On October 29, Krystal was admitted to NMSUMC. She was intubated and ventilated by the resident she worked with every night. He suspected HPS. Her labs were performed by the technician Krystal dated briefly the summer before. She was treated with IV fluids, antibiotics, and weaned to a nasal cannula for supplemental oxygen. Krystal lived two days longer than Daniel, Molly, Abigail, or Rick, but she died on November 1.
Sofia was focused on Eva Yellow Horn and the Antiquities Reclamation Initiative as the source of Sin Nombre. Orders were prepared to impound the RV and everything in it for examination by the Serology/Virology Division of the New Mexico Department of Public Health. Krystal Carson was the last person Sofia interviewed before returning to Colorado. The source of the Sin Nombre was identified as something carried by the Antiquities Reclamation Initiative, and the problem was turned over to the State of New Mexico.
Now, Krystal Carson was dead, and she was never exposed to Eva, but that was not what made Sofia hyperventilate. It had been two weeks from the time Krystal was exposed to Sin Nombre before she started showing symptoms. In that time, Krystal traveled to Texas for a family reunion. Carsons from all over the Southwest were there, hugging and kissing Krystal, as families are supposed to do. Sitting at a table in the records’ department, Sofia could not stop hyperventilating. She felt her lungs were full of carbon dioxide, and she couldn’t exhale it. No oxygen could get into her lungs. She knew she was feeling, for a moment, what the victims of Sin Nombre felt, just before they died.
Chapter Twenty-Seven
Ted always added diced mango to his salsa. He liked how the cool sweetness of the fruit balanced the fire of the onions and peppers. He chopped the vegetables himself, and preferred the precision of a knife and the human hand to the mindless whirling blades of a food processor.
“You might embrace cooking, if you thought of the kitchen as a laboratory,” Ted said.
He set two plates on the little table that looked out on Rachel’s apartment patio. A chilly drizzle kept them inside. Ted was serving a cheese omelet, his hand-chopped salsa, steamed asparagus with lemon butter, and asiago cheese bagels. Rachel smiled and kissed Ted lightly, as he served her plate.
“Food. The body begins breaking it down into its basic parts in the mastication process. Saliva dissolves the solids so they can be moved easily through the esophagus. In the stomach, strong acids continue the break down. The intestines separate nutrients from waste and absorb the good bits and pass on the unusable parts.”
“Enough. I know the end of this story.”
“Food is fuel, pure and simple,” said Rachel.
“Does nothing about this feast, prepared with so much skill and care, move you to sensual pleasure?”
“The eggs are really good,” Rachel said.
“That will have to do, I guess,” Ted made an exaggerated frown.
“I understand my medical training forces me to see eating as a physical process, but you’re the logical lawyer. What do you enjoy about cooking?”
“I think I get lost in the methodology. I take each ingredient, and through a series of precisely executed steps, I find the most efficacious method for making the food give up all the secret goodness it contains.”
“Ah, so cooking is an interrogation for you?”
“I assemble my ingredients into a dish, just like I assemble facts in a presentation to a judge or for a settlement conference.”
“See, we are both influenced by our professions. I want more salsa. Which way is the kitchen?” Ted laughed, as Rachel pretended to not know where the kitchen was.
After dinner, Rachel cuddled with Ted on the sofa. They watched a movie until they were both dozing, when Rachel got up to take a phone call. It was from Kruti D‘Costa, her friend at the CDC. Rachel kissed Ted and retired to the second bedroom to talk to Kruti. She was gone a long time. Ted turned off the movie and cleaned up the kitchen. Rachel was still in the bedroom she used for an office. Then, Ted heard Rachel’s fax machine. He caught the end of Rachel’s conversation through the bedroom door. “Let me think about it. Yeah, he’s here. I’ll ask him. I’ll call you later.”
Ted waited several minutes for Rachel to emerge from her office and ask him whatever it was she was going to ask. He made coffee. His instinct told him he would need all his synapses firing for the conversation to come.
