Contagion (39 page)

     Giving up on his paperwork, Jack impulsively went up to the DNA lab on the sixth floor. In contrast to most of the rest of the building, this lab was a state-of-the-art facility. It had been renovated recently and outfitted with the latest equipment. Even the white lab coats worn by the personnel seemed crisper and whiter than in any of the other labs.

     Jack sought out the director, Ted Lynet, who was on his way to lunch.

     “Did you get those probes from Agnes?” Jack asked.

     “Yup,” Ted said. “They’re in my office.”

     “I guess that means there’re no results yet,” Jack said.

     Ted laughed. “What are you talking about?” he questioned. “We haven’t even gotten the cultures yet. Besides, I think you might be underestimating what the process is going to be. We don’t just throw the probes into a soup of bacteria. We have to isolate the nuclear protein, then run it through the PCR in order to have enough substrate. Otherwise we wouldn’t see the fluorescence even if the probe reacted. It’s going to take some time.”

     Sufficiently chastised, Jack returned to his office to stare at the wall behind his desk. Although it was lunchtime, he wasn’t hungry in the slightest.

     Jack decided to call the city epidemiologist. Jack was interested in the man’s reaction to this case of influenza; he thought he could give the epidemiologist a chance to redeem himself.

     Jack got the number from the city directory and placed the call. A secretary answered. Jack asked to speak with Dr. Abelard. “Who should I say is calling?” the secretary asked.

     “Dr. Stapleton,” Jack said, resisting the temptation to be humorously sarcastic. Knowing Abelard’s sensitive ego, Jack would have liked to have said he was the mayor or the Secretary of Health.

     Jack twisted a paper clip mindlessly as he waited. When the phone was picked up again, he was surprised it was again the secretary.

     “Excuse me,” she said. “But Dr. Abelard told me to tell you that he does not wish to speak with you.”

     “Tell the good doctor that I am in awe of his maturity,” Jack said.

     Jack slammed the phone down. His first impression had been correct: the man was an ass. Anger now mixed with his anxiety, which made his current inaction that much more difficult to bear. He was like a caged lion. He had to do something. What he wanted to do was go to the General despite Bingham’s admonitions. Yet if he went over there whom could he talk with? Jack made a mental checklist of the people he knew at the hospital. Suddenly he thought of Kathy McBane. She’d been both friendly and open, and she was on the Infection Control Committee.

     Jack snatched up the phone again and called the Manhattan General. Kathy was not in her office, so he had her paged. She picked up the page from the cafeteria. Jack could hear the usual babble of voices and clink of tableware in the background. He introduced himself and apologized for interrupting her lunch.

     “It doesn’t matter,” Kathy said agreeably. “What can I do for you?”

     “Do you remember me?” Jack asked.

     “Absolutely,” Kathy said. “How could I forget after the reaction you got out of Mr. Kelley and Dr. Zimmerman?”

     “They are not the only people I seem to have offended in your hospital,” Jack admitted.

     “Everybody has been on edge since these infectious cases,” Kathy said. “I wouldn’t take it personally.”

     “Listen,” Jack said. “I’m concerned about the same cases, and I’d love to come over and talk to you directly. Would you mind? But it will have to be just between the two of us. Is that too much to ask?”

     “No, not at all,” Kathy said. “When did you have in mind? I’m afraid I have meetings scheduled for most of the afternoon.”

     “How about right now?” Jack said. “I’ll pass up lunch.”

     “Now that’s dedication,” Kathy said. “How can I refuse? My office is in administration on the first floor.”

     “Uh-oh,” Jack voiced. “Is there a chance I’d run into Mr. Kelley?”

     “The chances are slim,” Kathy said. “There’s a group of bigwigs in from AmeriCare, and Mr. Kelley is scheduled to be locked up with them all day.”

     “I’m on my way,” Jack said.

     Jack exited from the front entrance 6n First Avenue. He was vaguely aware of Slam straightening up from where he was leaning against a neighboring building, but Jack was too preoccupied to take much notice.

     He flagged a cab and climbed in. Behind him he saw Slam following suit.

     BJ had not been entirely confident he’d recognize Jack from the visit to the doc’s apartment, but the moment Jack appeared at the door of the medical examiner’s office, BJ knew it was him.

