Vivian glanced at the stage as punishing riff fell on the crowd. The nightly performances rotated between Russian synth pop, Neue Deutsche Harte, cybergoth distortion, and Czech metal.
Tonight the nu metal group Misanthrophilia was setting the atmosphere and sharpening their lyrics before lunging for the jugular. Slugging guitars and battering drums poured into the Toxic Mistress in a matter of minutes. Each cathartic rumble of the guitars added another layer to the bile fest.
As much as Vivian would have enjoyed the chaotic show, she was here for business and not pleasure. She finally spotted Gavin lording over the bar like a gatekeeper to the forbidden.
A Mohawk of slick blades protruded from his skull. Supposedly an explosion at an anatomy model plant left him with shrapnel embedded in his head.
How strange that an injury to his brain reshaped his personality. If that wasn’t odd enough, it drove him to the dark realms of the Toxic Mistress.
He fashioned the blades into a razor sharp Mohawk to cement his newfound identity in the deranged and deviant. A monocle gleamed on his right eye like a portal into his incognizant brain, always whirring with chaotic thoughts that would frighten outsiders.
His wardrobe consisted of a striped shirt and suspenders. He was a wiry figure with an equally angular face.
In so many ways he reminded Vivian of a villain she might see immortalized in film, albeit an eccentric one that would garner the audience’s praise far more than the hero.
She chuckled at the sight of Gavin. It amazed her to think that he once lectured her in the classroom. His knowledge of anatomy and human physiology was unparalleled, with a penchant for witty banter to match. He was easily her favorite teacher during her short tenure in college.
Now she considered him a confidant who listened to her life story without so much as a judging thought or pushing advice on her—unless he was advising her on her poison of choice.
“Vivian, always a pleasure to see you,” he smiled. “What will it be tonight? The Green Fairy? Or would you be inclined to try one of my newest concoctions? I call this little draught Mephistopheles’ Elixir.”
“I think I’ll wait for the toxicology reports from your victims before I give it a try. I can’t be too careful, now can I?”
“Ah, the young and headstrong, always so resistant to change. Here I thought you were bolder than most.”
Vivian propped herself up on the bar.
“But in all seriousness, Gavin, I came to tickle your brain about a certain subject. You’re the smartest and oddest character I know, so who better to approach about matters of medical nature?”
Gavin filled up another tray of shots, which was promptly fetched by a server clad in an eyepatch, garters, and a latex corset.
“I’m not sure whether you’re being overly dramatic or genuine in your praise, but I’ll take it all the same. As for your request, I hope you aren’t looking for a psychiatric evaluation. That would be cruel and unusual punishment for me.”
“No, nothing like that.”
Gavin flashed a cocky smile and leaned back—almost skewering a waitress with his steel-tipped Mohawk.
“Speaking of medicine, I don’t believe I’ve told you about my latest foray into civilized society! When I’m not catering to the depraved masses, I work at the medical examiner’s office. I suppose it’s the most conspicuous place a person of my nature can work, no?”
“Yeah, you don’t exactly look like the secretary type happily greeting patients.”
Vivian chuckled at her reflection in the blades affixed to his head.
“Not only that, but now I have the opportunity to put my medical knowledge to use. It has been far too long since I worked with human anatomy.”
“Really? I never could have imagined a shortage of anatomy at the Toxic Mistress. Don’t you flirt with the girls here?”
“Your anatomy jokes are starting to wear on me. Sometimes I wonder what you think of me. This isn’t a brothel we’re running. Before we get down to business, indulge me with a little pleasantry. Tell me how my favorite student is doing in the nursing program.”
“I’m being tormented at the hospital by a surgeon called Dr. Crenshaw. That’s the drama you’re looking for.”
“Ah, Crenshaw! We took a few classes together at the university—when I still had hair. I remember his prickly demeanor. He always went about with a chip on his shoulder. I never could figure out why.”
