The Perfect Pathogen

by Mark Atkisson

  Rob and Katie were planning on moving Hope into the new independent living facility at the Center as soon as it was finished. It was actually Hope’s idea to build the living units on the site of the training Center. She hoped to move into an apartment in the Center of Prince Frederick early next year. This would give her access to the stores, library, theater, and swimming pool facility. It was her dream to live on her own. Well sort of. She didn’t want to actually be on her own completely, for she had a friend in a wheelchair who was paralyzed below the waist and the two of them wanted to share an apartment. Rob thought it was a good idea for her to have company and they both could help each other out. They each had their own strengths that complemented the other’s weaknesses.

  Rob’s musings were interrupted by a phone call. He thought that maybe Katie had forgotten to tell him something.

  “Hi, this is Doctor Howard at University Hospital. I would like to speak to Dr. Katie McMann. I promised I would call her if the patient’s condition changed. Please have her give me a call at her earliest opportunity.”

  “Any message?” asked Rob.

  “No, just have her give me a call. Thank you. Good bye.”

  The doctor hung up the phone and Rob was left holding the receiver in his hand, assuming that the lady from the conference had taken a turn for the worse.

  A few minutes later Katie walked in. “What a busy day,” she said. “I thought it would never end.”

  “Well, it hasn’t,” said Rob. “Dr. Howard at the hospital called. He would like you to call him back at your “earliest opportunity”. It sounded urgent, but he didn’t want to leave a message.”

  “I think I’ll eat first, I’m starved. Would you mind pouring me a glass of Chardonnay? I need something to take the edge off.”

  “Certainly,” said Rob. “I’ll join you.”

  They both sipped at their wine while Katie devoured her tuna sub. She was wondering what the doctor had to say. She hoped it wasn’t bad news, but then why else would he have called? She expected the lady, Therese Espland, would require a lengthy stay, but had tried to push the doctor to release her so she could at least attend the last day of the conference.

  After finishing her sub and glass of wine, Katie picked up the phone. She dialed the doctor’s number, waiting several moments for the doctor to come on the line.

  “Dr. McMann. Where are you, are you sitting down?”

  “Yes, I am at home. Why?”

  “Ms. Espland died about forty-five minutes ago. When you left the hospital, the prognosis was that she could possibly leave the hospital in several days, but shortly after you left her vital signs degraded and it seemed that she just gave up. A few minutes later her heart stopped. Attempts at resuscitation failed. I am sorry, Dr. McMann.”

  Katie sat for a moment in shocked silence.

  “Dr. McMann, are you there?” the doctor asked after about thirty seconds, prompting a response from Katie.

  “This is all happening so suddenly. I don’t know what to say. Can you tell me what the cause of death was?”

  “I can’t be definitive without an autopsy, but it seems that she died of old age. The progression of her death was not abnormal for a woman of her age, it just seemed to happen quicker once it started. Normally with a stroke like this, the person could recover and live for several more days, months or years. In her case that was not to be. She went downhill rapidly.” There was a pause and then he added, “I must say, I haven’t seen that very often.”

  Still in shock Katie said, “Thank you for the call doctor.” Katie said good bye and hung up the phone, as a tear ran down her cheek.

  Rob came to her side and put his arm around her. She was visibly shaken. He had never seen her like this before. “Honey, I know this is very upsetting, but she was elderly.”

  “That’s not the point,” said Katie. “She was in great health, as was Margaret Smith. They both died in a similar manner and, you know, I don’t believe in coincidences. This is really unnerving,” she added. “I need to call my assistant Beth at home to see if there are others who didn’t make it to the conference because of health-related reasons.”

  Katie reached Beth and relayed her concerns; she had a bad feeling about this. She asked Beth how many no-shows there were for the conference, and was told there were around thirty. She asked Beth to contact each of the missing attendees to find out why they hadn’t made it to the event. After hanging up she tackled her emails.

  Soon enough, her initial shock, and that niggling concerns that had formed at the back of her mind turned to fear. As she opened each email from colleagues across the globe, she read reports of the deaths of over twenty-five centenarians in the last day. Whatever was happening wasn’t good, and it wasn’t clear why this was happening now, and so suddenly. As she read the last account of one of her fallen heroes, she decided it was time to alert her director.

  Katie tried to call Herb Simpson, her office director, but there was no answer. Next, she would try and reach his boss. She had never called the Washington DC head of the CDC before, but convinced of the immensity of this problem, she looked up her number anyway and, tentatively, dialed.

  “Hello,” she heard on the other end of the line.

  “Hello, is this Dr. Lin?” Katie asked.

  “Yes it is. Can I help you?”

  “Yes, hi, this is Dr. Katie McMann. I conduct the aging studies.”

  “Oh yes, I remember we met when you briefed me on your latest conclusion regarding the sustained increase in life expectancy. What can I do for you this late in the day?”

  “I know it is late, but I have some disturbing news. I can’t reach my boss, but it is important and I need to tell someone.”

  Katie explained what had happened, her hypothesis that something was killing the elderly, and what her next course of action might be.

