Taji's Syndrome

by Chelsea Quinn Yarbro

  “How high?” Irene asked, and when Reed hesitated, she said, “Dale, tell me. I’ll hear the hospital scuttlebutt in any case, and this way the information has a chance of being right.”

  “We haven’t had anyone come in with it so far who has . . . recovered.” He knew that this was more than she could handle and he did what he could to soften the blow. “That doesn’t mean quite what you think. So far we haven’t been able to isolate what we’re treating. That’s really the crux of the problem, that we aren’t sure what is disease and what is side effect. Once we do, then there are many methods of treatment open to us. We’re being cautious so that we don’t inadvertently fuel the fire.” That, at least, was accurate.

  “I see,” she said, her face turning from him again. “Will you leave me for a couple hours, Dale? I have to think about this. I have to steady myself.”

  “Sure,” he said reluctantly. He reached out and patted her arm through all the gear between them. “I’ll be back. You’re going to get well, Irene. I’m set on it.”

  “Thanks,” she said in a voice that quivered.

  “Nothing to thank me for yet,” he said, damning himself for the truth of his words. He was at the door when she spoke again.

  “I know that my hair looks awful, and that I’m chalky-pale and that I don’t smell very good. Half the time I want to sit and cry. I’m glad you want to cheer me up, and I know that when you say I look good, you mean that you care about me. But don’t flatter me, okay, Dale?” She had propped herself on her elbows and was watching him closely. “It makes me doubt everything you say when you do that.”

  “I’ll try to remember,” he promised her.

  “See you.”

  Once he had shed the protective clothing and passed through the double partition that separated the quarantined rooms from the rest of the hospital, Dale Reed headed at once for epidemiology on the second floor. He went at a brisk pace, his eyes fixed forward so that it was not likely he would be stopped by one of the nurses or his patients he might encounter on the way. He kept thinking about what Irene had said to him, and about the doubts it caused. It was not possible or sensible, yet he wanted to go back and argue with her, to straighten it out with her so that she would know for him it made no difference if her hair wasn’t perfect, or her make-up was on, or any of the rest of it: to him she was beautiful. That was for later, he vowed, when he had some hope to offer her as well.

  Wendell Picknor’s office had a view of the freeway interchange and the parking lot, but it was large and had access to the computer room. Wendell himself looked more like an overgrown farmboy than a highly qualified physician with an additional Ph.D. in public health and a genius IQ. He wore a lab coat over his plaid flannel sport shirt and his tawny hair needed cutting. “Hi, Dale,” he said as Reed came into his office. “Just the man I wanted to see.”

  “Convenient,” said Reed, making sure the door was closed. “How’s it going?”

  “We’re comparing test results for all the patients with the same condition Missus Channing has. I’ve got the first printout right here”—he indicated a stack of paper atop other stacks of paper on his desk—“and they’re running the second batch right now.”

  “And?”

  “Nothing so far,” Picknor admitted. “We’re drawing blank after blank. I’m getting all of this ready for Atlanta. The Environmental Disease branch has more statistics and information than we have in Dallas. They might have records from other parts of the country where this has cropped up. I think we might, be looking at a condition with a long fuse—possibly years of incubation—and that complicates the problem. Atlanta’s better able to develop information than we are, if that’s the case.” He looked up at the ceiling, as if reading dim runes there. “They also have access to some of the information on secret government dumping sites, in case this is one of those little goodies the feds cooked up and threw away.” He raised his head so that his lantern jaw stood out. “They might even have enough records there to show us where to look for what’s wrecking the collagen on all these patients. After the fever starts, their blood comes apart, almost. It can’t hold on to anything.” He sighed abruptly and looked at Reed. “Which is why I wanted to talk to you.”

  Reed had been listening with increasing apprehension. “What does that have to do with Missus Channing? Are you telling me her condition is deteriorating?”

  “It’s what I’m trying to find an obtuse way to suggest. I don’t want to tell you anything, because I don’t know enough, not really.”

  “When you consider her case, how optimistic can you be?” Reed asked, trying not to be too sarcastic. “Are we talking about weeks, or what?”

  “I don’t know. She’s alive, and though she’s very weak, she isn’t going downhill as fast as some of the others. She’s as close to holding her own as any patient I’ve seen, and that is encouraging, simply because it isn’t bad news. I don’t know how she’s fighting it, or if she has some kind of resistance to it built into her genes, but if there’s anyone in there I think could pull through it’s your Missus Channing.” He patted the printouts again. “There isn’t much else to report, not yet. I’ve sent word to most of the major hospitals in the Southwest, in case they’re seeing any of this stuff. So far, there’s only been one possible case in Flagstaff, which is all the more reason to think that we’re dealing with environmental contamination.”

  Reed nodded. “Suppose other parts of the country have something like this spreading—how would you know about it, and what difference would it make?”

  “Well, any doc worth his salt would run the standard tests, and given the peculiarities of the disease, would have to reach the same conclusion: environmental contamination of some sort. It’s the only diagnosis that fits.” He crossed his arms and grabbed his elbows as if to restrain them. “I hope Atlanta comes through for us. I hope that someone, somewhere, has a line on this shit.”

