Pandora's Helix

Seven

Neef stopped at a branch of Thresher’s on the way over to Eve’s apartment and picked up a bottle of Australian Chardonnay from the cold cabinet; the assistant told him that wines from Australia and New Zealand were very fashionable; he himself had little interest in wine. Suddenly worrying that white might not be appropriate; he also bought a bottle of Cotes du Rhone. He arrived at Eve’s just before eight.

Eve was wearing a cream silk blouse over black cord trousers which emphasised her good figure. She was wearing her hair loose again and swept it back from her face as she opened the door and invited Neef in. She accepted the wine with a, “Thank you,” and said, “I’m just about organised. Why don’t you help yourself to a drink while I do things in the kitchen?”

Neef was left alone in the room he had first been in on the previous Sunday. This time the curtains were closed, muted jazz was playing on the stereo and the air was lightly perfumed with the smell of incense emanating from a small brass burner on the mantle shelf. Neef guessed that the burner had the same origin as the blue rugs, Tunisia. If the conversation dried up he could always ask about it. There was a silver tray with a selection of spirits on it and some bottles of mixers. A red plastic ice bucket had its lid displaced to the side by matching tongs. Neef helped himself to gin and tonic and called through to Eve, “Can I get you something?”

“Gin would be nice.’

Eve returned from the kitchen, picked up her drink and said, “We’ve got about ten minutes. Do you mind if I ask you something?”

“Go ahead.”

“You said earlier that there had been two cases of cancer caused by this chemical or whatever it turns out to be?”

“Yes.”

“Were the two victims from the same part of the city?”

“Not as far as we know,” replied Neef, “but it’s reasonable to assume that their paths must have crossed at some time. This is what Public Health will be trying to establish. Ironically their job has been made easier by the appearance of a second victim.”

“How so?”

“From interviews with the families, the investigators will build up a picture of each girl’s movements over a period of time and then compare them. They should be able to spot any common factors like a park that both girls visited or woods or even a building. Then they can home in on it and mount a comprehensive search with the aid of the police if necessary.”

“I see. Sounds straightforward when you say it like that,” said Eve.

“It should be,” said Neef. He did not add that as yet, Public Health had failed to come up with anything. “Did you have trouble sitting on the story for the time being?”

“No. I convinced my editor that Mr Lees is under great emotional strain and that we really would have to be sure of our facts before we go to print with the story.”

“Good,” said Neef. “I’m grateful. This kind of story can cause great public alarm.”

“Sometimes public alarm is perfectly justifiable,” said Eve. “It’s the only thing that can galvanise some public bodies into action.”

“I suppose you’re right,” conceded Neef. “But it would be nice if PH were to clear this business up before it appears in print.”

“Let’s eat,” smiled Eve.

Dinner was good and Neef complimented Eve on her cooking. He said with a contented sigh, “That’s the best meal I’ve eaten in ages.”

“If you come to my place more than three times you start getting the same things all over again,” said Eve.

“I’m sure you’re being too modest.”

Eve asked Neef if he wanted a liqueur with his coffee.

“No, I need a clear head tomorrow. We’re starting the Gene Therapy trial.”

“It must be very exciting to be in at the start of something new like this,” said Eve.

“It’s also worrying,” said Neef. “Anything new always means unforeseen problems, “teething troubles” as people like to call them, and Gene Therapy has been having its fair share of these.”

“I didn’t realise it had been used before.”

“Several trials have been carried out internationally with varying results. University College Hospital tried it on Cystic Fibrosis patients last year without any great success.”

“Is that the disease where kids have to have physiotherapy all the time to free their lungs of mucus?” asked Eve.

Neef nodded. He said, “The condition is caused by a genetic defect in a gene that scientists have now identified. The challenge now is to put a normal working copy of the gene into the patient’s own lung cells so that they will start making the missing substance.”

“And cure themselves?”

“More or less. Cystic Fibrosis affects more than the lungs but the lung condition is certainly the worst aspect of the disease and that should clear up once they get the treatment working.”

“So how do they get a working copy of the gene?” asked Eve.

“That’s the easy bit, once you’ve identified it,” said Neef. “The difficult bit is getting it into the patients’ lung cells. For that, you have to use some kind of intermediate vector to carry it in, usually a virus.”

“A virus? You deliberately infect the patients with a virus?” asked Eve, with a horrified look.

“It’s not as bad as it sounds,” said Neef. “They disable the virus first so it can’t cause infection.”

“But you say it didn’t work at University College?”

