White death

SEVEN

After several hours of stop-go travel due to road works and the sheer volume of traffic, Steven finally found some space on the M6 and gunned the Porsche Boxster up to the legal limit. As he’d noticed so many times before, the further north you travelled, the lighter the traffic became. He had bought the Porsche as a replacement for his ageing MGF when it had finally become too expensive to maintain and its British manufacturer looked like joining it in the knackers’ yard. He knew that a Porsche might be considered an indulgence when he had so little time to drive it but he had compromised on his original plan to nuke the piggy bank completely and go for the 911 and settled instead for its little brother, the Boxster. Boys’ toys? Maybe, but there was no Mrs Dunbar to point this out.

Around two in the afternoon, the soporific boredom of the motorway gave way to the winding roads of the Lake District where the Porsche came into its own, sticking to the road like glue through the curves however hard he pushed it, not that he pushed it too hard, just enough to experience the exhilaration that driving a Porsche could bring.

He had deliberately come a bit further north on the motorway than had strictly been necessary just so that he could drive along the north shore of Ullswater and pass through Glenridding where he’d spent his childhood before heading on down to Windermere. His parents were both dead and he had no siblings so there was no reason for him to stop there but it was nice to flirt with old memories and feel nostalgia for an upbringing that had been idyllic. He coaxed the Porsche up through the Kirkstone Pass and paused at the top to take in the view. It never failed to gladden his heart. Wordsworth could keep his daffodils; for him the mountains were the thing. He had come to know other mountains well in his lifetime — especially those of North Wales, which had featured so much in his military training — but the Lake District peaks would always hold a special place in his heart. Feeling good, he let the Porsche dawdle down the pass into Windermere and started out along the shore road to Pinetops.

The first thing that struck Steven when he drove into the car park at Pinetops was that there seemed to be no children about. He had expected to see lots of them, wearing brightly coloured outdoor gear, chattering, laughing as they wheeled dinghy transporters and carried canoes to and from the water’s edge.

‘Change-over week,’ explained David Williams, the Welsh chief instructor. ‘We usually have a five-day gap between groups to allow us to clean and maintain things. You wouldn’t believe the havoc children can wreak when they’re not even trying.’

Steven could see from the window that several canoes were undergoing patching repairs with fibreglass: he’d noticed the strong smell of solvent in the air when he’d got out of the car. He asked Williams some general questions about the camp to get a feel for the place, establishing along the way the number of instructors employed and the type of activities available for the children.

‘It’s all about team work and personal responsibility,’ enthused Williams. ‘When you’re out on the hills and something goes wrong, you have to pull together; you share your knowledge, discuss your options and agree on a course of action. You come back safely because you worked as a team; you didn’t all run off in different directions doing your own thing.’

Steven knew the philosophy well enough and nodded in the right places. Society needed team players, which was all well and good as long as it didn’t lead to the ostracising and exclusion of gifted individuals who preferred to work alone. You didn’t often find genius working in a team.

‘So, how can I help you exactly?’ asked Williams, returning Steven’s ID and deciding that the pleasantries were over.

‘I understand a group of children were exposed to tuberculosis here a few months ago.’

‘So I’m led to believe,’ said Williams. ‘Nothing to do with the camp, you understand. Some kid brought it in but the relevant medical authorities moved quickly and the children were given protection.’

‘BCG vaccine,’ said Steven.

‘If you say so,’ said Williams. ‘Not exactly my field.’

‘There’s one thing I’m not clear about,’ said Steven. ‘How was the child with TB discovered? Did he or she become ill while they were here?’

‘Well, no one reported sick to the camp clinic if that’s what you mean,’ said Williams, ‘or I would have heard about it. We have a full-time nurse on the staff and we can call on a local GP if needed. All incidents are logged.’

‘Then how?’

Williams furrowed his brow. ‘You know, I don’t rightly know. I was informed by telephone of the situation.’

‘By whom?’

‘A Department of Health official, I think he called himself, snooty bugger as I remember. I guess the kid must have had tests before he or she came here and the results caused the shit to hit the fan.’

‘I suppose,’ agreed Steven who had noticed that Williams had not given away whether the child was male or female. Was this because he didn’t know?

‘What happened to the boy?’ he asked.

‘I’ve no idea.’

‘But it was a boy?’

‘I don’t know.’

Steven looked surprised in order to provoke further comment.

‘I suppose he or she was taken off to hospital but I wasn’t asked to make any of the arrangements so I didn’t see it happen. I was just asked to organise the other kids for vaccination.’

‘Do you know which school the child was attending?’

‘I don’t think they said,’ said Williams. ‘Does it matter? What could I have done?’

‘You’re right,’ agreed Steven, backing off. ‘The medical authorities seem to have had everything in hand and you had another hundred kids to worry about. Can you remember how long after the initial phone-call the other children were vaccinated?’

