by Mark Kelly
She accepted it reluctantly.
When they returned, she held the bottle gingerly between her thumb and forefinger. “Here,” she said, her lip curled up in disgust. The nurse left with the bottle.
A girl, around her age, stepped through the half-open door. Her eyes sparkled above the surgical mask that covered her mouth and nose. Her jet black hair, perfectly brushed and glossy, flowed down over her shoulder.
Saanvi gawked at her. Even with the ugly plastic gown that hid the rest of her body, Saanvi could tell she was beautiful.
Dr. Brar’s eyes lit up when he saw her. “Hi, Princess, come in.” He motioned her into the room.
She walked over and gave him a hug and then turned with a flourish to face the bed. She waved a gloved hand.
"Hi, I'm Dishita,” she said in a voice that bubbled with effervescence. The girl waved her hands excitedly as she talked. “My brother told me all about you. You must be terribly bored.”
Her brother? Saanvi was surprised her doctor had a family. Of course he does. Everyone does.
“I know your aunt and uncle visit every day,” he said, “but I thought you might enjoy talking to someone your own age for a change. Dishita was at the hospital today for a dedication ceremony. I asked her to drop by and say hello.”
He walked to the door and turned back. “I’m sorry, I have to go now. I’ll see you later, Saanvi—you too, Princess.”
“Why does he keep calling you Princess?” Saanvi asked after he had left.
“Because he's an ass,” Dishita answered flippantly and marched to the side of the bed.
“Do you mind if I sit?” She pulled up her plastic gown and sat without waiting for an answer.
Saanvi studied the girl from up close. Her eyes look like emeralds, they almost glow.
Dishita blinked. “Is something wrong?”
“No, sorry. Your eyes—they’re amazing.”
“Thanks, they’re special contacts. My eyes are brown, but I think green looks better.”
“Did they cost a lot?” The words tumbled out of her mouth. “I'm so sorry that was rude of me.”
Dishita laughed at her discomfort. “That’s okay. They weren’t too expensive—I think. I don’t actually know, my Grandmother bought them for me. She pays for everything. She can afford it. She's the Rajmata of Gujarat.”
“What’s that?”
“It’s kind of like a member of the Indian royal family."
“Is that why your brother called you princess?”
“Yeah. He thinks it's a big joke.”
“I like him. I’m glad he's my doctor.”
Dishita gave her a wicked look. “He's much too old for you,” she said in a scandalous voice.
Saanvi felt the blood rush to her face. Her cheeks burned. “Don't be silly, I mean he's a good doctor,” she said stiffly.
Dishita bit her lip and tried not to laugh. “I know, I was just joking—besides, he’s married.”
“How come you have an American accent?” Saanvi asked, changing the subject.
“I don't, do I?”
“Yeah, a little.”
“I go to school in the states, at Madeira. It’s a boarding school in Washington. I’m flying back next week.”
“Sounds exciting…You're so lucky.”
A couple of hours passed quickly as they talked about music and movies. Dishita described living at the boarding school and Saanvi gave her an update on her boring life in London.
“I’ve never been to London,” Dishita said. “I think that would be wonderful.”
Dr. Brar opened the hospital room door and poked his head in. “It looks like you two are getting on well. I have a surprise for you, Saanvi.”
She looked at him expectantly. He disappeared and then re-entered the room, pushing a wheelchair. The wheelchair wasn’t what she noticed first, it was the smile on his face. He wasn’t wearing his surgical mask!
Her eyes lit up. “Does that mean—“
“Yes, the infection is gone. You'll have to stay in the hospital for a few more days, but we'll need to move you to another room to free this one up for another case.”
“Did you learn anything from my tests?”
His shoulders sagged and he suddenly looked tired. “No, it’s still a mystery, but we’ll keep looking.”
