Error in Diagnosis (21 page)

Jack barely noticed when Marc and Madison came through the door of the crisis center. He had spent the last hour poring over the latest information posted on the Data Record.

“Okay, we're here,” she said, sitting down directly across from him. “What's going on?”

“As of nine o'clock this morning, there are about a hundred and thirty women hospitalized in South Florida with GNS. I've spent the last hour looking at their obstetric records.”

“I thought we covered that ground already,” Madison informed him.

“I'm looking specifically at each of their vaccination records.”

“All the way back to childhood?” Marc asked.

“Actually, I'm only interested in whether they received
the most recent flu vaccine.” Jack paused long enough to study their dubious expressions. “The new vaccine became available nationally about ten weeks ago. According to our records, two hundred sixty-five of the GNS patients definitely received the vaccine; the other thirteen we have no records on.” He closed the lid to the laptop, folded his arms in front of his chest and added, “I can't find a single patient who definitely did not receive the flu vaccine.”

Marc said, “Maybe it's just a coincidence. There are thousands of women with GNS. Looking at two hundred and seventy-eight of them . . . well, it might not prove a thing.”

“I couldn't agree with you more,” Jack was quick to say. “That's why we're going to expand the search. All the information's right here in front of us. We can start by checking the hospitals in Orlando, Tampa and Jacksonville. That would increase our patient population base to almost three hundred, which should be enough to at least suggest a trend.”

With a less than convinced expression, Madison asked, “When are we going to do that?”

“There's no time like the present.”

For the next half hour the three of them combined their efforts to comb through the patients' vaccine records. When they were finished they projected their results on the large screen.

“The information's about the same for all seven hospitals,” Jack said. “Two hundred and sixy-five women who were definitely vaccinated. There are thirteen with no
record one way or the other.” He looked up and smiled. “What's interesting is that there's not a single patient whose record clearly states she did not receive the flu shot.” He paused for a few seconds and then asked, “What do you think?”

“There are only two possibilities,” Marc answered. “It's either an incredible coincidence or there's a definite connection between the vaccine and GNS.”

“What next?” Madison asked.

“We check with the families of the thirteen patients to find out for sure if they received the vaccine or not.”

“I hate to point out the obvious,” she said, “but the flu vaccine is strongly recommended in pregnancy. There's no medical controversy about it.”

“Your point?”

“Maybe all this isn't as earth-shattering a revelation as you think. Maybe it's no surprise that almost all of them got the flu shot.”

Jack raised his index finger. “Most patients follow their doctor's recommendations. But there are those that don't, especially when it comes to vaccinations. Maybe they had a prior bad reaction, or maybe they read somewhere or talked to somebody who advised against it. There's a ton of anti-vaccine stuff out there. I have patients, friends including physicians who wanted nothing to do with the flu vaccine.”

“I'm one of them,” Marc confessed, with a casual shrug.

“Okay, for argument's sake, let's assume you're right and the flu vaccine is somehow tied into GNS. How do you explain all the pregnant women who had the
vaccination and never got GNS? I ask the question because for every one vaccinated woman, there have to be thousands more pregnant women who were vaccinated, but never got sick. What about them? What made them so fortunate to be immune?”

“My best guess is that all the women with GNS have some other factor or condition in common that made them susceptible. When we figure out what that factor is, we'll have the final piece to the puzzle.”

“When the Salk vaccine was first introduced, there was a bad batch and a lot of people got very sick,” Marc said. “It doesn't sound like you're suggesting GNS is a tainted vaccine problem.”

“I'm not. I believe the problem lies with the women themselves. My guess is there's something about the vaccine that changes their basic metabolism or immunological system. Whatever that change is makes the victim predisposed to getting GNS.”

“But you have absolutely no idea what that factor is,” Madison said.

“None whatsoever.”

“So, where do we go from here?”

“I assume none of us knows too much about who manufactures the flu vaccine or how it gets distributed. So, somebody needs to become an expert on the topic ASAP.”

As if it had been choreographed in advance, Jack and Madison eyes fell on Marc at the same moment. He returned their knowing stares with a sneer.

“The trickle-down theory at its best,” he complained.
“I'll get some of the residents and med students to help me.”

“I'd start with the CDC,” Jack advised. “We need to know the name of every pharmaceutical company that manufactures the flu vaccine and their specific areas of distribution. I would also check with the FDA to get a list of all reported adverse and allergic reactions to the vaccine. And we need all of this information as soon as possible.”

“No problem,” Marc said. “I do my best work with a sword of Damocles hanging over my head.”

“I'm afraid the sword's hanging over all of our heads,” Jack said. “At best, we only have a few days to figure this thing out before Vitracide therapy starts on a national level.”

“Supposing you're right about this vaccine thing, what do we do about it?” Madison asked.

“I'm not sure.” With a subtle grin, he added, “Maybe that's one of those bridges you jump off when you get to it that you're always telling me about.”

Jack was certain of one thing. He knew if his theory panned out, he'd have to share it with other doctors for their scrutiny and input. He realized as soon as he did, Hollis Sinclair and the naysayers who supported his parvovirus theory would label him a heretic. For the moment, he forced himself to push the problem of Sinclair from his mind. Every particle of his being was sure he was onto something, and the last thing he needed was to allow the politics of the situation to distract him.

It was seven
P.M.,
and Jack had just finished a three-mile jog on the beach. On his way back to the hotel, he glanced overhead at a formation of gray catacombed clouds that had just moved in from the west. Feeling as if the temperature had dropped ten degrees, he crossed his arms across his chest. A few moments later his cell phone rang.

“You sound like you're still running,” Marc said.

“I just finished a couple minutes ago,” he answered with clipped words wedged between heavy breaths. “What's going on?”

