Pathogen

by Jessica L. Webb

  Andy paused and leaned forwards very slightly, and Kate could feel every eye on her. She didn’t raise her voice, but her tone carried the weight of absolute authority.

  “The word hantavirus does not leave this room. Dr. Doyle, that includes hospital staff as well as board members. This remains an unknown virus with flu-like symptoms. I believe you are working on another press release, so we’ll need that immediately. Dr. Morrison…” Andy paused, only slightly. “I guess you have a flight to catch. For the rest of us, let’s reconvene here first thing tomorrow.”

  “What about me, Sergeant Wyles? You haven’t handed me my assignment yet.”

  It was impossible not to hear the condescension in Mona Kellar’s tone and equally impossible not to feel the tension in the room as Andy addressed her directly for the first time in almost a week.

  “This team would appreciate your continued input and support. Personally, I hope we’re not going to need your services again.”

  Kate could see by the reddening of Mona Kellar’s cheeks and the way her eyes went flat that the double meaning wasn’t lost. But Andy had already turned away, talking quietly and quickly to Constable Ferris.

  Kate left the room, blinking as she entered the bright light of the hallway. It was mid-morning already and bright sunlight flooded through the oversized windows, stretching far down the hallways. Kate felt briefly disoriented as she walked back towards the ER. Everything looked the same as an hour ago, but somehow everything felt darker. Her thoughts free-flowed with information, everything she knew or had read about hantavirus, about influenza A, fluid accumulating in the lungs, the use of oxygen therapy, steroids, and points of infection. Words like outbreak and bioterrorism hit like pointed daggers behind her eyes. As she pushed open the double doors of the ER, Kate felt not only the weight of urgency, but the weight of responsibility.

  Kate forced herself into the present, realizing that the ER, though busy, seemed perfectly under control. She checked in with the sandy-haired doctor, Dr. MacKay, who confirmed three more suspected cases of the virus, though none had been flagged as high risk. Harris Trenholm had been admitted and was stable, but the high flow oxygen was barely keeping him that way. Leaning up against the nurse’s station, Kate flipped through charts, surveyed the ER around her, and had to admit she was impressed. Given no warning and very little direction, this tiny ER had managed to control a panicked community dealing with a viral outbreak.

  Kate grabbed the phone book behind the nurse’s station, picked up the phone, and dialed the local RCMP office. As expected, Judy answered. After giving her overwhelming and genuine thanks for their morning coffee, Kate outlined what she needed: coffee, donuts, éclairs, cookies, and pastries. Basically anything overloaded with sugar and fat. She wanted a pile of it delivered to the ER as soon as possible.

  Kate made her way up to the second floor to check on Harris Trenholm. She couldn’t find it in her to be surprised when she saw Michael Cardiff in Harris Trenholm’s room in another immaculate business suit, talking on the phone while staring out the window. Kate picked up the chart, noting that Mr. Trenholm was breathing at least a little easier.

  “How are you doing, Mr. Trenholm?”

  “Harris.” He had a nice smile, even through his rebreather mask. “I’m all right.”

  “Which is what everyone says, even when they’re not.” Kate smiled when he gave a light chuckle, taking it as a good sign that it didn’t trigger a bronchial spasm.

  Cardiff’s voice intruded on their conversation, briefly loud, direct, then back down to a more subdued monotone. Kate raised her eyebrows at Harris, indicating Cardiff with a questioning jerk of her head.

  Harris pointed at himself and breathed out, “Campaign manager.”

  “Ah,” Kate said. “Well, not for the next few days, you’re not.”

  Harris pulled down his mask. “Have to. Campaign period starts…two days.”

  Kate adjusted the mask back onto his face. “And how useful do you think you’re going to be when you can’t get a complete sentence out?” she asked him gently.

  Cardiff strode over to the bed, his phone still clenched in his oversized hands.

  “Are you his doctor?” he asked Kate rudely.

  “Yes.”

  “Good. Anything this man needs he gets, whatever treatment or drug therapy or whatever. He gets it.”

  “Mr. Trenholm will get whatever he needs, Mr. Cardiff, because he’s sick and has to have treatment. Not because he’s your campaign manager,” Kate said evenly.

