Unnatural Exposure

by Patricia Cornwell

  Going back inside, I put on fresh gloves, slipped the mask back over my mouth and nose and returned to the kitchen to see what I might find in the garbage. The plastic can was lined with a paper bag and tucked under the sink. I sat on the floor, sifting through it one item at a time to see if I could get any sense at all of how long Pruitt had been sick. Clearly, she had not emptied her trash for a while. Empty cans and frozen food wrappers were dry and crusty, peelings of raw turnips and carrots wizened and hard like Naugahyde.

  I wandered through every room in her house, rooting through every wastepaper basket I could find. But it was the one in her living room that was the saddest. In it were several handwritten recipes on strips of paper, for Easy Flounder, Crab Cakes and Lila’s Clam Stew. She had made mistakes, scratched through words on each one, which was why, I supposed, she had pitched them. In the bottom of the can was a small cardboard tube for a manufacturer’s sample she had gotten in the mail.

  Getting a flashlight out of my bag, I went outside and stood on the steps, waiting until Crockett got out of his truck.

  “There’s going to be a lot of commotion here soon,” I said.

  He stared at me as if I might be mad, and in lighted windows I could see the faces of people peering out. I went down the steps, to the fence at the edge of the yard, around to the front of it and began shining the flashlight inside the cubbyholes where Pruitt had sold her recipes. Crockett moved back.

  “I’m trying to see if I can get any idea how long she’s been sick,” I said to him.

  There were plenty of recipes in the slots, and only three quarters in the wooden money box.

  “When did the last ferry boat come here with tourists?” I shone the light into another cubbyhole, finding maybe half a dozen recipes for Lila’s Easy Soft-Shell Crabs.

  “In a week ago. Never nothing since weeks,” he said.

  “Do the neighbors buy her recipes?” I asked.

  He frowned as if this were an odd thing to ask. “They already got theirs.”

  Now people had come out on their porches, slipping quietly into the dark shadows of their yards to watch this wild woman in surgical gown, hair cover and gloves shining a flashlight in their neighbor’s cubbyholes and talking to their chief.

  “There’s going to be a lot of commotion here soon,” I repeated to him. “The Army’s sending in a medical team any minute, and we’re going to need you to make sure people stay calm and remain in their homes. What I want you to do right now is go get the Coast Guard, tell them they’re going to need to help you, okay?”

  Davy Crockett drove off so fast, his tires spun.

  Nine

  They descended loudly from the moonlit night at almost nine P.M. The Army Blackhawk thundered over the Methodist church, whipping trees in its terrible turbulence of flying blades as a powerful light probed for a place to land. I watched it settle like a bird in a yard next door as hundreds of awed Tangiermen spilled out onto the streets.

  From the porch, I peered out the screen, watching the medical evacuation team climb out of the helicopter as children hid behind parents, silently staring. The five scientists from USAMRIID and CDC did not look of this planet in their inflated orange plastic suits and hoods, and battery-operated air packs. They walked along the road, carrying a litter shrouded in a plastic bubble.

  “Thank God you’re here,” I said to them when they got to me.

  Their feet made a slipping plastic sound on the porch’s wooden floor, and they did not bother to introduce themselves as the only woman on the team handed me a folded orange suit.

  “It’s probably a little late,” I said.

  “It can’t hurt.” Her eyes met mine, and she didn’t look much older than Lucy. “Go ahead and put it on.”

  It had the consistency of a shower liner, and I sat on the glider and pulled it over my shoes and clothes. The hood was transparent with a bib I tied securely around my chest. I turned on the pack at the back of my waist.

  “She’s upstairs,” I said over the noise of air rushing in my ears.

  I led the way and they carried up the litter. For a moment, they were silent when they saw what was on the bed.

  A scientist said, “Jesus. I’ve never seen anything like that.”

  Everyone started talking fast.

  “Wrap her up in the sheets.”

  “Pouched and sealed.”

