Tampered (6 page)

At five p.m. on Thursday, Zol slid into his regular spot at the Nitty Gritty Café and caught the eyes of Colleen, Natasha, and Hamish, already sipping their lattes. It had been a long, painful wait — forty-eight hours — for the results of the Camelot samples they'd taken on Tuesday. Yesterday and today he'd thrown himself into the countless other matters stacked on his desk and in his email inbox, but found himself bracing at every knock at the door. He'd convinced himself the RCMP were on their way with orders from the Party's faithful to give his investigation some muscle.

“Thanks for coming, everyone,” he said. “I know you've all put in a long workday already. I'm pleased to say that Dr. Trinnock is still in full support of your participation in solving what he calls
our situation
.” His boss had even told him to offer the team a light supper at the health unit's expense. Nothing like the Prime Minister breathing down the old guy's neck to get Trinnock to loosen the purse strings.

“Don't tell me he approves of my involvement,” said Colleen brightly, her hazel eyes dancing along with the glass-bead earrings she'd worn the first time he realized he was falling in love with her.

“Does he know she's a —” Hamish coughed, and his voice descended into the raspy whisper that appeared whenever he was anxious. “— you know, a private investigator?”

“Geez, Hamish,” said Zol. “Colleen has professional skills just like the rest of us.” He gave Colleen a reassuring smile. “And they come in very handy.” Trinnock had no idea that Colleen was a private eye. She was on the books as a consultant to the health unit and that was good enough.

“Okay,” Zol began. “Natasha is going to give us an update. Thanks to Hamish, we got the microbiology lab at Caledonian University Medical Centre to process our samples in record time.” Normally, public-health specimens had to be sent to the government laboratory in Toronto. The people there worked at their own glacial pace, then reported their results by pony express. “What about the soup? Did it give us our pathogen?”

Natasha bit her lip and shook her head. “Afraid not, Dr. Zol.”

He was disappointed but not surprised. Things never came that easily. “Oh well,” he told her, “carry on.”

Natasha had her clipboard and scribbler at the ready, but she didn't need them for reference. She kept everything in her head. “As of today, we've had thirty-five cases of gastro reported to us from Camelot Lodge since the outbreak began two months ago on January eleventh.”

“That's an awful lot of diarrhea,” Colleen said. “How many residents live at Camelot?”

“Thirty-eight,” Natasha said.

“So all but three have had diarrhea?” Colleen asked.

“Natasha can give us the exact numbers,” Zol said. “But I know that Art and Betty and Earl have had it two or three times. Which means that more than just three of the residents haven't been affected yet.”

“Forgive me for stating the obvious,” Colleen said, “but if residents are getting gastro more than once, the offending microbe isn't stimulating the immune system to protect the body from further infections.”

Again, Zol was impressed how quickly Colleen caught on to the medical stuff. Without any formal training, she'd run her late husband's internal-medicine practice when they'd emigrated from South Africa. After his death, she'd not had the heart to cancel his weekly subscription to the
New England Journal of Medicine
. She read the editorials every week, filing the issues meticulously.

“That's what's got everyone at Camelot spooked,” Zol told her. “They recover, think they're in the clear, then get sick with the same thing again. Or see their friends recover only to succumb the next time it hits them.”

“Succumb as in . . . you know?” Colleen asked. She was a strong, practical woman, but she never used the words
death
or
dying
. Not even
passed away
. She'd been touched too many times by violent death. Her only sibling was killed on his motorcycle at age eighteen. And her parents were bludgeoned by burglars in Cape Town, murdered in their own home for a television set and the equivalent of fifty dollars cash. Then, after she'd started life over as a newlywed in the promised safety of Canada, her husband perished when Swissair flight III caught fire and came down off the Nova Scotia coast. She hadn't dated again until she and Zol met late last year.

“The outbreak is intensifying,” Natasha said. “Four of the six deaths have occurred in the past five days. We're seeing a very high case fatality rate overall.” She glanced at her scribbler. “Seventeen percent.”

“Hell's bells,” Hamish said. “That's worse than pneumonia or meningitis. Must be a high-grade pathogen.”

Zol turned to Natasha. “What about the culture of Nick's rash? Any staph aureus there?”

Natasha shook her head, her mouth sagging in disappointment. “Just the normal bacteria you'd find on anybody's skin.”

