Taji's Syndrome

by Chelsea Quinn Yarbro

  “Of course,” said Dien Paniagua, curious to know who had brought this on. In the sixteen months she had worked for Blair her respect for him had eroded steadily, so that now she thought of him only as an incompetent physician interested in protecting his place in the power structure, and willing to do whatever seemed expedient to maintain it. As she followed him down the hall, she decided that she would take the time to review the various reports that came into their office to try to find out what was behind this atypical interest.

  The conference room was larger than necessary, and the chair at the head of the long table was taller than the others, and had two massive padded arms to enhance its throne-like image. Though there were only going to be four people at the meeting, Blair predictably took the head chair and indicated that Doctor Paniagua should sit four places down from him. Neither of the other two persons attending the meeting was permitted any nearer their boss.

  “I have called this meeting in order to inform you that we will be up for federal review again in six months, and the matching funds from the federal government will be reassessed. If we are to keep up our current duties, we will need to convince both the federal and state authorities that we are in need of more money and more help. You will all agree that the work load is too great for the number of men and women we have on the job here. Therefore, I want each of you to take the time to outline the upcoming projects you plan to pursue and to specify the amount of money and personnel you will need in order to complete those projects with the greatest dispatch. I do not want you to cut corners, nor to be sparing of budget. Remember, we always have ways to spend the money we have, but we do not always have ways to get more.” He spread his hands face down on the table. “So far each of your departments has shown a tendency not to meet deadlines, and for that reason, I think it best that you consider your projects both at current manpower and with increased employment.”

  “But it isn’t a manpower problem, it’s a time problem,” said Tracy Bell unwisely. “We simply don’t have time enough to gather all the data we need. If we could extend our deadlines we could manage with our current work force very easily.”

  Blair’s face darkened. “I don’t believe what I am hearing, Doctor Bell. You do not appreciate our position within the State Department of Health, and if you do not, it is time you did.”

  All three of his underlings concealed sighs with varying degrees of success.

  “Doctor Blair,” said Daniel Vitale, “we all share that same problem, and there’s no use saying that it isn’t important, or that more manpower is the answer: it isn’t, that’s all there is. You may want to think so, and that’s up to you, but I have to warn you that the reports we are sending out of my section are inadequate and misleading because we do not have enough time to compile our material and get useful comparative curves. We handle disability in my division, and that is a tricky area. In limiting us to six-month units, we have little opportunity to show either recovery rates, or seasonal fluctuations in the various accidents and injuries we have to process.” He stood up, one hand on his hip. “Recently there’s been a slight increase in short-term claims, but unless we’re given longer units of time, we can’t know if this is part of a normal cycle, or something else.”

  “I’ll consider what you say. It might be worthwhile to consider establishing a long-term statistical analysis branch to overview all the departments. That way we’ll be able to interrelate all our data.” Blair’s close-set eyes shone at the very thought. “We’ll need to think about that.”

  Vitale shook his head with frustration. “If you’ll forgive my saying so, Doctor Blair, we do not need another layer of paperwork and muddle to weight us down, we need, if anything, a simplification of our current system, not the addition of another cumbersome department.” He looked at Tracy Bell and Dien Paniagua. “What do you say? Can we get together and come up with a plan for simplification? Would you be willing to spend a couple extra evenings a week for the next month or so working out a way to streamline our departments?”

  “Fine with me,” said Bell.

  “I can make arrangements,” said Paniagua, who had a three-year-old son at home.

  “You see, Doctor Blair? We’re willing. It won’t cut into your time and there’s no reason for you to—”

  “This is ridiculous!” thundered Blair. “Good God, man, do you realize what you’re suggesting?”

  “I’m suggesting we find a way to deliver health information to the people of this state,” said Vitale with asperity. “We aren’t doing a very good job of that now, and if we muck it up with more bureaucracy, we’ll deliver even less.”

  “Your behavior is inexcusable,” said Blair with a frown that had frightened lesser men than Dan Vitale.

  “I’m trying to do the work I was hired to do, sir. No disrespect intended, Doctor Blair, but this department has not been very successful in that department. After the way we screwed up on the Tunis Flu, I think we ought to try to clean up our act.”

  That was twice in one day that the Tunis Flu had come up and by now Corwen Blair wanted to hear no more of it. He rose to his feet and leaned forward on the table so that he loomed over the others. “I have heard quite enough out of you, young man. When you have dried off behind the ears, you might be prepared to offer your criticism on the performance of this department, and the rest of the state bureaucracy, for that matter. But until you have a track record that consists of more than your medical degree, I suggest—I very strongly suggest—that you comply with my order. Is that clear?”

  “You bet,” said Vitale angrily. “Yes sir, sir.”

  “I am going to dismiss you all and I will expect to hear from you tomorrow with the plans I have already outlined to you. If you have some reason to question the advisability of these plans, we may discuss them in private then. Otherwise I will regard these last remarks as an unfortunate lapse, the result of zeal. If they are renewed in any way, I will have to change my mind. And that might have repercussions, Doctor Vitale. Is that clear?”

  “It’s clear,” said Vitale. “I got you.” He turned on his heel and left the room.