Dishita looked at her watch and ran to the door. “I didn't realize it was so late, Nanni is expecting me for dinner.” She turned to Saanvi. “I’m sorry, I have to go, but I can come back and visit tomorrow if you want.”
Saanvi beamed at her. “That would be great, see you then.”
11
I’M SO TIRED
March 26th, 12h45 GMT : Georgetown University, Washington D.C.
Tired as he was after spending the night in his office, Tony Simmons spotted Emma Rice the moment he stepped out of the elevator into the lobby. It was early, a few hours before classes would start. The building should have been empty, but there she was, sitting alone reading a newspaper.
I wonder if I can make it to the door without her spotting me, he thought as he plotted out his path.
He’d spent the last twelve hours comparing protein sequences from completely unrelated strains of bacteria to those from Gore’s sample. What he saw astonished him.
Everything pointed towards Gore’s bacteria as being genetically engineered. The variations were too perfect. It didn’t make any sense at all. He wasn’t aware of any research on genetically modified C. diff. Why go to all the trouble?
"Professor Simmons...Professor Simmons!"
Damn, maybe if I pretend I didn't hear her, I can make it to the door. He concluded that wouldn’t work and stopped.
"Have you seen this?" She waved a newspaper in front of him. “Look, it's like you said."
He had no idea what she was talking about—and didn’t care. He needed coffee and wanted to get back to work. The building’s cafe wouldn’t open for a few more hours. He would have to go off campus but she was in his way.
"No, I've been busy,” he said, reluctantly accepting the newspaper she shoved in his face. It was the current issue of the Wall Street Journal, not something he would normally read. He was surprised she did.
"It’s on the last page of the first section," she said excitedly as she took the paper back and turned to the page. “See…Bellevue Hospital in New York City…There's been a C. diff outbreak." She handed the paper back to him and he began to read.
By JAMES R. GERSWIN And CAROL VORTZ
Updated March. 25, 7:16 p.m. ET
New York—Dr. Thomas Dullet, Chief of Medicine at Bellevue Hospital addressed the temporary closure of one of the hospital’s floors to combat an outbreak of Clostridium difficile.
“This is a patient-safety issue,” Dullet said in a telephone interview, “We’re doing it out of an abundance of concern, but anticipate re-opening access to the floor in a couple of weeks.”
When asked what impact he expected the closure to have on Bellevue’s operations, Dullet responded, “Unfortunately, this will impact our ability to take new patients and we will be directing the citizens of New York to one of the other fine hospitals in the city until we’re back in full operation.”
Simmons blinked and re-read the article. Another outbreak? I’ll try Gore again and see what the CDC is reporting. They can’t be related. It doesn’t spread that quickly.
But first, I have to get rid of her. He handed the newspaper back to her.
“That's interesting,” he said nonchalantly, “but nothing to be concerned about. They’re just cleaning up—extra sanitizing, things like that.”
He started to walk towards the building exit. Before he could take more than a couple of steps, she was in front of him blocking his way. She’s like a rash that won’t go away.
He frowned. “What else can I do for you, Ms. Rice?”
“I need my backpack.”
“What?”
“My backpack—I left it in your office yesterday. I need it. My term p
aper for ENG104 is in it. I need to submit it today.”
“Now?”
She nodded, a crooked little smile on her face and he heaved a great long sigh. “Come on then.” He turned and walked back towards the elevator.
“My father says it’s pretty serious.”
The statement came from nowhere.
“Pardon?”
“My dad says the outbreak is bad.”
He looked at her dubiously. ”Who’s your father?”
“He’s a Military Attaché at the United Nations.“
“Your father is with the United Nations?”
“No, the Department of Defense. He’s a colonel in the army. He's been assigned to the UN for the last couple of years."
“When did he tell you this?” he asked as the elevator door opened.
“This morning. Called and woke me up…he sounded pretty worried. He said I should stay at home for a few days. He’s always worrying but I told him I had to hand in my paper.”
He stared at her, confused. “What does your father do at the UN?”
