Fatal (27 page)

“You know,” Strawbridge said, “we diplomats are taught never to give away something for nothing. If I hand over these documents, I do have a request of my own.”

“Yes?”

“Ever since they chose to hang on to their vaccine until we could meet their price demands, my government has been very disappointed with the people at Columbia Pharmaceuticals. If there is any way you uncover that we might, how should I say, make life more difficult for them, I would like your word that you will let me know.”

ELLEN SAT ON 
a sunlit bench in DuPont Circle, cradling her cell phone in her lap and following one passing couple after another. Andrew Strawbridge had come through not only with the passenger manifests of the Sierra National flights, but with those of Ghana Air as well. The next logical step would be to interview some of the few surviving Lassa fever victims. She had enough of a credit line on her Visa to make any necessary flights.

Since the confrontation in her living room with the monster who threatened her grandchild, she had been consumed with finding a way to bring the production and distribution of Omnivax to a halt without endangering Lucy or anyone else in her family. The man’s huge head, soulless eyes, and hallmark scar burned in her mind. Somehow she was going to find him. She was going to find him, and when she did, she would also find the means to destroy him in as painful a way as possible. Surprisingly to her, over the days since he appeared in her living room with his smugness and his threats, she had realized in her heart that she was perfectly capable of killing such a man. But in the meantime, she would take whatever chances were necessary to bring down those who had hired him. The problem was that, suddenly, she didn’t want to do it alone.

Over the years since Howard’s departure she had managed to hold her vulnerability and loneliness in check. Reading Rudy’s letter had changed things. Suddenly she felt uncertain and frightened. The last thing she needed at this point was to lose her incisiveness—to dilute in any way the hatred that was driving her. But that was exactly what appeared to be happening.

The first of the cases on the list Rudy had obtained did not answer the phone and had no machine or service. A man answered Ellen’s second call and assured her that, yes, his wife had survived her terrible illness, and yes, they would be happy to meet with Ellen after his wife returned home from work.

Next Ellen called information and jotted down the number of United Airlines. Then, barely realizing what she was doing, she dialed Rudy’s cabin.

“Hello?”

“Rudy, hi, it’s me.”

“Calling from the big city?” he asked with a make-believe twang.

“DuPont Circle.”

“How’d ya make out?”

“Six cases in three years, Rudy. That’s the sum total of all the Americans infected with Lassa in Sierra Leone. Six. Three were hospital workers.”

Rudy whistled.

“I don’t think I need my degree in statistics to know that ain’t very many compared with those who got infected on those airplane flights,” he said.

“I think not. Strawbridge gave me the manifests, too. All eighteen of them. I’ve already contacted one of the patients from your list. She lives outside of Chicago.”

“Going to go see her?”

“I want to.”

“Well, I say go for it.”

“Rudy?”

“Yes?”

“I . . . I want you to come with me.”

“Hey, that’s very nice of you. When are you going?”

“Today. This afternoon.”

“Oh, shoot. I’m really sorry, El, but I have a class to teach and a private lesson. I’m afraid tomorrow’s tight, too. I have this family of Russian immigrants that I teach English grammar and reading to. I might be able to change them to another day if I can get ahold of them, but they don’t have a phone and—”

Ellen watched a couple snuggling on a bench across from hers, and felt a knot in her chest.

“No, no. Please don’t change your plans,” she managed. “I’ll be fine. I’ll fly in and back, and drive out to the cabin late tonight or first thing in the morning.”

“You’re right,” Rudy said. “You
will
do fine. Who’s the woman? Where does she live?”

“She lives in Evanston. Her name’s Serwanga. Nattie Serwanga.”

 
CHAPTER
24

THE MASSIVE KILLER MOVED ACROSS THE FLOOR 
with surprising stealth and closed in on Nikki as she slept. Her eyes opened a slit, but it was too late. Before she could make a sound, his huge, fleshy palm clamped over her mouth. His knee ground into the small of her back, increasing pressure on her spine until she knew it was going to crack in two.

Please, no! Please stop!
her mind screamed.
I don’t want to be paralyzed!

Paralyzing her was clearly only part of what the man had in mind. He had tried to kill her before and botched it. He was not going to miss again. His moon face puffed into a lurid smile as he hooked his fingers beneath her chin and pulled her head back. His knee was pressing straight through her body.

Nikki awoke lost and totally disoriented, clawing at her pillow. The air in the strange room felt thick and stagnant. Then, as she was forcing herself to calm down, she heard the steady breathing of the man lying next to her. Startled, she sat up on the side of the bed, trying to ignore the land mines exploding behind her eyes. The sight of Matt Rutledge, sleeping deeply, his face peaceful and unlined, brushed aside the last of what had been a series of exquisitely vivid and frightening nightmares. A piece at a time, some of the events of the night just past drifted into place. The man lying there, her doctor, had saved her from certain torture and probable death—just rode in on his motorcycle and saved her life. She wondered how much her managed-care insurance carrier allowed for that service.