  In the abrupt silence that followed Vitale’s departure, Tracy Bell and Dien Paniagua exchanged covert and uneasy glances, though neither gave any sign of noticing the gravity of the insult Vitale had given Blair.

  “I will expect both of you to be in my office before noon tomorrow,” Blair announced, his voice loud and forceful.

  “All right,” said Tracy Bell, rising and gathering up her attaché case. “Tomorrow morning.”

  “Tomorrow morning,” echoed Dien Paniagua, wishing she had the courage to do what Dan had done. If only she did not have a child to support, if only she did not fear being unable to work. If worse came to worse, there were clinics where she might practice, but the pay was often poor and the locations unsafe. The reason she had taken this job was that the money was good and the hours predictable, so that she would not have to leave her child with sitters all the time. These considerations and apprehensions ran in endless repetition as she went back to her office.

  At last, in desperation, she went to the main computer room and asked to see the reported incidents of mononucleosis for the last four months. She needed something to take her mind off the conflicts that seethed in her. Long ago she had learned the anodyne use of study and now she sought it as eagerly as an addict.

  Two hours later, looking at the improvised graph she had prepared, she knew she had not escaped from anything, that the unpleasantness in the office was nothing more than a minor irritation. What she had found in her reading and figuring was more than an outbreak of mononucleosis, it was a potential epidemic of an unknown and deadly disease that appeared to have the greatest incidence in teenagers. She leaned back in her chair, pondering the best way to convince Corwen Blair that his greatest success might lie in bringing this to the attention of the medical pro
fessionals in the state as soon as possible, a prospect that chilled her almost as much as the thought of the possible outcome if he did not. for she knew without doubt that unwatched and unchecked the disease would increase and spread quickly, geometrically. She put the graph in her leather file envelope, determined to study the figures further in order to strengthen her argument. She was not looking forward to trying to convince Corwen Blair that they had a potential epidemic on their hands.

  —Sam Jarvis and Maximillian Klausen—

  “We’ve got an inquiry I thought you might be interested in,” Sam told Harper Ross on the phone.

  “Oh?” Harper sounded more fatigued than the week before, but his determination had not slackened. “What about?”

  “About the syndrome,” said Sam, knowing that those words would get Harper’s full attention.

  “What does it say?” Harper asked sharply.

  “It’s from Portland, from the new complex there, the one that specializes in environmental conditions. It seems that there’s a small town in Oregon that’s been hit with the same thing we’re seeing in Seattle, or something very like it.”

  “That is interesting,” said Harper after a moment. “How much information do you have?”

  “Not as much as I’d like,” said Sam. “Which is why I’m going to call them and ask a few questions of my own, before I jump to too many conclusions, in case they’re facing something different than we are. Would you like to be in on this?”

  “Damn right,” said Harper at once. “When are you going to make this call?”

  “Say an hour? Can you be here by three?” Sam looked at the clock on the wall and weighed up the various alternatives available to him. “I think I’ll call now and set up a phone appointment. That way, if this Doctor Maximillian Klausen isn’t going to be free, you and I won’t waste part of the afternoon.” He picked up his pencil and started to doodle.

  “Fine. I’ll be waiting for your call-back. How’s that?” Harper paused. “I have to be here at four; I can arrange to be a little late, but . . .”

  “We can do a conference call from your office and mine to Doctor Klausen in Portland, if that would be easier.” Sam frowned and drew several emphatic lines on his doodle. Much as he appreciated Harper’s aid, he preferred it when the criminologist was with him. Sam did not doubt Harper’s dedication to their project, but he did question his expertise where medicine was concerned.

  “How many cases have we had to date?” Harper asked.

  “Over sixty. Thirty-nine fatalities.” He crumpled his doodle and dropped the paper in the waste basket. “I’ve been asking around, to see if other hospitals have unreported cases.”

  “And do they?” Harper asked.

  “There are a few I think might have patients with the syndrome. There’s reason to be suspicious about the illnesses in any case. I’ll wait until I see the blood work to be sure, but the profile is right—most of them are young, and those that aren’t are showing the same symptoms we’ve seen so far.” He cleared his throat. “Most of them are still in your area, but I think it is spreading. How’re your analyses coming?”

  “Nothing specific yet. I haven’t been able to isolate any specific poison spectrographically; I’ve also asked for any indication of radioactive particles and gas levels, both on the skin and the internal tissues. It ought to show something. I’ve called the medical examiner’s office and asked that they do a full poison workup on the bodies they get to autopsy.” Harper stared at the wall, his eyes on the calendar though he did not focus on the figures there. “I’m hoping to get a full chemical analysis on the samples I have in the next twenty-four hours.”

  “Um. Keep me posted.” Sam hesitated. “How about Susan? How is she doing?”

  “Same as before. She wants nothing to do with this, and she has refused to discuss it with me. She’s planning to go to California, to visit Grant and her brother. I haven’t the heart to argue with her.” He did not quite sigh, but his breath came a little harder and slower than before. “I hope in time that she’ll decide that this investigation is a good memorial to Kevin.”

