“What can I do for you, Phil?” Gorman was in his early sixties and would retire soon, never having been the head of the department he had been a part of for nearly forty years. Still, he harbored no ill will towards Phil and actually enjoyed the intellectual stimulation Phil offered. Most of their work was fairly cut and dried, and before Phil had taken over, complacency had infected the entire staff—sadly, including himself.
“About a month ago, you told me that you had a case of viral encephalitis that was sent on to the CDC. Do you remember it?” Phil respected Gorman’s opinion. He was a very experienced pathologist, and in this case, he had the advantage of actually having worked on it from the beginning. “I’m looking at the slides now, and I have never seen anything like this before.”
“I remember the case well. I took a pretty close look at what was left of the brain, which wasn’t much. He had a nine-millimeter entrance wound in his left frontal bone, and I found the bullet in the right occipital lobe. I took a lot more sections than usual because I couldn’t see a young father going crazy like that without a reason. He had all these inclusion bodies in the walls of his ventricles that were definitely pre-morbid. So I figured he had an encephalitis, right, probably viral, most likely an arbovirus. I know—there are no mosquitoes around in January, but by this point, I was grasping at straws. Did you see the electron micrographs?”
“Yes, I’m looking at them now,” Phil said, not entirely comfortable with Gorman’s familiarity.
“Well, those, my friend, are not arboviruses, either in season or out of season. I sat on the case for a week while I researched it, but I couldn’t find shit. Nothing ever published looks like that sucker. I thought it might be a new species, or some radical mutation of a herpes virus.”
Phil was about to ask Gorman why he had not consulted him about it, but then he thought better of it. If this did turn out to be a new species, or even a new dangerous mutation, Gorman would be credited with the find, and in today’s culture of instant fame, the credit could be considerable. This was one of the rare moments when Phil was happy that he was not burdened with the usual human nature. “I see,” he said. “So you sent it on for identification.”
“Yeah. We got an answer pretty quick. Let me see if I can find that.” Phil listened quietly as Gorman rummaged through his desk. “Oh hell, let me just look it up . . .” His voice trailed off as he began to type at his keyboard. “Got it. Arboviral encephalitis. Signed, sealed, and delivered by the gods of the CDC, Special Pathogen Division.”
“They were wrong,” Phil said simply, staring at an electron micrograph of a six-sided viral particle.
“You think they just rubber-stamped it?” Gorman asked, with a subtly more professional tone. “It never sat well with me. I was hoping for something more interesting, and I have to admit that I was somewhat disappointed that they didn’t find it. Maybe my objectivity wasn’t as reliable as it should have been from the start, and after the CDC came back with arbovirus, I convinced myself that I was seeing things that weren’t there—the proverbial zebra in a herd of horses. So, I let it go. But there’s been this little voice in the back of my head that keeps screaming ‘bullshit’ whenever I roll that case around in my mind.”
Phil was quite familiar with little voices in his head, but the profanity made him wince. “Have you thought of anything else that might help shed some light on this case?”
“No, I haven’t. What’s your initial impression?”
Phil paused for a moment. He remembered being asked by Greg Flynn a month earlier if he knew of anything that might help to explain the recent social unrest. He had mentioned that they had found an unusual case of viral encephalitis, this very case, in fact, but until now, he hadn’t made the connection. Phil recalled that Greg had reacted strangely to the mention of a virus, but as it wasn’t important at the time, Phil had simply filed the encounter away. He glanced down at his schedule and confirmed what he clearly remembered, that Greg had called this morning asking for an urgent meeting. “Do you remember a conversation you and I had four weeks ago about the increase in homicides and suicides since the first of the year?”
“I remember having the discussion, but none of the specifics. I gather you think that this upswing in violent death may be related to our little friend here.”
“This virus is unprecedented. Your initial instincts were correct. It is either a mutation of an old pathogen, or a new pathogen altogether. This upswing in violent death is also unprecedented. I cannot look past the possibility that they are related.”
Gorman thought in silence. “I think you’re probably right. We’d better start broadening our search for this virus.”
