Lost Immunity

by Daniel Kalla

  Angela closes her eyes for a moment. “What do the parents say?”

  “I’m going out to see them this morning.”

  “Want some company?”

  “No. Thanks, though.” Lisa also declined Tyra’s offer to accompany her, sensing that another person—even one as sympathetic as Tyra or Angela—would only make it more uncomfortable for the parents. “I think this is a one-person job.”

  “Maybe oncology isn’t looking like such a miserable career after all.” Angela sighs. “How did the first clinic go yesterday?”

  “Surprisingly well. No medical disasters. No protests. No huge meltdowns.”

  “Excellent. How many people were vaccinated?”

  “Eight hundred,” Lisa says. “Double what we planned for on the first day. They were still lined up for blocks when we closed the clinic. The biggest complaints were from those who didn’t get inoculated.”

  “And what about the website? Anything untoward?”

  “There are fourteen reactions listed so far.” The data is fresh in her mind, as Lisa spent the last hour before coming to work reviewing the first reactions to be logged onto the website. “Most were redness or sore arms near the site of injection. Very typical for any vaccination. Two unusual ones, and I tracked down both of their parents. One mom said her daughter had a high fever. But I soon learned that she considers ninety-nine point two degrees to be a critically elevated temp. And that was before taking Tylenol.”

  Angela rolls her eyes. “And the other one?”

  “A kid with a diffuse rash. Her mom texted me a couple of photos.” Lisa grabs her phone, finds the photos, and turns the screen around for Angela to see the images of the girl’s exposed thighs, which bear scattered red wheel-like welts the size of nickels. “They’re definitely hives. But the kid has a long history of allergies. And the rash disappeared with a couple of antihistamine tablets.”

  Angela nods, satisfied. “All in all, a good day, then.”

  “Yeah. But in light of the new meningitis cases among younger kids, I think we have to lower the minimum age of immunization to at least six.” She exhales heavily. “Nathan is pushing back hard. He says Neissovax has never been tested in kids under ten.”

  Angela rubs her chin, considering it. “The other commercially available meningitis vaccines have been approved for kids as young as two months.”

  “Exactly.”

  “You’re driving this bus, so follow your gut. Either way, it will be key to get all teens and middle-schoolers immunized. That should create enough herd immunity to prevent the spread to the younger kids or anyone else, eventually.”

  Eventually. Lisa suppresses a sigh. “I’ve got to head out to Bellevue now. Are you going to stick around here today?”

  “Nah. I’ve got my own shit to do.” Angela taps her head scarf. “Thankfully, at least I don’t have to worry about keeping the hair colored and as damn stylish as it used to be. I’d never find the time.”

  Lisa grins as she stands up, resisting the urge to ask Angela what medical interventions she is facing today. “I’ll see you later, then?”

  “Better than a fifty percent chance of that, according to Vegas odds.”

  Lisa heads down to the garage and climbs into her car. She drives a few blocks east until she turns on the ramp that merges south onto the I-5. At rush hour, the freeways can slow to a snarl, but Lisa marvels at how well the traffic is flowing through the city’s major arteries now. In no time at all, she’s heading across the Lacey V. Murrow Bridge over spectacular Lake Washington, which forms the eastern border of Seattle and turns the city into the isthmus it is. She’s almost disappointed when she reaches the quiet tree-lined neighborhood in Bellevue in under twenty minutes, uncertain whether she’s been enjoying the drive or just dreading the destination. She considers dropping in on her niece while she’s in the vicinity but remembers that Olivia is enrolled in a sports camp all week.

  Lisa parks in front of a big Craftsman-style house on Hilltop Road and trudges up the driveway to the entrance. A fortyish man in sweatpants and a black T-shirt with a few days’ worth of scruff on his cheeks and chin meets her at the door. The devastation on his grim face pales in comparison to that of his wife, who’s already sobbing as she joins them in the foyer.

  Lisa introduces herself to Mason’s parents, Sam and Kimberly Pickering. They lead her into the living room, and she sits down across from them as Sam wraps an arm around his wife’s shoulders.

