A distressed murmur rumbled through the auditorium. Reflexively, Gayle’s head snapped up as she looked around for the cause. Her colleagues’ attention quickly pointed her to the podium. Two people from the audience were taking the steps two at a time to get onstage, but it was the speaker that had elicited the collective gasp.
The man slumped against the lectern, his body twitching. For a panicked moment, Gayle thought maybe the man had been electrocuted, but as the Samaritans from the audience laid him down, she realized he must be having some type of seizure. She could clearly hear the drumming of his heels as his shoes thumped against the dais. More people swarmed the stage with good intentions, though there was little anyone could do but wait out the episode.
After a couple of minutes, the seizures subsided. Two of the men onstage helped the CEO to stand, supporting the clearly disoriented man between them as they exited stage right.
RouterNet’s CFO, Paul Acklemore, took the microphone to advise the audience there would be a ten-minute break before the next speaker and that they would be updated on Michio Yamashita’s condition as soon as there was word from the hospital.
That word came some two hours later.
Gayle, numbed, listened to the announcement. “It is with heartfelt condolences to Mr. Yamashita’s friends and colleagues,” Mr. Acklemore told the gathered group, “that I must inform you Michio Yamashita passed away about fifteen minutes ago. The cause of his death is not yet known.”
*
To take her mind off her grief, Yamashita’s personal assistant, Kaoru, immediately sent regrets to the businesses Michio was scheduled to visit over the next month. Kaoru sniffed back tears as she tapped the final send button. Michio had so been looking forward to returning to the U.S. this year for his second stay with Triple E Enterprises.
Kaoru was flipping the key pad back in place when her right hand began to shake, badly enough that she had to use her left hand to help close and pocket her phone.
Nerves, she decided. And who could blame them for showing up now when she’d lost not only a boss she had respected but a friend she had been quite close to. Just the thought of the enormity of the job hunt before her made her tremble.
Chapter Five
“THANK YOU FOR MEETING WITH ME, Mrs. St. John. I know what a difficult time this must be for you.”
The reporter’s voice sounded soft and sincere on the phone, and Doris relaxed at once. With three interviews scheduled for the afternoon, she’d been dreading more of a paparazzi-style barrage of impudent questions and insensitive comments. “Thank you, my dear. I know I agreed to talk to you or you wouldn’t have this number, but I’ve agreed to so many people—who are you with again? You’ll forgive me; my calendar is such a mess. And I had to take my little Maltese into the vet this morning after she ran headlong into a wall, so I’m just not at all prepared, I’m afraid.”
“I’m Kristin Sharpe with the Shreveport Times-Courier, and no need to apologize. I’m sure I would be pretty messed up myself in your situation. I’ll try to keep this brief. If I can just verify a few facts first. Your husband, Jerome, was 51, is that right?”
“Jerry. He liked to be called Jerry by his friends. And he’d have been honored to have the whole city consider him a friend.”
“Of course. I know he was a cardiac surgeon at Willis-Knighton, but did he have a preference of disciplines?”
“Pediatrics. He loved being able to give infants a second chance at life. But he operated on adults for ten years before he considered himself knowledgeable enough to work on babies. That was what his Founders Award was for, you know. The American Academy of Pediatrics gave it to him for his contributions in neonatal care. “
“Yes, I have all the information on his awards. I’ll be sure to include them in the article. He was so young—is it true he had Alzheimer’s?”
“Well, the specialists don’t really know what it was. Alzheimer-like symptoms, yes, but it progressed so, so fast. Six months ago you wouldn’t have known there was a thing wrong with him. Then he started having short-term memory loss—not remembering what he’d had for breakfast or who had called him that day. I didn’t think that much about it at the time. Jerry was such a brilliant man, and Einstein was notoriously forgetful, you know. But then he began to forget what patients he’d seen and what drugs to prescribe.
