by Robin Cook
Jack perked up. “I wonder what made him think of plague?”
“I wonder too,” Martin said. Reaching over to his intercom system, he paged Richard Overstreet. While they waited for the man to arrive, Martin determined that Nancy Wiggens had signed out on the original gram stain. Martin paged her as well.
Richard Overstreet appeared within minutes. He was a boyish, athletic-looking individual with a shock of auburn hair that fell across his forehead. The hair had a habit of slipping over his eyes. Richard was ever pushing it back with his hand or throwing it back with a snap of his head. He wore a white jacket over surgical scrubs; his jacket pockets were crammed with test tubes, tourniquets, gauze pads, lab chits, and syringes.
Martin introduced Richard to Jack, then asked him about the short discussion they’d had about plague the day before.
Richard seemed embarrassed. “It was just my imagination getting the best of me,” he said with a laugh.
“But what made you think of it?” Martin asked.
Richard swept his hair from his face and for a moment left his hand on the top of his head while he thought. “Oh, I remember,” he said. “Nancy Wiggens had gone up to get a sputum culture and draw the man’s blood. She told me how sick he was and that he appeared to have some gangrene on the tips of his fingers. She said his fingers were black.” Richard shrugged. “It made me think of the black death.”
Jack was impressed.
“Did you follow up on it at all?” Martin asked.
“No,” Richard said. “Not after what you’d said about the probability. As behind as we are in the lab, I couldn’t take the time. All of us, including me, have been out drawing blood. Is there some kind of problem?” Richard asked.
“A big problem,” Martin said. “The man did have plague. Not only that, but he’s already dead.”
Richard literally staggered. “My God!” he exclaimed.
“I hope you encourage safety with your techs,” Jack said.
“Absolutely,” Richard said, regaining his composure. “We have biosafety cabinets, both type two and three. I try to encourage my techs to use one or the other, especially with obviously serious infectious cases. Personally I like the type three, but some people find using the thick rubber gloves too clumsy.”
At that moment Nancy Wiggens appeared. She was a shy woman who appeared more like a teenager than a college graduate. She could barely look Jack in the eye as they were introduced. She wore her dark hair parted down the middle of her head, and like that of her immediate boss, Richard, it constantly fell across her eyes.
Martin explained to her what had happened. She was as shocked as Richard had been. Martin assured her she was not being blamed but that they should all try to learn from the experience.
“What should I do about my exposure?” she questioned. “I was the one who got the specimen as well as the one who processed it.”
“You’ll probably be taking tetracycline by mouth or streptomycin IM,” Jack said. “The hospital infection-control officer is working on that at the moment.”
“Uh oh!” Martin voiced under his breath but loud enough for the others to hear. “Here comes our fearless leader and the chief of the medical staff, and both look unhappy.”
Kelley swept into the room like an irate general after a military defeat. He towered over Martin with his hands on his hips and his reddened face thrust forward. “Dr. Cheveau,” he began with a scornful tone. “Dr. Arnold here tells me you should have made this diagnosis before…”
Kelley stopped mid-sentence. Although he was content to ignore the two microbiology techs, Jack was a different story.
“What in God’s name are you doing down here?” he demanded.
“Just helping out,” Jack replied.
“Aren’t you overstepping your mandate?” he suggested venomously.
“We like to be thorough in our investigations,” Jack said.
“I think you have more than exhausted your official capacity,” Kelley snapped. “I want you out of here. After all, this is a private institution.”
Jack got to his feet, vainly trying to look the towering Kelley in the eye. “If AmeriCare thinks it can do without me, I think I’ll run along.”
Kelley’s face turned purple. He started to say something else but changed his mind. Instead he merely pointed toward the door.
Jack smiled and waved to the others before taking his leave. He was pleased with his visit. As far as he was concerned, it couldn’t have gone better.
6
WEDNESDAY, 4:05 P.M., MARCH 20, 1996
Susanne Hard was looking through the small, round window of the door to the elevator lobby with rapt attention. The end of the corridor was as far as she was allowed to go on her ambulation. She’d been walking with little steps while supporting her freshly sutured abdomen. As unpleasant as the exercise was, she knew from experience that the sooner she mobilized herself, the sooner she’d be in a position to demand release.
What had caught her attention out in the elevator lobby was the disturbing amount of traffic coming in and out of the medical ward as well as the nervous demeanor of the staff. Susanne’s sixth sense told her that something was wrong, especially with most of the people wearing masks.
Before she could put a finger on the cause of the apparent stir, a literal chill passed through her like an icy arctic wind. Turning around, she expected to feel a draft. There wasn’t any. Then the chill returned, causing her to tense and shiver until it had passed. Susanne looked down at her hands. They had turned bone white.
Increasingly anxious, Susanne started back to her room. Such a chill could not be a good sign. As an experienced patient she knew there was always the fear of a wound infection.
By the time she entered her room she had a headache behind her eyes. As she climbed back into bed, the headache spread over the top of her head. It wasn’t like any headache she’d ever had before. It felt as if someone were pushing an awl into the depths of her brain.