  “Right,” said Cardiff, staring down Kate while smiling his politician’s smile. “That’s exactly what I meant, of course. So, do you know if it’s the virus? How can we get the results fast-tracked?”

  Kate closed the chart and put it down on the bedside table. “Mr. Cardiff, I have some tests that I need to run with Mr. Trenholm. I’m going to have to ask you to wait outside. Maybe you could check on Serena. I believe she’s being discharged this morning.”

  Cardiff looked from Kate to Harris and back again.

  “Right. I’ll see you in a few, Harris.”

  Harris spoke once the door was closed. “Do I have it?”

  “We won’t know until later today or early tomorrow, but we’re treating you as if you do. The damage to your lungs from the car accident puts you at greater risk for developing infection, so you are going to have to be monitored in the hospital for the next few days.”

  Harris made a face behind his mask.

  “I know. I’m sure you’re sick of hospitals, but I wouldn’t keep you here if it wasn’t important.”

  “I need to work…that’s important.”

  “I’m sure Michael Cardiff can find someone to cover for a few days.”

  Harris shook his head, pointed at himself. “No, for me…Michael winning this election…important for my career…” he breathed out, sucking on his oxygen.

  Kate didn’t say anything, letting him get his breath back.

  “I know he hired me…for sympathy vote…” He stopped again, took a few long, deep breaths.

  “What do you mean?” Kate asked.

  “My accident…drunk driver, tourist from Whistler…town rallied around the cause…big news in Hidden Valley…” Harris stopped and rolled his eyes and Kate had to laugh. “Doesn’t matter though…still could make my career.”

  Kate considered the man intently. “Forty-eight hours of nothing. No calls, no paperwork, no sneaking in your laptop. Forty-eight hours of resting, then we’ll see how you’re doing.”

  “Boring,” Harris breathed out, the smile on his face making soft crinkles around his eyes.

  “Buy a book,” Kate said bluntly, but she returned the smile. It was hard not to like this guy. “And it’s up to you what medical information you want to share with your employer. He’ll get nothing from me that you don’t explicitly give permission for, got it?”

  Harris nodded. “Thanks.”

  “Rest, sleep, be bored, whatever. I’ll see you soon.”

  Cardiff cornered Kate the second she was out of the room.

  “If he has the virus, I need that information contained. It must not get out into the general public.”

  Kate took a step back, holding up one hand between them to define her personal space.

  “Mr. Trenholm is my patient, and all doctor-patient confidentiality rules apply.” Cardiff looked satisfied, like Kate had just fallen in line like he’d expected her to. “Which means,” Kate stressed, “that I cannot discuss his diagnosis or medical treatment with you, Mr. Cardiff.”

  Cardiff gripped his phone tighter.

  “How is Serena doing?” Kate asked, trying to direct the conversation to more neutral ground.

  “Fine, they just need your signature for discharge,” he said, still trying to pin her down with a glare.

  “I can do that right now,” Kate said. She attempted to side step around him, but he blocked her way, moving much more agilely than Kate would have expected. She felt a t
endril of alarm unwind in her stomach.

  “I understand you’re going to a lab out in Winnipeg. I can arrange for a private helicopter transport,” he said smoothly, once again overstepping Kate’s personal space.

  Before she had time to formulate an answer, Kate heard the tread of Andy’s boots approaching. Half a second later, Andy stepped in beside Kate, her arms stiff by her side, her grey eyes flashing, giving a clear message for Cardiff to back off, which he did, almost immediately.

  “That won’t be necessary, Mr. Cardiff. The RCMP has it covered.”

  Andy’s voice contained no inflection, but every muscle in her body was held rigid. She leaned in ever so slightly, the aggressiveness of her stance more like a generalized challenge. Kate knew it would take a bigger man than Cardiff to take her up on that.

  He held up his hands in a gesture of placation. It was an empty gesture, Kate was sure. Somewhere not too deep down, this giant of a man was pissed.

  “Just trying to help, Sergeant Wyles. Richard James was able to help out with transporting Dr. Salinger to Vancouver, I wanted to extend the same courtesy to Dr. Morrison.”

