Pandora's Helix

Twelve

It was raining heavily as Neef looked for a place near the medical school to park. A mixture of condensate and water on the car’s windows made it difficult to reverse into the one space he had found being vacated on his third circuit of the block. It was very small; its previous occupant had been a Fiat Panda and he needed two attempts at getting the Discovery into it. This did not please the driver in the car behind who displayed growing impatience with a blast of the horn. Neef glanced to the side as the other driver passed and saw it was a woman. She gave him a sour look and a shake of the head; he smiled pleasantly in reply.

Neef hunched his shoulders against the rain and ran across the road into the quadrangle. He slowed down on the cobbled surface which looked treacherous but speeded up again when he came to the long flight of steps leading up to the tall, arched entrance, taking them two at a time. He paused just inside the doors to brush the rain from his hair and shoulders and then crossed the hall quickly past the Reception desk. There were two men on the desk but neither paid him any attention. He walked straight past and into the elevator. It made him think of what Pereira had said.

David Farro-Jones’ lab was on the fourth and top floor of the building which had been built during the latter part of the nineteenth century and modified many times since. It retained its original high ceilings, which tended to dwarf people and contents but the walls bore the bumps and scars of constant redesigning of internal partitioning. Neef found Farro-Jones talking to a young man with a straggly beard and glasses which made his eyes seem enormous. He was wearing a sweat shirt bearing the logo of a brewery in Devon and sandals over bare feet. Neef waited until they had finished before approaching.

“Ah, Michael, be right with you,” said Farro-Jones. He picked up a wire rack containing several rows of test tubes and said, “I’ll just put these away in the fridge.”

Neef stood by the door looking at photographs pinned up on a cork board on the wall. They were electron micrographs of viruses, blown up to enormous proportions. One of them looked like an alien space craft. The caption said, T-Even Phage, Negative Stain, Uranyl Acetate.

“Sorry about that,” said Farro-Jones, joining him at last. “Come on into my office. Coffee?”

“Black, no sugar.”

Farro-Jones relayed the request to someone outside the door whom Neef couldn’t see. He did a few minutes later when a middle aged lady with her grey hair tied back in a severe bun came in with the coffee.

“Thank you, Marge,” said Farro-Jones.

“You’re welcome, Doctor,” replied Marge, with a Welsh accent and a smile of acknowledgement to Neef.

“Now then, what can I do for you?” asked Farro-Jones, swinging his feet round and up on to the corner of his desk with a practised ease. “More problems with Max?”

“Not exactly,” said Neef. “It’s about this carcinogen business. I had a talk with Max last night. I showed him the summary sheet we got from Public Health. Max thinks...” Neef paused as if reluctant to say the words.

“Max thinks what?” prompted Farro-Jones.

“He thinks we’re dealing with a virus.”

The smile faded from Farro-Jones’ face. “A virus?” he exclaimed. “You can’t be serious?”

“Max was,” replied Neef.

“But that’s crazy. Cancer isn’t an infectious disease. How could it possibly be a virus?”

“I know, I know. We went through all that last night but Max has almost convinced me. He thinks it’s a new virus and he knows an awful lot more about viruses than I do. That’s why I’m here. You’re an expert too; you’re also medically qualified. I’d value your opinion.”

Farro-Jones sat up straight and brought his hands to a peak over his nose and mouth. “What can I say? I think the idea is ludicrous. I suppose with Charles Morse and Frank MacSween’s grandson getting cancer in some secondary fashion it looks as if an infectious agent might be involved but the fact is, we would have seen a lot more cases if that were true.”

“Pereira suggests that the virus might have a low infectivity rate,” said Neef. “You need to inhale a lot of it. He also brought up the possibility of some people having natural immunity to it.”

“You’d certainly have to invoke something like that,” agreed Farro-Jones, his voice betraying his continuing scepticism. “But there’s been no mention of any new virus in the lab reports on the patients who’ve died.”

“I pointed that out too,” said Neef. “Max said that hospital labs examine specimens for the presence of antibodies against known viruses, not actual viruses themselves. He seemed to suggest they might not pick up on anything new?”

“There’s something in that,” conceded Farro-Jones. “The main screening test is for antibodies against known viruses, an indirect indication of infection if you like.”

