by Betsy Ashton
“You’re right,” my special granddaughter said. “Someone in the hospital is behind this.”
I flinched and looked over my shoulder. Johnny and I were alone in the corridor. No ghosts or solid human beings hovered, yet the hair on my nape stirred.
“I won’t ask how you know this,” I said after a startled pause.
“It’s something Mr. Ducks and I have been working on. I can’t explain it.”
“Do you have any idea who it is?” I asked, turning back to the matter at hand.
Johnny’s phone buzzed. Ducks. We listened to our respective callers for a few minutes. Both sensed an evil presence loose in the hospital and in the community at large. Both felt it might be a man, but they weren’t yet certain. It might be two people. Ducks felt a weak female presence.
Johnny slowly turned in a full circle to be certain we were alone. “We need to figure out who wants people to die,” Johnny said.
“And why,” I added, covering the speaker on my phone to add a comment to Johnny’s side of the conversation.
“I’ve been doing a lot of thinking. What if someone wants to make people sick and then ride to the rescue with a cure?” Ducks asked. “Like that condition, um, what’s it called?”
“Munchausen by proxy,” Johnny said.
My eyebrows rose. “How do you know about that?”
“What? I read about it in a thriller where child abuse was suspected,” he said.
“Right. Munchausen.” Ducks went silent for a few moments. “Could it be something like that, or hero syndrome, except the dead children are a miscalculation?”
“I don’t see how,” Johnny said. “The person or persons would not only have to have a stash of the pathogens in the hospital itself, but wouldn’t he also need a similar stockpile of the cure? So far, if he thinks he has the miraculous cure, it’s been a dismal failure.”
I was frustrated with Ducks and Emilie. I wasn’t being fair, but I’d grown accustomed to them having all the answers. Now, in the middle of a crisis, they only had vague feelings. I didn’t know who to turn to—Ducks and Emilie, who weren’t here, or Johnny and the doctors, who were.
“You’ll have to be extra careful. Let me add Mr. Ducks on a conference call. He’s over in the school bus,” Emilie told me. Whip, Emilie, and Ducks had returned to Mississippi, our sailing vacation postponed until further notice.
“Do you think this person will use anything else? Like a gun?” I’d had enough of being stalked by armed strangers to last the rest of my life. I owned a gun and had a license to carry it. I’d used it once in my life, taking the life of a madman. I never wanted to point it at a human being again.
Ducks’ voice came on the line. “Not guns. I don’t sense a shooting situation, but if you tell me you have your trusty .38, Max, I’ll feel a little better.”
“I do.” My revolver was upstairs in the room Johnny and I shared, in my over-large Jimmy Choo handbag, one of two bags Merry bought on the last day of her normal life. I’d liberated them for my personal use.
“I have my Sig, as well,” Johnny said.
“I’m glad, but it won’t be effective against the pathogens,” Emilie said.
“It would be effective against the person spreading the illnesses,” Johnny said.
“We’ll keep working on it. We’ll find out who it is, even though we haven’t been able to yet. He hasn’t shown his hand.” Ducks tried to sound confident.
“Or he’s blocking you,” I said, the thought flashing without warning.
Ducks clicked off, leaving Emilie, Johnny, and me on the line. I gave her an update on Alex and promised to call her later that evening. I’d call her father, too, after he got back from the job site. We closed with air kisses.
“I don’t like the fact that neither she nor Ducks have a clear feeling about what’s happening.” Johnny said.
“Yea. All they get is that it’s centered in and around the hospital.”
“That much is obvious,” he said. Exactly what I was thinking.
We checked Alex’s room, only to be told by a nurse that he was down in X-ray. Again. With nothing to do in the ICU, we followed the corridor to the physicians’ offices. Dr. White had commandeered an empty one for her workspace, and we needed to find it.
A door on the second floor was ajar; we looked inside. The walls were lined with what had to be every white board in the building, boards divided by symptoms, each patient diagrammed with background information, the date the illness began, where the patient was when he fell ill. Even a local map with push pins in it. Flip-chart paper covered the walls themselves, holding the overflow of data the white boards couldn’t handle.