Hamish squinted in obvious puzzlement. “What's that about?”

Natasha explained their theory, now debunked, about staphylococcus aureus exotoxin making its way into Camelot's meals from the infected-looking rash on the chef's arm.

“What else have you got, Natasha?” Zol asked.

“We took twelve samples from the kitchen on Tuesday,” she said. “Drains, surfaces, food. And at the same time, we collected seven stool specimens from the patients with active diarrhea.”

“And?” Hamish said.

“No bacterial or viral pathogens in anything. Not even under the electron microscope.”

“What about parasites?” Hamish asked.

Natasha shook her head. “Routine staining for cryptosporidium was negative in the hospital's lab. A parasite specialist next door at the university looked at the samples. Nothing.”

“No amoeba, no giardia, no cyclospora cayetanensis?” Hamish said.

Natasha dipped her eyes. “I'm afraid not.”

“What about C diff?” Hamish asked. “You
must
have looked for
that
.”

“All negative,” Natasha told him.

“You sure? What test method did they use?” Hamish asked. “Re-current diarrhea among the elderly is C diff until proven otherwise.”

Hamish was talking about clostridium difficile, C diff for short, a bacterium that lurked silently in the intestines. It caused explosive diarrhea when awakened from its slumber by antibiotics taken for unrelated infections. C diff epidemics raced through hospital wards and nursing homes, where it was particularly hard on the elderly.

Natasha looked at Zol as if to say,
Why am I taking the heat?

“It's your university hospital's diagnostic lab, Hamish,” Zol said. “We have to trust them to use the best test available.”

Hamish shrugged then raised his professorial finger. “Mind you, the smell of C diff is very distinctive. You couldn't have missed it, Zol, when you were collecting your samples.”

Zol hoped Hamish was right, but he got a sinking feeling at the memory of the nauseating odours on the Mountain Wing. Had he been so overwhelmed by the stench that he'd missed the telltale horse-manure smell of C diff?

“Moving on,” Zol said, “any ideas about the vector of transmission? I know we have damn little to work with.” They'd never bring this outbreak to a halt unless they could find where the responsible microbe was entering the Lodge's food chain.

“I keep thinking about those hard, stale doughnuts at Camelot,” Hamish said. “Restaurants waste a lot of food. And I mean a lot. I bussed tables for a couple of summers at university. It's amazing what gets thrown out. Not just scraps. Entire meals untouched.”

“Yeah,” Zol said, thinking back to his days as a junior chef when he'd thrown out bins full of perfectly good food. “No one goes to a restaurant to eat leftovers.”

“You started out by asking about the soup,” Hamish said. “Is there a problem with it?”

“Hard to say.” Zol looked to Natasha for confirmation. “We did wonder about the freshness of its ingredients and the fact that it never seems to get heated to a roaring boil.”

“Homemade soup can contain almost any old scraps,” Hamish said. He sipped his latte and held Zol's gaze, his eyebrows raised. “Did you look up freegans on the Internet, like I told you?”

“Sorry. Never thought of it again, till this second.”

“Well, just think about,” Hamish said. “Food is going to waste at the back of restaurants all over the city, we know that. Dumpsters are full of perfectly good but slightly wilted produce, day-old baked goods, and untouched full-course meals. On the other hand, you've got savvy entrepreneurs, like Gus and Gloria, feeding fixed-income seniors with poor eyesight and fading taste buds.”

“Dr. Wakefield,” said Natasha. She was hiding her smirk with her coffee cup, but her eyes revealed her unrestrained amusement at Hamish's theory. “You think Gus and Gloria are Dumpster diving? And bringing the stuff back to Camelot?”

“That's what freegans do. It's part of their manifesto. They refuse to shop in grocery stores because they're owned by hard-hearted, wasteful capitalists. Instead, they pull freshly discarded food out of Dumpsters and take it home. Claim they're saving money and the planet at the same time.”

Zol looked at Colleen, who was covering her mouth with her serviette. He bit his lip. The last time Hamish approached him with a wildly eccentric theory, Zol had laughed it off, and Hamish stormed off in a major pout — stayed incommunicado for a week. It turned out that Hamish had been exactly on track and Zol had to eat his words. The guy had amazing instincts.