  “I hope so,” said Sam, privately not holding much hope. Over the years he had seen families pulled apart by lesser things than this; he wanted to believe that the Rosses would survive their disagreement about Harper’s investigation but he dared not rely on it too much. “When does she leave?”

  “Next week; Tuesday.” Harper cleared his throat, changing the subject. “I’ve got some extra lab time if I want it on Friday. If you have anything you want checked here, let me know and I’ll schedule it.”

  “Thanks,” said Sam. “Let me call Portland; I’ll get back to you.” He decided it would be important to have as much information before he and Harper talked to Doctor Klausen as it was possible to get. That way, if they were following the wrong trail, it would not take much of their time or attention. Sam wanted to be convinced that the disease they were seeing in Seattle was isolated, that no other areas had been touched by it.

  “Fine,” said Harper. “Talk to you later.” With that he hung up.

  Sam referred to the letterhead number and the extension indicated beneath Klausen’s all-but-illegible signature. He placed the call and waited first for the switchboard and then for the extension to be answered.

  “Doctor Klausen’s office,” said a woman’s voice made heavy with sinus congestion.

  “Hello, this is Doctor Samuel Jarvis in Seattle at Harborview. I have a general letter from Doctor Klausen about a disease that he found in the town of Sweet Home in Oregon. He was requesting information about similar conditions . . .”

  “Oh, yes, Doctor Jarvis. I have your name here on the list. I can reach Doctor Klausen for you, if you like. Do you have patients with similar symptoms?”

  “Unfortunately, yes,” said Sam.

  “Oh, dear,” said the woman with a deep sniff. “I’ll put you on hold; do you mind?” Before Sam could answer, she had done it.

  For the next few minutes Sam was treated to a rock version of the Acceleration Waltz with four electric guitars, rhythm and synthesizer.

  “Doctor Jarvis, is it?” a deep, gravelly voice said. “This is Doctor Klausen. I understand you have seen symptoms like the ones I’ve found in Sweet Home.”

  “Yes,” Sam said. “What we have here fits the profile, including the age distribution. Almost seventy percent of the patients are teenagers.”

  “I’m sorry to hear that,” Max said with feeling. “I’ve now seen more than ninety patients with the symptoms, about sixty-five percent of them teenagers.” There was a brief pause. “I’ll send along the statistics and diagnostic printouts through your modem, if you like.”

  “We can trade,” Sam said, feeling almost overwhelmed with pessimism. “Have any of your patients survived?”

  “Not once the fever has gone up,” Max admitted unhappily.

  “Have you heard of any other incidents of the disease?”

  “I had a call this morning from a doctor in Idaho, named Landholm. He’s been treating several high school athletes with the symptoms you’re seeing. Most of his practice is with athletes, and therefore he didn’t have much information about other cases, although he mentioned that there were other patients at the hospital where he practices with what might be the same thing.”

  “Great,” said Sam, lowering his voice. “I want to get back to you after I’ve had a chance to go over your printouts. Do you have anything from Landholm you can send?”

  “Not yet, but I will by tomorrow. As soon as I’ve got the material, I’ll see that it’s forwarded to you.” Max paused. “When did you see your first case of it?”

  “November,” Sam said at once. “The son of close friends, in fact.” This last was an awkward admission.

  “I’m sorry.” Max swallowed. “An old friend, a colleague o
f mine; the man who alerted me to the disease in the first place—he and his wife have both died from the disease.”

  Sam tried to think of an appropriate response and could not. “That must be hard on you,” he said at last.

  “On all of us, I’m afraid. My wife hasn’t forgiven me yet for their deaths.” He wanted to make light of this but could not; Cassie’s ire was too real, too alive and present for him to dismiss it. “How soon can you get your material to me?”

  “Most of it by nine this evening,” said Sam, adding, “I’m working with the father of the patient I mentioned. He’s a professor here, of criminology, and he’s treating his son’s death as an unsolved crime. He’s running some tests and I doubt I’ll have the results before tomorrow. Do you want to have them as well?” He had started another page of doodles, this one more scattered than what he had done before.

  “That might be useful,” said Max. “Sure, send them along. His data can’t be any more confusing than the material we already have.” He cleared his throat, trying to rid himself of the tightness that was there. “Do you have any indication of what’s causing the trouble?”

  “Not so far. We’re assuming some kind of toxic waste—it fits the symptoms and the pattern.”

  “Yeah,” Max said. “We’ve been checking out toxic waste dumps. We haven’t turned up anything so far.”

  Sam glared at his doodle before wadding the paper into a ball and tossing it across the room. “Neither have we. I thought it might have a connection to some of the reforestation chemicals, but no luck so far.”

  “Reforestation?” Max said. “No, we haven’t got anything on that, but it might be a lead we can use. There were all sorts of fertilizers used as part of the reforestation, five, ten years ago. Maybe there was a toxic combination resulting from that.”

  “Nothing specifically wrong with any one element, but cumulatively dangerous?” Sam said, taking up the idea. “I hadn’t thought of that; I hate to admit it. I’ll put Harper onto it. Still you’d think something would turn up spectrographically if that was the case.”