“‘Welcome to my parlor,’ said the spider to the fly.” Dr. White stood in front of a puzzling graph of incomprehensible scribbles. “This is where I crunch data, although I’d be better off crunching Wheaties for all the success I’m having. I’m trying to find the disease vector to see where this mess started, but I’m not having the success I’d hoped.”
“Remind me what a disease vector is? Dr. Duval talked about it, but I forget.”
“Sorry. It means I’m looking for what infected these patients. A disease vector is generally some kind of organism that transmits viruses or bacteria into a human.”
“You mean like mosquitoes transmitting malaria in tropical climates?” Johnny said. “In Panama we had to take anti-malarial drugs all the time. Didn’t do a damned thing to keep the mosquitoes from dining on my blood.”
“That’s a good example. Did you have malaria?” Dr. White asked.
“I did. And dengue fever, too.”
“You’ve told Meenu?”
“Of course. She’s up to date on my somewhat colorful medical history.” Johnny rolled his head, vertebrae in his neck complaining with each rotation.
“Watch out for odd symptoms. If you had malaria once, you could get it again,” Dr. White said.
“No mosquitoes here.”
“You could have a relapse without a new bite. That would compromise your immune system.” She studied a board and tapped an equation I didn’t understand. “If this illness is transmitted by an insect bite, whether a mosquito, a tick, or something else, I need to find the original bite on the body.”
“I haven’t noticed any on Alex. About the only holes he has, other than the surgery on his fractured leg, come from IVs and blood work,” I said. I couldn’t remember if Alex had complained about mosquito bites or not. I didn’t think so—if he had any, I’d have noticed by now during his daily swabbing.
“He had a few old ones he got in Richmond, but they’ve cleared up.”
“How long ago was he bitten?” Dr. White asked.
“Probably three, maybe four weeks,” I said, studying the board with Alex’s name at the top. Johnny followed suit, and together we read everything Dr. White had on him.
“This isn’t right.” Johnny pointed to a notation about origin of the illness. “We went horseback riding up a trail near Navajo Springs. Alex climbed onto an outcropping and fell, breaking his leg. When we flew him into the hospital, he had no pulmonary symptoms.”
“Did he get dirt on his face?”
“Sure. He fell face down in the dust. I remember brushing him off when we turned him over to look at his leg,” I said.
She corrected her original entry. “And you’re sure he didn’t have a cough before?”
“Positive. His cough developed after he came into the hospital. Before that, nothing.” I finished reading the list. “Wait a minute. Dr. Running Bear said he had some breathing issues during surgery, but he thought it was from the dust he’d inhaled. He kept Alex to monitor his lungs in case he developed pneumonia.”
Dr. White made a cryptic notation on Alex’s board. Like most doctors, her handwriting was barely legible, although much of what I could read I still couldn’t understand. I pointed to a section on his board.
“Back to his chart. You also have him showing signs of cough, fever, and malaise two days after
he first complained of body aches. All three symptoms showed up at the same time on his second day in the hospital,” I said.
“When he complained that his body hurt, I thought it was because of the fall,” Johnny said. “Although we didn’t see the actual plunge, he thinks he bounced off rocks from about twenty feet up. He cracked a couple of ribs.”
If she’s wrong about Alex’s symptoms, could she be wrong about the other patients as well?
“Where did you get this information?” I asked.
“Mostly from his charts and talking with the nurses and Dr. Running Bear.” Dr. White looked at me. “I should have spoken with you. Broken ribs complicate matters. They could have masked the onset of the virus.”
“What about his rash?” Johnny asked. There was no mention of it on the board.
“Tell me more about that.”
I filled her in on when Alex’s rash started, since I’d been the one to notice it first—how it had spread, what it looked like, and how the lymph nodes were swollen. “When he’s awake, he complains that it’s painful,” I finished.