  “I let him go,” Kimberly blurts between sobs.

  Lisa tilts her head. “Go?”

  “To the game. Mason looked awful that morning. So pale. I knew he wasn’t right.”

  “Nothing would’ve stopped Mason from going, Kimmy,” Sam says as he squeezes her arm. But her chin drops, and her head bobs up and down.

  “It wouldn’t have mattered if he didn’t go,” Lisa says. “We’re seeing kids die within hours of getting this meningitis.”

  Kimberly looks up, rubbing her puffy eyes. “Really?”

  “Really. It’s such an aggressive infection. Half the time, we can’t stop it at all. Mason going to the game had nothing to do with his… outcome.”

  Sam looks at his wife. “See, Kimmy?”

  “Yeah,” she mumbles as fresh tears drip down her cheek.

  Her anguish is so palpable that Lisa feels a ball form in her throat. “Mason has a sister, right?”

  “Two,” Sam says. “We’ve got twin girls. They’re five.”

  “And everyone in the family has taken their prophylactic antibiotics?”

  “Of course,” Sam says.

  Lisa is tempted to offer Neissovax for the twins, but she knows she doesn’t have authority to do so yet. “Did Mason go to Delridge in the past week or so?”

  “Delridge?” Sam frowns. “Don’t know if he’s ever been there. We don’t get into the city that much, except downtown.”

  “So neither of you has been there recently, either?”

  “No.”

  “Camp Green in Delridge. Where this outbreak began. Are you familiar with it?”

  Sam shakes his head. “Only from the news.”

  “It isn’t a Bible camp, is it?” Kimberly murmurs.

  “It is,” Lisa says, straightening.

  Kimberly turns to her husband. “Isn’t Nicola a camp counselor at some Bible camp?”

  “Yeah,” Sam says. “My older sister’s kid. They’re kind of a religious family. We’re not super close.”

  Lisa leans forward. “Did Mason see Nicola in the past week at all?”

  Kimberly and Sam share a look of sudden recognition. “Grammie’s birthday,” he mutters.

  “Mason and Nicola were at the same party?”

  “Yeah, last Sunday. My grandmother turned ninety. My uncle threw a big party at his place out on Mercer Island.”

  Lisa’s heart beats faster. “How old is Nicola?”

  Sam shrugs. “Eighteen? Nineteen?”

  “Do you have her phone number?”

  Sam shakes his head, but Kimberly lifts her phone. “I think I do. She babysat a couple times for us a few years ago.”

  Lisa jots down the number and thanks the Pickerings for their time. Relieved to escape the pervasive despair that feels as thick as smoke, she hurries out of the house to her car. Once inside, she tries the number Kimberly gave her and is comforted to hear Nicola answer. After confirming she works at Camp Green, Nicola agrees to meet Lisa in person.

  Lisa races back across town, too preoccupied to appreciate the sumptuous Puget Sound scenery that is bathed in bright sunlight. She drives through the streets of Greenwood in northwest Seattle until she finds the address Nicola gave her, which turns out to be a modest bungalow.

  Nicola and her mother, Heather, are waiting for Lisa at their open front door. They bear a strong resemblance to one another, down to their matching short haircuts. They even wear similar loose-fitting jeans and baggy T-shirts.

  After introductions, Heather guides Lisa into the mo
dest kitchen. Lisa declines her offer of tea but joins mother and daughter at the table.

  “It’s so tragic about poor little Mason,” Heather says, shaking her head. “I only just heard this morning. He was such a sweet boy.”

  “That’s why I’ve come,” Lisa says, turning to the daughter. “So far, the only connection we can find back to Camp Green is through you, Nicola.”

  “What does that mean?” Nicola asks in a voice that’s eerily similar to her mother’s.

  “You were at a party with Mason, last Sunday? Your grandmother’s ninetieth?”

  “Great-grandmother,” Nicola corrects. “Yes.”

  “Did you spend any time with Mason?”

  “A little, I guess. I felt bad for him. There were no kids his age at the party. So I pitched a few balls for him out back of the house. Not for too long, though. It was really hot.”

