Wildcard (23 page)

‘Jesus wept,’ muttered Steven. He didn’t pretend to understand what was going on, but the elation at making a connection between the wildcards was more than welcome and long overdue. Four wildcards, four heart problems, four operations, this was too much of a coincidence to be one at all.

Caroline looked more tired than ever when she emerged from the changing room with Kate Lineham. She was losing weight, thought Steven; hollows were appearing in her cheeks.

Kate was trying to persuade her to take the following day off. ‘Do something else,’ she advised. ‘It doesn’t matter what, just anything else for a change.’

‘I’ll be here. I haven’t seen
you
taking the day off.’

‘I’m more used to this sort of work than you.’

‘No one is used to this sort of work,’ retorted Caroline, holding her gaze for a long moment.

‘You have a point,’ conceded Kate, ‘but there’s no sense in making yourself ill.’ She turned to Steven and said, ‘I’m off. See that this one gets to bed early.’

Caroline had had to leave her car at home that morning because it had refused to start, so Steven drove her back. ‘Rough day?’ he asked, although the answer was plain in her face.

‘The worst. You know, I’m beginning to wonder what the point is. We’ve had only three people show signs of recovery since I started down at St Jude’s. All the rest have died. All we do is wipe up blood and vomit and urine and shit … all day, every day, over and over again … And then they die.’

Steven glanced at her out of the corner of his eye and saw that tears were running down her cheeks although she was not sobbing and her face was impassive.

‘Kate’s right. You need some time off,’ he said gently.

‘No way,’ she said resolutely. ‘Not until we get some more volunteer nurses down there.’

‘Are you sure you’re not doing this out of some misplaced sense of guilt?’ said Steven as kindly as he could.

‘Maybe at the beginning,’ she agreed, without protest and to Steven’s surprise, ‘but not any more.’

‘Then why?’

‘You know, I think it’s simply because I hope someone might do the same for me if I ever need it,’ said Caroline. ‘That’s the best reason I’ve been able to come up with.’

‘I think you do yourself an injustice,’ said Steven. ‘But I won’t embarrass you by suggesting that you’re an exceptional human being, I’ll just feed you dinner.’

‘You’re serious?’

‘I am.’

They completed the journey in silence. Caroline leaned her head on the headrest and closed her eyes.

* * *

The food the hotel had provided was plentiful if, of necessity, cold. Since both of them were hungry but not particularly interested in food, it didn’t matter.

‘You haven’t said anything about your day,’ said Caroline as they sat in front of the fire nursing the last of the first bottle of wine.

Steven told her what he had discovered.

‘Heart surgery?’ she exclaimed. ‘What on earth can that have to do with the virus?’

‘I know it’s bizarre,’ agreed Steven, ‘but it’s also a fact and I think it’s too much of a coincidence to ignore.’

Caroline still looked doubtful. ‘Now, if they had all had surgery in the same hospital at the same time, I might have to agree that there was something fishy but they didn’t and even the timescale is all wrong. They had their surgery many months ago. The virus has an incubation time of around seven to ten days, so what exactly are you suggesting?’

‘I don’t know,’ confessed Steven. ‘I think I need to talk to a surgeon so I can get some feel for what’s going on.’

‘In the meantime, maybe we can open that other bottle of wine?’

‘Water of Lethe coming up.’

After a while, Caroline slipped off her chair and sat on the carpet in front of the fire at Steven’s feet. She rested her head on his knee. ‘How long till Christmas?’ she asked. ‘I’ve lost track.’

‘Ten days,’ he said. The question made him think of Jenny. It seemed unlikely that he would be with her. He would have to speak to Sue and find out how she was going to take it.

‘Where will you spend it?’ asked Caroline, as if reading his mind.

‘Here, I should think. You?’

‘St Jude’s,’ she said quietly, ‘piling up bodies for collection. Wonder how God will square that one.’

He stroked her hair gently and she made an appreciative sound. ‘God, it seems such a long time since anyone did that,’ she murmured.

The wine and the heat of the fire conspired to bring her eyelids together and it wasn’t long before she fell fast asleep. Steven slid slowly sideways to stand up. He picked her up and took her upstairs to her bedroom, where he removed her shoes and loosened her clothing before putting her to bed and tucking the covers in around her. The central heating had switched itself off and the room was chilly.