Zol stared at the foam on his latte. He remembered the large, unlabelled plastic bags of jumbled vegetables that Natasha had hauled out of Camelot's deep-freeze. He had to admit, those veggies could have come from a Dumpster. Who was to know? Suddenly, his coffee tasted cold and bitter. “Well,” he said, breaking the silence around the table. “How do we investigate the possibility that the Oliveiras may have embraced the . . . the freegan movement?”

Colleen put down her serviette and nestled her cup onto its saucer. There was no hint of a smirk on her lips, just professional concern. “Sounds like this comes under my scope of practice. Who procures most of the food for the Lodge? The husband or the wife?”

“The husband,” Zol said. “Gus does the actual shopping, though I imagine Gloria tells him exactly what to buy.”

“Perfect,” Colleen said. Zol loved the way her South African voice made the word come out like a purr:
purrr-fect.
She returned his smile. “I'll put a tail on our friend Gus.”

He felt guilty that Colleen was being sent out on a fool's errand, but if that's what it took to keep Hamish in the game, so be it.

At eight o'clock the next morning, Hamish felt an easing of the knot across his shoulders. No matter what, and especially on a Friday the thirteenth, a car wash was the perfect place to hide and meditate. Impenetrable to pagers and mobile phones, it provided a haven from an intrusive world. This was one of those automated jobs that left a lot of spots and was done in only a couple of minutes. Sadly, his regular, full-service place on Main Street West was on strike. It did a much better job and, more importantly, its twenty-minute cycle gave him plenty of time to practise his breathing exercises. During a stressful week, he'd visit the car wash half a dozen times. He hated the idea of mud spatters on the Saab's side panels, and going more than a day without his breathing exercises caused his anxiety to build almost to breaking point. He had no truck with all the yoga mumbo-jumbo that went with Pranayama breathing, but the exercises did put a rein on his galloping pulse and helped organize the thoughts that so often raced across his mind.

At the end of the cycle, he put the Saab into gear and eased through the car wash's narrow exit. He wasn't ready to face a long morning in his laboratory, verifying his research assistant's latest calculations. He parked at the curb, put on the CD of car-wash sound effects he'd downloaded from the Internet, and let the soothing vibrations sweep over him while he finished his breathing.

He hadn't missed the smirks last evening at the Nitty Gritty. Zol, Natasha, and Colleen had tried to hide behind their coffee cups, but he knew what they were thinking. They hadn't believed a word he'd said about the freegans. They were just humouring him. People did that. They humoured Hamish Wakefield, the prickly Sherlock, so he wouldn't blow a gasket. Well, sooner or later Zol would see that Hamish was right. Hell's bells, all Zol had to do was read the freegan article on Wikipedia.

He completed his exercises and killed the CD player. He turned on his cellphone. The display showed one voice-mail message from an unknown caller, left ten minutes ago. Unknown callers were usually anxious patients who blocked their identities. He wasn't on call for clinical cases this month. Someone else would have to handle it. He'd redirect them to the medical centre's switchboard.

The caller was elderly and not used to leaving messages. Hamish could hear that in his voice. “Dr. Wakefield . . . This is Art Greenwood, Zol Szabo's granddad . . . well, almost his grandfather. By marriage, if that counts after a divorce. Zol said it would be okay if I called you. Would you please return my call? We're really in trouble here and don't know where to turn.” There was a pause while the phone rustled in the caller's hands and the man nearly hung up without leaving his number. He came back on the line, apologized again, and recited his number.

Fifteen minutes later, Hamish strode toward the large glass doors under the ornate wooden canopy at the entrance to Camelot Lodge. He could see an elderly gentleman sitting in a scooter by the reception desk. He had the crossword in his lap, but seemed more intent on scrutinizing arriving visitors than completing the day's puzzle.

“Thank you for coming so quickly, Dr. Wakefield,” Art Greenwood said after introducing himself. “Zol said you were the best.” He pointed to the coat rack in the corner of the common room. “Hang your things over there. They'll be safe. No one around but us old birds, and fewer of us than ever.” He flipped the switch on his scooter and headed toward the elevator. “We'll go right up to her room.”

“She's expecting me?”

“Of course. Dr. Jamieson left this morning for a week's holiday. We've had it with him, anyway. A pill pusher of the first order. No one's getting better. New cases keep occurring. As you youngsters would say, the shit keeps hitting the fan.”