  Andy said nothing, and her body did not relax as she turned to Kate.

  “Dr. Doyle is waiting for you downstairs and Judy has made all the arrangements for your flight.”

  Kate swallowed once, trying to keep control of her voice. “I’ll just sign Serena’s discharge papers before I go.”

  Andy took a small step to the side to allow Kate to pass behind her. Kate knew she hadn’t actually been in any real danger, but she also knew Andy would count any threat against her as real. Michael Cardiff had just made an enemy of Sgt. Andy Wyles. Kate picked up the paperwork, scanned it, and scrawled her name at the bottom, suddenly feeling the need to get away from Hidden Valley.

  Andy fell in step beside Kate as they descended in silence to the first floor of the hospital. Michael Cardiff was nowhere to be seen.

  “Judy’s booked you on a flight to Winnipeg,” Andy said as they walked. “You’ve got a chopper into Vancouver, then connecting through Calgary, but you have to leave soon. You’re due to fly back tomorrow night. That’s a day to travel and a day to get as much information as you can on the virus.” Andy stopped abruptly and grasped Kate’s arm. “You’re sure you want to do this?” Andy’s grey eyes were worried, though Kate wasn’t sure what she was reacting to. At this point she had her pick: Mona Kellar, Michael Cardiff, or the animosity with Dr. Doyle. Not to mention a cross-country flight, six new suspected cases, an elusive bioterrorist threat, and the spectre of the hantavirus that hovered over Hidden Valley.

  “Positive,” Kate said, pushing every one of those previous thoughts aside.

  Andy searched Kate’s face. “When’s the last time you were in Winnipeg?” Andy asked quietly.

  Kate’s heart dropped as the fact she’d been carefully avoiding for the last few hours slammed into her body.

  “Sarah,” was all Kate could get out. The last time Kate had taken an urgent trip to Winnipeg had been after a late-night, panicked phone call saying that Kate’s younger sister Sarah was in trouble. Lost Sarah, junkie on the street Sarah. Baby sister Sarah. “It was a long time ago,” Kate said, finding her voice. “I can do this. I need to do this.”

  Andy looked at her carefully, and then she reached out and took Kate’s hand, turning it palm up, tracing the barely visible scars with a light touch. They stood together silently until they both felt time catch up to them, and Andy released Kate’s hand and led her out the doors of Valley General Hospital.

  Chapter Ten

  The next morning was sunny. A bright blue sky reflected off the hundreds of windows on the Canadian Science Centre for Human and Animal Health, which contained the relatively new National Microbiology lab. Kate walked across the street, the only thing in her stomach a complimentary hotel coffee and a feeling of unease. Kate entered through the front doors of the building and handed over the ID Judy had given her. Kate waited as the man behind the desk processed her information.

  She felt a moment of acute panic, like she needed to explain how she was really an ER physician, that this was only the second time she’d consulted with the RCMP. That it was temporary. That her girlfriend had been worried about Kate taking on this assignment. That she didn’t want to admit she was struggling. That there was a small possibility Andy had been right from the very beginning.

  The man behind the desk handed Kate back her ID, saying Dr. Levesque would be down momentarily. Kate took the few minutes to pull herself together, looking around the lobby at the colourful public service posters on vaccinations, safe food handling practices, outbreak preparedness, and hand washing. By the time she heard her name being called, Kate felt in control of herself again.

  Dr. Louise Levesque was a tiny wisp of a woman, with long grey hair pulled back to reveal a broad forehead, bright blue eyes, and a genuine smile of delight.

  “Dr. Morrison, it is very nice to meet you. How are you?” she said in her thick French-Canadian accent.

  “Fine, thank you,” Kate replied, willing herself to make it true.

  After signing Kate in and handing her a visitor’s badge, Dr. Levesque walked very quickly down several hallways, leaving the brightly lit visitors entrance behind and moving into what Kate suspected was the centre of the building.

  “It is very rude of me not to give you the whole tour, the Canadian Science Centre for Human and Animal Health is a fascinating place. But we have such a small amount of time before you are to return to BC, we must make the most of it, yes?”