“His neurologist, Dr. … oh my, his name is on the tip of my tongue … I’ll remember it in a moment. Anyway, his neurologist couldn’t find a reason for Jerry’s struggles. And Jerry just got progressively worse. He even started to lose function in those beautiful hands of his. They did brain scans and even did a brain biopsy. It was probably two months ago that his long-term memory started failing. And it was just last month when he looked at me and didn’t know who I was. After 26 years of marriage I was a stranger. From that day I was gone from his brain. It was wiped clean, like you do with a computer. He never called me by my name again. And he died not knowing who I was.”
“How awful!” After a respectful silence, Kristin asked, “Did you have children?”
“We almost had a baby, back when I was 27 and he was 30. I carried it for four months. But it wasn’t meant to be. I think all things happen for a reason, and I see now that not having children with what happened to him might have been for the best. Especially if it turns out it was something hereditary.”
“Sometimes a tragedy is a disguised blessing,” Kristin politely agreed. “Now I know you and Jerry have been involved in a number of our local charities and that he touched a great many lives. Since your husband was known by so many of our readers, I’m sure they’d like a story or two about him that would characterize him best. Do have an anecdote you can share? A hobby, maybe, that people would be surprised to know he had?”
“Not a hobby, no … but there was a sport he loved very much. Big-game hunting. He didn’t really have the time to go to Africa or Asia, though, to indulge. He was saving those trips for when he retired—assuming I could have ever gotten him to retire, he loved his work so much. But he did travel to one of the Dakotas three or four times, to a zoo or preserve or some kind of animal park, and had some quite lovely specimens shipped back to the house. There’s a tiger and a grizzly and a wolf in the library. He used to laugh and threaten to bring back an elephant or even a rhino! He would have, too, if we’d had the room.” Doris chuckled softly at the memory. “Is that the kind of story you wanted?”
“That was perfect,” Kristin assured her. “I’ll be interviewing some of his colleagues and the charities he worked with, too, and I’ll do my best to write a feature story that does justice to his life. Thank you again for your time, Mrs. St. John.”
“It was my pleasure. I’m sorry—did you tell me your name and say who you were with, my dear? I have so many interviews scheduled and I’m finding it so hard to keep everyone straight.”
Chapter Six
MIKE SHAFER BACKED HIS WAY THROUGH the swinging doors, carefully balancing coffee, muffin, a large white box and his backpack on his way to the six-by-six cubicle he called his office.
A passing colleague pointed to his watch and grinned. “Hey, Mike, did you forget? It’s your shadow day.”
Outside the doorframe to his office stood three polite-seeming workers in business dress looking alternately bored and anxious. Next to them stood one harried manager in khakis looking unmistakably pissed.
Mike nodded at the manager. “Morning, Kevin. Sorry I’m late. Thanks for covering. Have a muffin.” He pushed the white box into Kevin’s hands, then edged his way past the others into the cubicle where he could set down his belongings.
“Here. I’m late for a meeting.” Kevin shoved the white box—minus one strawberry muffin—back into Mike’s hands before heading off toward the conference rooms.
Mike turned to the three people left standing awkwardly by. “Muffins?” Baked goods and napkins quickly disappeared from the box, and polite smiles turned genuine. Muffins, Mike knew, always proved the best i
cebreakers. “So today you get to observe what a statistical analyst does for the CDC. Hope you all had your morning coffee, because you’re going to need it to stay awake. My name is Mike Shafer and I’m a numbers geek. And you are …?”
The workers, new hires all—and just out of college by the looks of them—introduced themselves: Karen, Luis and Sulak. Nice enough folk, Mike assumed, but having to play host for a day was not something he ever looked forward to. When time allowed, the first two weeks of every new hire’s tour of duty in, as the press releases pitched it, the “fresher and friendlier” Centers for Disease Control now included shadowing one person per day to see what their job was, how they did it and how it related to everyone else’s job in the department. The theory was that it built a stronger team. The reality was that the new hires were overwhelmed with more information than they needed and only took notes on how they might use the person being shadowed to get ahead in their own positions later on. Networking at the taxpayer’s expense.