Finally, Rachel returned to the living room. She took the cup of coffee Ted handed her, sat down at the opposite end of the sofa, and tucked her feet under her before she faced Ted.
“Here’s the deal. There is a possible outbreak of a hantavirus in New Mexico, Colorado, and Texas. The CDC wants to hire me as a consultant to lead the investigation because of my background in virology.”
“There are good virologists in New Mexico, but I’m surmising your friend, Kruti, has proposed you for the job,” said Ted.
“She offered to pull some strings.”
“You have a research project here. ROMeze? Relief to millions of sufferers of rheumatoid arthritis all over the world. Ring any bells?”
“Four patients have died. So far, the mortality rate is one hundred percent. It has to be a mutation.”
“You sound almost excited,” Ted said.
“Maybe, I am. It’s immediate. We have a chance of saving the lives of people who may already be infected.”
“You have worked eight years on this RA therapy.”
“I’ve been kicked off, remember? I’m ‘KOL.’ That stands for ‘kicked off lady.’”
“Don’t you feel any, for want of a better word, maternal emotions toward ROMeze? You brought it into the world. Don’t you want to at least see it through its first traumatic day of kindergarten?”
“Would you be using that metaphor if I were a man?” Rachel asked.
“I wouldn’t use any metaphor if you were a man, because I wouldn’t be here having this conversation.”
Rachel paused. She knew her comment was an attempt to skirt the issue. She was embarrassed by it, and sipped her coffee. Ted used her coffee, her coffee maker, water from her tap, and yet, his was delicious. Rachel wanted to ask Ted how he made such good coffee but thought he might not appreciate the obvious dodge in the middle of what was becoming a serious conversation.
Ted inhaled deeply. He looked at his coffee, while he worded the next question in his mind. This is what he did in depositions.
“The FBI and the NIH might see you leaving as a sign of something other than Hippocratic humanitarianism. The investigation has not focused on you, yet. Taking off right now would not convince them you were not involved.”
“I wasn’t involved, so convince them,” Rachel said.
“The FBI does not believe in the brilliant scientist concentrating on test tubes and ignorant of financial reports. They believe everyone gives into temptation, eventually. It’s how their minds work, sort of like you and your gastroenterological view of my cooking.”
Rachel set down her coffee and left the living room. She returned from her office with a file folder.
“This is from my desk at Socoro,” she said.
Ted leaned back and put up a defensive hand. “I don’t want to see it. I told you not to take any files from the office, Rachel.”
“This isn’t a research file. It’s personal, sort of.”
“Even worse. I told you I don’t represent you. I represent the company.”
Rachel sat down as close to Ted as she could get. “Just hear me out,” she whispered.
“Put down the file first.”
Rachel slid the file folder under her butt. “Satisfied?”
“OK.”
“The last few months, it’s been hard for me to work on the project, longer than that, actually. P1601 works. I know it. It’s done for me,” Rachel said.
“This isn’t you, Rachel. You’re a scientist. You want to tie up every little loos
e thread, no matter how irrelevant.”
“I want the loose ends tied up, but I don’t have to be the one doing the tying. Don’t you see the difference?”
“Not really,” said Ted.
“I’m a doctor, too. There are patients out there. People who need me.”
“Oh, please, you’re not so egotistical to think you are the only doctor who can save the country from an epidemic of hantavirus.”
Rachel pulled back from Ted. She leaned back, supported by her arms. She wanted as much distance as possible from Ted without actually moving. If she moved, it would mean something changed between them. Rachel did not want that.
“Is that what you think?” Rachel asked. “Do you think I’m some egomaniac? If I were, I would be out there giving press conferences for Socoro. That’s what Cella Troost wants me to do. It’s never been about that, never.”
Ted opened his arms to Rachel. She drew close and let him embrace her. After a few quiet minutes, their breathing synchronized. They melted into each other, one being from two.
