Cara looked at David, conveying a message of worry. “It wasn’t this bad when we left.”
“Where’s Rory?” David asked Kate.
“He’s asleep in the other room. I kept them separate, on account of the cold. He’s fine. No fever or cough.”
“Good decision,” David said. Then, turning to Cara, “I think Heather should take him home. There’s no point in him getting sick too. Thank God she left Leslie at home with Cami.”
“Yes, good idea,” said Cara. “You’ll stay here?”
“I’ll text her. I’ll stay here,” he confirmed.
Cara felt a bit embarrassed for asking him to stay, but she didn’t like the way Hope looked. “I’m going to call the doctor.”
David settled into the seat by the bed that Cara vacated while she stood in the hall and hunted for the number of her pediatrician. Her fingers were shaking. At last she found it and tapped the number in her phone. Promptly, she heard the voice of the answering service. Cara quickly explained what was happening and asked the doctor to please call her back as soon as possible. She tucked the phone in her pocket and put her fingers to her temples, assessing the situation. Cara could usually garner her wits and act decisively when others flailed in panic. She re-entered Hope’s bedroom. Kate stood with her arms clenched around her waist, staring at the moaning Hope.
“Kate, did you give her any Tylenol?”
Kate shook her head. “You didn’t give me permission to do that.”
“Follow me,” she told Kate, and took off for the kitchen. “We need to bring down her temperature.” Thankfully, Cara kept an organized kitchen. “I want you to know where I keep all medications. Next time if this happens, call me right away to ask if you should give medication. Don’t give it on your own—but I do want you to give it before it reaches this point. You need to know where I keep it.”
She pulled out a stepstool and climbed up to the shelf over the refrigerator. This was where her mother had always kept medicines and emergency kits. Lovie had said such things needed to be kept out of the reach of children who might see the pretty pink pills or the grape-flavored syrup and think it was candy. Cara pulled out a sealed plastic bin and brought it down to the counter.
“I keep my emergency supplies, like bandages and antibiotic ointment, here. And the medicines.” She dug through the bin, then pulled out a small red bottle. “This is it.” She brought the bottle to the light to try to read the tiny lettering. She couldn’t. “Damn, can you read this?” she asked Kate.
Kate took the bottle, lifted it to the light, and read aloud the designated amount for a four-year-old.
“Okay,” Cara said, and took off for the bedroom with Kate at her heels, just as Heather came rushing into the hall, her heels clicking on the hardwood floors. Her blond hair was pulled into a twist and her floral summer dress swished as she walked.
“Is everything okay?” she asked Cara with concern ringing in her voice.
“Hope is sick. She has a fever.”
“Oh no, I hope she’ll be all right.”
“We thought it best if you took Rory home. You don’t want him exposed to whatever virus she’s caught.”
Heather’s blue eyes flickered with worry. “Yes, of course. Thanks for calling. Where is he?”
Cara pointed to the bedroom across the hall from Hope’s. “He’s asleep.”
Heather nodded, spun on her heel, and hurried in that direction.
Stepping into Hope’s room, Cara was stunned to see Flo there, bent over Hope’s bed.
“Flo! What are you doing here?” Cara knew she sounded angry, but she was too worried to care.
“I came when I heard Hope was sick.”
“Cara,” David said with a tone of caution. “She thinks—”
“I have to give Hope Tylenol,” Cara said, approaching the bed. “We need to bring down the fever.”
“Cara,” Flo said sharply.
Cara looked up. It was automatic. Flo had the authority back in her voice, like her old self.
“Listen to me,” Flo said, her eyes intent, her voice calm. “This child has measles.”
“Measles?” Frustration and confusion bubbled, putting her on pins and needles. “Of course she doesn’t have measles,” Cara said. “She’s been vaccinated.”