  “Everything on the bed, linens, gotta go in the autoclave.”

  “Shit. What do we do? Burn the house?”

  I went into the bathroom and collected towels off the floor while they lifted her shrouded body. She was slippery and uncooperative as they struggled to get her from the bed inside the portable isolator designed with the living in mind. They sealed plastic flaps, and the sight of a pouched body inside what looked like an oxygen tent was jolting, even to me. They lifted the litter by either end and we made our way back down the stairs and out onto the street.

  “What about after we leave?” I asked.

  “Three of us will stay,” one of them replied. “We got another chopper coming in tomorrow.”

  We were intercepted by another suited scientist carrying a metal canister not so different from what exterminators use. He decontaminated us and the litter, spraying a chemical while people continued to gather and stare. The Coast Guard was by Crockett’s truck, Crockett and Martinez talking to each other. I went to speak to them, and they were clearly put off by my protective clothing, and not so subtly stepped away.

  “This house has got to be sealed,” I said to Crockett. “Until we know with certainty what we’re dealing with here, no one goes in or near it.”

  He had his hands in the pockets of his jacket and was blinking a lot.

  “I need to be notified immediately if anyone else here gets sick,” I said to him.

  “This time of year they have sickness,” he said. “They get the bug. Some take the cold.”

  “If they get a fever, backache, break out in a rash,” I said to him, “call me or my office right away. These people are here to help you.” I pointed to the team.

  The expression on his face made it very clear he wanted no one staying here, on his island.

  “Please try to understand,” I said. “This is very, very important.”

  He nodded as a young boy materialized behind him, from the darkness, and took his hand. The boy looked, at the most, seven, with tangles of unruly blond hair and wide pale eyes that were fixed on me as if I were the most terrifying apparition he had ever seen.

  “Daddy, sky people.” The boy pointed at me.

  “Darryl, get on,” Crockett said to his son. “Get home.”

  I followed the thudding of helicopter blades. Circulating air cooled my face, but the rest of me was miserable because the suit didn’t breathe. I picked my way through the yard beside the church while blades hammered, and scrubby pines and weeds were ripped by the loud wind.

  The Blackhawk was open and lit up inside, and the team was tying down the litter the same way they would have were the patient alive. I climbed aboard, took a crew seat to one side and strapped myself in as one of the scientists pulled shut the door. The helicopter was loud and shuddering as we lifted into the sky. It was impossible to hear without headsets on, and those would not work well over hoods.

  This puzzled me at first. Our suits had been decontaminated, but the team did not want to take them off, and then it occurred to me. I had been exposed to Lila Pruitt, and the torso before that. No one wanted to breathe my air unless it was passed through a high efficiency particulate air filter, or HEPA, first. So we mutely looked around, glancing at each other and our patient. I shut my eyes as we sped toward Maryland.

  I thought of Wesley, Lucy and Marino. They had no idea what was happening, and would be very upset. I worried about when I would see them next, and what condition I might be in. My legs were slippery, my feet baking, and I did not feel good. I could not help but fear that first fateful sign, a chill, an ache, the bleariness and thirst of
fever. I had been immunized for smallpox as a child. So had Lila Pruitt. So had the woman whose torso was still in my freezer. I had seen their scars, those stretched, faded areas about the size of a quarter where they had been scratched with the disease.

  It was barely eleven when we landed somewhere I could not see. I had slept just long enough to be disoriented, and the return to reality was loud and abrupt when I opened my eyes. The door slid open again, lights blinking white and blue on a helipad across the road from a big angular building. Many windows were lit up for such a late hour, as if people were awake and awaiting our arrival. Scientists unstrapped the litter and hastily loaded it in the back of a truck, while the female scientist escorted me, a gloved hand on my arm.

  I did not see where the litter went, but I was led across the road to a ramp on the north side of the building. From there we did not have far to go along a hallway until I was shown into a shower and blasted with Envirochem. I stripped and was blasted again with hot, soapy water. There were shelves of scrubs and booties, and I dried my hair with a towel. As instructed, I left my clothes in the middle of the floor along with all of my possessions.