     While he’d been waiting BJ had tried to figure out who was supposedly protecting Jack. For a while a tall muscular dude had loitered on the corner of First Avenue and Thirtieth Street, smoking, and intermittently looking up at the medical examiner building’s door. BJ had thought he was the one, but eventually he’d left. So BJ had been surprised when he’d seen Slam stiffen in response to Jack’s appearance.

     “He’s no more than a goddamn kid,” BJ had whispered to himself. He was disgusted. He expected a more formidable opponent.

     No sooner had BJ gotten his hand around the butt of his machine pistol, which he had in a shoulder holster under his hooded sweatshirt, than he saw first Jack and then Slam jump into separate cabs. Letting go of his gun, BJ stepped out into the street and flagged his own taxi.

     “Just head north,” BJ told the cabdriver. “But push it, man.”

     The Pakistani cabdriver gave BJ a questioning look, but then did as he was told. BJ kept Slam’s cab in sight, aided by the fact that it had a broken taillight.

     Jack jumped out of the cab and dashed into the General and across the lobby. The masks had been dispensed with now that the meningococcal scare had passed, so Jack couldn’t use one to hide behind. Concerned about being recognized, he wanted to spend the least time possible in the hospital’s public places.

     He pushed through the doors into the administrative area, hoping that Kathy had been right about Kelley’s being occupied. The sounds of the hospital died away as the doors closed behind him. He was in a carpeted hall. Happily, he saw no one he recognized.

     Jack approached the first secretary he came upon and asked for Kathy McBane’s office. He was directed to the third door on the right. Losing no time, Jack hustled down there and stepped in.

     “Hello,” Jack called out as he closed the door behind him. “I hope you don’t mind my shutting us in like this. I know it’s presumptuous, but as I explained there are a few people I don’t want to see.”

     “If it makes you feel better, by all means,” Kathy said. “Come and sit down.”

     Jack took one of the seats facing the desk. It was a small office with barely enough room for a desk, two facing chairs, and a file cabinet. The walls had a series of diplomas and licenses attesting to Kathy’s impressive credentials. The decoration was spartan but comfortable. There were family photos on the desk.

     Kathy herself appeared as Jack remembered her: friendly and open.

     She had a round face with small, delicate features. Her smile came easily.

     “I’m very concerned about this recent case of primary influenza pneumonia,” Jack said, losing no time. “What’s been the reaction of the Infection Control Committee?”

     “We’ve not met yet,” Kathy said. “After all, the patient just passed away last night.”

     “Have you spoken about it with any of the other members?” Jack asked.

     “No,” Kathy admitted. “Why are you so concerned? We’ve seen a lot of influenza this season. Frankly, this case hasn’t bothered me anywhere near the way the others did, particularly the meningococcus.”

     “It bothers me because of a pattern,” Jack said. “It presented as a fulminant form of a pneumonia just like the other, rarer diseases. The difference is that with influenza the infectivity is higher. It doesn’t need a vector. It spreads person to person.”

     “I understand that,” Kathy said. “But as I’ve pointed out we’ve been seeing influenza all winter long.”

     “Primary influenza pneumonia?” Jack questioned.

     “Well, no,” Kathy admitted.

     “This morning I had someone check to see if there were any other similar cases currently in the hospital,” Jack said. “There weren’t. Do you know if there are now?”

     “Not that I am aware of,” Kathy said.

     “Could you check?” Jack asked.

     Kathy turned to her terminal and punched in a query. The answer flashed back in an instant. There were no cases of influenza pneumonia.

     “All right,” Jack said. “Let’s try something else. The patient’s name was Kevin Carpenter. Where was his room in the hospital?”

     “He was on the orthopedic floor,” Kathy said.

     “His symptoms started at six P.M.,” Jack said. “Let’s see if any of the orthopedic nurses on the evening shift are sick.”

     Kathy hesitated for a moment, then turned back to her computer terminal. It took her several minutes to get the list and the phone numbers.

     “You want me to call them now?” Kathy asked. “They’re due in for their shift in just a couple of hours.”

     “If you don’t mind,” Jack said.

     Kathy started making the calls. On her second call, to a Ms. Kim Spensor, she discovered that the woman was ill. In fact, she’d just been preparing to call in sick. She admitted to severe flu symptoms with a temperature of almost 104°.