“Yes, we should. Please let everyone know. Also, remind them to adhere closely to the rules of universal precautions. We don’t know how this virus is transmitted, so everyone coming in contact with tissue is potentially at risk. Thank you, Dr. Gorman. We will speak again later.” Phil ended the conversation no more abruptly than usual. He picked up his ancient Dictaphone and had started to dictate a letter to the department when his phone rang. “Yes, Mrs. Miller?”
“Dr. Rucker, something has happened.” There was a slight break in her voice, and Phil waited for the bad news. Linda Miller was never emotional. “The Governor has been shot. He’s dead.” She waited for a reaction, but Phil was still waiting for her to tell him how this news affected the department.
“Was he here in Colorado Springs?” he finally asked.
“No, goddamn it, he was in Pueblo,” she screamed. “For God’s sake, he was your father’s best friend. You do remember that, don’t you?”
Grief! Phil admonished himself for missing the social cue . “I know who he was, and it’s a terrible loss. I don’t know what else to say.” He was going to add something about being sad, but thought it would sound a little over the top.
Linda wrestled with her emotions. She should quit right here and now. If this couldn’t provoke a human reaction from him, nothing would. He was a machine, devoid of emotion and feelings, and she wasn’t going to work for a machine. She counted to ten and calmed down ever so slightly. “Dr. Rucker, I know you don’t understand situations like this, but very soon there are going to be a lot of people focusing on you, evaluating you and your reaction to this ‘terrible loss,’” she said, mocking his words. “I am going to write out some quotes for you to use when you’re asked for a comment. I sincerely hope that your utter lack of emotion is mistaken for a feeling of overwhelming loss. After that, I am going home. I don’t think I should be around you any more today.”
Crystal Heller wheeled her Suburban into a parking spot that normally had the word Compact stenciled across the front. Today, however, a Suburban was as compact as anyone was going to get. Besides, the parking lot was less than a quarter full. She opened the door, and a gust of wind almost blew her door off. Her daughter laughed from the back seat as her mother struggled with the heavy door.
“That’s enough out of you, young lady—” A wave of nausea cut her off, and she swayed in the wind. It took a moment for her to regain control of her stomach. “Okay, let’s get you inside before we both freeze to death.” Crystal unbuckled her fragile little snow bunny and carried her into the clinic. It was a miracle that they were open today, but Crystal couldn’t imagine waiting another day for the test results. They were greeted at the door by Samantha Wood, one of the clinic’s nurses.
“Get in here, Miss Karen, and bring your mom, too, before you both catch pneumonia.” Samantha had that infectious smile that all good pediatric nurses should have.
“Hi, Sam,” Karen said without enthusiasm. The vestibule opened onto three hallways, each colored a bright, happy color, and three-year-old Karen Heller headed down the purple hallway without being told.
“Good morning, Sam,” Crystal said, apologizing for her daughter.
“It’s okay, honey, we’re old friends, Karen and I.” Sam smiled, and her eyes seemed to twinkle, unaware how sad it was for a thre
e-year-old to be old friends with a pediatric oncology nurse. “Dr. Ryan is running a little late, so just follow your little angel.”
Crystal found Karen slumped in a plastic purple chair, her arms folded across her chest, her mittens and hat discarded on the floor in front of her, and her face screwed up into a scowl. They were surrounded by that damnable color. Everything around them was purple—the carpet, the walls, the toys. Karen hated purple because purple meant pain.
“Honey, do you want to take off your jacket?” Crystal asked. Karen got up, stripped off her coat and dropped it to the floor, then slumped back into that horrible plastic purple chair with palpable resignation. “I brought your coloring books,” said Crystal, trying to entice her daughter out of her sullen mood. Karen brightened and reached for the crayons and books and then stretched out on the floor.
As Crystal watched her daughter silently color mermaids and giants, she cursed God and prayed to him at the same time. Karen was dying of acute lymphocytic leukemia, or ALL, as it was known. She had been diagnosed more than half her life ago and all she had ever known were hospitals, blood draws, and bone marrow exams. She had already survived two crises, but the odds were very long that she would survive a third. Crystal began to pray again, the words running through her mind with all the emotional energy she could muster, which wasn’t much. She had long ago lost any hope that God would personally intervene and save her little girl, but still she prayed, because if she stopped, there was only one thing left to do: accept the inevitable.