Caroline stirred sleepily and without opening her eyes said, ‘Are you putting me to bed, by any chance?’

‘I promised Kate Lineham I would,’ whispered Steven, and he clicked out the light.

He’d had too much to drink to consider driving back to the hotel, so he settled down on the couch in the living room. He awoke some four hours later with a crick in his neck. Rubbing it vigorously, he padded over to the window, opened a curtain, and cleared a patch in the condensation. He could see by the light from the street lamps that large flakes of snow were falling, laying a carpet of white over street and garden. He shivered and looked at his watch: it was 4 a.m. Not the best time of day to feel optimistic, but something about the way the snow was silently covering the city invited parallels with the virus and nurtured thoughts about the nature of good and evil.

‘You must be cold,’ said Caroline behind him. ‘I didn’t put out any blankets for you.’

Steven turned and saw her standing in the doorway. ‘I’m fine,’ he said. ‘Couldn’t you sleep?’

‘Too many bad dreams. I need coffee. You?’

He nodded and closed the curtain again. Caroline made the coffee and they sat on the couch, hands wrapped round their mugs, staring at the fire, which Caroline had turned on full.

‘I have such a bad feeling about the way things are going,’ said Caroline.

‘It’s always darkest before the dawn.’

‘Maybe there isn’t going to be a dawn. Did you know that the suicide rate in the city has gone up by a factor of eight in the past week?’

‘I didn’t,’ said Steven.

‘They reckon it’s guilt. Relatives of those going down with the disease feel helpless because they can’t do anything to help – they can’t even give their loved ones a proper funeral because of the restrictions.’

She shivered and Steven put his arm round her.

‘Would you think me awfully forward if I suggested that we should go up to bed together?’ she asked, still gazing at the fire.

‘No,’ replied Steven truthfully.

‘Somehow I feel that time is not on our side,’ she murmured.

FIFTEEN

‘I thought I’d feel embarrassed, but I don’t,’ said Caroline as she dropped bread into the toaster.

‘Good,’ said Steven, wrapping his arms round her from behind and planting a kiss on the back of her neck. ‘Me neither.’

‘Must be that good old British wartime spirit you hear so much about,’ she said thoughtfully. ‘Normal rules of social engagement will be suspended for the duration of the hostilities.’

‘My regiment marches at dawn,’ said Steven.

‘Only this time the war has come to us.’

He kissed her hair but didn’t answer.

After breakfast he tried starting Caroline’s car but found that it had a flat battery. Having failed to persuade her to take the day off, he insisted that she take his car to get to St Jude’s. In the meantime, he would try to sort hers out.

‘Will I see you later?’ she asked.

‘If you want to.’

‘I’ll see you later, then.’

A neighbour who had noticed Steven trying to start Caroline’s car came out, still in his dressing gown, to volunteer the use of his battery charger. Steven was able to charge the dead unit and be mobile within half an hour. He stopped at a fast-fit service on the way over to the City General and had the battery checked. The technician declared it defunct – ‘Won’t hold a bloody charge, mate’ – so Steven bought a new one and had it installed.

When he eventually reached the hospital he found George Byars alone in his office, sitting in shirtsleeves, juggling with columns of figures. ‘It’s been a while,’ said Byars.

‘I felt there was a danger of too many cooks,’ said Steven. ‘I’ve been trying to focus on my own job for a bit.’

‘You weren’t entirely successful if what I hear from St Jude’s is correct.’

Steven shrugged and said, ‘Some things you just can’t walk away from.’

‘I’m glad you think that way,’ said Byars. ‘I sometimes wonder about certain members of my profession.’

Steven decided not to push him on the subject. Instead, he asked, ‘How are things at the sharp end?’

‘Sharper than we’d like. I sometimes think I’m standing on the bridge of the
Titanic
, feeling the temperature fall. We’ve got an enormous problem with a shortage of nurses and another over accommodation for the victims. Three churches and two schools have been pressed into use so far, and all of them are just about full. The next step will be to close the city’s secondary schools and bring them into the equation.’

‘Why secondary schools?’ asked Steven.

‘Times have changed,’ said Byars. ‘It’s the norm for both parents to go out to work these days. Suddenly dumping hundreds of young children back home would cause big social problems. Secondary-school kids are old enough to look after themselves till the folks come home.’

Steven nodded. ‘What about the nursing volunteers who were supposed to come?’ he asked.

