Diane Hoh - The Fever

Here we are again, with another Diane Hoh and after “The Invitation”, I'm looking forward to this. This is another Point Horror book that I have never read. Somehow during my charity shop rummaging for Point Horror, this one has always eluded me. I remember seeing it when younger in the Puffin book club leaflets we'd get given in English class, and for ages, I thought the front cover actually depicted a knight! Come on... it does bear a resemblance if you look at it kinda cross eyed...

No wonder the story and picture never gelled in my mind. However, now I know it is a healthcare professional, the whole thing makes a bit more sense.

I've been a care worker in a range of places, including hospitals so reading through this, a fair few care practice issues and the odd plot hole came up. For a start, this is clearly written before the current litigation society and at a time when Doctor Was Right And Must Be Obeyed. Now we are all too familiar that medics can and do make mistakes. No doubt I will come back to this as when making notes, I was coming up with so much stuff that made me put on my carers' hat and get the old axe grinding.

The best bit is at the start of chapter 5. A perfect example of Good Doctor and Naughty Patient.

It also clearly has been written before “Care In The Community” type schemes and/or closure of the old Victorian asylums as the hospitals have grounds and open air spaces, with student nurses studying in the grounds. Here at least, students rarely live at the hospital anymore. Most hospitals don't have any grounds apart from the car park and some garden areas are barred from use because of Health and Safety. Man, whatever happened to the concepts of Be Careful, Personal Responsibility and Accidents Do Happen?

But, the opening description was great! A real gothic/art deco decaying hospital came to mind. Which is great to me because I love looking at pictures of the old asylums. Mentions of yellowing ceiling tiles and cracks in the walls really paint a gloomy image of this place!

We meet Duffy Quinn who is has been in hospital for 2 days so far after being struck down with a high temperature and associated delirium, probably caused by an outbreak of the flu. Duffy is fed up of being hospital and wants to go home, but unless her temperature comes down, the medics won't discharge her. So her job is to lie there, sleep well and get better.

In the hospital are various volunteers (candy stripers) who assist the nursing staff and are using this as a stepping stone into medical school. Most of them know Duffy from school, which makes for interesting patient confidentiality ethics. And, if you were at school with your carer, would you be ticketyboo with it? Can't say I'd have been baring my botty to my classmates! I did wonder as to their ages, but it appears that you can be a candy striper whilst still at high school, so what I thought was a plot hole, probably isn't one at all.

Duffy is crushing on Christopher 'Kit' Rappaport. Kit is being emotionally blackmailed by his grandfather to stay in Twelvetrees, whereas Kit would rather get the heck away. This isn't strictly relevant to the story, but does add pathos. Hoh describes Twelvetrees as the sort of place kids leave before the ink is dry on the diploma. That's quite a good summary of a town! Kind of like where I live. Kit suddenly leaves one day after arguing with his grandfather. Kit has been saying he wanted to go to California, so although sudden, it's not totally out of character. Take note of this factoid in the book: this is relevant kids!

Other people are subsequently introduced – Cynthia, Smith, Dylan and Amy are all volunteers. Jane is Duffy's best friend. All are aiming for medical school in the future. This doesn't really make much difference to the storyline apart from for Cynthia, but does give a bit more depth to the cast of characters. To me, they aren't really all that interesting. Apart from Kit but he never really features all that much. For once, the heroine doesn't end up with the hero.

Duffy being puzzled by something is the catalyst of the story. In the prologue, Duffy was awoken by people in her room and called out to them. No-one responded, which puzzles Duffy because no nurse would ignore a patient. Nurses just don't DO that.

Various incidents occur to further Duffy's paranoia that Someone Is Out To Get Her – she nearly falls down a lift shaft, her wheelchair goes careering off Heidi-style towards a lake with her in it and someone tried to drown her in the shower. Wow. That's gonna be one heck of a tweet when she gets home!