  “Where do I come in? What about Missus Channing?” Reed smoothed his tie nervously. “Isn’t there a way to get her more help than she’s getting now?”

  “There would be, if we knew what we were up against; you’re sensible enough to know that.” Picknor looked out the window at the winter afternoon and the traffic snarl on the freeway. “How many other cases are out there, that’s what I want to know. Who else is walking around with this crap in him, waiting to shred his blood?”

  “What about an alert or a screening?” Reed suggested.

  “I asked Public Health to start a screening program, the same kind we used for the Tunis Flu Two in Ninety-one, but they’re not willing to do it yet. They’ve agreed to send around a bulletin to all physicians, hospitals and clinics in the state—it duplicates some of what I’ve done, but what the hell—and to follow up any leads.”

  “That’s a start,” said Reed cautiously. In the distance he could hear the whoop of an ambulance siren. “I’m willing to do a blood workup on all my patients as standard for as long as you say it’s a good idea.”

  “Fine,” was Picknor’s absent response. “What bothers me is the number of teenagers who’ve come down with the stuff. It’s way out of proportion, almost three teenagers to one adult, and that doesn’t make sense.”

  “Maybe the contamination, whatever it is, was dumped, or released, or started while they were younger and that’s tended to make the condition show up sooner.” Reed frowned. “Mono is pretty much a teenagers’ condition.”

  “But what about younger kids? Why aren’t any little kids coming down with it?” Picknor asked angrily.

  “Long fuse, like you said,” Reed answered, dissatisfied with it as Picknor.

  “That’s a fucking weird long fuse,” Picknor said. “I’m going to get a cup of coffee. You want one?”

  “Sure; thanks,” said Reed, his mind still on the puzzle of the strange disease.

  “I hope th
at Atlanta can give us a hand on this one. If they can’t, I haven’t a clue about what to do next. I want to get to the bottom of this, but I don’t have enough to go on yet.” He went toward the door to the computer room where the coffee machine was. “Cream or sugar?”

  “Black, with a dash of cinnamon,” said Reed, endorsing the latest coffee fad. “What if Atlanta can’t give you a hand on this?”

  “Then we’re up the proverbial creek,” came Picknor’s voice from the next room. “And I don’t want to think about that yet.”

  Reed nodded slowly. He began to think over his patients and to consider the complaints he had had from them during the last six months. One of them, a principal at a local high school, had come in suffering from mild anemia and fatigue. There had been nothing more wrong, and Reed had not been very concerned since the woman had a history of heavy menses. Now he wondered if he ought to call her back and run more thorough tests on her. It would alarm her, of course, but surely he owed it to her to make certain she was not suffering from the same disease that was devastating Irene Channing. He reached for the phone on Picknor’s desk and dialed his own office. “Marge?” he said when his receptionist came on the line with his name and the name of his partners.

  “Doctor Reed?” said Marge.

  “Look, I want you to call Jenny Wentworth and schedule a full blood workup for her.”

  “What?” Marge said, then, before Reed could speak, she said, “Missus Wentworth called an hour ago. She wants to see you as soon as possible.”

  “Why?” Reed asked, though he was already certain he knew the reason. “Did she tell you?”

  “Only that her condition was worse and that she was starting to run a fever. She’s pretty upset, Doctor Reed. I told her I’d let her know how soon you can see her.”

  It took Reed a few seconds to gather his thoughts, and then he had to school himself to speak in his usual brisk fashion instead of with the worry that was at him. “Ask her if she can come to the office this evening at say, six. Tell her that I may want her to check into the hospital for a few days. If she can’t manage this, call me back at once. I’m in Picknor’s office and will be for another half hour.” He held the receiver away from his ear, knowing that Marge would tend to it in her usual efficient way. “Thanks,” he said before he hung up.

  “You look rotten, if you don’t mind my mentioning it,” said Picknor as he came back into the room with two cups in his hand. “Had bad news, or what?”

  “I think I might have turned up another case of the same thing Missus Channing has,” said Reed heavily.

  “You might as well get used to it,” said Picknor, handing one of the two cups to him. “If I’m right, you’ll be seeing more of it in the next several months.”

  “You sure know how to make a guy feel good,” said Reed. He tasted the coffee but the savor did not register. “I’m having her come to the office this evening. Is there room for her?”

  “I’ll call admissions and see what I can arrange,” said Picknor. “Give me the name and I’ll take care of it.”

  Reed scribbled Mrs. Wentworth’s name on a memo and handed it to Picknor. “She’s forty-nine, married, three children and one grandchild. She’s a high school principal. You’ll like her.”

  “Highland Park high school?” asked Picknor with false casualness.

  “No. But not far from there, come to think of it. It’s a private school, specializing in problem kids—not behavioral problems; learning problems, dyslexia, that sort of thing—and kids with minor handicaps. They do a lot of sports there; in fact, their track team walloped the competition all through last semester.”

  “Interschool competition, then?” Picknor said.

  “What are you getting at? Do you think that might be connected?”

