Error in Diagnosis (32 page)

It was eleven
P.M.
Three hours earlier, Jack had given Tess her second injection of the Streptogenase V. Jack was used to working long hours, but the amount of time he'd been out of the hospital over the past few days could be calculated with an egg timer. Adding to his fatigue and stress, he was dealing with Mike's unchecked anxiety and unpredictable mood swings. If it were possible to do so, Helen made matters worse by phoning Jack and Madison to remind them that unless Tess showed true signs of recovery by the morning of the twenty-sixth, Hollis Sinclair's Vitracide program would begin. It was a reminder neither of them needed nor wanted to hear.

An hour after Jack had given Tess the second injection, he convinced Mike to go home and get a few hours of rest. At the moment, he was alone in the room with Tess. True to Dr. Tau's warnings, Tess developed a high fever
after the second dose. Jack was just about to do another neurologic examination when Mike came through the door.

“I wasn't expecting you back for another couple of hours.”

“I couldn't sleep. It hasn't exactly been the Christmas Eve I was hoping for,” Mike answered in a deadpan voice as he made his way over to the bed. “Has there been any change?”

A short breath slipped from Jack's lungs as he shook his head and answered, “Not yet, I'm afraid.”

With defeat spreading across his face, Mike placed his hand on Tess's and then curled his pinky around hers.

“Did Madison come back in to check on the baby?”

“Right after you left. She said she's still in mild distress but holding her own.”

“How much more of this can the two of them take?” he muttered. “Sinclair left me a message. He wants to reschedule the C-section for the day after Christmas and start Vitracide six hours later. He's certainly no amateur when it comes to cranking up the pressure. He didn't mention a single word about what's going on.”

“What are you going to do?”

“I don't know. That's a day and a half away. I guess we can talk about it later.”

Jack had the feeling Mike had already made up his mind but couldn't find the words to tell him.

“Maybe you should consider speaking with Madison again before making a final decision.”

When Mike didn't answer, Jack shifted his gaze to him.
His posture was statue-like. His lips were widely parted and his eyes were fixed on Tess. Suddenly, he sucked in a couple of fragmented breaths. Jack reached for the hand control and turned the dimmer on the overhead lights all the way up. Jack's own breath snagged, leaving him feeling as if he had been robbed of his air by a powerful blow to his abdomen.

Tess's eyes no longer appeared inert and hollow. To the contrary, they were without glaze and focused on Mike. Her complexion, which for weeks had been chalk-like was now a muted shade of red. And for the first time, there was true animation to her face.

Jack took a few steps back, reached for a chair and slid it next to the bed. “Go ahead,” he told Mike, lightly placing his hand on his shoulder.

Covering his mouth with his hand, Mike sat down and leaned forward over the bed. He waited a few seconds and then placed his hand on top of Tess's. For a minute or so, he said nothing. Then, barely noticeably at first, Tess slipped her hand out from under Mike's. It wasn't a reflex or a random movement; it had purpose to it.

Mike spoke to Tess in just above a whisper. She didn't respond in words but her changing expressions spoke volumes. He talked to her as if he had no concern she understood every word he uttered. He brought her up to date on everything from her charity work to how much her family and friends loved and missed her. Looking through wet eyes, he told her their baby was fine and how much he needed her to get better.

Suddenly, Mike's face blanched in disbelief. When Jack
looked back at Tess, he understood why. She had moved her hand on top of Mike's, and the unforgettable smile that made her Tess Ryan was upon her face.

Choking back his own tears, Jack lowered his head and whispered into his best friend's ear, “I wouldn't have said this five minutes ago, but I bet this turns out to be the best Christmas of your life.”

Renatta Brickell was half-asleep when she glanced over at the digital clock on her nightstand. She had always been an early riser, but five thirty was a little extreme even for her. She pushed herself up against the leather headboard and then looked over at her husband who slept soundly. It had become an unshakable tradition for them to sleep late on Christmas morning. Once they were up, they shared a breakfast of strawberry pancakes heaped high with whipped cream and then opened their gifts. Over the years, the day had become one they both looked forward to with great anticipation. But this year, with the GNS crisis looming over the country like a stubborn ocean fog, it seemed like just another day to Renatta. Although they hadn't discussed it specifically, she suspected her husband felt the same way.

She was considering getting out of bed when her
phone rang. Her staff knew she didn't mind being called early, but she doubted even they would call her at such an hour on Christmas morning. She reached for her cell phone and checked the caller ID. A little surprised, she took the call.

“Good morning, Helen,” she said, bracing herself for bad news regarding Tess Ryan or one of the other GNS patients at Southeastern State.

“I apologize for disturbing you so early.”

“Actually, I was awake. Under the circumstances, it just doesn't seem like Christmas morning.”

“My information's still rather preliminary,” Helen began in a cautious voice, “but I have reason to believe we've made a major breakthrough.” Renatta threw back her comforter and shifted her legs over the side of the bed. “A few hours ago, Tess Ryan began showing signs of improvement. It began with her opening her eyes and displaying purposeful movement. Since then, she's become even more alert. I'm here at the hospital now. In the last hour, she's uttered a few words and has been responding to simple commands.”

“How can we be sure this is all related to the streptococcus therapy?” Renatta asked. “Perhaps we're just seeing the beginning of spontaneous recovery.”

“I don't think so. None of our other patients are showing any signs of improvement. We've also been calling as many of the other hospitals as we can. None of them have seen even the slightest hint of recovery in any of their patients.”

“It's only been a few hours,” Renatta said. “It would
be nice to keep things quiet for a while to see if she continues to improve. This is wonderful news but it may be a little premature to declare GNS has been cured and begin a national celebration.”

“I understand.”