She was pregnant again, but she hadn’t yet told her husband, Ron. At very best, she was six weeks along, and if they did an early C-section at thirty-four weeks, they may be able to get some cord blood, with its lifesaving potential—if the baby and Karen were a match, if she carried this baby to term, and if Karen could last the twenty-eight weeks. Crystal was overwhelmed by the “ifs,” and her eyes swelled with tears. It all seemed so hopeless, so futile. She turned away from her daughter, pretending to look out the window.
“Look, Mommy, I drew Aladdin and I stayed inside the lines,” said Karen, tugging at Crystal’s sleeve.
Crystal dried her eyes and gushed over her daughter’s latest masterpiece.
Karen scratched at the feeding tube that was taped to her nose. For weeks, it had been the only way they could get nutrition and fluid into her, except lately, she had done an aboutface. She had been eating reasonably normally for the last several days and had actually begun to complain about being hungry. Her energy level seemed to be better as well. On most clinic visits, Karen had been too weak to walk down the hall, forcing Crystal or her dad to carry her. Today, however, there had been no question about her walking to the car or stomping down the long purple hallway by herself.
“Mrs. Heller, Dr. Ryan is ready for Karen now.” Crystal and Karen both looked up at an unfamiliar nurse. Karen’s heart dropped, and Crystal’s raced. He was going to give them the latest blood counts today. Her cell phone suddenly started to cluck, and Karen stopped mid-stride to cluck along with it.
“It’s Daddy,” she sung out.
“Yes, honey, it is. Now go sit down for a moment.” Crystal made the nurse wait; she had earned the indulgence. “Hi. We’re about to go in now. I guess he was running late. I’ll call you as soon as I know something.” She listened to her husband’s response and then said, “I’m trying to be. Love you.” She closed the flip phone and fought back another set of tears. “Okay, baby, let’s go.” She reached for her daughter’s tiny hand and followed the nurse down another ridiculously purple hallway.
The nurse walked them past the three exam rooms that Dr. Patrick Ryan normally used and led them to his private office.
“There has to be a mistake. We always see Dr. Ryan in an exam room,” Crystal said, panic filling her voice.
“He wants to see you in his office today. Is your husband with you?”
It was happening too fast, and suddenly Crystal couldn’t breathe. The corridor began to narrow, and the nurse took her arm. “Please just have a seat in there. Dr. Ryan will be here in just a moment.”
Crystal lowered herself into one of the sofa chairs. Everyone knew the routine. Good news was given in the exam rooms, bad news in the office. She couldn’t stop the tears now, and she turned away from her fidgeting daughter. She stared at a wall filled with pictures of smiling children, most of whom had lost their hair from various treatments, and to her horror, she recognized that many of the children whose pictures hung on the wall had already died. She wanted to throw up, and it had nothing to do with pregnancy.
Patrick Ryan walked in through his side door. Rail-thin and six feet four inches tall, he looked more like a beardless Abe Lincoln than a pediatric oncologist. His lab coat was rumpled, and his tie was crooked and stained. Dark black circles under his eyes told the world that he needed a good night’s sleep. He sat in his chair flipping through the pages of a chart, barely acknowledging their presence. Crystal waited, dreading but needing to hear what he had to say. He rustled through the chart one last time, confirming what he had seen earlier, and then finally closed the file. The name Karen Heller was stamped across the bottom tab. Dr. Ryan looked up at Crystal and was surprised by the anguish written across her face.
“Crystal, are you all right?” he asked with genuine concern.
“No, I’m not all right. Why are we in here instead of one of the exam rooms?” She began to cry uncontrollably, but didn’t break the lock with Ryan’s eyes.
“We’ll be going to an exam room in a few minutes, but before that I need to talk with you. How are things at home?”
“At home?” Crystal practically screamed. “How are things here?” She reached over and grabbed her daughter’s chart.
