HPS patients often think they have the flu. They can develop a fever between 101° and 104°. They experience headache, abdominal pain, mild coughing, and even pain in joints and the lower back. If the infection becomes more severe, the patient has difficulty breathing. The lungs fill with fluid, and the patients suffocate because their airways are blocked with fluid. Sometimes, other symptoms present: pneumonia, diarrhea, bleeding, low blood pressure, and shock. HPS is detected by an enzyme-linked immunosorbant assay (ELISA), specific serum immunoglobulin M (IgM) or G (IgG).
Sofia had to question whether the four deaths in less than a month could have been caused by Sin Nombre. There were no reports of survivors. Also, the range of the cases was enormous. Either there was a family of deer mice with frequent flyer miles, or this was a different illness altogether. Whatever it was, one hundred percent mortality was unheard of.
There had to be other cases. First, Sofia asked the CDC to contact hospitals and pediatricians in all the states surrounding Colorado. She wanted to know if they treated patients for Sin Nombre. Next, she planned to gather all the lab specimens from the four patients and see what, exactly, they were dealing with. While she was at it, Sofia would gather evidence of exposure from the victims’ homes, schools, and workplaces, to find something these four unfortunates shared, something other than death.
Chapter Twenty-Five
Greeley, Colorado is about fifty miles north of Denver. It is home to about 98,000 residents, thirty-five percent of whom are Hispanic. Sofia drove into Greeley on a Monday. She checked into the Homestead Hotel, threw her suitcase on the bed, and headed straight to the apartments where Daniel Martinez lived.
The manager told Sofia the Martinez family left right after little Daniel’s funeral.
“Did they leave a forwarding address?” Sofia asked.
“No. My guess is they moved on to another meat packing town in Nebraska, most likely.”
“I would like to see the apartment and talk to their neighbors.”
“Sure.” The manager turned to a small cabinet on the wall behind her desk. She took out a key and walked toward the door. “Follow me.”
The apartment had been painted and the carpets shampooed.
“What kind of pest control do you have here?” Sofia asked.
“We are Section 8 qualified, so we are required to spray regularly, every three months.”
“Did the Martinez family have a garage?”
“No.”
“Storage of any kind?”
“We don’t have anything like that.”
Sofia opened the cabinets and looked under the kitchen sink. If there had been mice in the apartment, they were gone now.
“What about outside? Is there a playground the kids use?” Sofia asked.
“We have a little area on the other side of the complex. The kids play all over, outside,” the manager said.
“Thanks. I’ll walk around on my own. What school do these kids attend?”
“Monfort Elementary. I can give you directions.”
“I’ll find it. Thanks.” Sofia knew the fewer directions she got from other people, the more likely she was to stumble upon something useful, just by roaming around.
The manager walked Sofia out of the apartment and returned to the office. Sofia strolled around the building. There were countless places around the apartment building where deer mice might nest. Children kick up leaves and fall down in the grass. Who knows? Daniel might have caught a deer mouse and kept it for a pet. Sofia decided to talk to Daniel’s teacher and then swing by the North Colorado Medical Center, where Daniel died.
Daniel’s teacher was Miss Mendoza, and Sofia waited until the end of the school day to talk to her. Miss Mendoza became emotional talking about Daniel.
“He was so sweet and smart. His family was very close. They all left town together: Daniel’s parents, his grandfather, an aunt, and an uncle, I think.”
“Did Daniel seem tired or listless before he got sick? Was he coughing at all?”
“Not at all. He was in school on a Friday. The next Monday, the family called and said he died at the Medical Center. We thought it was an accident of some kind, but they said, no, he had la gripa, the flu.”
“More than the flu, I’m afraid,” Sofia said. “Do the children have any animals here?”
“No.”
“Had they been to the zoo or to a farm, maybe?”
“No. We haven’t had any fieldtrips since the beginning of the year.”