Rachel slid the file out from under her and held it in her lap. Ted said nothing. She opened the folder. Inside was a single piece of paper and a photograph. Rachel held up the letter. She did not have to read it because she memorized the words long ago.
Dear Dr. Bisette,
Please don’t be angry that I broke your code. I know that Charlie got the real drug in the test and not the placebo. Don’t ask me how I know. Just look at the photo of my son. We took this at a park near our home. Charlie loves this park. This picture is of Charlie’s first time down the big tunnel slide, alone. He has been down this slide lots of times before. Because Charlie’s knees were too stiff and hurting from RA to climb up the ladder on his own, his dad always had to carry him up. Today, Charlie climbed the ladder by himself. Did you ever see a happier kid? Charlie’s dream is to be a firefighter. He’ll have to climb many ladders to make it. He just climbed his first, thanks to you.
God bless you, Dr. Bisette.
* * *
Ted reached for the photo. Charlie’s knees were gnarled and misshapen. His shoes were untied and his t-shirt had slid up, revealing his belly. His smile spread from ear to ear. Ted looked at Rachel. Her eyes were filled with tears. Ted put the photo back into the file and laid it on the end table. He hugged Rachel to him. After a moment, Rachel pushed Ted away.
“Go home, now, and let me think,” she said.
“If you go to New Mexico, I’ll miss you,” he said.
“Come with me.”
“I can’t. You’ve just shown me evidence of another breach in your lab’s security,” Ted smiled. “Relax, I’ll take your secret to the grave.”
“Let’s hope it doesn’t come to that,” Rachel said.
At the door, Ted and Rachel kissed deeply. As he opened the door, Ted said, “If you go, I’ll cover your ass at Socoro.”
“Thank you, counselor,” said Rachel.
“And what a very nice ass it is, doctor.”
One more kiss and Ted was out the door.
Rachel carried the coffee cups into the kitchen. She went into her office and checked her e-mails. Kruti sent her copies of reports of the four Sin Nombre patients. She also sent a copy of Krystal Carson’s discharge summary. Sofia Soto printed three big stars on the top of the report before she emailed it to the CDC.
Rachel saw immediately Kruti’s concern. They studied together month after month in medical school. They could practically read each other’s minds. Rachel knew that a lab report was based on binary thinking, and a specimen was positive or negative. The culture was Sin Nombre, or it was not, but no one was looking for a mutated Sin Nombre, and all viruses mutate. That is what Kruti suspected, and if she was right and there was a mutated Sin Nombre that could be transmitted between humans, the possibility of a global epidemic, a pandemic, just became very real.
Rachel looked at the photos of Daniel Martinez and Molly Crane. Two children were dead before they had a chance to drive, graduate from high school, or fall in love. Rachel carried the papers into the living room and turned off the lights in the kitchen and the floor lamp in the living room. The only light came from a small lamp on the end table, not enough for reading but perfect for thinking.
On the coffee table, Rachel spread out the photographs of Charlie, Daniel, and Molly. One face was smiling, and two faces were composed in death. Rachel spoke quietly to the children before her.
“There are so many bad things in the world: pain, sickness, and death. Where do they all come from? Every one is a mystery. I wanted to solve some of those mysteries, and that’s why I became a doctor.”
After medical school, Rachel worked in a hospital. That’s what all new doctors did. As a resident, she saw patient after patient. One man had cancer, the next woman was having a baby, the next patient was a boy with meningitis, a girl with a broken arm, or a baby with seizures. She realized that there would always be more patients than she could help, even if she never slept. One of the nurses told her, “You have to learn to take care of yourself, first. You can’t save the world.”