Flo gripped her arm tightly, forcing Cara to look back at her. “I know what I’m seeing,” Flo said. “I’ve worked with children all my life. You know this. Back in the day, I saw a lot of cases of measles. And I’m telling you, this child has measles. Look for yourself. She’s got the rash—look at her neck, by her ears. It will get worse, creeping up her face and trunk in a few hours. And that fever, that hacking cough, she’s got all the symptoms. Cara, you’ve got to get this child to the hospital.”
“Really, Flo? Are you sure?”
“Yes, dear girl. Trust me, I know.”
Cara saw the old certitude in Flo’s eyes. She nodded. “I will.”
* * *
THE MEDICAL UNIVERSITY hospital was immaculate, the doctors who tended the pediatric care unit attentive and knowledgeable, the nurses friendly and helpful.
Cara had never been more terrified.
Arriving at the hospital, Cara had immediately told the receptionist at the emergency room that they were worried it could be measles. The intake nurse hurried over, took one look at Hope, and called for a quarantine. Masks donned, the team rushed Hope to an isolation room, leaving Cara and David to sign papers at the desk. A squad of doctors and nurses hurried in and wouldn’t allow Cara and David into the room until they both confirmed they’d been vaccinated for measles. Cara held Hope’s hand as the team worked quickly and efficiently. The nurses did their best to put Hope at ease, explaining what they were doing to minimize her fears as they swabbed her mouth, took blood samples, and offered fluids. Hope clung to Cara, afraid of all the strange people poking and prodding. David stood by Cara’s side. She knew he had to feel as helpless as she did. She leaned against his strength. His hand on her shoulder felt like a lifeline.
After what felt like hours but was in fact much less, Hope was once again asleep. The medicine she’d been given was helping. She wasn’t coughing as frequently and her fever had gone down. But the rash had already spread across her face. Flo had been right. Hope was still very sick.
The head doctor approached and asked Cara and David to follow him. David gently squeezed her shoulder, and they joined the doctor in the hall. He was a middle-aged, balding man with kind eyes behind wire-rimmed eyeglasses. His white coat bore the name Dr. Manigault in script.
Cara expected warmth and perhaps a soothing bedside manner. She didn’t expect the doctor to be so terse.
“It’s measles,” Dr. Manigault said.
“But…” Cara stammered. “I don’t understand. How did she get measles?”
His eyes flashed with annoyance. “That’s what happens when a child is not vaccinated.”
“But Hope was vaccinated!”
Dr. Manigault looked doubtful. “That’s not possible. She has the disease.”
“I gave her pediatrician her records when I moved back to Charleston. We went over them together. He said all was in order. I’m sure she was vaccinated.”
“Ms. Rutledge,” he said with authority, “your child definitely has contracted measles. You must know it is one of the most highly contagious of all infectious diseases. And it remains one of the leading causes of death among young children. It’s beyond me how parents can put their child at risk when vaccinations are so easy and inexpensive.”
Cara brought her hand to her throat. This doctor was sparing her nothing.
He continued in his matter-of-fact manner: “At four years of age, your daughter is at high risk. She’s mildly dehydrated. We’re focused on fluids and hope she doesn’t develop vomiting or diarrhea. Unfortunately, she’s developed an ear infection, a common complication.”
“I’m telling you. She was vaccinated.”
He lowered his head, as th
ough containing his frustration. “We cannot accept verbal statements that she’s received the vaccine. We will need to see her records. And we will have to quarantine her. Furthermore, we will need to know the names of everyone she’s been in contact with for the past fourteen to eighteen days. A person with measles can spread the virus to others for about eight days, starting four days before the rash appears. Especially to other children.”
David stiffened with alarm, and she knew he was thinking of Rory and Leslie.
“How is the disease transmitted?” David asked.
The doctor shifted his gaze to him. “Direct contact with infectious droplets, of course. But most likely through airborne causes—a cough or a sneeze. Do you have other children?”
“I have two grandchildren who have been exposed,” David replied.
“Are they vaccinated?”
“The four-year-old is. My granddaughter is an infant.”
