28
After making a grand gesture to look at his watch, Sinclair said, “I see we still have ten minutes. As some of you may already know, Dr. Wyatt has kindly agreed to serve as a guest professor so that he might offer his expert opinion regarding our GNS patients.”
Jack inhaled sharply and then shifted his eyes to Helen Morales. The solemn look on her face betrayed what she was thinking. She had made her feelings clear to him that there would be no discussion of GNS. He was sure she must have told Sinclair the same thing. Already having a sense for her astute political skills, Jack wasn’t surprised when she didn’t rise to put a stop to Sinclair’s uninvited commentary.
“With this growing national epidemic,” Sinclair continued, “I was hoping our distinguished guest from Ohio might offer us his insight into these very intriguing and challenging cases?”
As soon as Sinclair stepped aside, Jack returned to the lectern.
“Unfortunately, I find myself in the same position as my colleagues are across the country. I have no theory as to what’s causing GNS. Hopefully, that will change in the days to come. I would mention, however, that Dr. Sinclair and his team have done an outstanding job in caring for these patients.”
Sinclair moved toward the edge of the stage. He scanned the front row of seats.
“I see Dr. Lewis is with us today. I’m sure we’d all like to hear her opinion on a possible cause for GNS.”
Carmella Lewis was Southeastern State’s longstanding chief of infectious diseases. She had been involved since the first GNS patient had been admitted. She and her team had consulted on every case and were in constant communication with the CDC.
She stood up and waited for one of the audiovisual technicians to trot down the center aisle and hand her a microphone.
“We have done extensive diagnostic tests but to date we’ve not been able to identify either a bacterial or viral cause for GNS. Although we haven’t entirely excluded the possibility, we have no evidence at this time that GNS is a contagious disease. I believe the CDC has reached a similar conclusion.”
“Have you considered that this disease might be a new strain of parvovirus?” Sinclair asked.
It wasn’t hard for Jack to understand the astonished look that instantly swept across Carmella’s face. Sinclair cared for patients with neurologic problems. He had no training or expertise in the specialty of infectious diseases. His question was at the least inappropriate and at the most insulting. Jack’s eyes shifted to Helen. From the perturbed look on her face, he assumed she shared his sentiments.
Ever the diplomat, Carmella responded, “We certainly considered a parvovirus infection but all of the blood tests were negative. We therefore dismissed the diagnosis. I believe the CDC followed a similar protocol and arrived at the same conclusion.”
“I’m aware of those results, but based on the extraordinary nature of this illness, I contacted Carson McPherson.” Jack was quite familiar with Dr. McPherson. He was a nationally renowned professor of infectious diseases with particular expertise in viruses. He had spent most of his career at Yale Medical School but was now at the National Institutes of Health in Washington. “Dr. McPherson and I had a lengthy discussion and we both feel that the symptoms of GNS are quite consistent with a new strain of parvovirus that’s never been seen before.”
The pained look on Carmella’s face was understandable, considering she had just been thrown to the curb by a fellow physician. Basic professional courtesy would have dictated that Sinclair share his parvovirus infection theory with Carmella before publicly asking for her opinion.
“I haven’t spoken with Dr. McPherson, so it would be difficult for me to comment on his thoughts. That being said, Dr. Sinclair, I will again state that based on these patients’ natural immunity and the tests we conducted, we have ruled out a parvovirus infection as a possible cause of GNS. And if I’m not mistaken, the CDC has done the same thing.”
Sinclair wasted no time returning to the lectern, where he took up the position as the self-appointed principle speaker.
“Thank you, Dr. Lewis. In response to your comments, I would like to point out that Dr. McPherson feels it’s a strong possibility we may be dealing with a new strain of parvovirus that our current tests wouldn’t detect.”
Sinclair’s comments were met with a flurry of raised hands. He recognized Kenton Biggs, the chief of internal medicine.
“Are you saying the CDC and most of our leading experts in the area of contagious diseases are wrong?”
“That’s precisely what I’m saying. And the sooner we realize it, the sooner we can shift our focus in the right direction and begin helping these women and their unborn infants. There’s credible data suggesting that certain drugs are quite effective in treating parvovirus.”
Helen had already come to her feet and was quick-walking toward the center of the stage. Before Sinclair could make any further comments, she reached the lectern.
“It’s already a few minutes past the hour, so I’m afraid we’ll have to end the discussion here. I want to again thank Dr. Wyatt for agreeing to lead today’s conference. This has certainly been one of the more lively discussions we’ve had in quite some time.” She turned toward Jack and began to applaud. The audience followed. Sinclair wasted no time in descending the stage and falling in amongst the physicians who were quick to barrage him with questions.
“That was very well done,” she told Jack, motioning to Madison to join them.
“Thank you,” he responded, seeing no reason to offer any thoughts on Sinclair’s inappropriate behavior.
“Maybe it would be a good idea for us to get together later today,” Helen suggested. “Say about four in my office? I’m going to ask Dr. Sinclair to join us. I want to hear more about his parvovirus theory.”