  “Hot?” Lisa echoes, considering the implications. “You didn’t share a drink with him, did you?”

  She shrugs. “He might’ve had a few sips from my water bottle.”

  Lisa feels a chill run down her neck.

  Heather’s forehead creases. “You don’t think that has anything to do with Mason’s illness?”

  “Yeah,” Nicola says. “It’s not like I was sick or anything.”

  Lisa shakes her head. “You don’t have to show symptoms to be contagious.”

  “Contagious? Nicola?” Heather gasps. “How is that possible?”

  Lisa ignores the question. “You were seen by one of the public-health nurses last week, right, Nicola?”

  Nicola glances at her mom. “Yeah.”

  “When?”

  “Saturday, I think.”

  “So the day before you saw Mason?”

  Nicola nods.

  “And our nurse gave all of you doses of prophylactic antibiotics?”

  “Yes,” Heather interjects. “We took them right away.”

  Nicola says nothing, but Lisa notices the guilty look that flits across her face. “Nicola? You did take the medicine?”

  The teen looks helplessly over to her mom. “Remember when I was in seventh grade, and I took that penicillin for my tonsillitis? How you had to rush me to the ER when my throat closed over?”

  “It was terrifying,” Heather says.

  Lisa bites back her frustration. “The drugs we gave you weren’t related to penicillin, Nicola.”

  “That’s what the nurse told us,” Nicola says in a sheepish voice. “But I almost died that time with the penicillin. And I was feeling fine. I was sure I didn’t have meningitis.”

  Lisa rubs her forehead. “So you didn’t the take the antibiotics the nurse gave you?”

  Nicola looks down at the table. “I was too scared.”

  Everything suddenly makes sense. Nicola must be an asymptomatic carrier of meningococcus. She had to have spread the infection to Mason—and with him, all of Bellevue—through the shared water bottle. Maybe it was also a shared drink or two that spread meningitis through Camp Green originally.

  Lisa knows she should be relieved. But as reaches for the bacterial swabs and extra kit of prophylactic ciprofloxacin she’s carrying inside her bag, she feels anything but. How many other people could Nicola have already infected? And even worse, how many other asymptomatic carriers might have felt too scared or too complacent to take the antibiotics they were given?

  CHAPTER 26

  The yellow cap flicks off easily enough. Some specks of adhesive adhere to the underside. But they’re only noticeable if one looks for them.

  It seems so easy now, but it has taken ages to perfect the technique.

  All innovators face roadblocks. And for months this one step threatened to be the most insurmountable, like the Hillary Step for summiting Mount Everest. The challenge was to secure the cap seamlessly in place. It took countless hours of experimentation to find the right medium. Numerous attempts with almost every imaginable adhesive failed to meet the standard. Then, about three months ago, one type of glue emerged as a genuine contender. It left hardly any residue. It took only two drops, and once hardened, it became impossible to distinguish a difference with the naked eye between the resealed and the unopened vials. The caps even pop back off with exact same click and feel.

  The vials debuted brilliantly at the first vaccine clinic. No one seemed to notice.

  CHAPTER 27

  Perched high above the iconic Pike Place Market, Nathan and Fiona sit at a high-top table beside one of the windows encircling their hotel’s rooftop bar, where they’re treated to a panoramic view of Elliott Bay and the Olympic Mountain range beyond. Puget Sound in all its glory. There’s a door nearby that leads to an outdoor patio with overhead heat lamps, but Nathan prefers the view from inside.

  I’m definitely coming back with Ethan and Marcus, he vows again. It will be the trip to follow Quebec. If we make it to Canada. The window for squeezing in a northern road trip before the start of the school year is closing rapidly. And the guilt gnaws. He’s determined not to become one of those divorced parents who are full of promises but weak on the follow-through.

  Lisa suggested the three of them meet in her offices at Seattle Public Health, but this time Nathan was the one who wanted a more neutral venue. He has learned that business conflicts are best settled over food and wine. Not that there is much to settle. Surrender might be a better choice of term.