Dr. Manigault frowned with concern. “The MMR vaccine is given when the child is at least twelve months old, so the risk is highest for that child. You will need to be in touch with their pediatrician immediately,” he advised. “Anyone who had contact with Hope should review their inoculations.”
The doctor turned to include Cara. “She most likely caught the disease ten to fourteen days ago. The measles virus incubates. You likely didn’t see any symptoms during that time.”
“She developed a cold this week, maybe three days ago,” Cara said. “Coughing, runny nose. The temperature was low-grade, typical for a cold. I wasn’t alarmed—until tonight, when it spiked. That’s when we saw the rash and brought her in.”
“Classic pattern,” Dr. Manigault said. “Has she traveled during that time? Where do you think she may have contracted the disease?”
Cara looked at David as she replied. “We went to New York.”
The doctor pursed his lips. “Where in New York?”
David replied soberly, “Manhattan. Coney Island.”
The doctor inhaled deeply and nodded, as though to say, I understand. “There have been several outbreaks of measles in that community.”
Cara felt a chill spread through her body as a cloud of doom descended over her. “What should we do?” she asked.
“Hope will need to stay in the hospital. We can make accommodations for the mother to stay with the child. The nurse will help you with that. We’ve given her medication and fluids.” He paused. “Now, we wait.”
Chapter Twenty
After the sea turtle lays her eggs, she pats the disturbed sand down with her shell, then uses her flippers to toss sand in order to camouflage her nest. Her work done, she lumbers down the beach back to the sea, never to return to her nest. Back in the ocean, she is a lone swimmer.
CARA HAD HARDLY slept a wink in the wobbly and hard makeshift bed that was provided, but she was experiencing a nightmare nonetheless. Every noise Hope made had her jumping up to make sure she was all right. The small hospital room was institutional with a want of comfort. Metal bed frames, tables, and chairs with thin, nubby cushions were shadows in the dimly lit room. She shivered, feeling the chill in the air. Going to Hope’s bedside, she tucked the blanket higher up under her chin. Letting her fingertips graze her forehead, she felt the heat still radiating from her skin. She let her palm rest there, hoping its coolness brought some comfort.
She stood like that until the first gray fingers of light broke the blackness beyond the windows. When the nurse entered, that was her cue to leave for a few minutes. Cara straightened, feeling the stiffness in her joints, and went to the coffee shop in the lobby, relieved that she finally was freed from the pretense of sleep. She drank two cups of coffee, then went to the bathroom, where she brushed her teeth with supplies from the hospital. Returning to the lounge of the pediatric ward, she set to work assembling the information Dr. Manigault had requested.
First, she contacted her pediatrician’s office to e-mail Hope’s vaccination records to the hospital ASAP. Then she painstakingly went through her calendar to figure out who Hope had been in contact with during the past few weeks. She called Rory and Leslie’s nanny and, after bringing her up to date on Hope’s situation, got more contact information for children Hope had associated with.
Then she had to notify them.
She was nervous that the parents of Hope’s friends would react with fear and blame. Most, however, received the news well. Their first reaction was shock and then, with a few exceptions, compassion. These were the women who knew Hope—and Cara—well. Women who arranged playdates and birthday parties, who paraded around the schoolyard with Cara and Hope at Halloween and May Day. Most of the mothers reassured Cara that their children were vaccinated, so they were not fearful. But a brazen few felt the need to ask arrogantly how Cara could choose not to have Hope vaccinated and thus risk not only her daughter’s health but that of all the children in the school.
Once that was done, Cara, shaken, had to notify the nursery school. Having been an executive in Chicago years before, Cara was accustomed to making tough phone calls. But this was personal, not business. The emotions took their toll.
The principal at the school received the news somberly.
“Ms. Rutledge, we take this news very, very seriously,” the principal informed her. “We will immediately initiate appropriate procedures to alert all the parents of the school. Measles is highly contagious.” Cara held back her comment that of course she knew the disease was contagious. That was why she was calling.