For a few panicky moments Susanne lay perfectly still, hoping that whatever had seemed wrong was now all right. But instead a new symptom developed: the muscles of her legs began to ache. Within minutes she found herself writhing in the bed, vainly trying to find a position that afforded relief.
Close on the heels of the leg pain came an overall malaise that settled over her like a stifling blanket. It was so enervating that she could barely reach across her chest for the nurse’s call button. She pressed it and let her arm fall limply back to the bed.
By the time the nurse came into the room, Susanne had developed a cough that chafed her already irritated throat.
“I feel sick,” Susanne croaked.
“How so?” the nurse questioned.
Susanne shook her head. It was even hard to talk. She felt so terrible she didn’t know where to begin.
“I have a headache,” she managed.
“I believe you have a standing order of pain medication,” the nurse said. “I’ll get it for you.”
“I need my doctor,” Susanne whispered. Her throat felt as bad as when she’d first awakened from the anesthesia.
“I think we should try the pain medicine before we call your doctor,” the nurse said.
“I feel cold,” Susanne said. “Terribly cold.”
The nurse put a practiced hand on Susanne’s forehead, then pulled it back in alarm. Susanne was burning up. The nurse took the thermometer from its container on the bedside table and stuck it into Susanne’s mouth. While she waited for the thermometer to equilibrate, she wrapped a blood-pressure cuff around Susanne’s arm. The blood pressure was low.
She then took the thermometer out of Susanne’s mouth. When she saw what the reading was, she let out a little gasp of surprise. It was 106° Fahrenheit.
“Do I have a fever?” Susanne questioned.
“A little one,” the nurse said. “But everything is going to be fine. I’ll go and give your doctor a call.”
Susanne nodded. A tear came to t
he corner of her eye. She didn’t want this kind of complication. She wanted to go home.
7
WEDNESDAY, 4:15 P.M., MARCH 20, 1996
“Do you honestly think that Robert Barker deliberately sabotaged our ad campaign?” Colleen asked Terese as they descended the stairs. They were on their way to the studio where Colleen wanted to show Terese what the creative team had put together for a new National Health campaign.
“There’s not a doubt in my mind,” Terese said. “Of course, he didn’t do it himself. He had Helen do it by talking National Health out of buying adequate exposure time.”
“But he’d be shooting himself in the foot. If we lose the National Health account and we can’t restructure, then his employee participation units are worth the same as ours: zilch.”
“Screw his employee participation units,” Terese said. “He wants the presidency, and he’ll do anything to get it.”
“God, bureaucratic infighting disgusts me,” Colleen said. “Are you sure you want the presidency?”
Terese stopped dead on the stairs and looked at Colleen as if she’d just blasphemed. “I can’t believe you said that.”
“But you’ve complained yourself that the more administrative duties you have, the less time you can spend on creativity.”
“If Barker gets the presidency he’ll screw up the whole company,” Terese said indignantly. “We’ll start kowtowing to clients, and there goes creativity and quality in one fell swoop. Besides, I want to be president. It’s been my goal for five years. This is my chance, and if I don’t get it now, I’ll never get it.”
“I don’t know why you’re not happy with what you’ve already accomplished,” Colleen said. “You’re only thirty-one and you’re already creative director. You should be content and do what you are good at: doing great ads.”
“Oh, come on!” Terese said. “You know we advertising people are never satisfied. Even if I make president I’ll probably start eyeing CEO.”
“I think you should cool it,” Colleen said. “You’re going to burn out before you’re thirty-five.”
“I’ll cool it when I’m president,” Terese said.
“Yeah, sure!” Colleen said.
Once in the studio Colleen directed her friend into the small separate room that was affectionately called the “arena.” This was where pitches were rehearsed. The name came from the arenas of ancient Rome where Christians were thrown to the lions. At Willow and Heath the Christians were the low-level creatives.
“You got a film?” Terese questioned. In the front of the room a screen had been pulled down over the chalkboards. At best she thought she’d be looking at sketchy storyboards.
“We threw together a ‘ripomatic,’” Colleen explained. A ripomatic was a roughly spliced together amalgam of previously shot video that had been “stolen” from other projects to give a sense of a commercial.
Terese was encouraged. She’d not expected video.
“Now I’m warning you, this is all very preliminary,” Colleen added.
“Save the disclaimers,” Terese said. “Run what you have.”
Colleen waved to one of her underlings. The lights dimmed and the video started. It ran for a hundred seconds. It depicted a darling four-year-old girl with a broken doll. Terese recognized the footage immediately. It was part of a spot they’d done the year before for a national toy chain to promote the company’s generous return policy. Colleen had cleverly made it appear as if the child were bringing the doll to the new National Health hospital. The tag line was “We cure anything anytime.”
As soon as the video stopped, the lights came on. For a few moments no one spoke. Finally Colleen broke the silence. “You don’t like it,” she said.
“It’s cute,” Terese admitted.
“The idea is to make the doll reflect different illnesses and injuries in different commercials,” Colleen said. “Of course, we’d have the child speak and extol the virtues of National Health in the video versions. In print we’d make sure the picture told the story.”