“They didn’t actually use a virus vector,” said Neef. “They opted for a liposome system. That’s safer than using a live virus but not nearly so effective in delivering the new gene to the patients’ cells.”

“So it failed?”

“Unfortunately, but the word is, they’re going to try again soon with a new vector.”

“A virus this time?” asked Eve.

“Almost certainly.”

“So it will be more risky?”

“As David Farro-Jones put it, the more efficient the vector, the bigger the risk.”

“Who’s David Farro-Jones?”

“He’s the molecular biologist in charge of Gene Therapy at University College.”

“But not at St George’s?”

“No,” smiled Neef. “St George’s is run by a different hospital Trust, although in practice, we still talk to each other! Our entry into Gene Therapy is coming through a commercial company called Menogen Research and their chief scientist, Max Pereira.”

“Who’s going to be the first patient?” asked Eve.

“Rebecca Daley aged eleven, a hepatoma patient, cancer of the liver. We’re treating her tomorrow morning.”

“Here’s to Rebecca,” said Eve, raising her glass.

Neef nodded.

Eve topped up Neef’s coffee cup and changed the subject. “Do your patients ever get out at all?”

“What do you mean, out?”

“Day trips, home visits, that sort of thing.”

“Yes, that’s quite common.”

“But not Neil?”

“Neil comes from a children’s home. It would be awkward for the routine of the place.”

“Would you let me take him out?”

“I suppose...”

“Maybe to the zoo or something like that.”

“If he’s feeling well enough, I can’t see any harm in it. In fact, it might do him the world of good.”

“Good,” said Eve. “I was just thinking how perky he seemed today. It would be nice if we could go out somewhere away from the hospital.”

“People will stare, remember. His face is not a pretty sight, though you’ve probably got used to it.”

“You’re right, I have,” said Eve, as if she’d just realised it. “I don’t notice the tumour now at all.”

“Maybe a crowded place like the zoo isn’t such a good idea,” said Neef.

“Well, a run in the car perhaps, or a picnic in the country.”

“Sounds good.”

It was raining heavily when Neef left Eve’s place just after eleven thirty. The big tyres on the Discovery made such a noise on the now flooding roads that Neef turned off the Vivaldi tape he’d inserted and listened to the hiss of spray instead. The sound of an English summer, he mused as he turned off the main road and dropped a gear to negotiate the steep hill down to the cottage. He could see the lights, partially blurred by the river running down the windscreen but none the less welcoming. He had fitted random time switches in three of the cottage’s rooms so that it would always appear inhabited.

Neef poured himself a night cap of whisky and sat down on the couch with a sigh. Dolly positioned herself at his feet. Eve was still very much in his mind; if he closed his eyes and put back his head he could see her smile. She put her head a little to one side when she laughed; it was a mannerism he liked a lot. He felt a pang of guilt at the thought, something to do with Elaine’s ghost but there was no denying the fact that he had enjoyed the evening very much. His only regret was that it seemed to have flown by. But there would be other evenings, he felt sure of that. He decided to concentrate on that thought as he rinsed out his glass. He was only vaguely aware of Dolly making herself comfortable on the foot of the bed as he dropped off to sleep.

Neef woke with a start as the telephone rang. He clicked on the bedside light and looked at his watch. It was two thirty am.

“Mike? It’s Kate Morse. I’m really sorry to disturb you.”

“What’s the problem?” asked Neef, rubbing his eyes. He was trying to remember if Kate was on duty tonight. He felt sure she wasn’t.

“It’s Charlie,” said Kate. “I’m worried sick.”

“Charlie?” repeated Neef.

“He’s a lot worse. I called in the GP again as you suggested but he said there was nothing to worry about. It was just a bad dose of flu. He’d be right as rain in a couple of days. He should stay in bed and take aspirin, you know the routine. But he won’t be, I know it, Mike. He’s really sick and I don’t know what to do for the best.”

Neef could hear how worried Kate was. She was a very experienced nurse and used to modulating her voice through all sorts of crises but she was having a hard time doing it this time. “I’ll come over, Kate. Give me fifteen minutes.”

“Thanks Mike. I’m so grateful.”

Neef pulled on jeans, a tee shirt and a warm sweater while Dolly opened one eye to watch the proceedings. “Keep my place warm, Dolls,” he said as he put on a waterproof jacket and pulled his medical case out from beneath the bed. Dolly closed her eyes again. She didn’t move.