“So you couldn’t test for antibodies against something you didn’t know existed?”

“Quite so,” agreed Farro-Jones.

“How would you go about identifying a new virus then?” asked Neef.

“You’d have to examine samples directly, using the electron microscope. You’d actually have to look and see if anything resembling a virus was present.”

“Can that be done?”

“Of course.”

“I was thinking of samples from Charlie Morse? Do you think it’s worth having a look?”

“If you like,” said Farro-Jones without much enthusiasm. “Have you mentioned anything about this to Public Health?”

“Not yet. I thought I’d see what you thought first.”

Farro-Jones nodded and said, “All right, if it would make you feel better, why don’t I discreetly examine a few specimens from Charles Morse as you suggest and see what I come up with. If there’s nothing there, as I suspect there won’t be, we won’t have to worry PH with Max’s crazy idea. Can you imagine the panic if this notion got out? A virus that gives you cancer...”

“It doesn’t bear thinking about,” said Neef.

Eve’s story reporting the third and fourth cancer victims appeared on Saturday evening and Neef’s telephone started ringing almost immediately. Tim Heaton was first; he was furious.

“Damn it! I’ve had the national papers on the line, radio and television, all wanting to know what St George’s are going to do about the situation. This is a Public Health problem!” he exclaimed, “But that woman has made it sound as if St George’s is at fault. Can’t you do something about her?”

“What do you suggest, Tim?” asked Neef coolly.

“I don’t know. Think of something. She’s a friend of yours, isn’t she? This is doing the hospital no good at all. It’s just the sort of thing we didn’t need.”

“Eve believes she is just doing her job,” said Neef. “There is a problem and we don’t know where it’s coming from. She’s just reporting facts.” He felt uncomfortable at having to make out a defence for Eve which he didn’t fully support, a bit like prosecuting an argument in a debating society because it had been picked for you. He reflected that barristers must feel that way a lot.

“But it’s not our problem!” insisted Heaton. “It’s up to the Public Health Service to work this thing out. All this stuff about doctors at St George’s being puzzled is just sheer bad publicity for us.”

“With respect Tim, with one of our staff members at death’s door and the grandson of another already dead, it is our problem. It’s everyone’s problem.”

“We need to agree a policy.”

“If you say so.”

“I’m instructing our PR people to refer all press enquiries on the subject directly to Public Health, making it clear that it’s their investigation, not ours. I’m instructing everyone else to say nothing at all.”

Neef understood that ‘everyone else’ in the context of this conversation, included him. “As you wish.”

“I don’t suppose you have any good news about the Gene Therapy trial that we could use to create a diversion, have you?”

Neef had to admire Heaton’s one track dedication to what he saw as his job. He said, “At the moment, it looks like one success and four failures.”

Heaton sighed then said, “I think I’m going to give Mr Louradis the go-ahead.”

“For what?” asked Neef in trepidation.

“He’s been asked by one of the papers to write a layman’s guide to gene therapy.”

“That vague?” asked Neef.

“Not exactly. The paper wants him to explain just exactly what you and Menogen are trying to do in the current trial.”

“Why doesn’t Louradis go on the stage and be done with it,” snapped Neef.

“I feared you might see it that way,” said Heaton almost apologetically. “But what harm can it do? None of the staff and patients will be identified by name and it might give the hospital a more positive image.”

“If you say so,” said Neef.

“Damn. You know the thing that really galls me,” continued Heaton, “University College Hospital is getting off scot-free! Not a mention apart from the fact that they are the people treating our staff member! They’ve come up smelling of roses again. They’re the star hospital. We’re the baffled donkeys!”

“This will probably all be history in a few weeks time,” said Neef. “I think we should try riding it out with quiet dignity. If we start a slanging match it won’t do anyone any good.”

“Oh absolutely,” said Heaton. “I wouldn’t dream of saying this to anyone else you understand. They’d think I was paranoid or something.”

Neef grinned. He didn’t say anything in case the amusement showed in his voice.

“There is one more thing, Michael.”

“Yes?”

“I was wondering if it might not be a good idea to deny Miss Sayers further access to the hospital. After all, she has no real business here, has she?”