“I’d like to walk around the playground, if you will point me in the right direction.”
“Of course. We had a guest come after Labor Day. She did a sand painting for the kids. Daniel was fascinated with it,” said Miss Mendoza.
“Sand painting? Here in the classroom?”
“Yes. She had a large tray, like a cookie sheet only larger. It was filled with sand. She made the painting in the tray. We took pictures. It was so beautiful. Let me show you.” Miss Mendoza went to her desk and opened a drawer looking for the pictures.
Sofia’s eyes widened. At last, a piece of evidence to examine. “Do you still have it?”
“No. The native woman told us that a sand painting is a transient work of art. After she finished and talked to the children, she took the tray outside with her and let the wind blow it away. She said that was how the healing power of the painting was released.”
“Show me where, exactly, she disposed of the sand,” Sofia said. It was times like these she loved the authority of a public health officer. “What was the native woman’s name?”
In the folder with the pictures of the sand painting, Miss Mendoza found a card.
“Eva Yellow Horn. I got her name through the University of New Mexico website. She was involved in a traveling exhibit called the Antiquities Reclamation Initiative. The exhibit was in Denver and Colorado Springs. I contacted her through the website, and she came down with some pottery and kachina dolls to show the kids. She did the sand painting and taught the children a song. They loved it. A professor was with her. I don’t see his name in the folder.”
“I’ll check it out. They were a long way from Albuquerque.”
“I guess they are traveling around to retrieve artifacts from collectors. They go where the collectors are. We were a last minute side trip for them.”
Sofia made notes about the Antiquities Reclamation Initiative, the website, and Eva Yellow Horn’s name. “There must be lots of native pottery in the hands of collectors around Denver. It’s a good idea to take some of it back where it came from.”
“They came to Greeley in a big RV. It’s a very impressive exhibit.”
“Did any of the kids go inside the vehicle?” Sofia asked.
“No. They brought the pottery into the school in boxes. Several classes participated, not just mine.”
“OK. Show me where the sand painting hit the wind, and I’ll get out of your way.”
Miss Mendoza seemed to want to talk more. Sofia held back. The students’ desks formed a U shape, with rugs and pillows in the middle. This must be the story pit, Sofia thought. Miss Mendoza walked to a desk at one of the corners of the U shape.
“This was Daniel’s desk. He was so curious and sweet.”
“I’m sorry you had to lose him.”
“And so fast. What kind of sickness comes on so fast and is so deadly, like that?”
“That’s the question I am here to answer,” said Sofia.
“Have there been other cases?”
“Three that we know about.”
“Other children?”
“One child, two adults. Not all were in Colorado, though,” said Sofia.
“Good. I mean, good for us here in Greeley.”
“I understand. Thanks for your help.”
Sofia walked to the area where Miss Mendoza said
Eva Yellow Horn threw the sand painting to the winds. She scraped up some soil, hoping to find traces of the sand. If so many children were exposed to the sand, it was unlikely the virus came from it. Besides, the native woman used colored sand, most likely dyed. Any hantavirus would likely have been killed by the dye, but maybe she would get lucky. Sofia walked on, around the playground, looking for places where mice might nest.
As Sofia walked the perimeter of the Monfort Elementary School playground, she heard the squeals and high-pitched shouts of children turned out to play. “This must be the after-school care kids.” Sofia thought the children sounded a bit like birds gathering on a beach at low tide. A few weeks ago, Daniel Martinez may have lent his voice to this happy chorus. Sofia learned that it was not possible to explore the corners and closets of a patient’s life without imagining that person well, happy, and surrounded by loving people. It was more painful for Sofia to visualize a healthy, giggling Daniel than his pale, little corpse on a dissection table.
“Let the dead bury the dead,” the Bible said. Sofia never understood what that meant. In her mind, she brought the dead, in memory only, back to a time before the “shadow of death” fell on them. Sofia left the playground, hoping she conjured up good memories of Daniel for his neighbors and his teacher.