“We don’t allow anyone in our school who hasn’t had the MMR vaccination,” the principal continued in a tight voice. Then with a hint of criticism, “Your records indicated Hope was vaccinated. I don’t understand how this happened.”
Cara tried to explain what had transpired. She could hear the shift in the woman’s tone from annoyance to concern and at last, sympathy. Still, the issue was serious, and the school had its work cut out for it. Cara promised to keep her updated.
The afternoon was shifting into evening. Cara laid her head in her hands, exhausted and utterly drained.
* * *
LINNEA DOUBLE-CHECKED THE beach house before locking up. The bright sun lit up the rooms. Seeing the cream sofas and Heather’s painting over the fireplace, Linnea felt soothed by the cocoon of happy memories.
She and her mother had come to the house to feed the canary and pack up clothing and toiletries for Cara. While there, they tidied the bedroom, washed up the few dishes in the sink, and gave the house a good sweeping and dusting. It was nothing Cara wouldn’t do for them. As they stood by the front door, all seemed in order. Moutarde was chirping in his cage, pleased with the fresh greens they’d offered.
“I think we have everything,” Julia said, taking a final sweep of the house.
“Poor Cara,” Linnea said. “I can’t imagine what she must be going through.”
“Whoever thought Hope could catch measles in New York?” said Julia. “It certainly puts a pall on the trip.”
“Don’t say that! The trip was perfect. This was one of those weird accidents that happens that makes us shake our heads in wonder.”
“But it happened because we went to New York,” Julia pointed out. “See what happens when you take a southern girl out of the South?”
Linnea rolled her eyes, hoping her mother was kidding. She could never be entirely sure.
“Let’s go,” Julia said. “I’m sure Cara is dying for a change of clothes.” Then, realizing her poor choice of words, she frowned and led the way out of the house.
* * *
THEY STEPPED OUT of the elevator onto the main floor of the pediatrics unit. After checking in with the desk, they walked through the brightly lit, pleasantly decorated halls to the waiting room of the isolation unit. There, Linnea saw Cara sitting at a table, her head bent and eyes closed. She was still wearing her party dress, though now the linen was woefully wrinkled. Linnea approached carefully, in case she was asleep.
“Cara?”
Car
a jerked her head up and her eyes sprang open. “Linnea,” she said as a smile of recognition eased across her face. “Julia.”
Julia stepped forward, pulling the roller bag. “We brought you a change of clothes, some toiletries, a few bottles of water.”
“And your computer,” added Linnea.
“Bless you,” Cara said gratefully.
Linnea thought Cara looked exhausted. Her face was chalky despite the tan, and shadows encircled her red-rimmed eyes. “How’s Hope?” she asked.
Cara shook her head wearily. “It’s measles.”
“Oh no,” said Julia with some alarm.
Linnea held her breath. She’d been expecting Cara to say Hope was much improved, ready to go home.
“I’m waiting for an update. She’s breathing well, but…” Cara’s lips trembled and, pinching them tight, she looked away.
Linnea couldn’t remember seeing Cara cry since Brett’s funeral. Cara was always the staunch one, the woman who stood strong when everyone else was caving. To see her on the verge of collapse shook Linnea.
“Is there anything else we can get you?”
Cara looked at them, shook her head. Then suddenly, she broke down and began to weep. Julia immediately stepped closer to wrap her arms around her sister-in-law.
“She’ll be all right,” Julia murmured as she patted Cara’s shoulders.
Linnea knew pat phrases were always expressed at such times. Though spoken in rote fashion, they nonetheless expressed all one’s sympathy, concern, and hope. The few chosen words were exactly right.
Cara collected herself and wiped her eyes with a napkin from the table. “Thank you,” she said. “For being here. I was feeling so alone.”
“You’re not alone,” said Julia. “Your family is here.”
“We’re always here,” Linnea echoed.
Cara reached out her hand and Linnea took it. “Thank you,” she said, her voice more under control. “Moutarde is well? I was worried about him.”
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