Neef bit his tongue. Telling Heaton where to go might not be such a brilliant idea at this particular moment. “I don’t think that’s wise, Tim,” he said. “Eve has nothing at all against us. She thinks she’s reporting the facts. I shudder to think what it might be like if she were suddenly to see us as the enemy.”

“Mmm, I hadn’t thought of that,” conceded Heaton. After a few moments thought he said, “Perhaps you’re right.”

“Apart from that, she has become very attached to one of the children in my unit. She visits him daily.”

“Oh well then. Just a thought.”

Neef closed his eyes and felt relief as the moment passed.

“I’m going to contact George Lancing at the Regional Health Authority now,” said Heaton. “I want him to put pressure on the Department of Health to have this thing handled at top level. I don’t think Lennon’s up to the job.”

“It’s a particularly difficult job for anyone at the moment,” said Neef. “There’s nothing to go on.”

“I don’t think some extra help would go amiss. Action is what’s needed, not understanding.”

“Up to you,” said Neef and the conversation came to an end. Next to call was Eve Sayers.

“I’ve been trying to get through for ages,” she said.

“I had Tin Heaton on the line. He’s our chief executive.”

“Not very pleased, huh?”

“You could say.”

“Are you very angry?”

“More numb than angry,” replied Neef.

“I just reported the facts, Mike.”

“Heaton thinks you made us look like donkeys.”

“That wasn’t my intention.”

“I know.”

“He isn’t going to ban me from the hospital, is he?”

“No, nothing like that,” replied Neef without further explanation. “Just don’t count on getting a Christmas card from him.”

“Will I get one from you?”

“You might.”

“I’m sorry for hanging up on you the last time we spoke.”

“We were both pretty angry as I recall.”

“Pax?”

“Pax,” agreed Neef.

“Want to come over?”

“If you’re not too fussy about what we eat why don’t you come over here and I’ll find us a delicious packet from the freezer.

“Okay. I’m on. About an hour?”

“Fine.”

“What are we having?” asked Eve as she came in and sniffed the air appreciatively.

“Something with an appetizing picture on the packet,” said

Neef.

“They’re all pretty good at that,” smiled Eve.

“I particularly liked the look of rapture on the faces of the people on the front of this packet,” said Neef.

Eve picked up the empty packet and looked at it. “Irresistible,” she agreed. “Looks like they just had sex instead of Salmon in Puff Pastry.”

The meal wasn’t wonderful but it was palatable and washed down by a good wine that Eve had brought.

“Did you see Neil today?” asked Neef.

Eve nodded. “He wasn’t too well. I think Lawrence had upped his medication. I read him a fireman story and he dozed on and off and held my hand. It was nice, as if we didn’t need to talk somehow.”

Neef nodded.

“The sparkle is going from his eyes. It’s like watching a flame start to flicker and die. God! I’d give anything to be able to help him. I really would.”

Neef put his hand on top of Eve’s. “Hang in there,” he said gently. “For his sake.”

“Of course. I’m sorry,” said Eve, pulling a paper tissue from her handbag and blowing her nose. “Let’s talk about something else.”

As if on cue, Dolly made her first appearance of the evening and walked across the floor to take up her customary position in front of the French windows.

“Do you think she’s jealous of my being here?” asked Eve.

“I doubt it,” said Neef. “Dolly is too self-possessed and confident to even imagine anyone else as a rival.”

“What a comfortable feeling that must be,” said Eve. “How do I make contact with her?”

“The orange fish,” said Neef.

“Pardon?”

“It’s her new toy. I stuffed it down the back of the couch.”

Eve went over to the couch and extracted the orange fish. She held the cane in her right hand and dangled the fish at Dolly’s side. Dolly responded immediately and started to chase the fish which Eve swung across the floor and round the room.

“Come on, Dolly!” urged Eve as she moved the fish even faster and Dolly gave a display of feline ability when it came to a chase.

“She certainly can move.”

“Cats are like that,” said Neef, joining her on the couch. “Their agility can really take you by surprise.”

“Like this, you mean,” said Eve, sitting up straight and kissing Neef full on the lips. She drew back slightly as if waiting unsurely for a response. There was a hint of vulnerability in her eyes. Neef wrapped his arms round her and kissed her long and hard, his senses heightened by the sudden desire that came over him. It had been such a long time. “If you like,” he said.