     “Would you mind if I talked with her?” Jack asked.

     Kathy asked Kim if she’d be willing to speak to a doctor who was in her office. Kim apparently agreed, because Kathy handed the phone to Jack.

     Jack introduced himself, but not as a medical examiner. He commiserated with her about her illness, and then inquired about her symptoms.

     “It started abruptly,” Kim said. “One minute I was fine; the next minute I had a terrible headache and a shaking chill. Also, my muscles are aching, particularly my lower back. I’ve had the flu before, but this is the worst I’ve ever felt.”

     “Any cough?” Jack asked.

     “A little,” Kim said. “And it’s been getting worse.”

     “How about substernal pain?” Jack asked. “Behind your breastbone when you breathe in?”

     “Yes,” Kim said. “Does that mean anything in particular?”

     “Did you have much contact with a patient by the name of Carpenter?” Jack asked.

     “I did,” Kim said. “And so did the LPN, George Haselton. Mr. Carpenter was a demanding patient once he started complaining of headache and chills. You don’t think my contact with him could be the cause of my symptoms, do you? I mean, the incubation period for the flu is more than twenty-four hours.”

     “I’m not an infectious disease specialist,” Jack said. “I truly don’t know. But I’d recommend you take some rimantadine.”

     “How is Mr. Carpenter?” Kim asked.

     “If you give me the name of your local pharmacy I’ll call you in a prescription,” Jack said, purposefully ignoring Kim’s question. Obviously his fulminant course started after Kim’s shift had departed.

     As soon as he could, Jack terminated the conversation. He handed the phone back to Kathy. “I don’t like this,” Jack said. “It’s just what I was afraid of.”

     “Aren’t you being an alarmist?” Kathy questioned. “I’d guess two to three percent of the hospital personnel are out with the flu currently.”

     “Let’s call George Haselton,” Jack said.

     George Haselton turned out to be even sicker than Kim; he’d already called in sick to the floor supervisor. Jack didn’t talk to him. He simply listened to Kathy’s side of the conversation.

     Kathy hung up slowly. “Now you’re starting to get me worried,” she admitted.

     They called the rest of the evening shift for the orthopedic floor, including the ward secretary. No one else was ill.

     “Let’s try another department,” Jack said. “Someone from the lab must have been in to see Carpenter. How can we check?”

     “I’ll call Ginny Whalen in personnel,” Kathy said, picking up the phone again.

     A half hour later they had the full picture. Four people had symptoms of a bad case of the flu. Besides the two nurses, one of the evening microbiology techs had abruptly experienced sore throat, headache, shaking chill, muscle pain, cough, and substernal discomfort. His contact with Kevin Carpenter had occurred about ten o’clock in the evening, when he’d visited the patient to obtain a sputum culture.

     The final person from the evening shift who was similarly ill was Gloria Hernandez. To Kathy’s surprise but not Jack’s, she worked in central supply and had had no contact with Kevin Carpenter. “She can’t be related to the others,” Kathy said.

     “I wouldn’t be too sure,” Jack said. He then reminded her that someone from central supply had perished with each of the other recent infectious cases. “I’m surprised this hasn’t been a topic of debate with the Infection Control Committee. I know for a fact that both Dr. Zimmerman and Dr. Abelard are aware of the connection, because they have been to central supply to talk to the supervisor, Mrs. Zarelli.”

     “We haven’t had a formal committee meeting since all this started,” Kathy said. “We meet on the first Monday of each month.”

     “Then Dr. Zimmerman is not keeping you informed,” Jack said.

     “It wouldn’t be the first time,” Kathy said. “We’ve never been on the best of terms.”

     “Speaking of Mrs. Zarelli,” Jack said. “She’d promised me printouts of everything central supply had sent to each of the index cases. Could we see if she has them and, if so, have her bring them down?”

     Having absorbed some of Jack’s anxiety about the influenza, Kathy was eager to help. After talking briefly to Mrs. Zarelli and ascertaining that the printouts were available, Kathy had one of the administrative secretaries run up to get them.

     “Let me have Gloria Hernandez’s phone number,” Jack said. “In fact, give me her address as well. This central supply connection is a mystery that for the life of me, I can’t understand. It can’t be coincidence and could be key to understanding what is going on.”