The next day, before going to the Medical Center, Sofia stopped again at Miss Mendoza’s class. She talked to the class after they returned from morning recess. She showed them a video of adorable little deer mice.
“Have you ever seen a little mouse like this?” Sofia asked the class. A few hands went up, tentatively.
One boy volunteered, “I saw a mouse like that once when I went hunting with my dad. It was way bigger than that.”
“I’m only interested in the little ones,” said Sofia. This kid was no help at all. Now the kids’ imaginations would kick in, and they might cook up any kind of creature: winged, horned, or with huge fangs.
“Did you ever see one of these little mice around school or in your neighborhood?”
“No.”
“Yes.”
Sofia hated kids as witnesses. There was no delaying the inevitable question. Better to ask it now before someone reported chupacabra in his backyard or a pterodactyl in the pines.
“Did you ever see Daniel with a little mouse like this? Maybe, as a pet?”
“No, Daniel played in his yard. His grandfather watched him.”
“His grandfather met him at the bus every day.”
“Yeah, his abuelito was always with him.”
Sofia understood. Daniel’s parents worked, and his grandfather took care of him at home. If the family was not legal, they would never leave a child alone, even for a few minutes. The prospect of being picked up by Immigration and Customers Enforcement, ICE, in a raid at work, or by the police for some infraction, was constantly in their minds. Daniel did not wander around the apartment grounds, dig through dumpsters for treasures, or play with a little mouse behind the garages. He was never out of someone’s sight. Yet, he got sick and died, and the only way he could have contracted HPS was by contact with the furry brown rodent, Peromyscus maniculatus.
Sofia stopped at the North Colorado Medical Center, picked up Daniel’s blood and tissue specimens, and returned to Denver. Her boss refused to authorize her to fly to Tucson to investigate the second victim, Molly Crane. They argued about it all one morning. Cases in other states were outside of Colorado Public Health’s jurisdiction. There were no funds available. Flu season was starting, and there was plenty of work for Sofia in Denver.
Sofia called the CDC. She had lab specimens of a fast gestating, deadly strain of HPS. She asked if the CDC would authorize funds for her to fly to Tucson, now. Few civilians in the United States understand the power that public health officials have, or that, in a pandemic situation, the government has the authority to shut down just about anything.
After only a few phone calls, Sofia found an administrator with the curiosity and authority Sofia was looking for. The next morning, Sofia was on a 747, taxiing down a runway bound for Tucson. Headed in another direction on a different runway, was a FedEx plane to Atlanta, carrying blood and lung samples from Daniel Martinez and a plastic bag of colored sand.
* * *
In Tucson, Sofia talked to Dr. Crane about his daughter’s illness. The onset and progress of Molly’s sickness was much like what Daniel Martinez experienced. The symptoms began suddenly, and Molly was on a ventilator in less than thirty-six hours. Sofia asked about Molly’s outdoor activities.
Dr. Crane asked, “Tell me what you are looking for. I’ve seen all the pathology reports. I know it was an HPS.”
“Sin Nombre, to be exact, but a much more virulent form than we’ve ever seen.”
“Any other patients?”
“Three others,” said Sofia, “all fatalities.”
“All? There were no survivors?”
“We’ve only begun our investigation. We are looking at families, classmates, and everyone involved with the patients. Molly was a Girl Scout. Have any other girls in her troop been ill?”
“I don’t think so. Not seriously ill. I’ve been in contact with all the hospitals around. No other HPS patients were admitted before or since Molly became ill.”
“Did Molly go camping before she got sick, with the family or the Scouts?”
“No, the girls camped early in the summer. There’s a Scout camp outside of town. That was months before.”
Sofia asked to see Molly’s room. Well-to-do girls kept secrets, just like all kids. Maybe, she went for walks with boys in secluded places where deer mice hang out. Sofia looked in the back of Molly’s closet and under her bed for dirty shoes. There was nothing, not even a dust bunny under the bed. This girl was too clean for an American pre-teen.