“I like,” replied Eve.

Eve rolled over on to her front and propped herself up on her elbows to look at Neef’s face. His eyes were closed but there was a smile on his lips that said he wasn’t actually asleep. She pushed the hair back from his forehead and said, ‘This of course, is another way of dealing with stress and tension.”

“I think I like it,” murmured Neef.

“Do you?” Eve teased. She ran her fingers lightly across his closed eyelids.

“God, yes.”

Eve looked at the trail of clothes and underwear that stretched out the door of the bedroom. She rested her head on Neef’s chest and said, “I must say, I’m feeling quite relaxed myself.”

The telephone rang just before three in the morning. Eve, being disorientated, picked it off the bedside table and almost answered it before she remembered where she was and handed it to Neef.

“Neef.”

“It’s Lennon. There’s been another case.”

“Who?”

“An electrician on the staff at St George’s.

“Another staff member.” murmured Neef. “Pereira must be right.”

“Right about what?” asked Lennon.

“I talked to Max Pereira on Friday night. He’s the research scientist who’s running our Gene Therapy trial. He’s an expert on viruses. He said our problem looked like a virus was responsible not a chemical.”

“A virus?” exclaimed Lennon. “But how?”

“I know, I know,” sighed Neef.

“Have you mentioned this to any of the university people?” asked Lennon.

“I asked David Farro-Jones for his opinion.”

“What did he say?”

“Like you, he didn’t think much of the idea but he agreed to have a look at samples from Charlie Morse under the electron microscope to see if he could spot any sign of a new virus.”

“I see,” said Lennon.

Neef detected a coolness in the comment. He added, “I was going to tell you if he found anything. It seemed such a weird idea I didn’t want to bother you with it unless we could back it up but now that there are five cases...”

“When will Dr Farro-Jones have the results of his search?”

“David thought Monday but I could call him in the morning and ask if things could be hurried up.”

“I’m sure the idea of an infectious source must have flitted across all of our minds during this business but we dismissed it because it simply isn’t possible,” said Lennon. “Cancer cannot be transmitted from person to person.”

“Certainly not in the past,” said Neef. He thought about what Pereira had said about people not wanting to consider anything new. “We really should keep an open mind at this stage,” he said.

“Naturally,” replied Lennon.

“But let’s hope Max is wrong.”

“I’m sure he must be.”

“What have you done in the light of the new case?” asked Neef.

“I’ve put out a general alert to all hospitals warning them to be on their guard about cases of viral pneumonia.”

“Good,” said Neef.

“I’m also going to try and set up another full meeting for this afternoon to discuss the implications of the new case.”

“What about the Press?” asked Neef. He looked at the ‘Press’ lying beside him in bed, wide eyed as she listened to the conversation.

“I don’t think it’s worth even trying to keep quiet about the latest case,” said Lennon, “but I think we should keep the virus notion very definitely under wraps.”

“Agreed,” said Neef, his eyes not leaving Eve.

Neef passed the phone back to Eve who replaced it on the table. “You heard?” he asked.

Eve nodded. Neef waited for her to say something.

“I heard. I won’t use any of this, if that’s what you’re worried about.”

“What I’m worried about is not a newspaper story,” said Neef. “It’s the very real possibility that we have a virus on the loose which is capable of spreading lung cancer like it was chicken pox.”

“Then you believe the virus hypothesis?”

“I’m a damned sight more worried about it than Lennon seems to be.”

“What can you do if it is a virus?”

“Very little,” conceded Neef. “There’s nothing we can do at all for people who already have it. Our only hope lies in trying to contain it and stop it spreading. We’ll have to isolate the victims and Public Health will have to trace all their contacts but most important, we’ll have to determine the source of the outbreak and wipe it out. That’s easier said than done. To the best of my knowledge no one has ever found out where a new virus came from.”

“Oh Mike,” said Eve, cuddling into Neef. “I have such a bad feeling about all this.”

Neef didn’t admit it but he was thinking exactly the same thing. “Get some sleep,” he whispered.