The journey to the small bungalow where Kate and Charlie Morse lived took twelve minutes. During the day it would have taken half an hour but at three in the morning the streets were virtually free of traffic. A couple of taxis and a police panda car were the only other signs of life as he negotiated roads that were rapidly turning into rivers.

“Thanks for coming, Mike,” whispered Kate as she answered the door. “He’s through here.”

Charlie Morse didn’t turn to look at Neef as he entered the room. He continued to stare up at the ceiling while taking rapid shallow breaths. He had the bed-covers down at waist level. His skin was pale and a thin film of sweat coated it. There was an unpleasant, sweet smell in the room, nothing specific, just the universal smell of illness, thought Neef.

“I won’t ask you how you’re doing, Charlie,” he said. “I can see that for myself.”

Neef took out his stethoscope and warmed it briefly on the palm of his hand before applying it to Charlie’s chest. When he’d finished, Kate stepped in to help support her husband in a sitting position while Neef sounded Charlie from the back.

“Okay,” said Neef.

Kate let Charlie sink back down on the bed. She tried to bring up the covers but Charlie stopped her with a vague push of his hand.

Neef moved back from the bed and Kate joined him, looking apprehensive.

“We’re going to have to get him to hospital,” said Neef. “He has severe pneumonia, both lungs.”

“The phone’s out here,” said Kate. She led Neef out into the hall where he dialled 999.”

“That bad?” said Kate.

“The quicker the better,” said Neef, “and if you’ll take some advice, Kate.”

“Yes?”

“Change your GP. He’s an idiot.”

Kate nodded. Her mind was racing ahead to the next problem. “Mike, could I possibly ask you to stay here for a few minutes in case the kids wake up. I’m going next door to see if I can a get a neighbour to look after them. I’d like to go to the hospital with Charlie.”

“Of course,” said Neef.

Kate threw a coat round her shoulders and disappeared out through the front door. Neef returned to Charlie’s room and told him the ambulance was on its way. Charlie acknowledged with a slight nod of his head. He was breathing more rapidly than ever. A long way off in the distance, Neef thought he could hear the wail of a siren.

As the ambulance drew up outside the house, Kate came running up the path. “Mrs Redpath is going to come over,” she said to Neef. “Could you hang on till she comes?”

“Of course.”

Neef watched the two green-clad technicians load the stretcher bearing Charlie Morse into the back of the ambulance. Kate stood beside the open doors, her coat draped over her shoulders against the rain. She glanced up at Neef and he saw the worry on her face. The neon street lights were being unkind. She had aged ten years.

“Mrs Redpath won’t be long,” said Kate.

“Don’t worry about it.”

Kate climbed into the back, the doors were closed and the ambulance moved off into the night, its blue light flashing mutely through the rain.

“Where are they taking him?” asked a well modulated woman’s voice behind Neef.

Neef turned to find a small, stout woman standing there. Her fair-skinned face was fringed by a halo of pure white hair. She had a coat on over her dressing gown but was still wearing carpet slippers. Neef could see the wet ring around the outside edge of them. “Mrs Redpath?” he enquired.

“Yes, and you must be Dr Neef. Kate told me you’d wait.”

“University College Hospital,” said Neef.

“He’ll be well looked after there,” said the woman.

Neef nodded.

Neef left Mrs Redpath in charge of the house and the Morse children who had slept throughout the proceedings and drove home. He wasn’t going to get much sleep, he realised.

Neef actually slept for three hours before the alarm went off but it felt as though his head had hardly touched the pillow. He got up and took a long, hot shower before making himself plenty of strong coffee and two slices of toast. It was seven forty-five when he set off for the hospital and a scheduled early morning briefing with staff. This was held in a small seminar room beside the theatres. Neef was last to arrive; he pulled a paper cup off the stack and poured himself some coffee from the machine.

“Good Morning everyone,” he said in a voice loud enough to quieten the hubbub. “I just thought I should say something about the Gene Therapy trial we’re starting this morning and how it affects you. The fact is that we will be using more or less standard surgical procedures throughout so we won’t be asking anything new of you at all; that’s why I could leave this briefing so late. Our first patient this morning is, Rebecca Daley. Rebecca has a hepatoma and it will be our task today to inject the tumour with a virus suspension provided by Dr Pereira here. The virus carries a gene which hopefully will make Rebecca’s liver tumour sensitive to Gancyclovir which we will start giving her in seven day’s time. I’ll be doing the injection myself under ultra sound guidance. It should be quite straightforward. The second operation will be on Martin Liddle and this will be performed by one of Mr Louradis’ surgical team. I’m afraid I haven’t been briefed on who exactly. Martin has a pancreatic tumour and we will be introducing Dr Pereira’s virus through ERCP. If anyone has forgotten, that is Endoscopic Retrograde Cholangio Pancreotography. In this instance of course, we won’t be using the technique to extract a tissue sample, we’ll be injecting the virus.” Neef turned to Pereira who this morning was wearing a Tee shirt advertising a SCUBA diving school on Crete. “Basically they’ll be inserting an endoscopy tube equipped with light and video camera down the patient’s throat, through the stomach and duodenum until we reach the pancreas. We’ll be able to follow its progress all the way on a video monitor.”