‘Next day,’ said Williams. ‘The team was here at ten sharp next morning and we had the kids ready and waiting. I remember we had a late start that day to outdoor activities.’

‘Well, no untimely delays there,’ said Steven. ‘Sounds like a very efficient operation.’

‘Maybe you’d like to see round the camp, see the clinic for yourself?’ asked Williams, who clearly wasn’t at all sure what Steven’s interest was in all of this.

Steven said that that wouldn’t be necessary, congratulated Williams on having such an enviable job and left. Deciding that he felt hungry — he had missed out on lunch — he drove along the shore to Ambleside and found somewhere advertising all-day-food.

He had to admit that he hadn’t come up with anything about the handling of the situation at Pinetops that could have upset Scott Haldane although he did feel a bit puzzled about the apparent secrecy surrounding the identity and movement of the sick child while at the camp. It was understandable after the event and the reasons given by the authorities to Macmillan and relayed by him had seemed valid enough. Anything to do with race relations issues and possible problems affecting them had to be handled with kid gloves — but the more he thought about it, the odder it seemed that Williams, and presumably his staff, knew nothing about the child. He was chewing his way through a particularly tough gammon steak when another thought struck him. How did the Department of Health know about the child so quickly? Williams had told him that it was someone from DOH who had phoned him. How did the ‘snooty bugger’ know so quickly?

‘Is everything all right for you?’ asked the waitress.

Steven nodded. ‘Fine.’ It wasn’t but it was hard to break the habit of a lifetime. Surely, he reasoned, a sick child with lung problems would be seen by his or her GP and referred to a local hospital for X-rays and tests. It was they who would make the diagnosis and arrange for the child to be admitted to hospital. There would have been no need to involve the DOH. Steven paid and left. He walked down to the edge of the lake and threw a couple of pebbles into the water while he continued to follow his line of thought.

TB was a notifiable disease, which meant that the hospital would be obliged to report any incidence of it, but notification would almost certainly be to the local health authorities in the first instance. DOH would be involved in collating national figures but surely not in individual cases and certainly not in the practical aspects of vaccinating contacts.

Maybe he was making a mountain out of a molehill, he conceded as he started to walk back to the car, but there was something not quite right about how things had been handled at official level and he wanted to know what. It preyed on his mind all the way home. There was a message from Jenny on his answering machine when he got in.

‘Daddy, I’m ringing to say I’m sorry about what I said but you’re not there. Auntie Sue says I can stay up till nine o’clock if you want to call me back. Love you.’

Steven looked at the time. It was 2 a.m. ‘Shit,’ he murmured as he poured himself a nightcap. It was impossible not to imagine Jenny’s face when 9 o’clock had come and gone. It was an image that reappeared at intervals during a restless night. He was up early to call her before she left for school.

‘Hello, nutkin, I’m sorry I was out when you called last night. I was working. I was driving home at the time but it was lovely to hear your voice when I got in.’

‘You work very late, Daddy.’

‘Sometimes I have to, nutkin.’

‘Auntie Sue says that’s why you can’t look after me and not because you don’t love me.’

‘Auntie Sue’s right, Jenny. I love you very much. We all do.’

‘That’s what Auntie Sue said.’

‘Auntie Sue’s very wise.’

‘Are you coming up at the weekend, Daddy?’

‘You bet.’

‘Can we go swimming?’

‘Of course we can.’

Steven put the phone down and let out his breath in a long sigh of relief as the tension he had been feeling over Jenny left him. He felt in a good mood as he set out for Great Ormond Street Hospital. He wanted to have a word with an old friend before he went in to the Home Office. Jim Brewer and he had gone through medical school together. Brewer had pursued a more traditional career path and was now a consultant physician, married to Linda, a radiologist who worked at another London hospital. Steven had last seen them both at the christening of Gerald, their third child, some two years ago. He noticed that his friend’s reddish fair hair had become thinner in the interim and his waistline thicker as he headed for his forties but he seemed relaxed and at ease with the world. A round peg in a round hole, thought Steven. Can’t ask for better than that.

With the pleasantries over, Brewer asked, ‘Well, Action Man, what can I do for you?’

‘I need some advice,’ said Steven. ‘I’d like you to imagine that you have a hundred or so children living together at a school camp and one of them is confirmed as having tuberculosis… what happens next?’

Brewer rested his elbows on his desk and made a steeple with his fingers. ‘Well, let’s see. The child would have to be admitted to hospital for assessment and the start of treatment. Assuming that it wasn’t a problem strain — resistant to one or more of the front-line drugs — he or she would be started on triple chemotherapy — streptomycin, PAS and isoniazid. They’d be kept on that regime for at least six months but they could be released from hospital once their sputum had gone negative and they weren’t infectious any more. Does that answer your question?’