Neef was at the hospital by eight, all thoughts of spending a relaxing Sunday with Eve having been dispelled by Lennon’s middle of the night phone call. It wasn’t as if he had a definite plan of action to follow, he just felt he should be there. He was very much on edge. Lennon called again at nine thirty. “I think I know how the electrician got it,” he said. “His work sheet shows that he was called to Pathology to work on a faulty extractor fan. The request was made by Charles Morse.”

“Well done,” said Neef.

“There’s more. I had a bit of luck.”

“Long overdue,” said Neef.

“I went down to Pathology this morning to look around and the duty technician came in while I was there. She told me that Morse and the electrician, Cooper had some sort of a mishap while the repair was being done. Apparently the cowling came off the fan and showered them both with accumulated dirt from inside the ducting. It hit them full in the face and from what she said there’s a fair chance they both inhaled a good deal of it.”

“I see.”

“They thought it a bit of a joke at the time but on further investigation I found out that this extractor was above table 4 in the PM room and that’s where Frank MacSween conducted the autopsies on both Melanie Simpson and Jane Lees.”

“It’s the one he prefers,” said Neef.

“It’s my guess that the carcinogen was concentrated in the dirt behind the cowling because of the fault in the fan. Does MacSween wear a mask when he’s cutting?”

“Always when an infectious disease has been present.” replied Neef.

“So he would wear one when doing Simpson and Lees?”

“I know he was,” replied Neef. “I myself was present on both occasions for a short time.”

“You wore one too?”

“Yes. We were assuming that viral pneumonia had been involved.”

“Just as well,” said Lennon. “I’m having the dirt from inside the ducting examined for the presence of carcinogenic substances.”

“Or a virus,” though Neef as he put down the phone. He reflected on this latest piece of information. It meant that Frank probably hadn’t given the disease to his grandson. It had been Charlie after all.”

“Almost certainly,” said Pereira when Neef called to tell him of the latest development.

“But what we still don’t know is how Melanie Simpson gave it to Jane Lees when they didn’t know each other and most important of all, how Melanie Simpson got it in the first place.”

“Is Lennon going to look for a virus in the dirt from the duct?” asked Max.

“He said he was having it examined for carcinogenic substances,” replied Neef. “I assumed he was going to have the virology lab take a look at it too.”

“If you say so,” said Pereira.

“Why don’t you come along to the meeting this afternoon?” suggested Neef.

“I won’t be finished here in the lab until well after two.”

“I’ll pick you up at three. What do you say?”

“OK.”

Neef tried phoning Farro-Jones at home but his wife, Jane said that he had gone into the medical school. Neef called him at his lab and Farro-Jones replied.

“David? It’s Michael Neef. I tried calling you at home. Jane said you were working.”

“I’m screening these samples from Charles Morse,” replied Farro-Jones. “I thought the sooner the better.”

“Good, that’s really why I was calling,” said Neef. He told Farro-Jones about the new case.

“This is beginning to look more and more like a nightmare.”

“Lennon was wondering if you might have a result by the time of the meeting this afternoon. I think he’s planning on making some kind of statement to the Press afterwards.”

“I can’t promise,” said Farro-Jones, “but I’ll certainly do my best. What time is the meeting?”

“Three thirty.”

“Talk to you later.”

Neef picked up Max at the Menogen Labs at three o’clock. He found him excited. “The new melanoma vector’s looking real good,” he announced. “Like I said, there’s no way we could get the paperwork done in time to help your kid but I was thinking, maybe you could?”

“I don’t understand,” said Neef.

“If a special request for licensing was to be made by the hospital maybe there’s a chance they would listen?”

“That’s certainly worth a try,” said Neef. “You’ll have to tell me what to do, who to approach, that sort of thing.”

“I’ll call lovely Lillie at home when I get back and get her to call you. She’ll tell you all you need to know.”

“Lovely Lillie?”

“Her name’s Miss Langtry,” said Pereira. “She’s the lady who deals with all our license applications.”

The venue of the meeting had been changed at the last minute from St George’s to the Public Health Department offices in Sutton Place. This had been done at the insistence of Tim Heaton who had withdrawn permission to use the hospital when he heard that a press briefing was to be given afterwards. He had done this on the grounds that continual association of St George’s with the Public Health problem was doing the hospital’s reputation no good at all.