  “I don’t know what to think. I don’t know what’s connected, and damn it all to perdition, I don’t know where to start. I only pray that I don’t make a wrong choice and lose valuable time chasing down false leads.” Picknor slapped his thigh in disgust. “I hate this. I fucking hate it.”

  “Yeah,” Reed said. He drank most of the rest of his coffee, then said, “Look, after you talk to Atlanta, will you let me know what you’ve found out, if anything.”

  “Sure. Where can I reach you?” Picknor did not let Reed answer, but held up the memo. “Call me once Missus Wentworth’s admitted. Maybe we can compare notes then. I ought to have the first response by then. If not, I’ll try to catch you on rounds tomorrow.”

  “Okay,” said Reed. He let his thoughts wander briefly, and then he said, “Do you mind if I look over those printouts? I don’t know if I can help any, but sometimes two heads are better than one.”

  Picknor shrugged and handed a stack to Reed. “Help yourself. If you see anything you can make heads or tails of, tell me about it, won’t you.”

  Reed was almost halfway through the printouts when his office called back saying that Mrs. Wentworth would meet him at his office or the hospital, whichever he preferred, at six-thirty. “Tell her to make it the hospital, then, the out-patient entrance—that’ll save time. Thanks, Marge.”

  “Sure thing, Doctor Reed,” she said.

  Reed went back to the printouts with a growing sense of defeat.

  —Corwen Blair and Wilson Landholm—

  “There are more than twenty kids in the school out with that stuff, and that’s in addition to the dead ones,” Wil Landholm shouted into the telephone. “I want someone from your department to move ass down here right now and start checking this out before we have a full-scale epidemic on our hands.”

  “Doctor Landhold, I’m sure that—”

  “Landholm,” he corrected. “Doctor Wilson Justice Landholm. Your office must have my credentials on file somewhere.” His temper was not helping him, he knew, but he was not willing to play the endless games that the bureaucrats demanded. “Don’t give me any shit, Blair. I know about you and the trouble you got into during the Tunis Flu. We could have saved two thousand more people if you hadn’t held us up with paperwork forever. Your office was so busy making sure you were protected that you left everyone else out in the cold.” Before he could compound his offense, Landholm took a deep breath and deliberately let it out on a slow count of eight.

  “Doctor Landholm,” said Blair in a condescending tone, “I don’t want to upset you any more than you obviously are already, but you have to understand that one of the purposes of our office is to assuage the general public’s fears so that we will not have any panic. If there is some sort of communicable disease with a high fatality rate, than it behooves us to do everything possible to calm the citizens. If they are permitted to panic, they might leave the area, and then we would have trouble, because the disease could not be contained.”

  “Did you actually say ‘behooves’?” Landholm wondered aloud.

  “It is the correct word, Doctor Landholm,” said Blair. “Not that it would matter to you. You specialize in athletic medicine, don’t you? Sports injuries, tennis elbow, football knee, that sort of thing?”

  Landholm bit back two equally contemptuous retorts, then said evenly, “I want to understand why it is that you are permitting this to go uninvestigated. I want it on record that I believe you are exceeding your authority in this matter, that you are abusing the public trust, that you are not acting in the best interests of the people of this state. And furthermore, I am going to contact the Environmental Authority in Washington to find out what might be causing this outbreak.” He wanted the satisfaction of slamming down the receiver, but was stopped by the cold, imposing tones of Corwen Blair.

  “You’re free to do that, of course. But if it turns out that you have made a mountain of a molehill, Doctor Landholm, I want you to know that I will do everything in my power to see that you lose your license and I will sue you for slander and defamation of character. Win o
r lose, I will tie up your life in litigation for the next decade.”

  “See you in court, Doctor Blair,” Landholm muttered as he hung up.

  Blair glowered at his telephone, furious that he was deprived of the satisfaction of hanging up first. When at last he put the phone down, he had brought his breathing almost back to normal and the flush had receded from his fair skin. He stared at the notepad on his desk and tried to decipher what he had said to himself.

  “Doctor Blair?” said one of his underlings from the door, a fresh-faced young woman recently out of internship. She was an exotic in this office, a talented internist of Mexican-Vietnamese parentage who had placed fifth in her class but had not yet found a specialty that attracted her.

  “Miss Paniagua,” he said, forgetting her proper title as usual.

  “You sent for me? It’s eleven o’clock.” She looked at her watch as if there might be some doubt.

  “Oh, I hadn’t realized it was so late. That last call took longer than I had anticipated.” He moved away from the desk, then said as if he had a passing thought, “Have we had any change in the incidence of mononucleosis recently? Any increase or more severe cases?”

  “I don’t know,” said Dien Paniagua. “Would you like me to look up the records?”

  “If you would. There’s no rush, of course, but I gather that there might be a slight increase and it would be sensible to keep an eye on the stats, in case we need to issue schoolwide recommendations and physicians’ advisories.” He squared up the stack of envelopes at the corner of his desk. “Also, if there are any indications that we ought to be on the alert for some kind of toxic reaction in the general public, something that has to do with an old dump or maybe delayed fallout reaction from the old testing grounds, keep me informed, will you?”