“Sounds a breeze,” said Pereira.

If anyone else had said this there would almost certainly have been laughter but people were unsure of Pereira. There were only a few uncertain smiles.

“There’s no reason why it shouldn’t be,” said Neef. “Any questions?”

“I’d like to ask Dr Pereira what exactly his virus does,” said one of the theatre nurses. There was a murmur of assent.

Pereira stopped picking his teeth with his thumbnail and looked lazily about him before scratching his head. “Basically, the virus does nothing,” he said. “We’re just using it to transport a new gene into the patient’s tumour cells. The gene is called the thymidine kinase gene, the TDK gene for short. Once it’s inside the cells it will start producing thymidine kinase and it just so happens that any cell producing thymidine kinase will be killed by the drug, Gancyclovir. In a week’s time we’ll give the patient Gancyclovir and kill the tumour. Simple huh?”

“Sounds a breeze,” said the nurse. There was general laughter.

“Our third patient today will be Thomas Downy and his case will be handled by Mr Beavis and the neurosurgical team in the main theatre. Thomas has an inoperable tumour of the cerebellum. Injecting the virus into the tumour will almost certainly not be a breeze. Video and ultrasound are of course, out of the question. The progress of the needle will be monitored by CT scan at staggered intervals. The cerebellum, as many of you will know, is a bit of a minefield. Any damage to the normal cells around there and the patient’s equilibrium and balancing function may be totally destroyed. Are there any questions?”

“What’s to stop Dr Pereira’s virus getting into the patient’s bloodstream and putting this kinase thing into all his cells. Surely there’s a danger of making all his cells vulnerable to Gancyclovir?” asked one of the radiology department’s team.

“Good point,” said Pereira. “Firstly the virus is actually disabled. It can’t replicate itself so there’s no question of spiralling viral infection. Secondly we have engineered the kinase gene to suit the tissue it’s being injected into. That’s why there are several variations of the virus being used today. For instance, the version we’ll be using for the hepatoma kid has an alpha fetoprotein promoter sequence in front of the kinase gene. It can only be turned on by liver cells.”

“Isn’t science wonderful,” said one of the nurses.

“That I think, is what we’re about to find out,” said Neef. “Any more questions?”

There were none.

Rebecca Daley’s body looked very small and fragile as Neef prepared to begin the procedure which would end with eight millilitres of Pereira’s virus suspension being injected into the heart of her tumour. Pereira had asked to be present at all the injections. Neef explained what he was doing for his benefit.

“We’ll just rub a bit more jelly on her abdomen to make sure that we have a really good contact for the ultra-sound probe,” he said. He smeared the conductive gel over the exposed area of Rebecca’s stomach and then applied the head of the probe, moving it ton and fro several times until he was satisfied with what he saw on the screen monitor in front of him. “There we are,” he said. “Can you make out the liver?”

“It all looks a complete blur to me,” replied Pereira. “Sorry.”

“I suppose we’re used to it.” said Neef. He stretched out one arm towards the screen and pointed. “That’s the liver there,” he said. “And that...” He manoeuvred the probe a little to get a better picture, “is Rebecca’s tumour.”

Pereira leaned closer the screen to get a better view. “Now I see,” he said. “I guess you use this gear a lot these days?”

“We certainly do,” replied Neef. “In many ways it’s revolutionised medicine. It’s just so good to be able to see inside your patients without the need for invasive techniques.”

Neef made a mental calculation of the angles involved in introducing the needle that was to carry the virus. He said to Pereira, “I’m positioning the probe so that the needle will cross its path and show up on the screen. That way we can follow its progress.”

There was a moment’s silence while Neef pushed the needle through the wall of Rebecca’s abdomen and started to feed it slowly inside.

“I can see it!” exclaimed Pereira as a solid white line appeared on screen.

Neef continued to propel the needle on its journey towards the tumour, watching the screen all the time instead of the patient. “Almost there,” he said as the tip of the needle reached the outer edge of the tumour. “And now we’re about to go into it.”