Being Sunday, the traffic was mercifully light and Neef and Pereira were only five minutes late in getting to Sutton Place. As they made their way along to the Public Health offices Neef saw Eve standing on the pavement outside with a group of other journalists. He caught her eye and she smiled. He pointed to his watch to signify that they were late and mouthed the words, see you later. Eve nodded in reply.

“I must apologise for the cramped conditions this afternoon,” announced Lennon, “but we had a few last minute problems to contend with.”

The room that had been pressed into service for the meeting was a bit small for the twenty or so people who attended. Neef found it unpleasantly hot and stuffy.

“Some of you know of course, about the latest development but others may not. There has been another case; an electrician on the staff of St George’s. We think we know how this man was affected and because of this, it has become untenable to propose contamination at a common primary source. We must in fact, consider that the carcinogenic compound has been still present on or in the patients when admitted to hospital. A most interesting and unfortunately alarming alternative has been proposed by Dr Max Pereira of Menogen Research who is currently collaborating with staff at St George’s in a Gene Therapy trial on cancer patients. Dr Pereira suggests that we should be looking for a brand new virus as the agent responsible for our outbreak.”

There was a sudden hubbub in the room as people hearing the idea for the first time, made all the objections that had been voiced before. Lennon held up his hands for calm.

“I know, ladies and gentlemen, this is heresy but the suggestion has been made by someone I understand is an expert in such matters so it is only right that we consider it.”

Another hubbub broke out.

“In the interim, I have issued an alert to hospitals, asking them to isolate all suspected viral pneumonias and to notify Public Health so that contacts can be traced and advised.”

“Don’t you think this is all a little bit premature?” asked a man Neef knew to be a member of the Regional Health Board. “If you are proposing the existence of a virus completely unknown to medical science, don’t you think you should wait until you have at least a shred of evidence to support it?”

There was murmured agreement for his comment. “All you apparently have to go on is the word of this, Pereira man.”

“I believe Dr Pereira is with us,” said Lennon, seeing the small swarthy man standing beside Neef.

“I’m here,” said Pereira.

“Perhaps you’d care to comment?” asked Lennon.

“Do you know how long it took the medical establishment to acknowledge the existence of the AIDS virus?” Pereira asked.

“Surely you’re not suggesting that this is anything like...”

“Who’s to say?” interrupted Pereira. “I think a few precautions are just common sense. Don’t you?”

“There’s a world of difference between taking precautions against a known risk and causing widespread public panic over something you’ve just made up!” retorted the Health Board member. Neef noticed the man had gone red in the face. Pereira had an unsurpassed talent for rubbing people up the wrong way, he conceded.

“I’m against anything that causes unnecessary public alarm,” said the health board official.

There were murmurs of agreement all round.

“Yeah, yeah, the mushroom approach to the public,” said Pereira.

“What do mushrooms have to do...”

“Keep ’em in the dark and feed ’em bullshit.”

“Gentlemen, please,” interrupted Lennon. “We all want to see this thing resolved as soon as possible. Bickering among ourselves is not going to help. Is Dr Farro-Jones here?” he asked.

He wasn’t.

“The reason I asked, ladies and gentlemen, is because Dr Farro-Jones has been conducting an electron microscope search on lung tissue samples taken from Charles Morse in an effort to detect the presence of any such new virus. He has been working all day on it. I hoped he might be here with some news but apparently not. In the meantime I’ll furnish you with details of the new case and his relationship to the old ones. I apologise for the hastily rigged screen. Copies of the summary will be available as you leave.”

As the first overhead appeared on the screen, Pereira whispered to Neef, “I’m off, I’ll catch you tomorrow.”

Neef nodded. He saw that as Pereira opened the door to leave, David Farro-Jones entered. The two had a brief whispered word then Pereira left and Farro-Jones sidled quietly into the room. He joined Neef to watch the succession of overheads.

Neef now felt that he knew them off by heart. He looked away for a moment but then caught sight of the expression on David Farro-Jones’ face. He had obviously seen something up on the screen that had shocked him to the core.

“Are you all right?” whispered Neef.

Farro-Jones nodded without taking his eyes off the screen.