Nobody believes her and Duffy finds herself getting repeatedly sedated to calm down because she's clearly delirious and naturally, there are logical explanations for all these events. Someone switched the lift sign by mistake, a student released the brake to take her back in and got distracted, nobody attacked you in the shower you were going crazy. Oh and the noises you heard was probably just someone on shift bringing a date to the hospital. That's okay then! If I was the date, I wouldn't be getting fresh in a hospital!

In many ways, I can see this from the medical staff's point of view – she has had a temperature and it's the adults role in Point Horror to not believe and to leave our heroines in mortal peril, but I really don't feel right with the way they keep doping her up the minute she becomes vaguely awkward. This really is from the old days!

Duffy soon starts feeling off colour and experiencing strange symptoms. It also transpires that some digoxin pills have gone missing. This does nothing to improve Duffy's paranoia, particularly when she realizes that the symptoms she has come on after every medication time and mimic those a person taking digoxin would have. Duffy Quinn, Medicine Woman!

Here we have the old position of “We Never Do Any Harm” coming out. The pills are missing but the staff are blasé thinking they will just turn up on the floor somewhere. Nobody could POSSIBLY be given these pills by mistake, because y'know, we're trained and don't make mistakes. That happens in OTHER hospitals! Foreshadowing here.

As a former carer, I rankle at this. Mistakes can happen to anyone and by anyone, no matter how trained you are. And if pills went missing, there'd be a massive search for them. As far as I know, medication is locked away and each dose is made up at the time for the patient. So unless there was massive negligence and failure to follow protocol, Duffy shouldn't have been able to be given digoxin repeatedly.

Duffy hides her pills and gets Amy to send them down for analysis. Amy agrees and the lab are all cool about it too. Hmm. This is all a little bit too convenient and required substantial suspension of belief! I did think I had another plot hole – you could check MIMS or BNF to find out what they were, you wouldn't need lab analysis. Apparently, someone took the antibiotic out of the capsules and replaced it with digoxin.

Also, it isn't guaranteed that the side effects from the digoxin will be experienced. If Duffy felt fine she could have been bumped off not knowing any different. I digress.

To me, this part of the story doesn't make sense. Going back, the noises Duffy heard in her room were Cynthia and Kit fighting (read the book to know more!), but thinking about it, Duffy probably would never have worked the mystery out, until Cynthia's confession. At the beginning of “The Fever”, the prologue has nothing in it that could help Duffy work out what it was.

Actually, just as I wrote that paragraph, none of the attacks on Duffy make any sense! Duffy just wouldn't have worked it out.

Kit's logic and solution also doesn't make sense. Even though the chart mix up was initiated by Cynthia, Cynthia's admission would not have exonerated the nurse. She should still have checked the medication charts and confirmed the patient is who they are either verbally or via name band. Lack of time to check patient identity would be no defence at all. The nurse is still to blame. So, Kit's saying that Cynthia should own up, is pointless in terms of helping the nurse.

Unless I am reading this story all wrong, the digoxin arc isn't needed. If you cut that out the storyline, it makes no difference to the ending. Add into that the previous comment about Duffy probably never working the mystery out, this is bit of a by-play.

However, there is a semi local record of a nurse killing people with digoxin from 1988. It is possible that Ms. Hoh had heard of these even though the cases weren't tried until 2006 as these cases were around New Jersey, and Ms. Hoh had lived in this area. Maybe this storyline was added from real life inspiration.

The big question – did I enjoy reading the book? Yes, I did actually. Despite the plot holes, care practice issues, I never really wanted the book to end. It did end a bit suddenly and Cynthia's admission in the morgue to Duffy seems unlikely, but with the way the book was going, it is the only way events could be explained. Duffy could not have come to the solution with the evidence she had as already stated.

I doubt I'll ever read it again, but I am one book closer to have read every Point Horror! As it's an early one, it definitely has status and being from a frequent Point Horror writer, it had to be done!