The epidemiologist made several new notations on Alex’s board. She moved from column to column, patient to patient, to see if any others presented similar symptoms. Three children did, including the boy who died. Each had come to the emergency room already sick.
“I need to see these kids. Jerry and Meenu have examined them, but I have to see the rash for myself. I can’t leave anything to chance. Jerry took scrapings and studied them under his super-duper microscope. He’s still searching.” She continued circumnavigating the room.
“No answers?” I asked.
“Nothing definitive.”
“What are you looking for?” Johnny walked with her.
“Anything that ties these cases together. Like I said, I crunch data. I’ve got everything on my PC, but I’m an old-school, visual kind of gal. I need white boards, markers, and patients.” She rubbed the back of her neck. “Just when I think I’m getting close, I receive new data that doesn’t fit, like the rash and swollen lymph nodes. It’s like a jigsaw where multiple puzzles have been dumped together. With no picture, I can’t tell what’s important and what’s not.”
“Oh my. Square pegs and round holes, huh?” I didn’t envy her the task ahead.
“If you want to interview the other parents, either Max or I can translate for those who are more comfortable speaking Spanish,” Johnny offered.
“I’ll take you up on it. In fact, I’d like one of you to be with me at all the interviews. The parents are more likely to open up when they see someone they trust and who is in the same predicament.”
I’d do anything to help her find the disease vector so the doctors could heal Alex. I wouldn’t admit it, but I didn’t care all that much about the others. My grandson came first.
My phone buzzed. It’s okay. Worry about Alex. Let the doctors take care of the rest. Ducks. This new normal of eavesdropping watchdogs still unnerved me. I held it out for Johnny to read. He turned from the boards. “Did you perform an autopsy on the child?”
“The first child?” Dr. White asked.
“What? Has another child died?” I put a hand to my throat. No one on any ward mentioned more deaths. Of its own free will, my hand moved to my mouth, the easier to bite a knuckle.
“I shouldn’t have said anything. We have three bodies downstairs. Only one died here. The others were brought in by their families as we requested. We put all outside doctors, clinics, and funeral homes on alert. Any corpse has to be brought here immediately. We also issued a warning that precaution be taken when handling the bodies,” she said.
“Why?” I asked.
“Until we identify the pathogen, we have to assume the worst. If the disease spreads through bodily fluids, handling a dead body could be a transmission point. It could be every bit as deadly as coming into contact with sprayed droplets from a live person.”
“Like Ebola?” Johnny asked.
“Exactly, except we aren’t dealing with Ebola. I’m going down to the makeshift morgue and see if Jerry has any new information.” Dr. White headed toward the door. “Sharon and Meenu suggested we keep everything under need-to-know protocols.”
“You can count on us,” I said. Too bad Alex wasn’t his old self. He’d have loved to be involved in such a mystery.
Johnny cast a final look at the boards before we left Dr. White’s workspace. She closed and locked the door behind her and headed down to the morgue. Johnny turned me to the right toward the ICU and Alex; Toby rushed past us toward the ICU. I was about to call out when Johnny put a restraining hand on my arm.
“His lab is in the basement of the main building. Why would he be in the wing with the physician offices?” Johnny had a strange look on his face.
CHAPTER NINETEEN
DR. WHITE OUTGREW her office space by the third day and commandeered the largest conference room in the hospital. A sign next to the door read “Classroom.” Three walls were now lined with the portable white boards. The fourth wall was a ceiling-to-floor, permanent white board covered with flip-chart paper. Tick constantly changed the data as she added new symptoms or crossed out others as unimportant.
“Isn’t this equipped with Wi-Fi and smart boards? You’d think they’d have them in a state-of-the-art hospital,” I said.
“You would. Looks like an oversight when they built the facility. It would help if it had what I needed, but I make do. Have you heard we admitted our first healthcare worker overnight?” She glared at the boards, hands clasped behind her back, as if demanding they divulge their secrets. “He’s in critical condition. I don’t think he’ll live.”
