Alarm in the House

 When Dr Keith Bottomley arrived in the ward for his two o’clock round he found the charge sister, Barbara Green, in a surly mood. Seldom had he seen her give way to displays of emotion, but today something had got under her skin. He was surprised to find her dressed in white theatre gown, cap and gloves.

“Lovely spring afternoon,” he remarked, by way of greeting.

Her only reply was to shove white gown, cap and gloves roughly into his hand. Bottomley sensed that this was not the time to ask questions. It was apparent that he was expected to dress up in the anti-infectious gear. When in Rome, do as Rome does, he thought, silently, to himself.

“We’ve got a new patient,” Barbara murmured, leading him to the single room near her office. “A Mrs Miruku, thirty-five years old, from Noumea.” She spoke as if the arrival of Mrs Miruku was an event that did not please her.

On the door of the room a sign blazed the words “REVERSE BARRIER NURSING” in huge red letters. Bottomley halted, mystified. He turned to the Junior Resident.

“What goes on?”

Dr Christopher Wyndham-Jones was one of the best junior residents Dr Bottomley had known. Still in his first year after graduation, his knowledge was above average, he was resourceful and devoted to his work, and he had a practical mind. Yet on this occasion he appeared uncomfortable, flashing a sidelong glance at his chief. Bottomley was persistent.

“Why do we all have to dress up?”

“It’s a long story,” Wyndham-Jones murmured, as if reluctant to begin.

“Take your time.”

“This lady, Mrs Miruku, arrived late last week for a course of radiotherapy for cancer of her uterus. When she was admitted she had a slight temperature, although she wasn’t aware of it, and I could find nothing abnormal on examination. We didn’t know how long she’d been febrile.”

“So?”

“I ordered some tests.”

“I’m listening.”

“Well, you see, she’s from the islands. So I thought I ought to check her for every-thing. Malaria, tuberculosis, AIDS, all the exotic tropical infectious diseases that we don’t see here.”

“Well?”

“We found nothing. I think she just had a cold.”

“So, what’s the problem?”

“The problem is that amongst a couple of dozen other tests I ordered, I included agglutination tests for typhoid.”

“Was there any reason to suspect typhoid?”

Wyndham-Jones shook his head slowly. “None at all.”

“You just didn’t want to miss anything?”

“Exactly. But word got through to Administration that there was a case of typhoid in the hospital.”

“You’ve lost me. Why would Administration think there was a case of typhoid?”

“It’s how rumours start. It’s not so easy to kill them once they take off.”

“Did you explain to the people upstairs?”

“Of course I did. I made a special visit to the Medical Superintendent and the Executive Medical Assistant, and I explained to them both that it was all a mistake. There was never any typhoid at all.”

“What did the Med Super say?”

“He just puffed away at his pipe and laughed. He treated it as a joke. But the Exec took it more seriously. He said he understood, but I’d have to square it with Nursing Administration. That’s when the trouble started.”

“How come?”

“I went to see the Ward Nursing Supervisor, the Director of Nursing Services, and the Staff Nurse-Administrator. All of them insisted that Mrs Miruku would have to stay in quarantine until she could be cleared.”

“But how could she be cleared if she didn’t have typhoid in the first place?”

“As far as they’re concerned, she has typhoid until proved otherwise.”

Bottomley turned to the ward sister for enlightenment. Barbara rolled her eyes upwards in droll resignation. It was clear she had spent no little time on the telephone.

We look like members of a decontamination squad in a Hollywood movie, Bottomley mused, leading the way into the room. Inside, he was greeted by an astonishing sight. In the bed, sitting up, was a human figure, covered from head to foot by a sheet. The woman, whom he assumed it to be, refused to show her face.

“She doesn’t speak much English,” Barbara explained. “She has the idea we think she’s dirty.”

“What else could she think? Have you tried to explain the situation to her?”

Barbara returned his gaze steadily with her blue eyes.

“Would you be able to explain to her how Administrators think?”

The three stood by the bedside, looking at each other over their face-masks. If they had been gangsters planning to rob a bank they couldn’t have looked more sinister, Bottomley reflected.

“Some people from the Noumean community arrived to take her out to church,” Barbara informed him. “I had to send them away. They didn’t understand.”

“I’m not surprised. Have you got a spare bed out in the ward with the other patients?”

“Yes.”

“Well, what’s stopping us from moving Mrs Miruku out there right now?”

“The Infection Control Sister!”

“And who is that?”

“I don’t know.”

“She doesn’t come to the ward?”

“I’ve never seen her.”

“Well, how will anyone know if we move Mrs Miruku quietly outside the barbed wire?”

Barbara looked at him steadily. “I’m game if you are.” She took off her mask and turned to the apparition in the bed, tapping the woman on the shoulder.

“Mrs Miruku, would you like to go out and sit with the other people in the common room? Your friends can call and take you to church on Sunday if you like.”

The sheet disappeared in a flash. The woman was out of bed and dressed in no time at all.

Bottomley gazed at the Melanesian woman. Her face was illuminated by an expression of pure joy. She smiled at him, then looked down self-consciously. Bottomley wondered what she thought of them all. As they left the room Barbara tore down the notice on the door and tossed the gowns and gloves into the laundry basket.

“There’s just one other thing,” Wyndham-Jones announced, innocently, as they walked along the corridor. “I haven’t got all the results back yet.”

Bottomley stopped to look his junior resident directly in the eye, his suspicions aroused. “What else did you ask for?”

Wyndham-Jones hesitated, taking a long time to come clean. “Leprosy. I heard it’s endemic in the islands.”

“Listen,” Bottomley declared, placing a firm hand on the young man’s shoulder. “When that result comes back don’t let anyone see it. Don’t even read it yourself. Tear it up and throw it in the waste paper basket. Or, better still, burn it. On no account let it appear in her files!”