“I have some interesting information on the flu vaccine.”

Jack slowed his pace. It was getting windier with each passing minute, but he decided to sit down on a bench instead of going back inside the hotel.

“What did you find out?”

“There are seven companies that manufacture the vaccine. Six of them are distributed in the United States. We wound up spending most of the day on the phone calling clinics and obstetricians' offices trying to get a general idea of which vaccine each woman received. We were able to get specific information on one hundred eighty-one of them.”

“Was it an even distribution of all six companies?”

“Not even close. All of the women with GNS received a vaccine manufactured by one of two companies; either Aptiprev or Ontryx. They're both European companies.”

“Are they distributing in Europe, because to my knowledge there are no cases there?”

“Not yet. The U.S. demand was too high.”

“You're absolutely sure none of the women received the vaccine from any of the other four manufacturers?”

“No way. I'm positive.”

“Were you able to check with the FDA if there have been any problems with either of those two companies?”

“It took a while but I finally got through to them. They have no record of any significant side effects.”

Jack puffed out a few quick breaths.

“We need specific information from the two companies regarding the national distribution of their vaccines. We have to know if it's available in all areas of the country where we're seeing cases of GNS. We also have to find out exactly how their vaccines are produced. They must be doing something different than the other manufacturers.”

“I assumed you'd want that information so we're already working on it.”

“Is Madison up to speed on all this?” Jack asked.

“That was going to be my next phone call.”

“And Dr. Morales?”

“I assumed either you or Madison would want to let her know.”

“Thanks,” Jack told him. “I'll discuss it with Madison.” His feeling was that as a visiting professor, it would be more appropriate if the call came from Madison. “What do you think about getting some more help and expanding our inquiries to other hospitals across the country?”

“You must be reading my mind. I already have some new volunteers. I know it's a little late but we're having our first meeting in about an hour in the crisis center.”

After going over everything they had discussed again, Jack told Marc he'd speak to him later. He then headed up to his room to grab a shower before calling Madison. He assumed as soon as she brought Helen up to speed on the latest developments, she'd want a sit-down with Sinclair. She hadn't said it in so many words, but Jack suspected she didn't embrace his parvovirus theory. Jack clung to one hope: that for every hour Helen Morales could keep Sinclair from convincing the hospital board to support Vitracide therapy, he and Madison would be that much closer to finding the real cause of GNS.

Alik Vosky looked up and down the hall one final time before opening the door to Southeastern State Hospital's environmental services department. He walked down a faintly lit corridor unit he reached a lengthy row of double lockers. Trying each of the lockers in turn, he found himself somewhere between pleased and surprised to find so many of them open. Well before he reached the final locker, he found a standard-issue powder blue golf shirt with the hospital's logo on it and a tool belt. It further delighted him to find Max Shudderman's identification badge clipped to the pocket. After a quick look around, Vosky changed his shirt and left the locker room.

It was no secret that every hospital involved in the care of GNS patients had a designated crisis center. By asking an unassuming elderly volunteer, it didn't take him long to find out where Southeastern State's was located.

Under the guise of fixing a faulty thermostat, he opened the door and walked in. As he assumed before leaving his hotel, the late hour would increase the likelihood of being left undisturbed while he gained access to the National Patient Data Record. With his computer skills, he had no concerns that in short order he'd be able to penetrate the Data Record's security system.

He chose the computer closest to the thermostat in case someone saw him. He wasn't at work on the keyboard for more than a minute or two when he heard voices outside the room. After an annoyed half sigh, he stood up and took the few steps over to the wall. He reached for a small Phillips-head screwdriver from the tool belt and removed the outer case of the thermostat.

While Vosky pretended to be working, Marc and several of the residents and medical students sat down around the table. He didn't acknowledge any of the group, and they treated him as if he were invisible. He was, however in an excellent position to hear everything they were saying. He hoped they wouldn't be there long, allowing him another opportunity to hack into the Data Record.

“I know it's late,” Marc told the group, raising his hands in the air, “but Dr. Wyatt really needs the flu vaccine information as soon as possible. If we all work together on this thing we can be out of here in an hour.”

For the next forty minutes, Vosky listened to everything that was said. The information he gathered regarding Dr. Jack Wyatt and his flu vaccine theory was, in his mind, beyond fortuitous—it was fate. He decided
against trying to wait out the research group any longer and reattached the outer case of the thermostat. Vosky made his way out of the crisis center.

The pain in the back of his head and neck, which he'd first noted before he left his hotel, reached a crescendo. He rubbed his neck slowly, refusing to allow something as subjective as pain to interfere with his thought processes. Everything was clear to him now. He had been completely wrong about Hollis Sinclair. He was an amateur and posed no risk, but Dr. Jack Wyatt was different. Vosky didn't understand how, but Wyatt had somehow managed to stumble upon the key element of his work. Ultimately, the question was purely an academic one because the manner in which Wyatt had discovered the truth behind GNS was irrelevant. The only thing that mattered was to assure the spread of GNS would continue without interruption.

He thought about a professor he had idolized while obtaining his doctorate. The old man's life's lessons had a strange but logical way of intersecting with certain tenets of scientific research. One of Vosky's favorites was that sometimes the best solution to a highly complex problem was so simple—it was a gift.

An easy grin came to his face. There was no question in his mind what he had to do. As much as he hated to admit it, he had been a fool. Hollis Sinclair was nothing more than a clever decoy. For all his showboating, he wasn't larger than life; he was a buffoon. If given all the time in the world, he'd never figure out how to stop GNS.
Vosky's task was simple. It was an easy matter of simply changing his focus from Hollis Sinclair to Dr. Jack Wyatt. The small variation in his plan would ensure GNS would continue to spread through the United States like a brush fire in a gusty wind.