‘Slowed to a trickle.’ Byars shrugged. ‘Can’t blame them. Watching people die without being able to do anything about it isn’t exactly glamorous or uplifting. Apart from that, we’ve lost two nurses to the virus.’

‘Two?’ exclaimed Steven.

‘It’s not common knowledge, like a lot of things in the city these days,’ said Byars.

‘Then you’re managing to keep things out of the press?’ asked Steven.

‘Someone is,’ corrected Byars. ‘Don’t ask me who, but I suspect government pressure’s being brought to bear.’

‘It certainly wouldn’t be an appeal to the hacks’ better nature,’ said Steven.

‘And you? Any progress?’

‘Let’s say I’m more optimistic than I was a few days ago, but there’s still a lot to work out. That’s really why I’m here. I need to talk to a cardiac surgeon – please don’t ask why. Can you help?’

Byars picked up the phone and dialled an internal extension. After a short conversation he replaced the receiver, said, ‘Our Mr Giles will be glad to give you all the help he can,’ and told Steven how to get to the cardio-thoracic unit.

Steven smiled and thanked him. He’d come to like and respect Byars over the past few weeks, and was relieved that the crisis-management team had recognised his abilities and kept him on as crisis co-ordinator.

At the cardio unit, Steven was met by a formidable-looking woman who introduced herself as Martin Giles’s secretary. ‘He’s expecting you,’ she said brusquely. ‘Go straight in.’

Steven’s immediate impression was that Giles looked more like a heavyweight boxer than a surgeon but when he spoke it was as an educated, articulate man. ‘How can I help?’ he asked, hunching muscular shoulders as he folded his arms on his desk. What neck he had seemed to disappear, making his head look like a cannonball perched on a castle wall.

‘I need to know something about modern heart surgery,’ said Steven. ‘What’s on offer and what you do exactly.’

‘Depends what the problem is,’ said Giles. ‘Anything from a couple of stitches in the right place to a complete heart–lung transplant.’

‘Sorry to be so vague,’ said Steven, ‘but I’ve got no idea how common heart surgery is these days or how many people benefit from it.’

‘Every cardiac unit in the country has a waiting list a mile long,’ said Giles. ‘Cardiac surgery has become commonplace.’

‘Supposing a man is referred to you with a history of rheumatic fever in childhood, and this has led to current heart problems. Talk me through it.’

‘That used to be very common,’ said Giles. ‘Rheumatic fever isn’t as prevalent as it used to be but it often resulted in a bacteraemia which in turn caused a build-up of bacteria on one or more of the heart valves with resultant stenosis. We would take a look at the problem with a range of options in mind. If the damage weren’t too bad we might attempt a physical repair to the damaged tissue – we’d stitch the damaged portions together if at all possible. If a valve was irreparably damaged, however, we’d have to consider replacing it, either with a mechanical valve – a plastic one – or a tissue one should one be available.’

‘Supposing the heart damage was age-related?’ asked Steven, remembering Frank McDougal’s medical records.

‘The same options would apply. Age defects are usually associated with the left side of the heart, the mitral and aortic valves, while infection usually affects the ones on the right, but either way we would repair or replace as appropriate, with repair being the preferred option.’

‘And you say this is quite common?’

‘I read recently in one of the journals that 225,000 heart-valve operations are performed every year in the developed world and 60,000 patients receive replacement valves.’

‘How about post-op problems?’

‘All surgery carries risks, of course, but heart-valve surgery has an excellent success rate. The vast majority of patients make a good recovery and generally feel like new people into the bargain.’

‘And the ones who don’t?’ asked Steven.

‘There’s always a slight risk of stroke, bleeding, infection, kidney failure and, on occasion, heart attack and death; but they’re the exceptions.’

‘Heart-surgery patients haven’t shown up as being susceptible to secondary illness in any way, have they?’ asked Steven cautiously.

‘Secondary illness?’ queried Giles. 

‘Viral infections, that sort of thing.’

Giles said, ‘Not in my experience, although it may be true of transplant patients if they’re immuno-compromised because of the anti-rejection measures. I haven’t noticed increased susceptibility in valve-surgery cases and I haven’t heard that from anyone else in the business. We did have a major problem back in the eighties with mechanical failure of one make of replacement valve, the Björk-Shiley CCHV, which was prone to fracture, but that model was withdrawn way back in 1986, if my memory serves me right.’