  A nurse waited in the hall, and she briskly walked me past the surgery room, then walls of autoclaves that reminded me of steel diving bells, the air foul with the stench of scalded laboratory animals. I was to stay in the 200 Ward, where a red line just inside my room warned patients in isolation not to cross. I looked around at the small hospital bed with its moist heating blanket, and ventilator, refrigerator and small television suspended from a corner. I noticed the coiled yellow air lines attached to pipes on the walls, the steel pass box in the door, through which meal trays were delivered, and irradiated with UV light when removed.

  I sat on the bed, alone and depressed, and unwilling to contemplate how much trouble I might be in. Minutes passed. An outer door loudly shut, and mine swung open wide.

  “Welcome to the Slammer,” Colonel Fujitsubo announced as he walked in.

  He wore a Racal hood and heavy blue vinyl suit, which he plugged into one of the coiled air lines.

  “John,” I said. “I’m not ready for this.”

  “Kay, be sensible.”

  His strong face seemed severe, even frightening behind plastic, and I felt vulnerable and alone.

  “I need to let people know where I am,” I said.

  He walked over to the bed, tearing open a paper packet, a small vial and medicine dropper in a gloved hand.

  “Let’s see your shoulder. It’s time to revaccinate. And we’re going to treat you to a little vaccinia immune globulin, too, for good measure.”

  “My lucky day,” I said.

  He rubbed my right shoulder with an alcohol pad. I stood very still as he incised my flesh twice with a scarifier and dripped in serum.

  “Hopefully, this isn’t necessary,” he added.

  “No one hopes it more than me.”

  “The good news is, you should have a lovely anamnestic response, with a higher level of the antibody than ever before. Vaccination within twenty-four to forty-eight hours of exposure will usually do the trick.”

  I did not reply. He knew as well as I did that it might already be too late.

  “We’ll autopsy her at oh-nine-hundred hours and keep you for a few days beyond that, just to be sure,” he said, dropping wrappers in the trash. “Are you having any symptoms at all?”

  “My head hurts and I’m cranky,” I said.

  He smiled, his eyes on mine. Fujitsubo was a brilliant physician who had sailed through the ranks of the Army’s Armed Forces Institute of Pathology, or AFIP, before taking over the command of USAMRIID. He was divorced and a few years older than me. He got a folded blanket from the foot of the bed, shook it open and draped it around my shoulders. He pulled up a chair and straddled it, his arms on top of the backrest.

  “John, I was exposed almost two weeks ago,” I said.

  “By the homicide case.”

  “I should have it by now.”

  “Whatever it is. The last case of smallpox was in October 1977, in Somalia, Kay. Since then it has been eradicated from the face of the earth.”

  “I know what I saw on the electron microscope. It could have been transmitted through unnatural exposure.”

  “Deliberately, you’re saying.”

  “I don’t know.” I was having a hard time keeping my eyes open. “But don’t you find it odd that the first person possibly infected was also murdered?”

  “I find all of this odd.” He got up. “But beyond offering biologically safe containment for the body and you, there isn’t much we can do.”

  “Of course there is. There isn’t anything you can’t do.” I did not want to hear of his jurisdictional conflicts.

  “At the moment, this is a public health concern, not a military concern. You know we can’t just yank this right out from under CDC. At the worst, what we’ve got is an outbreak of some sort. And that’s what they do best.”

  “Tangier Island should be quarantined.”

  “We’ll talk about that after the autopsy.”

  “Which I plan to do,” I added.

  “See how you feel,” he said as a nurse appeared at the door.

  He conferred briefly with her on his way out, then she was walking in, dressed in another blue suit. Young and annoyingly cheerful, she was explaining that she worked out of Walter Reed Hospital but helped here when they had patients in special containment, which, fortunately, wasn’t often.