The postage-stamp room featured a bed that was probably rented out as a queen, but looked smaller, and a fan-back, white wicker chair. In addition, there was a small, three-drawer bureau with some clothes neatly folded on top. Nikki padded to the tiny bathroom, washed her face with cold water, then brushed her teeth and hair with brand-new supplies that seemed to be waiting there for her. Her arms were a mass of bruises from IVs, blood drawing, and God only knew what else. There was a thick, tender scab, an inch or two long, just above her right ear. She felt certain she knew what had caused it, but with her thoughts careening about like bumper cars, she just couldn’t seem to get her mind around anything specific.

She returned to the bedroom, settled onto the wicker chair, and dropped her feet heavily onto the bed. The impact was enough to visibly jar Matt, but he lay there undisturbed, his half smile suggesting that whatever
his
current dream, it was far removed from those that had been tormenting her. He had kicked the sheet aside, and lay there in a pair of sweat pants, naked from the hips up. He had the full waist and broad shoulders of an athlete past his prime, but managing to keep up. She had never been particularly drawn to men who wore their hair in a ponytail, but his seemed to fit his rugged features well. All in all, he was not Hollywood handsome, but he was damn attractive in most of the physical ways that mattered to her—and he had just saved her life. She knelt by the bed and studied the tattoo on his deltoid. It was—what had he said?—a hawthorn tree, about two inches high—beautifully rendered as far as she could tell. Because of her own unusual tattoo, she always paid attention to them on others. A tree was a first. There was a story there, she was certain of that. She brought her face up so that her eyes were just a few inches from his. She felt his breath and expected him to react in some way to her closeness. Nothing. He continued his sleep and, judging from his peaceful expression, his dream as well.

The clock radio on the bureau read seven-thirty, which more or less corresponded to the light filtering through the curtains. It seemed like waking her new roommate was going to take nothing short of a frontal assault, but not just yet. She shifted back onto the chair and sorted through what she could remember of the strange and deadly events since her departure from Boston. One thing, and maybe only one, was clear—Kathy Wilson was at the center of whatever was going on. She was one of at least three people from Belinda with a bizarre, terrifying, inexorably lethal syndrome. Matt was certain that a toxic exposure was responsible for the unusual constellation of signs and symptoms. His theory made as much sense as anything did, especially backed up by his discovery of large-scale toxic waste storage in a cave near the Belinda mine. But what was Kathy’s connection with the mine? And why did the chief of police send men to kill Nikki and subsequently become obsessed with finding out whom she had spoken to about Kathy’s condition?

At the moment, she didn’t have the wisp of an answer to any of her own questions. But knowing Joe Keller as she did, if there was a clue in the anatomy of Kathy’s nervous system, he would find it. There was a phone on the bureau with a note taped to it that local calls were free and long-distance calls had to be collect or credit card. Holding her breath, she dialed 1-800-COLLECT and placed a call to what she hoped her disrupted memory had held on to as Joe Keller’s direct line. If the clock radio was correct, her boss would have been at the office for an hour already—possibly two—sipping his thick black coffee and working out anatomic and biochemical puzzles.

“Bless you,” she muttered when his voice came on the line and accepted the prompt to say “yes.”

“Joe, I’m all right,” she said quickly.

“Thank God. People have been very worried about you. We even called the police.”

Nikki started to explain that a chief of police was, in fact, responsible for her trouble, but quickly stopped herself. There would be time.

“I’m on my way home right now. I should be there by late tonight.”

“Excellent.”

“Joe, I’ve had some trouble in West Virginia related to my friend Kathy—the one you autopsied.”

“What sort of trouble?”

“There are two other cases down here that looked and acted exactly like hers—neurofibromas and progressive paranoid insanity.”

“Well, now, that
is
something,” Keller said. “You see, your instincts were absolutely correct in this case. I am looking at the slides of Miss Wilson’s brain right now. She has unmistakable spongiform encephalopathy.”

Spongiform encephalopathy.
Nikki caught her breath. The degenerative, transmittable, ultimately fatal nervous-system disease had a number of forms, including a syndrome called Creutzfeldt-Jakob disease; kuru, once found in the brain-eating cannibals of New Guinea; fatal familial insomnia; and bovine spongiform encephalopathy, also known as BSE, or more commonly, Mad Cow disease.

Excitedly, Nikki stretched out and kicked Matt firmly on the sole of his foot. He bunched his pillow beneath his head and pulled his foot away. She kicked him again, even more forcefully, this time with her heel against his calf. He moaned and began to stir.

“Go on, Joe,” she said, knowing better than to ask if he was sure. “This is quite incredible.”

“You say there are two other cases where you are?”

“In the town where Kathy grew up, yes.”

One final kick and it was clear Matt had at last ascended to a higher plane of wakefulness. If he hadn’t taken some sort of drug, he was a candidate for the
Guinness Book of Records
. Her clients in the coroner’s office were easier to rouse.

“And these other cases,” Keller asked, “they had spongiform encephalopathy also?”

“I don’t know. Their brains appeared normal on gross exam, so the microscopic wasn’t done.”