Rachel’s best friend, Kruti, worked in a research facility. She told Rachel she could save more people by fighting the viruses that made people sick. Through the rest of her residency, Rachel struggled with the decision of entering patient practice or research. She met a seven-year-old patient named Charlie who suffered with rheumatoid arthritis. No matter how carefully she examined him, Charlie’s legs hurt terribly. At the end of the examination, he whispered to her, “Dr. Rachel, when will I be able to climb the ladder and whoosh down the slide?”
Rachel was proud of the work she had done at Socoro, but lately, the work left her unsatisfied. She was hoping she could shake off her restlessness when the team began patient trials. Now, she had been removed from the team. She would not see the benefits of P1601 on patients. She would probably be assigned to another research team, and then another, whatever was most beneficial to Socoro. Rachel longed to look into her patients’ eyes and hear their voices as they cried, so she could share in their happiness when they could laugh again.
What was happening in New Mexico was not only the biggest challenge any research virologist had faced since the Great Influenza of 1918, it was a chance to work directly with patients. Rachel would be studying patients already infected with the virus, people who, up to now, had no chance for survival. Rachel had a chance to change the outcomes for patients with names and faces and families who loved them. This was the time, this was what the dreams and the visions had meant, this was what the kachina had been calling her to do.
Chapter Twenty-Eight
Rachel turned onto Highway 599 at the Santa Fe Municipal Airport. She rented a Prius and planned to drive straight to the Public Health Office. In her purse was a letter from the CDC, “To Whom It May Concern,” explaining that Dr. Bisette was consulting for the CDC and was to be afforded access to any and all patient medical information, under authority of the Department of Homeland Security.
“I’m not sure this is a matter for Homeland Security,” Rachel said, when Kruti faxed her the letter.
“DHS decides what is a matter for DHS. Besides, this is an epidemic that could have been introduced by terrorists.”
“We don’t know that or suspect that, do we?”
“We suspect everything. Public health has plenty of authority on its own, but with Homeland Security behind you, doors will open. That is, if their computers and the hospital computers can communicate. There is always that problem,” Kruti said.
“You’ve been a bureaucrat too long,” Rachel joked.
It didn’t really matter what government agency authorized Rachel’s work. The epidemic was spreading fast. New cases of the mutated Sin Nombre were verified in Texas, Oklahoma, Arizona, and Utah. The Carson family was far flung and dying. So far, no one had survived the infection. Treatment of those wh
o were still alive was palliative at the moment. New Mexico Public Health people had spent a lot of time looking for Daniel Martinez, Patient Zero. Now that the virus was being passed from human to human, the animal source of the virus was moot.
Rachel entered the address of the Department of Public Health into iPhone Maps. She pulled onto Highway 599, heading northeast. After meeting with the public health officials, the plan was to fly her by helicopter to Albuquerque. Lab specimens for all the Sin Nombre victims, including the patients in Colorado and Arizona, were at the University Medical Center.
Part of Rachel’s genius was her ability to break a problem down into its parts, prioritize them, and work on each part, or delegate the work in its proper turn. She also knew what was important and what was interesting, but not critical. It was an instinct Rachel knew she possessed in high school. She was brilliant, but her nearly perfect grades also came from her ability to discern and focus on what her teachers thought most important. In more than one class at the university, Rachel prepared one set of notes for the final exam, another set of notes based on what she found interesting in the class, and even though she knew instinctively the professor would not include that material in the final exam, she achieved mastery of the whole subject. In four years of college and four years of medical school, Rachel rarely guessed wrong about what to learn. That same instinct made her a top researcher. She did not chase red herrings.
Daniel Martinez and Molly Crane seemed to be infected by an animal as yet undetected. Rachel’s intuition told her that these cases were still important, and she planned to pursue them even if the Public Health Office thought they did not matter, since the virus had mutated.
Rachel looked into her rear view mirror. She had not adjusted it when she left the airport, an oversight based on her eagerness to get on the road. As she pulled the mirror down, all she saw was the grille of a big vehicle and the word JEEP filling the entire mirror.
Blood of the White Bear Page 12