“The first thing I usually do on a Monday morning is check our trending output. See if anything has changed over the weekend.” Mike booted his Pad-L, connected it to the large monitor hanging on his fabric-covered wall, and plugged into the CDC network as the new hires crowded into the cubicle behind him and tried to make themselves comfortable.
“It won’t be long before the software becomes more intelligent than we are and I’ll be out of a job. In fact, all I’m really good for right now is to recommend to the field agents which of the data presented is worth pursuing and which isn’t. The software, by the way, is known affectionately around here as the ASS—Aberration Surveillance System. It’s an upgrade to what many of you may know as the EARS—the Early Aberration Reporting System—that was developed way back in 2001. No? Never heard of it? Didn’t you guys read up on arcane CDC history before coming to work today?”
The blank expressions on the new hires’ faces told Mike it was obviously too early in the morning for lame jokes. He plunged ahead.
“So, what data are we going to look at? Well, hospitals and clinics are required to enter non-identifying patient data—we have those pesky privacy restrictions, you know—into a state database within 24 hours of the patient being seen. Then the admins have to fill in things like symptoms and diagnosis and a confidence factor for that diagnosis. For instance, if the patient presents with a rash, has an allergy to cats and was petting a cat right before the rash appeared, then that confidence factor would likely be 100 percent. But if the patient presents with a rash that appears to be an allergic response, is treated as though it’s an allergic response, but the patient has no history of allergies and no allergen is identified, then the confidence factor might drop to 70 or 80 percent.
“If someone’s admitted to a hospital, then their data is updated every 24 hours as warranted. It’s a standard form we have and pretty quick for the admins to fill out, especially after the first 20 or 30 of them they do. In the old days, only certain suspected diseases were required to be reported, but now Big Brother—that’s us—wants to see it all. What may be an anomaly in one hospital may be the beginning of an outbreak as seen across multiple hospitals or states or regions.
“So, the software we have for the state databases looks at all the incoming data and parses it by family, heredity, age, work environment, home environment, household income, neighborhoods, et cetera. Then those computers send that compiled data to our regional computers that compile all the data sent to them and they in turn send it to the national database where it’s compiled yet again and, voila: statistics.
“What’s really cool is that instead of me having to pore over hundreds of pages of spreadsheets, the software highlights any deviations from the norm. It’ll flag spikes in any one of the areas of interest and serve it out in digest form.
“The data is then trended over the last 24 hours, 48 hours, week, month and year. Or we can ask for a breakdown however we like. Is there possible contamination in a certain brand of canned meat and we’re trying to pinpoint the manufacturing run that was contaminated? We can look at trends starting from each distribution date in question and narrow the run responsible pretty quick.
“Remember last year’s Type 2 Pneumococcus outbreak in Florida? Remember how fast we were able to confine it? That’s because we spotted it right here first and were able to set up quarantines in airports, docks and bus stations within 72 hours of the first case being reported. Those are the kinds of results that can make statistical analysis pretty exciting.
“So let’s see what’s trending today.”
The new hires craned their necks to see the monitor over Mike’s shoulder. He tabbed through chart after chart, most of which looked like a flatliner’s oscilloscope. Karen stifled a yawn and Luis let his attention be distracted by the cartoons pinned haphazardly to Mike’s fabric walls.
“What’s that?” Sulak bent over and pointed to a slow-rising hill on the screen.
Mike zoomed in. “Looks like a few more wealthy males than usual have been admitted to hospitals in the past six months for … let’s see … muscle spasms, tremors, memory loss, confusion … probably just the tail end of the Gen X’ers. We’ve been seeing this for a while. Nothing precipitous.”
He hit the tab button a few more times before a strong spike appeared, towering over the flat plain that preceded it. “Ah.” Mike leaned closer to the screen; the new hires took the cue and focused on the jagged line that looked like a lightning strike in reverse and was obviously a tell-tale clue to something out of the ordinary.