Shaking the last bit of sleep from her mind, she stood up, “Is there any possibility this has already leaked out to the media?”

“I've no way of knowing for sure, but our staff has been advised in no uncertain terms that family and patient confidentiality is of paramount importance, and that they would be putting their jobs at risk if they spoke to anybody.”

“I appreciate you calling. Could you phone me again in a few hours to let me know what's happening?”

“Of course.”

Brickell glanced out of her window. It wasn't very often she turned to divine intervention but on this occasion, she made an exception and said a short prayer. She slipped on her robe, crept out of the bedroom and then climbed the circular staircase to her third-floor library. She knew the intelligent thing to do before calling President Kellar would be to wait for Helen Morales's next call. That way it would be a little later in the morning and she'd have more information to share with him. For the moment, she was a tad short on answers—a situation she knew from personal experience the president found irritating. The more she thought about the strategy, the more convinced she became that a short period of watchful waiting was the prudent way to go before phoning Kellar.

Sitting at her desk, she had a sudden craving for her morning coffee. With her mind still racing, she turned off the highly polished brass desk lamp and left the library. She was halfway down the spiral stairway when she stopped. She'd never been one to rely heavily on intuition, but just this once she was going to make an exception. She could feel it in every cell of her being—the enigma that was GNS had been solved and one of the worst outbreaks in modern history was about to come to an end.

Renatta reached the bottom of the staircase where her eye was caught by the phone sitting on her hall table. A few seconds passed and a slight smile crept to her face.

“The hell with good sense and optimal timing,” she muttered. And then, without an instant's hesitation, she walked over to the table, picked up the phone and tapped in the number to the White House.

DECEMBER TWENTY-EIGHTH

East Room of the White House

For the first time since she had accepted President Stephen Kellar's invitation to serve as the surgeon general of the United States, Renatta Brickell felt no apprehension stepping up to the lectern. To the contrary, she was bursting with anticipation at the prospect of addressing the press corps. Even with the president in attendance, standing a few feet from her, she felt completely confident.

“Good morning, ladies and gentlemen. My statement this morning is one of profound national importance.” She waited for the murmur to die down before going on. “I understand the rumors regarding GNS have reached enormous proportions. My hope is to dispel all of them today.” She paused long enough to allow her comments
to be well seeded in the minds of the reporters. “Several days ago, a patient with GNS underwent a bold treatment to cure her disease. It involved both a surgical procedure and an innovative new therapy. I am extremely happy to report that she is now well on her way to making a full recovery. She is alert and responding to questions, and almost all of her symptoms have disappeared.” Renatta stopped just for a few seconds and raised her eyes, expecting a barrage of questions. Instead, the room was overtaken with a ghostly silence. She went on, “It is the opinion of the Presidential Task Force on GNS that this disease is being caused by the interaction of three factors, and that all three must be present for a woman to contract the illness. The first is an unusual genetic profile termed chimerism; the second is the altered hormonal state of pregnancy; and the third is the administration of a specific type of flu vaccine. The combination of these factors creates an illness that is quite similar to lupus or rheumatoid arthritis where abnormal antibodies attack the brain. Several days ago, researchers at Southeastern State were able to formulate a multifaceted treatment plan that reverses that process.”

The end of her remarks met with a flurry of hands. She recognized Edmond Carlisle from the Associated Press.

“What about the babies? Will you be recommending termination for those under twenty-six weeks?”

“No. We believe once the mothers are cured, the babies will follow suit.”

Renatta next gestured at Larry Jensen, representing Reuters.

“Since the beginning there have been rumors that GNS might be the result of a terrorist act. Are you saying that possibility no longer exists?”

“After doing an exhaustive investigation, it is the firm belief of the FBI that GNS is categorically not an act of biological warfare.”

Jensen then asked, “Can we assume the same is true for some type of environmental toxin?”

“Based on the research done at Southeastern State, we are comfortable we have identified the cause of GNS, and it's not in any way related to an environmental toxin, be it an e-waste product or nanotoxin.”

“Do you anticipate having enough of this special strep injection?”

“We prefer to think of it as a vaccine. We presently have twelve separate facilities manufacturing the product. We do not anticipate having a shortage.”

“In that case, when do you expect to complete treatment on a national level?”

“Obviously from a logistical standpoint, we're looking at a monumental project. Our latest projection is to have every woman treated by the end of the second week in January.”

“Have you determined what's wrong with the flu vaccine?”

“We don't believe there's anything wrong with the vaccine. The process to manufacture vaccines changes all the time. Our theory is that there's a complex interaction between these two particular vaccines and the chimera cells that makes certain pregnant women susceptible to GNS.”

“Any idea what that interaction is?”

“At this time, no. But our scientists are already at work trying to answer that question.”

Renatta again scanned the room. She pointed toward the back at Alice Quay of the
Cleveland Plain Dealer
.

“Assuming this outbreak of GNS is now cured, what's to prevent another outbreak in the future?”

“The only way to prevent another outbreak is to develop a test capable of predicting if a particular vaccine will trigger the body to produce toxic proteins. The development of such a test will of course be of the highest priority.”

“Is there any way of knowing if there's been any long-term injury to the babies?”

“The simple answer to your question is no. However, our perinatologists continue to advise us that the babies appear to be holding their own. Obviously, we expect to have a lot more information as the women recover and begin to deliver.”

For the next thirty minutes, Renatta answered questions. What followed when she finally brought the press briefing to a conclusion was unprecedented. With her first step back from the lectern, every reporter in the room came to their feet and participated in a jubilant display of applause and cheering. Renatta watched for a few seconds and then returned to the podium. With her signature smile, she raised her hands high over her head in a gesture of absolute triumph.