“A chip on his shoulder? More like a pole up his ass. Anyway, I have something else in mind tonight. What would you say if I told you I need genetic testing for an umbilical cord? Do you think you could work your magic on it?”
She discretely handed the satin-wrapped bundle to him. Gavin took a peek and his eyes rounded.
“It must have been preserved for years. It’s in impeccable condition. Look at the way the torsions are still visible!”
“That’s mildly disturbing how excited you sound over an umbilical cord.”
“My dear Vivian, all aspects of medical science, even the morbid and strange, are fascinating and worthy of appraisal.”
“So can you use this to trace Camilla’s lineage and come up with a list of living relatives? Or am I hoping for too much?”
“Your friend Camilla? Why in the world does she have an umbilical cord?”
“It’s a long story, but we suspect it might be hers. Suffice to say, someone left it for her, along with a series of disturbing messages. We think she has a stalker.”
“Ah, so this isn’t merely out of medical curiosity. I may have some connections that can help you. I need Camilla to provide a DNA sample for comparison, of course. Once we have a positive confirmation, I’ll see what I can do.”
Vivian leaned in with a look so intense that it electrified Gavin.
“I also need your opinion on a woman who died in the hospital. It’s not really any of my business but it’s bugging me. Her skin looks like something out of a horror movie and I’d wager it’s somehow connected to her death.”
“Where is she now?”
“The body is in holding at the hospital morgue. I don’t think they’ll transfer it to the medical examiner unless they have reason to believe a crime was involved.”
“True enough,” Gavin said. “And I can’t exactly drop in and take a peek.”
“Which is why I had to break some rules and take a picture for you. I know, I know, privacy and all that. Shoot me later.”
She whipped out her phone. Gavin’s eyes fell to the photo.
He lowered his glasses on his hawkish nose and suppressed a shiver in his voice. Vivian had never seen him look so unnerved.
“You took this photo from the University Hospital? How many cases of this have you seen?”
“Only one so far. What do you know about this?”
“Cutaneous lesions with a nodular appearance, red plaque clustering around the neck and cheeks… How precisely did she die?”
“She was brought in for respiratory failure. She coughed up bloody mucus. Once she went into cardiac arrest there wasn’t much we could do to save her.”
“This doesn’t bode well at all… Respiratory arrest isn’t a common factor but this looks like lupus vulgaris… Cutaneous tuberculosis.”
Vivian looked at her arm where she received her BCG vaccine. She silently thanked the charismatic blood technician for poking her with a needle.
“I could be mistaken. Of course I would need to take other symptoms into account such as weight loss, bloody sputum, fatigue, and chills, but I can’t account for that with a single photograph.”
“How does tuberculosis spread?”
“It is a bacterial infection caused by Myobacterium tuberculosis. The difference between tuberculosis and its cutaneous cousin is that the bacteria nests in the skin instead of the lungs.”
“I thought tuberculosis was usually transmitted through coughing and sneezing. You’re saying this directly attacks the skin?”
Gavin gnawed on his lip.
>
“Yes and no. It could be a combination of mycobacterium in the lungs and skin. Judging from the progression of her lesions and the reddish-brown appearance, it fits the case of lupus vulgaris. I can’t confirm it without a blood test, but I’m damned sure. Your director needs to know about this.”
“But I can’t tell him how I discovered this… I can’t say I took a photo from the morgue and showed my professor-turned-bartender. Not to sound harsh, but she’s dead. She can’t cough or sneeze on anyone. It can’t be transmitted by any other means, can it?”
Gavin’s eyes wandered from the photograph to the performers tearing up the stage.
“Yes, I’m most likely getting riled up for no reason. Cutaneous tuberculosis isn’t contagious. How could I get ahead of myself like that? The germs aren’t on her skin or clothes.”
He reached for a glass and generously splashed absinthe, black raspberry liqueur, and peach vodka against the sides. After adding grenadine and a pinch of peppermint, he pushed it Vivian’s way.
“Forgive an old man’s ramblings.”