  “Last time was when those two lab workers got exposed to partially thawed field mouse blood contaminated with Hantavirus,” she said. “Those hemorrhagic diseases are nasty. I guess they stayed here about fifteen days. Dr. Fujitsubo says you want a phone.” She laid a flimsy robe on the bed. “I’ll have to get that for you later. Here’s some Advil and water.” She set them on the bedside table. “Are you hungry?”

  “Cheese and crackers, something like that, would be nice.” My stomach was so raw I was almost sick.

  “How are you feeling besides the headache?”

  “Fine, thanks.”

  “Well, let’s hope that doesn’t change. Why don’t you go on in the bathroom, empty your bladder, clean up and get under the covers. There’s the TV.” She pointed, speaking simply as if I were in second grade.

  “What about all my things?”

  “They’ll sterilize them, don’t you worry.” She smiled at me.

  I could not get warm, and took another shower. Nothing would wash away this wretched day, and I continued to see a sunken mouth gaping at me, eyes half open and blind, an arm hanging stiffly off a foul deathbed. When I emerged from the bathroom, a plate of cheese and crackers had been left for me, and the TV was on. But there was no phone.

  “Oh hell,” I muttered as I got under the covers again.

  The next morning, my breakfast arrived by pass box, and I set the tray on my lap as I watched the Today show, which I ordinarily never got to do. Martha Stewart was whipping up something with meringue while I picked at a soft-boiled egg that wasn’t quite warm. I could not eat, and did not know if my back ached because I was tired or from some other reason I would not contemplate.

  “How are we doing?” The nurse appeared, breathing HEPA-filtered air.

  “Don’t you get hot in that thing?” I pointed my fork.

  “I guess I would if I stayed in it for long periods of time.” She was carrying a digital thermometer. “All right. This will just take a minute.”

  She inserted it into my mouth while I stared up at the TV. Now a doctor was being interviewed about this year’s flu shot, and I shut my eyes until a beep said my time was up.

  “Ninety-seven point nine. Your temperature’s actually a little low. Ninety-eight point six is normal.”

  She wrapped a BP cuff around my upper arm.

  “And your blood pressure.” She vigorously squeezed the bulb, pumping air. “One hundred and eight over seventy. I believe you’re almost dead.”

  “Thanks,”
I mumbled. “I need a phone. No one knows where I am.”

  “What you need is to get lots of rest.” Now she had out the stethoscope, which she pushed down the front of my scrubs. “Deep breaths.” It was cold everywhere she moved it, her face serious as she listened. “Again.” Then she moved it to my back as we continued the routine.

  “Could you please have Colonel Fujitsubo stop by.”

  “I’ll certainly leave him a message. Now you cover up.” She pulled the blanket up to my chin. “Let me get you some more water. How’s your headache?”

  “Fine,” I lied. “You really must ask him to stop by.”

  “I’m sure he will when he can. I know he’s very busy.”

  Her patronizing manner was beginning to really get to me. “Excuse me,” I said in a demanding tone. “I have repeatedly requested a phone, and I’m beginning to feel like I’m in prison.”

  “You know what they call this place,” she sang. “And usually, patients don’t get . . .”

  “I don’t care what they usually get.” I stared hard at her as her demeanor changed.

  “You just calm right down.” Eyes glinted behind clear plastic, her voice raised.

  “Isn’t she an awful patient? Doctors always are,” Colonel Fujitsubo said as he strode into the room.

  The nurse looked at him, stunned. Then her resentful eyes fixed on me as if she did not believe it could possibly be true.

  “One phone coming up,” he went on as he carried in a fresh orange suit, which he laid on the foot of the bed. “Beth, I guess you’ve been introduced to Dr. Scarpetta, chief medical examiner of Virginia and consulting forensic pathologist for the FBI?” To me, he added, “Put this on. I’ll be back for you in two minutes.”

  The nurse frowned as she picked up my tray. She cleared her throat, embarrassed.

  “You didn’t do a very good job on your eggs,” she said.