Based on the volume of the tumour calculated from Rebecca’s CT and MRI scans, Neef knew that he had to advance the needle one centimetre further to be at the heart of the tumour. He did this by watching the lumen of the needle which had graduations etched along it. “We’re there,” he announced.

“And now you pull the trigger,” said Pereira.

Neef injected the virus and the operation was over. He withdrew the needle slowly and let out a sigh as he pulled it out. “Our first patient,” he said. “Good luck, Rebecca.”

There was a one and a half hour gap before the next operation was due to begin. Pereira decided to take himself off for a walk and get some fresh air. Neef wondered if he was feeling queasy. If Pereira was having problems with a simple needle op he was going to be in real trouble by the time the afternoon came. Neef asked in the duty room if there had been any word from Kate Morse. Staff Nurse Collins shook her head and said, “Sister’s not on duty till two.”

“Her husband was taken ill last night,” explained Neef. “I thought she might have phoned to say how he was.”

“Fraid not,” replied the nurse. “But Mr Louradis was trying to get in touch. Did the switchboard not tell you?”

Neef shook his head and the nurse rolled her eyes skywards. “Maybe you should call him.”

Neef returned to his office and called Mark Louradis. He was hoping that there wasn’t going to be any problem with the surgical team due to operate on Martin Liddle.

“Mark? It’s Michael Neef. No problem I hope?”

“None at all, Michael. I just thought I would tell you that I plan to carry out the ERCP on Martin Liddle myself, this morning.”

Neef was slightly taken aback. “I’m sure we’re very honoured. Isn’t it a bit routine for a surgeon of your standing?”

“I just thought I’d like to be part of a little piece of history in the making at St George’s. Our first Gene Therapy trial and all that. You don’t mind do you?”

“No, of course not,” replied Neef, still a bit puzzled. “I hope you won’t object if Dr Pereira and I observe?”

“Not at all.”

Neef put the phone down. Mark Louradis had actually sounded as if he was in a good mood. Not often that happened, he mused. Neef checked his watch and saw that he had plenty of time. He called the emergency admission ward at University College Hospital.

“Staff Nurse Mellor. Can I help you?”

“Good Morning, Staff. It’s Dr Neef at St George’s. You had an emergency admission last night. I was wondering how he was this morning.”

“We had two last night, Doctor. Which one are you interested in?”

“Charles Morse. He’s our Chief Path Technician.”

“Mr Morse had a rather uncomfortable night, I’m afraid. He’s not well at all.”

“Has there been any word from the lab yet?”

“Perhaps you’d better speak to Dr Clelland, sir.”

“Rules is rules,” muttered Neef under his breath as he waited. He did not have to wait long.

“Dr Neef?”

“Good Morning, Doctor. I was responsible for having Charles Morse admitted to you last night. I was wondering if you’d had any lab results yet?”

“Not yet, Doctor. Although there were several atypical features, he’s been provisionally diagnosed as Klebsiella pneumonia because of the severity. He’s been put on ampicillin.”

“I suppose it’s too soon to say how he’s responding?” asked Neef.

“We’ve certainly had no encouraging response as yet,” agreed Clelland. “He’s still very ill but as you say, it’s early days.”

“Thank you Doctor.”

Neef put down the phone and reflected on the unpleasant sense of foreboding that had come over him. Maybe he was just hyper-sensitive to the word pneumonia these days but Clelland’s additional qualification of, “atypical” had only heightened his unease. He thought for a moment about the GP who’d called Charlie’s condition, flu and then called Kate Morse’s home number.

“Kate? I hear Charlie’s not so good.”

“Hello, Mike. Good of you to call. He’s really ill. In fact, I think if you hadn’t come out and called the ambulance when you did, he mightn’t have made it through the night. He had to have oxygen in the ambulance. He’s still on it this morning.”

“The ID unit at University College think it’s Klebsiella pneumonia. That would certainly explain why it’s so severe. The ampicillin should get it under control though. He should start getting better soon.”

“God, I hope so, Mike. It gave me a real scare.”

“I’ll bet.”

“I’m on at two. I’ll see you then.”

“Look, Kate, if you don’t feel up to it today, we’ll manage.”

“I’ll be there,” said Kate. “Sitting around worrying doesn’t help anyone, least of all Charlie.”

“As you wish,” said Neef. “I probably won’t see you until after Thomas Downy’s op. We’re going to theatre at two thirty.”