Normally, Hamish couldn't waltz in and write orders for another doctor's patients. But these weren't normal times, and he was now working for the health unit in an official capacity. The law provided for Zol's boss Peter Trinnock to appoint a team to plunge into any epidemic. This situation was going to take hip waders.

“How long has Betty been ill?” Hamish asked, rubbing sanitizer between his fingers as he strode to keep up with Art's scooter.

“Two or three days. Started as a gurgly tummy but Jamieson said it was a bladder infection. Treated it with antibiotics, of course. Then last evening she got hit with the runs. Told me she was up and down all night, poor thing. And she's got the shivers. I'm terrified she's going to get that terrible headache that often spells . . . well . . . you know . . .”

They took the elevator to the second floor. Art led the way to Betty's door. Hamish gave Art his pen and watch for safekeeping, then rolled up his shirt sleeves. There were no isolation gowns or gloves in sight, but he wasn't going in there unprotected. He pulled a pair of vinyl gloves from his pants pocket and put them on before knocking on the door.

The first thing he noticed was the pungent smell of commercial air freshener in Betty's room. He rubbed his nose against the sleeve of his shirt, forced a smile, and introduced himself. Betty smiled back and reminded him that he'd given her several rabies shots last year, during the bat-bite scare. He took a brief history and eased back her pink and green patchwork quilt.

Her thin, sparrow-like body was white from head to toe. Her forehead was hot, her pulse strong but rapid, her tongue glistening with moisture. No shock or dehydration. He fought to keep a neutral expression on his face as he checked for stiffness in her neck (it moved normally) and tenderness in her belly (it showed only slight discomfort). So far, so good.

“Do you have any headache?” he asked.

“A little, yes.”

“How severe is it?”

“I don't like to complain. I know I'm not the only one who's got this.”

He looked for signs of meningitis or a stroke, but her brain was okay — no confusion, slurred speech, droopy mouth, or weak limbs.

“I'm going to order some tests and a painkiller. Be sure to ask for it when you need it,” he said and replaced her quilt.

“Really, Dr. Wakefield, can you tell me what's wrong? Do you have a diagnosis for me? When I had this before, no one could put their finger on it, though I must say I didn't feel this sick, or have this much tummy pain.” Her pale grey eyes pleaded as they searched his face. “And what I'd really like to know is, how did I get it?”

Patients always wanted to know how they contracted their infections. More often than not, he didn't have an answer that made them feel any better. They never wanted to hear that their kids, their neighbour, their doctor, or their wayward spouse had infected them.

The answer to Betty's questions had three parts:
what
,
which
, and
how
.

What
was easy to tell her — she had an infection, apparently of the intestinal tract, that seemed to fit the description of the thirty-some other gastro cases Natasha Sharma had documented in the past two months.

Which
germ was making her sick, he couldn't say, though it was obvious Dr. Jamieson's antibiotic was ineffective against it. If the germ were a virus or a parasite, no antibiotic would help her. She'd need either tincture of time to let the infection resolve on its own, or exactly the right drug selected on the basis of culture results. Of course, her cultures were likely to be negative, just like all the other Camelot gastro cases.

How
was impossible to answer. After two months of hunting, Zol and his team couldn't say how this infection was being transmitted. Was it the food? The staff? The other residents? The environment?

“At this point,” Hamish told her, “all I can say is you've got an intestinal infection. As far as I can tell, your bladder's fine. And I'm working with Zol Szabo at the health unit to make you better and put a stop to further cases.”

“Well, let me tell you, I was fine until I started writing my memoirs. Phyllis said I should start with a creative writing course at Caledonian University, so we enrolled together and . . .”

Hamish prided himself on being a good listener, but this sounded like a tangent that wasn't going to lead anywhere useful. “Yes?” he said, hoping she wouldn't go on much longer.

“And she was right. It was a lot of fun, and the instructor was a real hunk. Like our Dr. Szabo.”

She shot him a look that said
Just bear with me, Doctor
. “I bought a notebook computer and I've written five stories so far — the humorous side of cabinet politics.” She raised an eyebrow and fixed him with a coquettish gaze. “An insider's view. In the sixties and seventies I was the secretary to the Prime Minister and various members of his cabinet.”

“What about the Official Secrets Act?”

“It was all a long time ago. I'm allowed to talk now.”

“Do you think you've ruffled some feathers?”