  “You did the right thing by calling me,” said Dr. Lin. “Looks like we’ll need to get to the bottom of this. Meet me in my office tomorrow morning at 9 a.m. with any new information you may have. I will call in Dr. Ben Shah, our leading expert in viruses and pandemics. Whatever this is, it needs to be looked into and, if true, needs to be stopped before it causes anymore damage. I will see you in the morning.”

  Katie hung up and tried again to call Herb. There was still no answer. She suspected he was out for a late dinner with his wife. She would have to skip the conference tomorrow morning and report directly to the office, making sure that she was there in time to check her emails and prepare a brief before her boss arrived at 7 a.m., and their meeting with Dr. Lin.

  Rob had been sitting and listening to all of the phone calls, and was also growing increasingly concerned. “Say, it’s getting late. I have checked on the kids and they’re ready for you to tell them goodnight.”

  Even though the boys were older, they still enjoyed the good night kiss from their mom. Katie expected it was because of the extra attention she paid to Hope and the desire for notice that is normal in the human makeup. She said good night to all of the children and then joined Rob in their room.

  “What a night,” she said.

  “Preceded by quite a day,” said Rob.

  Katie put her arms around Rob.

  “The only way I am going to be able to sleep tonight is if you give me a sleeping, pill, if you know what I mean.”

  “I was hoping I would be able to fulfil my manly duties and provide you with the comfort needed to overcome your stress,” Rob replied.

  Katie gave Rob a long deep kiss and they fell into bed together.

  CHAPTER 5

  The next morning, Katie arrived at the office a little before seven. She liked the early morning hours when the office was silent, absent of other workers. She could dig into her work without any interruption.

  As soon as she sat down, Katie opened her email and immediately saw the plethora of death notices she had received from her colleagues around the world overnight. A quick count showed the loss of another forty-two centen
arians. What the hell was happening? Moments later her phone rang, and she heard the strained voice of Melody Simpson, her boss’s wife.

  “Yes, hi Katie, this is Melody Simpson. I am at the hospital with Herb. He had a stroke last evening. I have been here all night and he doesn’t seem to be getting any better.”

  Chills went up Katie’s spine. She took a deep breath and tried to keep the panic out of her voice as she replied.

  “Melody, I am so sorry to hear this. Which hospital is he in? Is there anything we can do to help?”

  “Not right now,” said Melody. “ All the family is here and we are saying prayers for his quick recovery. He is in the Anne Arundel Medical Center. Your prayers would be appreciated also.”

  “Of course we will keep Herb in our prayers and I will inform the Director about his illness this morning. Our best wishes for a speedy recovery for Herb. Please call if you need anything,” said Katie. “I’ll try and drop by later today.”

  Katie hung up and sat, unmoving, at her desk for about two minutes. Thoughts were racing through her head. Herb was 72 years old, and certainly wouldn’t be considered “elderly.” But she couldn’t help wondering if this was just a coincidence, or was the illness that had struck her study group also effecting other age groups? Surely this couldn’t be the beginning of some kind of pandemic that started by attacking the elderly? Or the weak? Or perhaps everyone? No. It was just coincidence. She knew from her studies that in the United States about 8,000 people die every day. But that number is spread out among everyone, not just the elderly. Maybe what she was seeing was within the statistical average. There had to be a reasonable explanation, she thought, and it was just her mind working overtime. But she couldn’t help thinking that there were too many coincidences of late.

  Katie did a quick back-of-the-envelope calculation. Her centenarian group was dying at about twenty times the normal rate. So it could be the early stages of a pandemic. She shuddered. She knew from past experience that at the early stages of a pandemic the death rate is low and then it starts to increase. If twenty times normal was low, and this was the start of something, then the death toll could be huge.

  She continued to gather her statistics to prepare for her 9 a.m. meeting with the Washington Director of the CDC, and then, on a hunch she called the Emergency Room of the Anne Arundel County Medical Center.

  “Hi, this is Dr. McMann from the CDC. I am gathering some statistics regarding people who have suffered strokes. Have you seen an increase in patients that have required emergency medical care with stroke type symptoms?” said Katie.

  “It is funny you should ask,” the ER physician on duty replied, “We were just commenting that we have seen about five times as many patients with these types of symptoms in the last twenty-four hours. Not clear what the cause is, but clearly something’s amiss. We have used MRIs to confirm the strokes. The limited lab testing we have done so far has been coming back normal.”

  “Have you had any deaths from this illness?” asked Katie.

  “Yes, so far we have had three people die, all were in their 90s. Of the five so far, it seems that the younger you are the better chance you have for survival. We expect the increased number is just an aberration, for people in their 90s dying of strokes is not uncommon.”

  “Thank you very much for the information,” said Katie. Before hanging up, she gave the doctor her email and contact information in case he had more information to share.

  She gathered up her documents and notes from her disturbing conversation with the hospital and left for her meeting.

  As Katie entered the Director’s conference room she was greeted by Dr. Benjamin Shah who extended his hand as he introduced himself.