Vivian sighed and laughed. Somehow Gavin always knew when she needed a drink.
“And what do you call this mad little concoction?”
Gavin’s eyes glazed over and he raised a glass brimming with crimson liquid to his lips.
“Red Widow. Even now as you sit before me, you remind me so much of the determined woman who walked into the Toxic Mistress a year ago. There’s a fire in you that will never be put out. I know you’ll do great things with your life. You can’t even imagine, but your journey is just beginning. Here’s to the most inquisitive student I know.”
Vivian’s mind shifted from business to pleasure in those fragile few seconds.
SIX
Two months passed since Vivian consulted Gavin in the Toxic Mistress. She was adapting to her routine of classes and clinicals. Exams were creeping over the horizon and waiting for an auspicious Monday to pounce. She would be ready for them this time—assuming she wasn’t distracted by fantasies of Milo again.
As for Camilla, she had an entirely different man on her mind. The thought of her stalker continued to eat away at her, despite his notable absence of letters or threats. She believed it was only a matter of time before he resurfaced. Gavin was still working tirelessly to track down her lineage but he ran into a few snags. That was to be expected when investigating a family of deceased recluses.
Meanwhile, Vivian was assigned to watch over a female patient recovering from emergency surgery. She was placed in the psychiatric department because she remained a danger to herself.
Suicide watch was an unfamiliar experience for Vivian. She couldn’t let the woman out of sight, going so far as to accompany her to the bathroom. In addition, the patient’s belt, jewelry, and shoelaces had been confiscated.
She finally nodded off to sleep after Vivian read her a story. She was feeling drowsy herself after spending two hours hunched over a book. Apparently it wasn’t the first time this patient needed monitoring. A few months ago, a team of surgeons saved her from another perilous attempt to end her life.
Vivian tossed the book aside and sauntered over to the window. The window in the ward wasn’t designed for opening—it was just a portal to the world beyond. At least she could kill a few minutes of boredom by watching the people outside.
When even that task became mundane, she turned around to check on the patient. For the first time, she noticed something jarring about the woman’s face. She leaned in for a closer look.
Lesions. They boiled on the surface like fleshy barnacles feasting on her ear.
“The same symptoms as the homeless woman…” She remembered her conversation with Gavin about the nature of the red markings. Lupus vulgaris is tuberculosis of the skin. If untreated, the lesions will evolve into skin cancer.
She barged into the hall.
“They have to believe me now. They can’t dismiss this anymore.” Her green eyes frantically scanned the hall, looking for someone to share her findings with.
She couldn’t hunt down the hospital director and force him to hear her out. Barring the fact that she didn’t know who the director was, Vivian would likely be jumping over an ambiguous chain of command. She had no choice but to seek out Bryan Hajek, her mentor for the nursing program.
He often wandered from one department to the next to survey the students and pull them out of the fire. She could spot him a mile away from his portly stature and the glasses slipping over his nose and mustache. He also insisted on wearing tweed jackets in a hospital brimming with lab coats and scrubs.
Vivian’s heart leaped when she spotted Bryan, but it sunk just as quickly when she saw who was occupying his time. He was conversing with her least favorite surgeon, Crenshaw. How could she forget the man who humiliated her on her first day of clinicals?
Vivian crossed paths with Crenshaw a few times since their introduction, and each encounter left a more dour impression than the last.
If she didn’t know any better, she’d say he suffered from an acute inferiority complex. He simply wasn’t content unless he was cutting through someone’s soul with his scalpel of words. It was a skill he excelled at with exceptional cruelty that must have taken decades to perfect. He was a combination of arrogance and scorn with nothing to show for it.
As far as Crenshaw was concerned, nurses didn’t exist. The only people worthy of his attention were like-minded male surgeons. Rumor had it that the enormous workload or exams didn’t make students drop out of the program in droves.
It was Crenshaw.
“Bryan, I need to talk to you about something,” Vivian piped up. She took mild pleasure in Crenshaw’s irritation.