“Earl Crabtree — he's one of our mates and a long-time Party insider — forwarded two of my stories to a friend in the Ottawa Press Club, across from Parliament Hill. The word is, the reporters think the current Prime Minister might not see the humour in my behind-the-scenes anecdotes of his predecessors. Afraid I might diminish the Party's carefully crafted image.”

Hamish had no interest in government or politics and couldn't see any plausible link between memoirs and epidemic diarrhea.

Betty pulled at her quilt with her knobbly fingers and winced slightly. “I don't type as fast as I used to. It makes my arthritis play up. Thank heavens for those Xanucox pills.”

“They help, do they?”

“On a good day, they work wonders. Raimunda used to share hers with me. I gather they're rather expensive. Vik provided them to her for free. You know, because she was Gloria's mother.” She dipped her gaze, as if embarrassed at speaking out of turn about the recently deceased. “All in the family, if I can put it that way.”

Camelot's residents, and so many others like them, would be on dozens of medications in a variety of eye-catching shapes and colours. Hamish could see how trading them could become an intramural sport.

Betty's face crumpled as tears welled in her eyes. “Poor Raimunda died on Tuesday. Such a shock. She was the strongest person here. She kept getting gurgly tummy, before and after she spent that week in the hospital. But I must say, neither her arthritis nor her tummy ever stopped her from helping Gloria with the cleaning.”

Hamish handed Betty the box of tissues from the bedside table and watched as she dabbed her cheeks. “Don't worry, now, Betty. It's not Xanucox that upset your tummy or gave you the fever. The drug company is making a fortune out of the fact that Xanucox is easy on the stomach.” Finally, an arthritis medicine that didn't induce ulcers or intestinal bleeding. And didn't cause strokes and coronary syndromes like its competitors. “But I need to remind you, it's not a good idea to share your tablets. You never know what that could lead to. If you think you need Xanucox, you should ask Dr. Jamieson about it.”

He pulled off his gloves and asked her to drink plenty of fluids and stop the antibiotic that Dr. Jamieson had prescribed. It obviously wasn't working. He promised to check on her again soon and told himself that if she got any worse he'd send her for X-rays of her abdomen. He scanned the room for a bottle of alcohol hand sanitizer but couldn't find one. He hated washing his hands in a patient's bathroom. The inevitable clutter of pills and tubes and bottles around the sink gave the maneuvre an unsavoury ick factor. He had no other choice, so he carefully soaped and rinsed his hands, turned off Betty's taps with his elbows, and shook the water from his fingers. He couldn't bring himself to touch her frilly towels.

At the doorway, still shaking the water off his hands, something stopped him. A faint, unpleasant smell, rising above the scent of Betty's lavender soap. He closed his eyes and sniffed. Yes, there it was. Unmistakable. The textbooks said it smelled like a horse barn, but he'd have to trust them on that. It wasn't the normal odour of urine or feces you'd expect in a healthy person's bathroom, it was the odour of para-cresol. And it gave him Betty's diagnosis on the spot.

He returned to her bedside and kept his hands in his pockets.

“You found good news in my bathroom, Dr. Wakefield?” She hadn't missed the smile of success on his face.

“Absolutely. Tell me, have you noticed anything unusual about the odour of your stools?”

“Really, doctor,” she replied with a teasing grin, “what a thing to ask a lady. Even the Queen doesn't pass lavender-scented motions.”

“But I mean, do your stools smell any different with this illness than they did the other times you had gastro?”

“Well,” she said, glancing at the floral-scented deodorizer on her night table. “It's not the sort of thing one brings up in polite company, but I did notice an unusual odour for the first time this morning. Brought me back to my childhood, my uncle's farm. In Manitoba.”

“Horses?”

“That's right. How
ever
did you know?”

“And you're sure you haven't smelled that odour here at Camelot before?”

“Certainly not. Goodness, Dr. Wakefield, what are you getting at?”

“I have good news for you. Well, good news in the sense I know what's wrong and how to fix it.”

“Don't keep me in suspense, Doctor. What is it?”

“Clostridium difficile. C diff for short. That distinctive horse-manure odour proves it.”

She paused, as if trying to remember something. When it came, her eyes burned with understanding. “It's my antibiotic, isn't it? Just like in the papers. All those old people dying in hospital. They came down with C diff diarrhea after being plied with antibiotics.”

“In your case, though, we've caught it early. You have a private drug plan, don't you?”