand why it happened to their child. I can feel their hurt and for some reason I can’t fathom, it becomes mine. I know I should be able to stop it happening, put up some kind of barrier against it, but sometimes I just can’t manage. I soak it up like a sponge and it drains me of everything... energy, optimism, hope.”

Neef looked directly at Eve. “Well, Counsellor? What’s the answer?”

Eve stayed silent for a moment while she thought about the question. Eventually she took a deep breath and pronounced, “I think you should run away and join the circus.”

Neef broke into a smile and Eve joined him. “No easy answers,” she said.

“At least we’re agreed on that.”

“How about recipe number two?”

“Sounds good.”

“More gin?”

“Yup.”

Eve drove Neef home shortly after midnight. He had taken full advantage of not having to drive and although not completely drunk, he felt, ‘pleasantly relaxed’ as he put it.

“Have you got your key?” asked Eve.

Neef fumbled in both his coat pockets before holding it up triumphantly.

“What time do you have to be at the hospital in the morning?” asked Eve.

“Don’t worry; I’ll call a taxi in the morning.”

“I can come over on my way to the office,” said Eve. “Pick you up around eight thirty?”

“I can get a taxi.”

“Nonsense. This is all my fault,” said Eve.

“Fault?” exclaimed Neef. “I can’t tell you the last time I felt this good. I’m indebted to you.”

“I’m glad you enjoyed yourself,” said Eve softly. She leaned over and kissed Neef lightly on the cheek.

Neef turned towards her hesitantly and said, “You know, you’re very beautiful.”

“Well, thank you,” smiled Eve. “Tell me again when you’re sober.”

“I’m not dru...”

Eve placed a finger lightly on his lips. “Ssh,” she said, kindly. “You’ve also got something to do about a ghost. Be off with you. I don’t know what Dolly’s going to say when she sees the state you’re in.”

Neef manoeuvred himself out of the car with some difficulty, again protesting that he wasn’t drunk.

“Sorry,” smiled Eve. “Pleasantly relaxed.”

“Exactly,” said Neef, turning to look back inside the car.

“See you at eight thirty.”

“I can get...”

“Eight thirty.”

Eve was as good as her word. She picked Neef up promptly at half past eight and took him to the hospital. On the way they talked about Neil.

“I’d like to take him out this Sunday if that’s all right,” said Eve.

“Sounds fine,” said Neef. “He’s still quite stable and he’s obviously very comfortable with you. I think your visits are doing him the world of good.”

“I’d like to think that was true,” smiled Eve. “He’s so easy to get attached to.”

Neef half turned his head as if to say something but Eve got in first. “I know, I know,” she said. “You really don’t have to warn me.”

“Sorry,” said Neef. “Have you thought what you two might do together?”

“The forecast for the weekend sounds reasonable. I thought we might try for a picnic by the river.”

“Sounds good.”

“Why don’t you join us?”

“Me?” exclaimed Neef.

“Why not you?”

Neef didn’t get more than a couple of words out when he stopped and reconsidered. He said, “I was about to say something pompous about not getting personally involved with the patients but I thought better of it.”

“Good. Then you’ll come?”

“I’d love to,” smiled Neef. “What would you like me to bring?”

“Just yourself. I’ll fix the picnic. I’ll also pick Neil up from the hospital. You can meet us somewhere. Better still, we’ll pick you up from home.”

“I look forward to it,” said Neef.

“If I don’t get a chance to speak to you before then, I’ll see you at ten thirty on Sunday morning. You’ll tell the nurses?”

“I’ll tell Kate when I get in.”

“Sister Morse?”

“Yes.”

“I don’t think she likes me.”

“She’s suspicious of your motives. You’re a journalist.”

“Guess that doesn’t put her in a minority of one,” said Eve.

Neef shrugged.

Eve dropped him off outside the main gates and he waved to her as she drove off.

Neef hung up his jacket in his office and called into the duty room to warn Kate about Neil’s picnic. She wasn’t there. The night staff nurse said that she had called in. He husband had taken a turn for the worse. She was up at University College Hospital.

Neef phoned University College Hospital and spoke to one of the housemen on the ward where Charlie Morse was a patient.

Mr Morse has been moved to ICU. He was transferred last night with severe breathing difficulties.

Neef felt a dark cloud come over him. He asked to speak to Clelland, the physician he had spoken to last time.

“I’ll ask the switchboard to page him,” replied the houseman.

There was a thirty second delay before the operator said, “Still paging Dr Clelland for you.”

After another thirty seconds Clelland came on the line.

“Doctor, it’s Michael Neef. I understand Charles Morse’s condition has deteriorated?”

“He’s very ill; he’s not been responding to antibiotic therapy.”

“Did the lab confirm your Klebsiella diagnosis?”

“I’m afraid not,” replied Clelland. “They found no evidence of bacterial involvement at all.”

Neef closed his eyes and rubbed his forehead lightly. He could sense a nightmare coming true. “So where do you go from here?” he asked quietly.

“There’s not much we can do,” confessed Clelland. “If it’s not bacterial it must be viral. It’s just a case of keeping him as comfortable as possible and hoping he pulls through. We’ll keep him on broad spectrum antibiotics of course, to make sure secondary infection doesn’t set in.”

“I don’t think he has pneumonia at all,” said Neef.

“I’m sorry. I don’t think I understand.”

“I don’t think I do either,” said Neef. “But Charles Morse is displaying the exact same symptoms as two young girls who have recently died from cancer after being exposed to some unknown carcinogen. They both presented as severe pneumonias but no bug was isolated and they didn’t respond to antibiotics.”

“The story in the local papers?”

“Yes.”

“Have I got this right? You’re telling me that Mr Morse has cancer?”

“I hope to God I’m wrong but yes, I am. I think you’ll find his pneumonia symptoms subside when you try him on steroids instead of antibiotics. Once the inflammation goes down you’ll be able to find the tumours on X-ray.”

“Look, his wife is here at the moment,” said Clelland. “I don’t think I want to tell her this without knowing something more. It’s a very awkward situation, if you see what I mean.”

“I understand,” said Neef. “I don’t think I want to say anything to Kate at the moment either. I could be wrong but it seems one hell of a coincidence.”

“But if you’re right it would mean that Morse had been exposed to the same carcinogen as the two girls,” said Clelland.

“I suppose it would,” agreed Neef. “Another connection for the Public Health Service to ponder.”

“Maybe this will make it easier for them.”

“Maybe,” said Morse, reluctant to see any good coming out of Charlie Morse’s misfortune. “Will you give steroids a try?”

“Nothing to lose.”

“Good. I’ll hold off saying anything to Kate until you’ve tried it. If it doesn’t work we’ll know I was wrong. If it does, I’ll tell her.”

“Might be best coming from you.”

Where have I heard that before, thought Neef.