At that moment, Paul Boland, one of the senior radiation oncologists strolled up.
“That was an excellent presentation,” he told Jack in a South African accent that hadn’t faded a drop since he’d moved to the United States twenty-seven years earlier. Boland then turned his attention to Helen. “I wonder if I could have five minutes of your time. I’m afraid my department is in dire need of your help.”
“Of course, Paul. We can talk in my office.”
Helen turned to Jack and Madison. “I’ll plan on seeing you two at four.”
Jack was well aware Helen Morales hadn’t reached the position in academic medicine she had without learning how to sidestep a few politically charged landmines. This was one of those situations. Jack suspected she was seething but her manner was controlled and diplomatic. He wondered if she would be as calm at their four o’clock meeting.
29
Malcolm Athens quick-walked through the West Wing of the White House. Clutched in his hand was a report he’d received five minutes earlier from the Royal Canadian Mounted Police. Athens had been a White House liaison to the CIA for the past four years. It was his principal responsibility to brief the president regarding matters of national security.
He walked past two Secret Service agents standing like pillars on either side of the entrance to the Situation Room, a five-thousand-square-foot chamber consisting principally of six flat-screen televisions and a large conference table. An eight-foot ornately decorated Christmas tree brightly lit with a ceiling-mounted floodlight stood in the near corner.
Casually dressed in a plaid shirt, President Kellar was seated at the table. The only other person in the room was Zachary Carlton, his chief of staff.
“I just received this report from the RCMP,” Athens began. “It seems our Canadian colleagues have been able to determine that Alik Vosky took a job with Bitrax Industries in Winnipeg a little over a year ago. They are a small pharmaceutical company.”
The president frowned. “With his immigration history, how in the world did he get a job like that? I thought drug companies were more cautious in the
ir hiring practices.”
“I’m sure they are, unless somebody applies under a false name. Vosky’s no amateur. The documents he used in support of his application were all excellent forgeries. He even had three phony letters of reference.”
Kellar steepled his fingers. “In what capacity did this drug company hire him?”
“As a senior laboratory technician.”
“In what area?”
Athens fidgeted in his chair. “He was assigned to the research and development department. He participated in several areas. One of them was developing new antibiotics for the treatment of serious obstetrical infections.”
“Great,” the president muttered. “Does anybody have an idea how all of this might tie into Mr. Vosky’s disappearance?”
“There was an . . . an incident at the company. Vosky’s computer skills were exceptional. The IT department at Bitrax discovered he had acquired certain sensitive files that contained information that went light-years beyond his pay grade. Their first thought was he was involved in an industrial espionage scheme, but before they could sort things out, Vosky must have realized they had nailed him. He never showed up for work again. The company pressed charges but it wasn’t the type of case that was going to receive a lot of resources. As of today, Vosky’s whereabouts are still unknown and the case remains open.”
“Has anybody considered that perhaps it wasn’t his intent to sell the information to a competing pharmaceutical company?” Turning his palms up, he continued. “Maybe he had more personal plans for the information.”
“We agree with you, sir. The Canadian authorities have undertaken a major initiative to locate Vosky. I’ll be receiving daily briefings from them.”
“Perhaps you and I should have a similar arrangement,” Kellar suggested with a manufactured half smile.
“Of course,” Athens said. “I’m sure they’ll locate him soon, Mr. President. They’re putting their best agents on it.”
The president pushed back in his chair and stood up. With a stiffened posture, he said, “Optimistic predictions are not what I need at the moment. What I want is for somebody to locate this son of a bitch. If the American people should even get an inkling that GNS might be an act of bioterrorism, it’s going to touch off a national panic the likes of which this country’s never seen before.”
30
After the noon conference, Jack caught up with Madison and accompanied her to the auditorium exit. Most of the physicians had dispersed but a few remained in the expansive atrium talking in small groups.
“What do you think about Sinclair’s parvovirus theory?” Madison asked.
“I’m a neurologist. What I know about parvovirus infections wouldn’t fill a thimble.”
“The most common one is called fifth disease and is seen mostly in children. It’s generally a mild flu-like illness that’s frequently accompanied by a very distinctive rash. It’s called a slap-cheek rash because it’s bright red and looks like the patient’s been smacked. Most women already have natural immunity to the virus before they ever get pregnant. If not, there’s a vaccine. The few who do get the illness usually have a pretty mild case, and there’s only a very small chance they can pass it along to the baby.”
“What happens if the virus does reach the baby?”
“They generally do okay,” Madison explained. “But a few will develop serious heart and liver problems, and very occasionally, the disease is fatal.”
“I’ll ask you the same thing you asked me. Do you think there’s any chance Sinclair’s right about some new strain of parvovirus being the cause of GNS?”