  “Yes. I want to know everything you know about this virus.”

  The woman smiled again. “Curiosity is a most useful tool.”

  Dr. Levesque used her passkey to unlock a set of heavy frosted glass doors, the words Viral Disease Division stencilled in a thick, dark font. “We have brought the HV1A-CS virus to the Viral Disease Division. There was an argument early on about whether or not it should be here or in the Influenza and Respiratory Division, but viral disease won out. They usually do these days,” she added, with a smile.

  A long, segmented desk bisected the conference room they entered. A man and two women, all in in lab coats, sat talking. They all looked up as Kate and Dr. Levesque walked in. Kate noted one of the faces looked friendly, one serious, and one disgruntled. Dr. Levesque introduced them to Kate, who only remembered that the serious woman’s name was Rayna and the grumpy guy reminded her strongly of Jack. He had curly hair, was unkempt, and constantly fiddled with his laptop.

  “Dr. Morrison,” Dr. Levesque began, “we’d like to go over our initial results in terms of viral pathogenesis, our hypothesis for viral replication, life cycle, and so on. I realize that as a physician you are more used to looking at patients on a macro level, meaning the onset and progression of symptoms, the broader implications of medical history and drug interactions on illness. So, while I imagine you are eager to put what we have in context of your patients, I would like to encourage you to think micro for the next few hours, try to forget the effects this virus has on your patient and instead think cellular, the effects that one small virus has on a host cell.”

  Kate looked doubtfully at Dr. Levesque, unsure if she would be able to clear her mind of the chest x-rays, the autopsy results, the picture of Harris Trenholm gasping into his O2 mask. “I’ll try,” Kate said.

  “Excellent,” Dr. Levesque said happily. “I truly think once we can begin to understand this virus on a cellular level, it will make the symptoms, the progression, and hopefully the treatment make more sense.”

  “Okay, let’s get started,” Kate said, leaning forwards in her chair, attempting to push thoughts of Hidden Valley out of her head.

  “Who’s up for a game of Go Fish?” Grumpy Jack asked, tapping at the mouse pad on his laptop and looking around.

  “I’m in,” the not-serious woman with dirty-blond hair said, squinting her eyes in mock challenge at Grumpy Jack.

  Kate saw Dr. Levesque sh
aking her head. “We could at least attempt to make a positive professional impression upon Dr. Morrison,” she murmured. “The NML does have a worldwide reputation to maintain.”

  “Come on, Dr. Lou, we’ll still get all the information across but in half the time and in a much more entertaining format.” He sat back and folded his hands innocently across his stomach. “Unless you believe our west-coast neighbour here can’t hack the content?”

  Dr. Levesque looked at Kate with apologetic eyes. “Dr. Morrison, do you have any idea why the most brilliant minds are also the most uncooperative?”

  Kate grinned in response, feeling a bit of the pressure relieved in the midst of the banter. These were people she understood.

  “Okay, I’ll play the hantavirus hand and Nicole, you play the influenza A hand,” Grumpy Jack said, without waiting for the go-ahead from his supervisor. Kate saw Dr. Levesque throw up her hands in surrender and take her seat.

  “Do you have a single strand?” Grumpy Jack challenged the blond woman, Nicole.

  “Yes.”

  “Point one for me. Do you have RNA?”

  “Yes.”

  “How about a Class 5 on Balty’s Classification System?”

  “Yep.”

  “And do you have a negative sense?”

  “Absolutely.”

  “Okay, four points for me,” Grumpy Jack calculated. “So far so good, Dr. Morrison?”

  “Both the hantavirus and influenza A come from the same group of viruses which contain ribonucleic acid, or RNA, as their genetic material. So far they are more similar than different,” Kate summed up. “I take it this means the HV1A virus is also a Class 5, single-stranded, RNA-based virus.”

  “Single-stranded, RNA, and negative sense we can confirm. Class 5 at this point is only assumed since we don’t actually know what we’re dealing with,” Nicole replied. “Let’s make it interesting,” she said, with a smile to Grumpy Jack, who scowled across the table. “Do you have eight genes?”