  Nathan looks over to Fiona, who wears a simple blue dress with her hair tied back. There’s a serene quality to her as she sips her Chardonnay and studies the harbor below. He expected her stress levels to peak once the vaccination campaign launched, but paradoxically, the go-live seems to have had the opposite effect on her.

  “You seem… satisfied?” Nathan ventures.

  “It’s way too early for satisfaction,” Fiona says, before turning to look at him. “Sometimes, though, the anticipation is the worst part.”

  He lifts his bottle of hazy IPA in a small toast. “Waiting sucks.”

  She raises her own glass. “Plus, I’d rather not be stuck in Seattle for too long.”

  “Your mom?” Nathan asks.

  Fiona’s mother suffers from debilitating rheumatoid arthritis and lives, wheelchair-bound, in a private-care home in Connecticut. Fiona visits her several times a week, even though it’s a one-hour train ride each way from Manhattan.

  “It stresses Mom when I’m away too long.” Fiona takes another sip of wine. “Your boys must be bummed about potentially having to miss this summer’s road trip, huh?”

  “They’re OK,” he says, downplaying his sense of shame. “Spoke to Annie this morning. They’ve moved on for now. Apparently, their older cousins are taking them ATV-ing this weekend, and now they’re like ‘Quebec who?’ ”

  She laughs. “It’s good you and Annie can still be friends. Especially for the boys.”

  Fiona has always shown a deep interest in Ethan and Marcus. She doesn’t have kids of her own. And while Nathan never met her husband, he knows Walt was fifteen years older than her, and she was only in her midthirties when he died. What Nathan doesn’t know is whether they chose not to have kids, were still planning to, or simply couldn’t. With most friends, he would feel comfortable asking. Not Fiona. It would be too much of an invasion of her well-guarded privacy. So instead he asks, “Did you and Walt travel much?”

  “When we could,” she says. “Walt was so busy between his teaching and his research. Most of our vacations had to be built around his academic conferences. And sadly, math profs don’t tend to meet in the most exotic locales.”

  “How did you end up with a math prof?”

  “In the most clichéd way imaginable.” Her cheeks flush. “I had to take a master’s-level statistics course as part of my doctor-of-pharmacy program. Walt was my prof. You know what’s funny?”

  “What?”

  “I found him so arrogant at first. He used to wear bow ties or, sometimes, even scarves. Those goofy ascots. I couldn’t stand him.”

&nbs
p; “Couldn’t stand whom?” Lisa asks as she appears beside the table.

  “Walt,” Fiona says, reddening further. “My husband.”

  Lisa sits down beside her. “Isn’t that normal? To not be able to stand your spouse sometimes?”

  “The only time for me, ever, was before I got to know him.”

  “You’re a lot more tolerant than I am, then. How long have you been married?”

  Fiona takes a sip of her wine. “Walt died a while ago.”

  Lisa touches the back of the other woman’s wrist. “Oh, Fiona.”

  “It was a long time ago, to be honest.” Fiona moves her hand away to grab the bar menu and pass it to Lisa. “Will you have a drink?”

  “Sure, why not?” Lisa says.

  But Nathan sees through Fiona’s feigned dismissiveness. The grief is as fresh in her eyes as it was the first time they discussed her husband, almost five years earlier.

  The server, a muscular young man who doubles as the bartender, sidles up to the table. Lisa orders a glass of Merlot, while Nathan opts for a different IPA, and Fiona a refill of her Chardonnay.

  “How about you, Lisa?” Fiona asks. “Are you married?”

  “Yeah. Twelve years. No kids, though.”

  Nathan throws Lisa a conspiratorial look. “They’re dinks.”

  “Oh,” Fiona says.

  “An inside joke,” Lisa says with an amused glance at him. “And not a particularly good one, either.”

  Nathan appreciates her sardonic smile. Despite her senior position, Lisa doesn’t come across as the kind of physician—of which he has met several—who takes herself too seriously. It only makes her more appealing.

  The server returns and distributes a drink to each of them.

  “How do you think it’s going so far, Lisa?” Nathan asks as soon as the bartender is gone.

  “Depends what you mean. The outbreak or the vaccination clinic?”

  “Both, I suppose.”