Mrs. Crane came to the door of Molly’s bedroom. She hesitated before crossing the threshold. Sofia doubted she had set foot in the room since she came in to select an outfit in which to bury her daughter. The rims of her eyes were red where no make-up could reach.
“Have you found anything?” asked Mrs. Crane.
“No,” Sofia whispered.
“How does a killer virus choose a girl like Molly?”
“There is no choosing. It’s just luck, or fate, or God’s will, if you believe in that,” said Sofia.
“I don’t believe that way, now. Senseless suffering. My husband said keeping Molly on the ventilator was only prolonging our suffering. He said Molly’s organs were shutting down. He said she could not be saved, only maintained. I wonder, if I could ask you something?”
“Of course,” said Sofia.
“You saw the reports, the medical records, the post-mortem, didn’t you?”
“Yes, I did. What do you want to know?”
“I want to know, I need to know, if my husband was right.”
“He was right, Mrs. Crane. There was nothing we could have done to save Molly. I’m so sorry.”
“I know. I just needed to hear that. The medical community is so close. Sometimes, I feel like they are speaking another language.”
“We get caught up in our science, sometimes,” Sofia admitted.
Sofia stepped back and let Mrs. Crane enter the bedroom. She touched her daughter’s bed and the hair band lying on the night stand. Sofia thought she should let Molly’s mother be alone in the room. She turned to step behind Mrs. Crane and noticed something under a book on the desk. The bright colors of a sheet of paper drew her attention. Sofia pulled the sheet out and looked at kachina masks, colored with markers.“Where did Molly get this?” Sofia asked Mrs. Crane.
“I don’t know. What is it?”
“Drawings of kachina masks. Kachinas are part of the Navajo culture.”
“Oh, yes, I’ve heard of them. I don’t know where Molly got that. Maybe, she made it in art class or in Scouts.”
/> “Maybe,” said Sofia, but she knew Molly did not make the mask. Printed on the inside was “University of New Mexico.” Sofia turned to face Mrs. Crane. “May I take this?”
“Yes, if you think it is important.”
“I don’t know. It might lead to something. I’ll return it, of course.”
Mrs. Crane was smoothing the duvet on Molly’s bed. She was too absorbed in her own memories to think it strange that Sofia would want a drawing of kachina masks.
Back at her hotel, Sofia had to make only a few phone calls to discover that the Antiquities Reclamation Initiative had been at the Tucson Convention Center on the same day Molly was there for the MDA Telethon. She made more calls to Las Cruces, New Mexico and discovered that A. Marco and Rick Foote, like Molly Crane and Daniel Martinez, were exposed to the same person just before their illness: Eva Yellow Horn.
Chapter Twenty-Six
Krystal Carson missed her shift at the New Mexico State University Medical Center on Monday, the week before Halloween. She worked 7:00 p.m. to 7:00 a.m. in the ICU. Krystal had been tired and achy all weekend. On Sunday night, she started coughing. She took Tylenol PM for a headache that nagged her all afternoon. She slept most of Monday and ate only some cereal around 5:00 p.m.
Krystal had cared for A. Marco and Rick Foote two weeks before. Everyone on the floor had a complete blood count (CBC) with platelets after the patients died, and everyone came up clean.
By Wednesday, Krystal was running a low fever, and her pulse was 148. She was experiencing shortness of breath even when she went to the bathroom or microwaved soup in the kitchen. Her cough worsened, and she vomited after one coughing spell. On Thursday, Krystal’s chest was hurting. She used her stethoscope and heard crackles in the lower lobes of her lungs.
Krystal got an appointment with her GP on Thursday afternoon. She wore a mask in the waiting room. Her chest x-ray showed pulmonary infiltrates, and her white blood count (WBC) count was elevated.
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