“That had completely slipped my mind,” said Kate. “I hope it goes well for Thomas. He’s such a nice kid.”

Pereira returned from his walk and Neef asked him if he still wanted to attend the next operation.

“You bet,” replied Pereira.

Neef wasn’t convinced but he shrugged his shoulders and suggested they started making their way down to theatre. Mark Louradis was already in scrub when they got there. Neef introduced him to Pereira. “Mr Louradis is our chief surgeon here at St George’s. He is going to inject your virus into Martin Liddle.”

“It’s nice to have the best,” said Pereira, lathering his hairy arms.

Louradis looked sideways at Pereira as if searching for signs of sarcasm but didn’t find any there. Pereira had obviously meant the comment to be taken at face value. How like Louradis to have doubted it, thought Neef. Despite a faultless reputation as a surgeon, Louradis suffered greatly from some unfathomable Mediterranean inferiority complex. Neef sometimes wished he had a fiver for every time he had seen Louradis’ features darken with suspicion over something everyone else present would regard as innocent.

“What a colour!” whispered Pereira to Neef as he saw Martin Liddle’s yellow skin hue.

“That’s the tumour,” replied Neef. “Pancreatic tumours are notorious for being advanced by the time they’re diagnosed. The bile duct gets screwed up as the tumour spreads.”

“This isn’t ultrasound, right?” asked Pereira, nodding at the monitor positioned to the side of the table.

“No, it’s a real video picture. There’s a small camera positioned just to the side of the end of the endoscope.”

Louradis inserted the endoscopy tube and everyone watched its progress through Martin Liddle’s alimentary canal.

“Now we come to the tricky bit,” whispered Neef to Pereira. “He’s reached the duodenum.”

Louradis coaxed the control levers at the head of the tube until he had negotiated an awkward turn and was satisfied with the picture on the monitor. “Almost there, Dr Pereira,” he said. “About here do you think?”

Neef sensed Pereira’s discomfort at the question. He had obviously not been expecting to be asked for his opinion.

“What d’you think, Mike?” Pereira asked.

Neef smiled behind his mask. “Maybe another half inch,” he said.

“Here?”

“Fine.”

Louradis injected the virus and started the process of extracting the tube.

“I need a cigarette,” said Pereira with feeling as he and Neef left the theatre together. “That’s it till two thirty, right?”

“That’s right,” said Neef. “Two down, one to go.”

After changing out of gown and gloves, Pereira disappeared outside for his cigarette and Neef walked back to the unit alone. As he crossed the courtyard past groups of chatting nurses a vehicle parked on the far side caught his attention. It had a press sticker in the windscreen. Two men with notebooks at the ready were standing nearby; they were talking to a man with a camera bag slung over his shoulder. “What’s that all about?” he wondered with an uneasy feeling.

When he got back to his office he called the hospital press officer, John Marshall. “You are remembering our agreement about no publicity for the Gene Therapy trial aren’t you?” he said.

From the first faltering syllable of Marshall’s reply, Neef knew there was something wrong. He closed his eyes in anticipation of hearing something unpleasant.

“It didn’t come from this office, Michael, I promise. But the press got it from somewhere. Mr Louradis is giving an interview about the Martin Liddle case at this very moment.”

“Oh shit,” said Neef. He put down the phone. So this was why Louradis had been keen to carry out such a routine procedure himself. He wanted media attention. He must have set the whole thing up for himself. The man bitterly resented all the press coverage the surgical teams at University College had been getting. He must have seen this as his chance to grab some of the limelight for himself.

Neef’s first thought was to have it out with Louradis and give free rein to the tide of adjectives that were springing to mind but he began to see that what was done was done. It seemed likely they were now going to have to conduct the trial under press scrutiny as University College had done the year before. Nothing was going to change that. He decided not to say anything to Louradis. In the event, Louradis phoned him some twenty minutes later.

“Michael, I’m calling to assure you that I had nothing to do with the press being here this morning. I was a surprised as everyone else.”

“Of course.”

“There were a couple of reporters waiting for me when we’d finished with Martin Liddle this morning. I don’t know how they possibly got wind of it but I felt I had to say something. You know how it is.”

“Quite.”

“I know you didn’t want the press to know about the trial until you knew how it was shaping up but I’m sorry, there it is, there was nothing I could do without being rude. I played it down as much as I could. No hard feelings I hope?”

“Of course not.”

“Good. I look forward to hearing how our young friend progresses.”

“I’ll see that you’re kept informed.”

Neef heard the line go dead and tried out some of his adjectives anyway. Who else would have called the press?