“I hadn’t heard. Someone who works in the hospital or a community worker?” I asked.
“He’s an orderly whose been on duty since the outbreak began.”
“Did he work in the ICU?” A couple of orderlies rotated in and out, most of them cleaning, disinfecting, and removing the used protective gear and bedding in the burn and laundry barrels.
“And everywhere else. Anyway, he said he’s felt sick for a few days, but didn’t say anything because we are so short on staff. When he woke up this morning with pustules all over his torso, he knew he was in trouble.” Dr. White erased and corrected a note on a board, her already tiny handwriting even smaller. Some boards were nearly solid black from her cryptic notations.
“That little girl next to Alex has pustules, too.” I didn’t remember anyone else with them. Rashes like Alex’s, yes, but large pus-filled blisters, no. “Can whatever is causing them be treated?”
She nodded. “If caught soon enough, it doesn’t have to be a death sentence. There’s an outside chance for the orderly.”
I grew as warm as a menopausal hot flash when a memory nudged at me.
“You might ask if he has any healing cuts. Look on his hands,” I suggested.
“Why?”
“I just remember a tray of spilled and broken syringes. I don’t know if any had been used already. That could be the cause of the orderly’s illness if the needles were already infected,” I said.
“Will do.”
###
The lockdown continued, with no end in sight to new cases and the multiplication of symptoms. I returned to Alex to relieve Johnny for a couple of hours. He updated me on Alex’s condition.
“Alex’s breathing is stable. He had inhalation therapy about an hour ago. He’s still congested, but the nurse said he shows no signs of pneumonia.”
“That’s good news. You look beat. Why don’t you go lie down?” I said.
Johnny stood and stretched. Before he left the ICU, he kissed me and gave me a big hug. I suspected he’d head over to the medical library. He and Ducks were in continual communication by phone and text about what each was learning.
Alex started panting as if trapped in a nightmare. I shook his shoulder, and Leena slipped in to take his vitals. Alex’s eyes flew open. He screamed.
“What’s wrong?” I sat
on the bed and drew the boy into my arms.
Alex’s words emerged between pants. “A—a dragon. A—a white dragon. It leaned over me and breathed on me.” His body shook.
“A dragon?” I asked. Alex had never been interested in dragons, other than Dungeons & Dragons on his computer. He nodded against my chest.
I stared up at Leena, who shrugged before she pushed a syringe into his IV port. “It’s a light sedative to calm him down. Is this the first time he’s had nightmares?”
“I think so.”
“In all other ways, he’s holding his own. Dr. Running Bear scheduled daily CT scans to be sure his lungs stay healthy.”
“Will you tell Dr. Running Bear about this nightmare?” I asked. Could it be a hallucination, or did Alex remember someone bending over him?
“Don’t worry, I will,” Leena assured me.
“I heard four more cases came in overnight. Three from the surrounding community.”
“Yes. It’s spreading outward from San Felipe.”
Alex relaxed in my arms, and I eased him back onto the bed. “How soon do you think the FBI’s investigation will give us some solid leads as to how this is expanding?” I asked.
“Not soon enough.” Nurse Leena made a couple of entries on her laptop.
“By the way, when I reviewed Alex’s medical history with Dr. White, several entries on his board were incorrect.” The variance in when Alex’s symptoms began continued to worry me. I couldn’t imagine how Dr. White’s information could be so wrong.
“Like what?” Nurse Leena looked at me. I gave her a rundown. She frowned and searched Alex’s health record. “That’s weird. I don’t see some of the information I entered right after he came into the ICU. I’ll check with the other nurses. I could swear we didn’t take anything out.”
“Could someone have changed it later?”
The nurse shot me a look of utter confusion. She moved the cursor over the record. She didn’t answer, so I pressed further. “Shouldn’t there be a history in each record of who made actual changes?”
“What do you mean?” she asked.
“Aren’t all entries time-stamped with some notation as to who entered the data?” Surely a state-of-the-art hospital had at least that amount of accountability.