“I think you have the wrong idea, Crystal. You’re not here because I have bad news. I brought you in here so I could understand how Karen’s blood counts have normalized.”
“Normalized? What does that mean? She’s not having another crisis, is she?” Crystal’s eyes grew as big as saucers as confusion and fear entangled in her mind.
“Absolutely not. In fact, and I find this hard to believe, I can’t find any sign of leukemia in Karen’s blood smear.” He leaned forward. “I want you to understand what I’m saying. I don’t see any evidence of any abnormality.” He spoke slowly and emphasized each individual word. “Either past or present. It is inconceivable, unbelievable. I had the lab repeat the tests, but we got exactly the same results. I checked the blood myself, and the machines were correct. Karen doesn’t have a single malignant cell in her system. It goes beyond even that. Her liver and kidney functions have both normalized, and her nutritional state is exactly what we would want for a threeyear-old. By every objective measure, Karen is a healthy little girl.”
Crystal listened to Dr. Ryan, but the words made no sense. “How?” was all she could manage.
“I don’t know, but Karen is not the only one. She’s had the most miraculous turn-around, but there are two other children who seemingly out of the blue have erased their cancer. Have you or Ron had the flu this year?”
Crystal was having a hard time processing information. “The flu? Maybe—I don’t know. I think I may be pregnant, and I assumed a lot of my symptoms were related to that. Ron was sick about two weeks ago. He had to take some time off from work because of it. Why? Do you think that has something to do with it?”
“Did Karen get sick?” His question was pointed. He had warned her several times that she had to do everything necessary to keep Karen from being exposed to contagions, especially the flu.
“Maybe. It wasn’t bad. She had a fever for a day and coughed a lot, but then she got over it,” Crystal answered defensively.
“The parents of the other two children both got sick, and their children had a very mild case, just like Karen. There has to be a connection. The changes are too amazing, and the coincidence too great. I’d like you to do a pregnancy test while we check out Karen. Is that all right with you?”
Realization finally crashed in on her, and Crystal broke down. “Are you saying that Karen is cured?” she asked through choking sobs.
“I wish I could, but I just don’t know,” Ryan said, trying to maintain a degree of professional detachment; but Crystal’s emotions were close to overpowering his restraint. He was in uncharted territory. On occasion in the past, he had discussed remissions; and even then, he had to temper his responses, but this was different. This wasn’t a remission, it was an eradication, and he wanted so much to tell her that what was happening to Karen had never happened before, anywhere. But twenty-two years of experience held him back. Miracles happened only to other people, and he and his patients had to deal with reality, no matter how difficult. The best he could do was to let Crystal cling to her hope, and he hoped that he wasn’t making a mistake.
“But we have a chance. Tell me, Doctor, that my daughter has a chance,” she pleaded.
“Mrs. Heller, Crystal, your daughter has a chance to grow up.” He would have finished, but she flew across the desk and pulled him out of the chair by his neck, covering his cheeks with kisses and tears.
Amanda was beginning to calm. Her heart was still racing, but it was starting to slow. She turned away from the mirror and began to pace the length of the hotel room. She was a little off balance and swayed into the bedside table, nearly knocking it over.
“Damn it,” she cursed, and slowly cruised back to the bed, where she carefully sat down. For a moment, the room spun around her; she closed her eyes and waited for the vertigo to pass.
She could still feel Him. “Klaus Reisch,” she said unexpectedly. The name reverberated in her head. He was the one, and he was just like her. She wasn’t alone anymore, and in fact, had never really been alone.
That thought should have made her happy, but it didn’t. There were times over the past seven years when she had thought that she felt Another—a consciousness beyond her own that always seemed to be just beyond her mind’s reach. Someone, who had survived and then Changed, just as she had survived and Changed. Someone who could answer all her questions and finally set her on the right path; someone whose very existence would confirm that her survival had not been some random event that only served the laws of probability; someone who would finally prove to Amanda that her survival, and everything that had come before it, served a purpose—that it all had meaning, even the deaths of her family. Except Reisch wasn’t Another, he was just an Other.
Hybrid Page 12