She shrugged. “I don’t know.”
The elevator door began to close. He stuck his arm out and forced it back open. “Come on, let’s get your backpack.”
They entered his office. Her backpack lay on the floor in front of the desk where she had left it the day before. She picked it up and threw it over her shoulder.
“Are you working on the same thing from yesterday?”
Already deep in thought, he ignored her and walked to his chair. He opened his laptop and navigated to the Center for Disease Control website and signed in. He’d done work for the CDC in the past. His login credentials still worked.
She stood beside him and leaned forward to watch. "What are you looking for?"
“Health advisories—the CDC has a database that records outbreaks.”
He clicked on the type selector and chose 'C. diff' from the drop down list. A seemingly random series of dates and locations filled the screen. He realized he needed to change the sort order. He clicked on 'most recent' and the display refreshed. Not seeing Bellevue Hospital, he clicked to the next page, and then again.
A chill coursed through his body as he flipped through the pages. There are outbreaks being reported all over the world!
“Do you see anything, Professor Simmons?”
He nodded and pointed to the screen. “There are a lot of outbreaks. Here's one in India with twenty-seven cases and one in Europe with thirty-two, and here's one in Scotland with—“
"With what?" She stared at the screen, trying to see what he had seen. "With what, Professor Simmons?"
“Two hundred and twelve cases..."
He looked up at her blankly as he remembered Gore’s words from the day before. Thirty-nine cases is what Gore had said—but now there are two hundred and twelve…five times as many in less than twenty-four hours.
"What about Bellevue?” she asked.
When he didn’t answer, she reached over and shook his shoulder. “Professor Simmons?"
He stared at her hand and then her face.
“Yes?" he asked, in a distant voice.
"What about Bellevue?"
He nodded and clicked on the hospital’s entry.
“Sixty-eight.“
“Is that a lot, Professor Simmons? It doesn’t sound like a lot—especially compared to two hundred and twelve.”
“It’s a lot,” he answered in a stunned voice, “even five or six is a lot in any one hospital.”
He scanned through the data, sorting it in different ways. The cases had all been reported in the last week. The outbreaks started in Scotland and spread from there. At this rate, it will be everywhere in another week or two.
He couldn’t just pick up the phone and call the CDC for more information. He wasn’t even supposed to have access to their database. The newspaper lay on his desk. He grabbed it and flipped to the article. Bellevue…I think that’s where Mei ended up.
He and Mei had dated while she was getting her medical degree and he was finishing his Ph.D. Things turned serious towards the end, they’d even talked about marriage, but he was too wrapped up in his research and she had an opportunity at Bellevue. Neither of them was willing to compromise. After a failed attempt at a long distance relationship, they’d given up after six months. They still traded birthday cards but he hadn’t talked to her in years.
He pulled the top drawer of his desk open and then closed it. I can’t just call her out of the blue, he thought, oddly nervous. Yes, I can, it’s important. She’ll understand. He yanked the drawer back open and searched through the mess of papers for his old address book. Her phone number was in it.
MEI’S exhausted brain blended the ringing telephone into her fitful dream. It was Robinson calling. He wanted to know why she hadn’t told him about the infection. “But, I tried…you wouldn’t listen.”
She jolted awake and looked around, blinking from the bright light. She was in the staff lounge lying on the couch. A phone was still ringing. It was her’s.
She rolled off the couch and staggered to her locker. What the hell is the combination? Her brain was dumb with sleep and she fumbled with the lock. Twenty seconds later, the phone was in her hand.
“Hello?”
“Ah…hello, Mei, it’s me, Tony.”
She hadn’t heard his voice in years but recognized it immediately. The memories came in a flood. She didn’t know what to say.
“Mei?”
“Hello, Tony,” she said after a pause.
“I heard about the outbreak at Bellevue. It was in the Wall Street Journal.”
“It’s in the paper?” She was surprised.
