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nosocomial infection problem started three and a half months previously. Cynthia was a dark-complected, raven-haired woman with a bit of a temper. Angela had been willing to put up with her thin-skinned and often caustic style because of her training, dedication, intelligence, and reputation. She'd been the reputed savior of several institutions with infection-control problems.
    "They might be open, but they aren't being utilized except by a fraction of our medical staff," Dr. Herman Straus said. Angela had recruited Herman from a Boston community hospital, where he'd been a well-respected assistant administrator. A big, athletic man with an outgoing personality, he had a particular affinity for dealing with orthopedic surgeons. That quality combined with his Cornell Hospital administration training made him an ideal president of Angels Orthopedic Hospital, and his record was proof of it.
    "And why is that?" Angela asked. "Surely they know we have been on top of this problem right from the beginning. Cynthia, remind everyone what has been done."
    "Just about everything possible," Cynthia snapped, as if she was being challenged. "Every OR has been cleaned with sodium hypochlorite and fumigated at least once with a product called NAV-CO2. It's a nonflammable alcohol vapor in carbon dioxide."
    "And not without considerable expense," Bob interjected.
    "And why that particular agent?" Carl questioned.
    "Because methicillin-resistant staphylococcus aureus, or its more common designation, MRSA, is highly sensitive to that particular preparation," Cynthia shot back, as if it were a fact everyone should know.
    "Let's not get testy," Angela said. She wanted to keep the meeting friendly and, she hoped, productive. "We are all on the same page here. No one is casting aspersions. What else has been done?"
    "Every hospital room that has seen an infection has also been similarly treated," Cynthia said. "More important, perhaps, as you all know, every member of the medical staff and every employee of the hospitals are cultured on a recurrent basis, and those who test positive as a carrier are treated with mupirocin until they test negative."
    "Also at great expense," Bob added.
    "Please, Bob," Angela said. "We are all aware of the expense side to this disaster. Cynthia, continue! Do you think culturing and treating the staff and employees is critical?"
    "Absolutely," Cynthia said. "And we might consider the same for patients as a prelude to admission. Both Holland and Finland had a particularly bad problem with MRSA, and the way that they brought their problem under control was by treating both staff and patients: anyone who tested positive as a carrier. I'm beginning to wonder if we might have to do the same thing. Yet my real concern is that the MRSA is occurring at all three of our hospitals. What does that say? It says that if a carrier is responsible, then that carrier must routinely visit all three hospitals. Consequently, I have as of today ordered the testing and treating of all employees from even here at the home office who regularly visit all three hospitals, whether they have actual patient contact or not."
    "Anything else?" Angela asked.
    "We have mandated aggressive hand-washing after each patient contact," Cynthia said, "particularly with the medical staff and nursing personnel. We've also instituted strict isolation for all MRSA patients, and more frequent changing of medical staff clothing, such as white coats and scrub outfits. We also require more alcohol cleaning after each use of routine equipment, like blood pressure cuffs. We've even cultured all the condensate pans of all the HVAC air handlers in all three hospitals. All have tested negative for pathogens, especially the strain of staph that has been plaguing us. In short, we are doing everything possible."
    "Then why haven't the doctors been admitting patients?" Bob questioned. "As they are all owners, they have to be aware they are taking money from their own pockets