“Hollis is an extremely well-read, talented doctor. But I don’t know if he’s truly convinced GNS’s a viral infection or he’s just showboating for the hospital board hoping to find a shortcut to the chief of neurology’s office. He’s made no secret that he sees himself as the only logical choice for the position.”
“His personal agenda aside, sometimes a physician can have a vague hunch about a disease that turns out to be right on the money.”
“I guess anything’s possible,” she said, “But I prefer to practice medicine by sticking to proven scientific facts. At the moment, this parvovirus theory has all the scientific basis of an Ouija board prediction.”
“You said the rash was very distinctive. It almost sounds a little like the one Tess and the other women developed. Maybe that’s why Sinclair’s convinced GNS is a parvovirus infection.” They exited the stairwell on the second floor and then made their way toward the ICU. They continued to talk about the cases, focusing on what further diagnostic steps could be taken that might lead to an answer. “I’m supposed to meet with Isabella’s grandmother in a few minutes,” Jack said, stealing a glance at his watch. “Do you think we should touch base before our meeting with Helen?”
She shrugged. “I don’t but if you think it’s necessary, I will—”
“No. I just thought it might be a good way to . . .”
“I have a lot to do, so unless there’s anything pressing, I’ll see you at the meeting.”
He cleared his throat twice and said, “Absolutely, sounds good.”
With slumped shoulders, Jack watched Madison disappear down the hall. He felt as if he were in eleventh grade and had just been turned down cold for a date. Although she’d been a little more civil to him since they spoke on the plane, it was apparent she had no intention of forgetting the past. After an inward sigh, he told himself that Madison’s opinion of him had no bearing on anything. She had promised to work with him in a collegial and productive manner, and that was all that mattered. Jack started down the hall toward Isabella’s room. He hadn’t taken more than a few steps when he made a firm promise to himself to accept the way Madison Shaw felt about him, and give up the ghost trying to convince her he was a decent guy.
31
Hollis Sinclair strolled into the ICU family conference room for the urgent meeting his administrative assistant had set with Bud Kazminski and his son-in-law, David Rosenfelt.
The moment Sinclair entered the room, Kazminski and David rose from the couch. With a quick gesture, he invited them to retake their seats while he sat down in a plaid upholstered chair across from them.
“I assume I have your permission to speak freely in front of your father-in-law.”
“Of course,” David responded.
“As you know, I’ve been very much involved in your wife’s care since she was admitted. For many reasons, it’s my belief that her illness is being caused by a new strain of a powerful virus. My suspicion is that both mother and baby are infected with the virus.” He paused for a moment and then with a hard stare added, “I feel certain if we don’t begin treatment soon, this illness will ultimately prove to be fatal to both of them. I am, therefore, recommending to you that you consent to a test that will very likely lead to a diagnosis.”
Kazminski stole a peek at David. The skin bunched around his eyes in a pained stare. From the time he and Sherry began dating it was clear that she was the alpha member of the relationship. David was a considerate and caring husband, but he was short on confidence, and predictably indecisive relating to matters of importance.
“Dr. Sinclair,” Kazminski began, “before we agree, I think both David and I would like to hear something of the specifics of this test.”
“I’m proposing that your daughter undergo a brain biopsy. I believe a microscopic analysis of her brain tissue will confirm conclusively that a virus is causing her illness. And, as I mentioned, such a confirmation will open the doors to beginning treatment for her and the baby.”
Over the course of a very long career as an investigative reporter, Kazminski had interviewed all types of people. Anybody who knew him professionally would say he’d been around the block more times than the UPS truck and that he had developed an astute sixth sense about people. He combed the stubble under his c
hin with his finger for a few moments. David remained expressionless, his eyes frozen open.
“Dr. Sinclair, are you suggesting we perform brain surgery on my daughter?”
“Technically, yes.”
“This whole thing sounds a bit risky to me,” Kazminski said.
“I assure you, it’s a very routine procedure performed by neurosurgeons across the country every day. It’s done with a needle using a CT scan for guidance. It’s called a stereotactic biopsy. I believe the benefits far outweigh the risks. And, as I’ve already mentioned, I’m convinced the biopsy will reveal the cause of Sherry’s disease.”
“Would she feel any pain?” David asked.
“Absolutely not.”
Kazminski asked several more questions, most of which Sinclair answered in a manner somewhere between offhanded and overly confident. As he expected, David was unable to give his consent for the biopsy even when pressed by Sinclair.
Finally, when Kazminski sensed Sinclair’s patience was going from thin to exhausted, he said, “I think my son-in-law and I need a little time to consider your recommendation. When do you need an answer by?”
“The sooner the better,” he said, getting up from his chair. “I’ve already discussed the matter with the chief of neurosurgery, Dr. Constantine. He agrees fully with the need for a biopsy and is ready to do it as early as tomorrow.”
“What if the biopsy doesn’t provide the information you’re looking for?” Kazminski inquired.
“I don’t believe that will be the case, but even if it is, we’ll be no worse off than we are now.”
“Except that my daughter would have undergone an operation that did her no good.”
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