“The problem is it’s too cute,” Terese said. “Even if I think it has some merit, I’m sure the client won’t like it, since Helen via Robert would certainly trivialize it.”
“It’s the best that we’ve come up with so far,” Colleen said. “You’ll have to give us some direction. We need a creative brief from you; otherwise we’ll just keep wandering all over the conceptual landscape. Then there will be no chance to put anything together for next week.”
“We have to come up with something that sets National Health apart from AmeriCare even though we know they are equivalent. The challenge is finding that one idea,” Terese said.
Colleen motioned for her assistant to leave. Once she had, Colleen took a chair and put it in front of Terese’s. “We need more of your direct involvement,” she said.
Terese nodded. She knew Colleen was right, but Terese felt mentally paralyzed. “The problem is that it’s hard to think with this presidency situation hanging over me like the sword of Damocles.”
“I think you’ve got yourself in overdrive,” Colleen said. “You’re a ball of nerves.”
“So what else is new?” Terese said.
“When was the last time you went out for dinner and a few drinks?” Colleen said.
Terese laughed. “I haven’t had time for anything like that for months.”
“That’s my point,” Colleen said. “No wonder your creative juices aren’t flowing. You need to relax. Even if it’s just for a few hours.”
“You really think so?” Terese asked.
“Absolutely,” Colleen said. “In fact we’re going out tonight. We’ll go to dinner and we’ll have a few drinks. We’ll even try not to talk about advertising for one night.”
“I don’t know,” Terese voiced. “We’ve got this deadline…”
“That’s exactly my point,” Colleen said. “We need to blow the tubes and clear out the cobwebs. Maybe then we’ll come up with that big idea. So don’t argue. I’m not taking no for an answer.”
8
WEDNESDAY, 4:35 P.M., MARCH 20, 1996
Jack navigated his mountain bike between the two Health and Hospital Corporation mortuary vans parked at the receiving bay at the medical examiner’s office and rode directly into the morgue. Under normal circumstances he’d have dismounted by then and walked the bike, but he was in too good a mood.
Jack parked his bike by the Hart Island coffins, locked it up, then whistled on his way to the elevators. He waved to Sal D’Ambrosio as he passed the mortuary office.
“Chet, my boy, how are you?” Jack asked as he breezed into their shared fifth-floor office.
Chet laid his pen down on his desk and turned to face his officemate. “The world’s been in here looking for you. What have you been doing?”
“Indulging myself,” Jack said. He peeled off his leather jacket and draped it over the back of his desk chair before sitting down. He surveyed his row of files, deciding which one to attack first. His in-basket had a newly replenished pile of lab results and PA reports.
“I wouldn’t get too comfortable,” Chet said. “One of those looking for you was Bingham himself. He told me to tell you to come directly to his office.”
“How nice,” Jack said. “I was afraid he’d forgotten about me.”
“I wouldn’t be so flippant about it,” Chet said. “Bingham was not happy. And Calvin stopped by as well. He’d like to see you, too, and smoke was coming out of his ears.”
“Undoubtedly he’s eager to pay me my ten dollars,” Jack said. He got up from his desk and patted Chet on the shoulder. “Don’t worry about me. I have a strong survival instinct.”
“You could have fooled me,” Chet said.
As Jack descended in the elevator, he was curious how Bingham would handle the current situation. Since Jack had started working at the ME’s office, he’d had only sporadic contact with the chief. The day-to-day administrative problems were all handled by Calvin.
“Close the door,” Dr. Harold Bingham commanded.
Jack did as he was told. Bingham’s office was spacious with a large desk set back under high windows covered with ancient venetian blinds. At the opposite end of the room was a library table with a teaching microscope. A glass-fronted bookcase lined the far wall.
“Sit down,” Bingham said.
Dutifully Jack sat.
“I’m not sure I understand you,” Bingham said in his deep, husky voice. “You apparently made a rather brilliant diagnosis of plague today and then foolishly took it upon yourself to call my boss, the Commissioner of Health. Either you are a completely apolitical creature or you have a self-destructive streak.”
“It’s probably a combination of the two,” Jack said.
“You’re also impertinent,” Bingham said.
“That’s part of the self-destructive streak,” Jack said. “On the positive side, I’m honest.” He smiled.
Bingham shook his head. Jack was testing his ability to control himself. “Just so I can try to understand,” he said as he entwined the fingers of his shovel-like hands, “did you not think that I would find it inappropriate for you to call the commissioner before talking with me?”
“Chet McGovern suggested as much,” Jack said. “But I was more concerned about getting the word out. Ounce of prevention is worth a pound of cure, especially if we’re looking at a potential epidemic.”
There was a moment of silence while Bingham considered Jack’s statement, which he had to admit contained a modicum of validity. “The second thing I wanted to discuss was your visit to the Manhattan General. Frankly, your decision to do this surprises me. During your orientation I know you were told that our policy is to rely on our excellent PAs to do site work. You do remember that, don’t you?”