  “Dr. McMann? Ben Shah. It is good you came over here this morning. The Director called me last night after your conversation with her, and I’ve been able to reach out to some of our regional contacts to see if they had any abnormal information regarding the death of the elderly. This morning, I have been receiving reports from our tracking Center of higher than normal death rates across the U.S., but no apparent cause has been identified. In fact, no one really noticed until I asked.”

  This was as Katie had expected, and she was relieved to know there was at least some corroborating evidence to back up what had up until now been her hunch: she wouldn’t seem like an alarmist. But it still didn’t make any sense. There had to be a cause and she knew the CDC organization would get to the bottom of it tout de suite.

  Moments later, the Washington Director of CDC entered the room, her physicality, her reputation and her personality filling the room. She was known for her outstanding work with the health department in Chicago before she was appointed to this position last year.

  After a firm handshake and greeting, Dr. Sarah Lin asked Katie to show her what she had.

  “Well, here is a quick slide I put together regarding the statistics on aging that I normally follow. This depicts on the left side the death rate of the population we track throughout the world now, compared to the death rate over the last twenty-four hours on the right side of the slide. As you can see, we are at about twenty times more than normal right now. Every time I check my email there are more reports of the same from my seven tracking points across the globe. There is no known cause at this point, but anecdotal evidence indicates they are all suffering from stroke-like symptoms. Routine testing at a local hospital has not identified any consistent cause associated with the illnesses, except for the victims being mostly those in their 90s,” Katie explained.

  “Thank you, Katie. Where did you get your information regarding the local hospitals?’

  “Herb Simpson is at the Anne Arundel Medical Center. He suffered a stroke. I called the ER doctor at the hospital and he said that it appears that their admissions of people with these symptoms are up five-fold in the last twenty-four hours. Herb is only 72, so I can’t be sure if he is part of the pattern or if it’s just coincidence. The hospital has seen three deaths, all in people who were over 90 years old.”

  “That agrees with information I have been receiving now at the CDC Epidemic Tracking Center,” said Ben. “We have seen an alarming increase in deaths across the country with no apparent cause. It is way too early to know more, but biopsies, cultures, immune assays and path reports have been ordered, and we’ll have to wait for the results. The Regional Director in Kansas indicated there were symptoms of very old age in the younger deaths as well as in those that are very old. It is almost like they seem to be suddenly and rapidly growing old, and then are having a stroke and dying. I have a team of twenty researchers looking at this now, and we will start by doing autopsies on some of the dead here in the DC area. Another team in Atlanta is experiencing the same thing and will be conducting parallel research to try to determine the cause.”

  Then the DC Director said, “I have set up a secure Digital Video Conference call with the Director of the CDC and the Secretary of Health and Human Services for 10 a.m. this morning. I want you both in the meeting. Please do not discuss your findings thus far with the press. All inquiries should be submitted to our Press Officer. We certainly don’t want mass panic on the streets. We need to contain the information surrounding these deaths and temper any misinformation, so only official press releases are permitted. Katie, I want to thank you for bringing this to my attention so quickly. I talked to the CDC Director in Atlanta and the Secretary last night, and they were both glad for the heads up. Great work so far, now let’s take a few minutes to get ready for the Video Conference Call.”

  The Director and Dr. Shah left the conference room. Sarah’s assistant entered the room and began to set up for the call. Katie took advantage of the pause to check her email and check in with Beth at the conference. She hoped there was no more bad news, but prepared herself for the worst. Her thoughts turned to Herb. Was he part of the group? And if he was, how about everyone else in the DC area?

  CHAPTER 6

  For Rob this was just another day. He k
new Katie had some big concerns, but he had no idea what had transpired after she left home today. He dropped off the kids as usual and then headed into the Center, enjoying the familiar journey down route 231 and across the Patuxent River. He gazed across to the north and saw the vast expanse of the organization he had built, with its green houses, water front pier and training facility. He could picture in his mind how it would look with the new living facilities completed and hundreds of kids enjoying the wonders of independent living.

  Marge was already there when he arrived, waiting for him with a grave look on her face.

  “Rob, one of our students has died,” she said, breaking down in tears as she uttered the words. Rob held her as she wept, understanding her grief. Both of them had strong, personal attachments to every student at the Center.

  “What happened? Who was it?” asked Rob.

  “It was Seth,” she replied. “We don’t know for sure what happened, but he fell sick last night at home and was rushed to the St. Mary’s County hospital, and died shortly afterwards. His parents said he had some kind of seizure, and that it wouldn’t stop. It was the first time he had ever had one. The doctors called it status epilepticus.”

  Rob hesitated for a moment, his thoughts turning to Katie and her work.

  “Marge, my wife received news last night of a large group of elderly people that died. I don’t know if it was because of seizures, and it could be a coincidence. But if there is a connection... I don’t think it is good to speculate, I think we should watch the children closely. At the first sign of any health issues, we need to call an ambulance.”

  They had experienced children dying at the Center before, albeit not very often, and Marge was a little shocked by Rob’s news.