“Yeah, this morning’s edition. But it isn’t the only one.”
“What do you mean? There are others?” she was suddenly awake.
“A lot—all over the world according to the CDC.” She listened as he told her about what he had seen on the CDC website and his conversation with the British scientist. “Do you remember when it started—who your patient zero was?”
“A British man,” she replied and told him about Muir. “I think he was the first, but a lot of the cases seem to be random, unrelated. And not just the elderly—young healthy people as well. Some are kids.” She thought about the little girl in the ICU. I need to go check on her. See how she’s doing.
“I don’t think they’re random,” he said, interrupting her thoughts. “The strain appears to be hypervirulent. I can’t really explain it—at least not yet—but it doesn’t look natural. It looks engineered—like someone had taken specific genes from other strains to create this one.”
“Why would anyone do that?” She asked, dubiously.
“I don’t know—Maybe it escaped from a research lab,” he answered, “Or it might be…” His voice trailed off
“Or what?” she asked when he didn’t finish.
“It might be bioterrorism.”
The thought seemed far-fetched. The hospital had a preparedness program for a bioterror attack. It hadn’t been activated.
“It’s definitely man-made,” he continued. “How are you treating your patients?”
“Antibiotics but nothing works. It seems to be resistant.”
“It probably is,” he said, confirming her fear. “If it’s the same strain as the one I looked at, there are resistance genes in it. “What about FMT? Have you tried that?”
“We aren’t set up for it,” she answered. “There are a bunch of FDA regs. The hospital’s administration is working to get it all sorted out, but it’ll be a few weeks. Even then, we don’t have a supply of screened material.” She couldn’t bring herself to call it what it really was—screened poop.
The chime of the PA system sounded. It wasn’t urgent, just loud. It reminded her she had patients to see. “I have to get back on the floor, Tony.”
It was nice to hear from him but a lousy time for a call.
“Maybe we could catch up later?”
She liked the wistful tone in his voice. “That would be great.”
“Ask her if the hospital is going to be closed,” a female voice shouted into the phone.
“Tony, who is that?" Her warm feelings disappeared.
”Emma Rice, one of my students. She showed me the article in the Wall Street Journal—Shit!” He began to talk quickly. “ I should have asked you earlier. It said some of your floors were closed.”
“That’s right, four floors yesterday—for decon—”
“Were there patients on them?” He sounded frantic.
“Yes, of course.”
“What did you do with them?”
She tensed at his tone. He was starting to freak her out. “We moved them to another hospital—Why?”
“Damn it! Were any of those patients infected?”
“No, I don’t think so. Our ICU is full but as far as I know we’re keeping infected patients here—what’s going on, Tony?” He had her even more worried now.
“Gore, the scientist in England, told me the spores are extremely hardy, more so than normal. Bleach or high temperatures is the only way to kill them. Plain old soap and water might work as well—I don’t know.”
“I’m positive they’re using bleach to decontaminate the closed floors,” she answered. She knew they were, she could smell it every time she rode the elevator.
“That’s not what I’m worried about,” he replied. “If they didn’t decontaminate the patients before transferring them, there’s a good chance the spores—”
His voice disappeared.
“Hello, Tony?”
“Hello?”
She looked at her phone. No service.
“Damn it.”
“HELLO…hello…Mei?”
Simmons pressed the redial button. Nothing, not even ringing. He tried again, and then once more.
“It’s dead. I can’t get through.”
“Maybe it’s your phone, Professor Simmons,” Emma suggested.
He used his cell phone to call his desk phone. The sound of ringing filled the office. “Nope, it works fine.”
He plopped down in his chair and tried to call Mei one last time. Nothing.
Irritated, he placed the phone on his desk and began to spin it, faster and faster until he couldn’t keep up with the rotations. On his last attempt, he knocked it over. The sound of ringing played through the speaker and he reached for the phone, ready to disconnect the call.