SE was caused by germs known as prions—infectious protein particles capable of reproducing themselves without DNA or RNA. One of the characteristics of SE was that despite an often spectacular clinical picture, the brain looked grossly normal until sections of it were examined under the microscope, where diffuse, sponge-like holes could be seen. Another characteristic was that the incubation period of the disease was often a decade or more, during which time the victim might well be infectious to others.

“Did these cases of yours also have neurofibromas?” Keller asked.

Matt was awake now, pawing sleep from his eyes and looking over at her quizzically. She put a finger to her lips and motioned that she would fill him in momentarily.

“Yes, both of them. From what I have been told, there was nothing unusual about them on microscopic.”

“Well, maybe and maybe not,” Keller said. “I tried a number of stains and stain combinations on them, and found an approach that clearly distinguishes these lesions from the reference neurofibromas in my library.”

Keller the ever-curious, Keller the intellectual. Nikki smiled just picturing her boss. He was forever playing with stains and with his department’s powerful electron microscope. His library, in addition to the hundreds of texts, included hundreds, probably even thousands, of unstained specimens from every organ and countless disease states, each carefully catalogued. Evidently, among those unstained tissues were some run-of-the-mill neurofibromas—the reference specimens.

Spongiform encephalopathy with unusual neurofibromas.
The Belinda syndrome
, Nikki speculated. . . .
Or maybe Rutledge-Solari disease.

“Joe, listen, we’ll be home between ten and twelve tonight.”

“I should be here then.”

“If you are, great. But if not, we’ll see you tomorrow morning.”

“We?”

“A doctor from down here saved my life two or three times recently. He’s got more than a passing interest in this syndrome. He thinks it’s due to a secret industrial dump spilling toxic waste into his town’s groundwater.”

“Given what we know about prion infections,” Keller said, “I really don’t see how.”

“Well, we’ll talk about it when we get there. Thanks, Joe.”

“I’m so relieved you are okay,” Keller said. “Oh, by the way, the police had no trouble finding the man who killed your drowning victim, Roger Belanger. His name was Halliday. That was what the ‘H’ was for. They were friends and business associates. The police believe they fought about money. Halliday invited him over to his place to make up. He wrote a check and the two of them had a few drinks. Once Halliday got him into his pool, he got his hands around Belanger’s throat and dragged him to the bottom.”

“Process,” Nikki said.

“Exactly,” Keller concurred.

By the time Nikki set the receiver down, Matt had pulled on a new, blue sweatshirt with
YALE
block-printed on the front.

“Mornin’,” she said.

“Mornin’, yourself.”

She motioned at the sweatshirt.

“Did you go there?”

“No, but while you were trying on things in that Target store last night, I bought some stuff for me. This was one they had in my size.”

“Believe it or not, I remember. Well, sort of. Where
did
you go to school?”

“Good ol’ WVU. The Mountaineers. That was the only college we could afford. Turned out to be a great place.”

Nikki felt certain she recalled a nurse telling her that Matt had gone to Harvard Med, yet he didn’t feel that minor factoid was worth tossing in. She gave him high marks for modesty, as if he needed any more high marks after what he had done for her.

“You sleep soundly,” she said.

“People have noticed that from time to time, yes.”

“If you have trouble walking today, it’s from me kicking you to wake you up.”

“The nurses at the hospital quiz me when they call, to be certain I’m awake. They don’t know that I’ve mutated so that I can now answer most of their questions, even the complex mathematical ones, in my sleep. Do you remember much of last night?”

“Unfortunately, I think I do. I hope I thanked you enough for rescuing me the way you did.”

“I have a thing against losing patients. So, what was that call all about?”

“I phoned my boss, Joe Keller, to tell him I was alive and well, and to see if anything had turned up in Kathy’s microscopic.”

“And?”

“You’re not going to believe this, Matt. Kathy had spongiform encephalopathy. Joe’s absolutely certain of that, and believe me, he’s, like, never wrong.”

Matt sank back onto the bed, incredulous. He was hardly an expert on the various versions, but he was keeping up on the condition in the medical literature—at least as much as his cramped schedule would allow.

“Prion disease?”

“Yes,” Nikki said. “Quick point of interest—most people pronounce it
pry-on,
the way you do, but Stanley Prusiner, who won the Nobel prize for describing the beasties, pronounces it
pree-on
. I heard him speak a year or so ago.”

“Pree-on it is. This is incredible. Do you think my two cases had SE as well?”

“How can I not?”

“Well, what in the hell? . . . What about the neurofibromas? Anything special about those?”

“Apparently there was. Joe Keller is sort of a stain freak. He might try a dozen different staining techniques on a piece of tissue just to see what shows up. He tells me Kathy’s facial lesions take up this one obscure stain differently from the usual Elephant Man type of fibromas.”

“I just don’t get it.”

“Neither do I. But listen, Matt, the way I see it, maybe you’re still on the right track. Before we jump to any conclusions, let’s go up to Boston and see what Joe has to show us.”