‘What about the other children?’

‘Close contacts would be screened for the disease, as would family members of course. Depending on the outcome of the tests they would be vaccinated or even put on treatment themselves if they were showing signs of infection.’

‘How about non-close contacts, say, children at the camp but from another school group?’

‘Skin tests.’

‘I take it it’s still the Mantoux test we’re talking about?’ asked Steven.

Brewer nodded. ‘Nothing much has changed in the last fifty years.’

‘What would you think to the idea of vaccinating the whole camp immediately?’

‘With BCG?’

Steven nodded.

‘Without skin testing first?’

Another nod.

‘Sounds way over the top,’ said Brewer. ‘Unless of course there was some good reason for doing it.’

‘Like what?’

‘Like it wasn’t a straightforward strain of TB. The World Health Organisation has been reporting multi-resistant strains appearing in Africa and Asia, some of them resistant to all known drugs. If they were to get a grip in this country we could find ourselves back in the nineteenth century with people dropping down with “consumption” all over the place.’

‘The affected child was an immigrant.’

Brewer shrugged. ‘That could be your answer. The problem cases are coming from the third world. Desperate times, desperate measures and all that.’

‘Thanks, Jim, you’ve been a big help,’ said Steven, getting up to go.

‘You’re welcome. You’ll have to come down and see us all soon.’

‘I’d like that,’ said Steven. ‘I’ll give you a call.’

It was raining quite heavily when Steven left the hospital but he found a cab that was just turning around to leave and got in, asking to be taken to the Home Office.

‘Bit of a mess your place these days,’ said the driver.

‘Really? I hadn’t heard.’

‘Yeah, they’re going to cut it up into smaller bits. Good idea if you ask me. It’s too bloody big the way it is, far too much for one bloke to run.’

‘Right,’ said Steven. ‘Well, another bloke’s always welcome…’

Steven had coffee and leafed through the current copies of a range of medical and scientific journals while he waited to see John Macmillan. He found a report about what Jim Brewer had mentioned regarding the appearance of drug-resistant strains of TB. It didn’t make for happy reading.

‘He’s off the phone,’ said Jean Roberts and Steven nodded that he was ready. She clicked the intercom and told Macmillan he was waiting.

‘He isn’t going to like this,’ murmured Steven as he passed Jean’s desk.

Macmillan was standing at the window with his back to Steven. He seemed deep in thought. ‘I trust you’ve brought some sunshine to brighten up a rainy day?’

‘Not exactly.’

Macmillan turned round. ‘Well, they do say it never rains but it pours. What’s the problem?’

‘I do need to know more about the child who contracted TB at Pinetops camp — the one they were reluctant to give you information about.’

Macmillan’s look suggested that he’d need to hear more than that to comply. He invited Steven to continue.

‘There’s something they’re not telling us. It’s not just a case of keeping a low profile for reasons of racial harmony. There’s a real chance the kid was suffering from one of the drug-resistant strains that’s been reported in the journals of late.’

‘Need that concern us?’

‘Not directly,’ agreed Steven. ‘But Scott Haldane was very upset about something that was going on with the green sticker business and I’d like to know what it was.’

‘It sounds like you’ve entirely abandoned the possibility that Haldane committed suicide?’

‘The girl herself says her scalding was an accident so there was no reason for him to feel guilty and certainly no other reason for him to take his own life.’

‘And the possibility of murder?’

‘I haven’t been able to rule it out completely and I won’t be until I know what upset him about the Trish Lyons case. I need to know more.’

Macmillan sighed and said, ‘Well, your instincts are usually spot on. I’ll let you know when I get the information. Anything else?’

‘Jean got me a list of all the green sticker kids. I’d like to know how many of them have had occasion to visit a doctor since their time at the camp and for what reason.’

‘You’re not asking for the medical records of over a hundred children, are you?’ asked Macmillan, appalled at the thought.

‘No, just the ones who’ve had their records updated since being at the camp — the records submitted to the TB monitoring group.’

‘Do you think some of them may have contracted TB?’

‘It would be as well to know.’

‘All right, you can ask Jean to deal with it on your way out.’

‘Thanks,’ said Steven, noticing the presence of a red folder on Macmillan’s desk. He always used red folders for new Sci-Med cases when they came in. ‘Anything I should know about?’

Macmillan looked thoughtful. ‘Our computer search picked up on the death of a medical scientist in Cambridge, young chap, hit and run, driver didn’t stop.’

The Sci-Med computer was programmed to scan news stories from all over the UK, looking for possible criminal activity related to science and medicine.

‘Sounds like a police matter,’ said Steven.

‘That’s my feeling too,’ agreed Macmillan. ‘But I’m going to keep an eye on how things develop.’

‘A university don?’

‘No, he worked for a biotech company, St Clair Genomics.’