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Edinburgh 1988

The power driven door of the steriliser swung slowly shut. Its side shields clamped it in an air-tight embrace and a vacuum pump began sucking out the air until, four minutes later, the automatic controller stopped the pump and opened up a valve. Scalding steam from the hospital's main supply line flooded in to raise the internal temperature to one hundred and twenty-six degrees centigrade. The pre-formed vacuum ensured that the steam found its way into every nook and cranny of the load, giving up its latent heat and, in doing so, destroying all vestige of microbial life. The smallest virus hiding in the remotest corner of a crease would be sought out and exterminated by the relentless steam. There would be no hiding place, no escape, no reprieve. An orange light flicked on as the temperature reached its target and triggered an electric timer. A relay clicked on and off as it held the temperature steady on 126 degrees.

Half way through the cycle Sister Moira Kincaid returned from lunch and furrowed her brow. She walked over to the unattended steriliser and took down a clip-board from the side of the machine, checking through the one line entries with her fore finger and frowning even more. Last entry nine fifteen, eight packs of surgical dressings, fourteen instrument packs, gloves, gowns…Cycle Normal…Emptied eleven thirty…Signed J. MacLean. There was no further entry, no indication of what the present load might be or who had commissioned it. Two sins had been committed and Moira Kincaid was annoyed. As sister in charge of the Central Sterile Supply Department at the Princess Mary Hospital it was her job to know every thing about everything in her own department. She was a stickler for order and routine. Someone had upset that routine and that someone, she decided, was going to have a very uncomfortable afternoon.

Steriliser Orderly, John MacLean, was whistling as he returned from his lunch break but the off-key rendition died on his lips as he saw the vinegar stare that welcomed him.

"Is something wrong?" he asked tentatively.

Moira Kincaid tapped the edge of the clipboard against the side of the steriliser and paused for effect. "This autoclave is running yet there is no entry on the board. "

MacLean sighed slightly with relief.

Moira Kincaid looked puzzled. "That's what I thought," she said quietly.

"Might be MacDonald Sister. "

"MacDonald?"

MacLean looked uncomfortable. "Harry sometimes sterilises his home brewing equipment in it," he said sheepishly.

"Ask him to come and see me when he gets back," said Moira Kincaid as she turned on her heel and walked across the tiled floor to her office.

Moira Kincaid closed the door behind her and leaned back on it for a moment before letting her breath out in a long sigh. She was glad to have these few moments before MacDonald arrived. It would give her time to calm down and get things into perspective. She would give MacDonald a dressing down but it would go no further than that for, facing facts, MacLean and MacDonald were the best orderlies she had had since taking over the department. She would be loath to lose either of them. Running the Sterile Supply Department was very different to ward work for there was no chain of command, simply because none was required. The work of preparing sterile dressings and instruments did not demand qualified nursing personnel, only the application of average intelligence. As a result her staff of seven, five women and two men were all of equally unqualified status. Keeping harmony among the seven was a prime consideration; petty niggles and jealousies had to be stamped out as soon as they occurred while the vital nature of the work had to be stressed constantly. An unsterile instrument pack in theatre would almost certainly mean infection and death for an innocent patient and should such an event occur there would be only one head on the chopping block…hers. A knock came to the door. "Come. "