Mike moved to the next screen and there was a similar climbing line. It was there on the screen after that, too. And the screen after that as well. He paged back and forth among the charts, his attention turned from the new hires to the data displayed. Clearly he’d found something of more than passing interest.
“Is it important?” Sulak prompted.
“Oh, sorry.” Mike had forgotten there were people expecting him to narrate his thinking processes. “If enough people employed at a single company seek medical help, the software picks up on that. We’ve got four companies reporting a greater than 5 percent increase in emergency room visits in the past 48 hours. Enough of an increase to alert the software. Not anything overly suspicious, though it is a little more unusual to see spikes in the spring.”
“Does it say why they were admitted?”
“Memory loss, tremors, shakes—even full-blown seizures. A couple of deaths. Unknown causes. Not related to age that I can see. And the company workers are spread out, though it looks like there are pockets around San Luis, Denver, Shreveport and Watford City, North Dakota.”
“What companies?” Luis started to pick up interest. Hired as a problem-solver for the Environmental Health Services Branch of the CDC, mysteries to him were personal challenges.
“RouterNet Technologies, Cable-In Corporation, Willis-Knighton Heart Institute and Triple E Enterprises.
“Is there a connection?”
“That’s something we’ll have to find out.”
Sulak tapped her thumbnail against her front teeth, a habit she had when she was trying to remember something important. “Didn’t you say there’s been a rise in cases of tremors and memory loss among wealthier males?”
Luis nodded. “That can’t be coincidence.”
“Hold on, guys.” Mike swiveled in his chair and faced the eager new hires with a grin. “We’re not looking at the next plague here, you know. We get these kinds of flags a lot. Most of the time—in fact, practically all the time—it’s nothing. A local case of food poisoning or some bug that someone brought back on a trip. We’ll check them out—that’s why I have a full-time job. But 99 percent of the time I can backtrack the cause and save the time and expense of sending our field agents out.
“Since you’re assigned to me today, you can help do the research. Grab your Pad-Ls and we’ll go to one of the conference rooms. We’ll hit the companies’ websites, make a few con calls, ferret around a bit an
d see what we come up with. Then we’ll go to lunch and this afternoon you can watch me put together my monthly report and help me justify my job.”
As Mike led the three new hires down the hall, he could hear the enthusiasm as they speculated about similarities among cities in widespread pockets of America. He didn’t begrudge them their excitement. Ten years ago, just out of college with his Master’s in hand, he would have reacted the same way. In fact, he had reacted the same way when he’d been handed his first reports, finding meaning in coincidences and chasing aberrant data to their inevitable dead ends. True epidemics—AIDS and Legionnaire’s Disease and Swine Flu—came around rarely enough, maybe once every three to five years. And if they spent their time looking for the rare and elusive pandemic, like the Spanish flu of 1918—over 100 years ago now—they were going to be sorely disappointed.
They’d learn quickly enough that the work of the CDC wasn’t all flash and dash. It was tedious research, frustrating politics and slow but incremental steps to a healthier society—along with a deeper understanding of the interconnectedness of people and activities around the world.
The knowledge that his efforts were helping to fund that understanding was what kept him showing up for work every day. He hoped it would be enough to keep the new guys focused and engaged as well, since the excitement of a new outbreak of some never-before-seen disease coming along their first day of work was as likely as the Seattle Mariners taking the pennant this year. Although, if pressed, he would have to bet on some fluke outbreak happening before a Mariners win.
Chapter Seven
THE SUN WAS BARELY ABOVE THE HORIZON when Donna Bailey pulled her truck up to the back door of the McKenzie County Animal Clinic. Yawning, she pushed open the driver’s door, wondering vaguely when it had grown so heavy.
A black-and-white blur leaped over her lap and onto the gravel drive, nearly upsetting the half-finished cup of tea in her hand. “Alfie!” The border collie threw an apologetic look over its shoulder and waved its tail. With decidedly far less enthusiasm, Donna followed it out the door.
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