“Yes, Vivian, what is it?”
“I’ve noticed a pattern of lesions on patients during my time here, starting with a woman who died in our care a few months ago. Normally I would have written it off, but I can’t ignore the possibility. I think we’re looking an outbreak of cutaneous tuberculosis.”
Crenshaw’s nasally voice cut in.
“And how many cases of tuberculosis have you diagnosed, young lady?”
“Oh, a dozen or so,” she scoffed. “In all seriousness, I think there’s a connection between the two cases I saw. I first noticed these lesions on a woman in the ER. What if it spread somehow?”
“Was the first patient diagnosed with tuberculosis?”
“No, I think her death was passed off as a drug overdose because she was homeless.”
“You’re still hung up over that incident?” Crenshaw said. “When you tried to humiliate me in front of my team and question my judgment? Just because you’re wearing scrubs doesn’t mean you suddenly have a knack for diagnosing a disease on sight.”
Vivian could see she was fighting an uphill battle to convince Bryan while Crenshaw shot down her theories. She was already off to a rocky start trying to outline the possibility of tuberculosis.
To her relief, Bryan said, “Let’s assume you’re right about this outbreak. How do you suppose it spread from the initial patient? Contamination?”
“I don’t know. It’s a possibility.” That thought seemed to provoke Crenshaw as violently as a punch in his ribs.
“How do you know you didn’t spread a contaminant? Did you clean the ER after that woman was removed?”
A lump stuck in Vivian’s throat.
“I’m not suggesting that I spread it—”
“But you clearly think someone is to blame here. Tuberculosis doesn’t sporadically appear overnight. It must spread because of someone’s laziness and negligence.”
“No, I—”
“Did you clean the room? Were you not given the simple task of discarding the linens and scrubbing down the equipment?”
“No one told me to—”
“I did tell you but you were obviously too arrogant to listen to your superiors. You need to be told matters of common sense? Do I need to stress how stupidity on the part of students can contribute to spreadi
ng an infection?”
Vivian matched his glare with every bit of intensity, and the sight made Crenshaw take an involuntary step back. He muttered under his breath just loud enough for her to hear.
“If this patient has tuberculosis, it’s likely an isolated case. Tuberculosis has steadily been on the decline. We hardly see new cases anymore.”
“But—”
Crenshaw aggressively launched forward as if to back her into a corner.
“Are you trying to create a public relations nightmare?”
“And are you trying to ignore the possibility?” she snapped. She could tell from the fires in his eyes that he despised her, probably down to her gender and race. How dare a lowly nursing student show insubordination to a surgeon. She should be groveling at his feet and kneeling before his every divine judgment.
Bryan raised his hands in a placating gesture before the blood could fly.
“Vivian, there’s no need to jump to conclusions. We’ll look into this matter. But Crenshaw is right, we can’t let rumors spring up before we know precisely what’s going on. When and where was the last patient you saw with these lesions?”
“I was watching her during…” Suicide watch. Her throat parched in terror. “I shouldn’t have left her alone.”
Vivian raced past bewildered nurses toward the patient ward.
“Vivian!”
Bryan and Crenshaw pursued her but she vanished around the corner like a bolt of lightning. She couldn’t remember which room belonged to the patient; the awful knowledge that she could be asphyxiating herself or worse taunted her. Vivian pushed through the door and saw the patient resting in bed.
Bryan and Crenshaw piled in behind her.
“What was she doing by herself?!” Bryan howled. “You are never to leave a patient on suicide watch by herself, am I perfectly clear? You can’t leave her bedside until you’re relieved by another aide, not even for a second. We’re lucky she didn’t hurt herself! Do you realize the damage you could have caused?”
“I’m sorry.”
“Sorry doesn’t cut it. I need to report this incident to the head of psychiatry.” Vivian’s tongue folded in her mouth. She felt stupid for letting her out of sight, but what was she to do?
Arsenic for the Soul Page 6