“Rossit’s a fucking idiot!” Williams bellowed when I alerted him to the trouble.
Or a saboteur, I thought.
Williams and I went into the ward where the suspected carriers had been isolated and tried to calm them down, assuring them Rossit wouldn’t be allowed to lavage their noses, but it was too late. Teams of lawyers had already been summoned by the parties on both sides of the argument, the employees’ union and the department of health. They descended on St. Paul’s and went at each other tooth and nail somewhere upstairs.
“Nobody talks to reporters but me,” Williams growled at a hastily reconvened session of our special committee. Rossit didn’t attend.
But shortly afterward a very hostile media arrived, probably alerted by one of the individuals unhappy with the quarantine. Soon local news bulletins were also ripping into the validity of the health department demanding that citizens submit to the tests being done at St. Paul’s.
The call-in shows were the worst. “Civil liberties versus state health. Is Big Brother now Big Doctor? When the men and the women in the white coats take ‘knowing what’s good for us’ too far...” one commentator blared. Everyone in the auditorium heard him over a portable radio that a nurse had brought in. Williams happened to be there at the time, giving an interview to a newspaper reporter in an attempt to add some balance to the debate that was raging.
“Turn that crap off,” he yelled, then walked away shaking his head, looking more worried than I’d seen him so far.
By early afternoon the open revolt against compulsory compliance, stoked by the local broadcasters, was resulting in fewer and fewer patients agreeing to come in. Yet even when the whole operation was threatening to collapse, Williams persisted with his order that we keep the lid on what was really happening. “I’m afraid the panic would evacuate the hospital,” he warned, “and patients too unstable to be moved could die.”
“But evacuation’s illogical,” others on the committee protested.
“So’s panic,” retorted Williams. “You’ve seen the media zoo here today. Imagine how they’d play up an unstoppable organism that can kill in forty-eight hours and is carried unknowingly in the noses and on the hands of hospital personnel. The first impulse of patients would be to sign themselves out, and family members would insist on it. Do you really think you could control that kind of hysteria with clinical logic and measured reassurances?”
As uncomfortable as I’d been with his deception, his stark prediction of what a candid disclosure might unleash left me even more alarmed.
But then the entire exercise was salvaged in a totally unexpected way by pure luck and a nasty bit of gossip.
Small groups of patients were still responding to the call-up, enough to keep some of us busy despite the hue and cry, and a young resident was taking cultures at a table situated near my own. Suddenly he turned to some of his colleagues who were waiting for subjects and declared rather loudly, “I don’t for a moment believe what they’re telling us.”
Smart lad, I thought, continuing to take swabs from a young girl’s fingernails.
“In fact,” he continued, “I just read an article that might explain what they’re really looking for.”
He instantly had my attention. His buddies looked interested as well, and any patients within hearing distance visibly perked up. I also noticed a reporter with a microphone who’d been trying to get interviews look over from where he’ d been reading his notes.
“It’s staphylococcus all right, but a new MRSA strain.”
I was about to throw down my culture swab, run over, and quickly whisper that he keep his theories to himself when he pronounced, “It’s a nasty, virulent bug recently reported in Ontario, Canada, that infects thirty percent of its carriers. I’ll bet some Canadian shopper has brought it down here.”
I sighed my relief and went back to culturing fingernails. The so-called Ontario strain had been around for years, was causing a problem just over the border in Toronto but fortunately hadn’t been reported here yet. Most important, it was sensitive to vancomycin.
But seconds later the reporter had his microphone in the resident’s face, beaming while the young doctor expounded with absolute certainty about the Ontario strain of MRSA. “Oh yeah,” a few of the other residents added, proceeding to corroborate that they’d either read or learned during a lecture about that same organism. Some nurses who also had overheard the conversation quickly joined in the interview, expressing their own alarm and explaining they had friends caught in Williams’s quarantine. In the ensuing discussion the residents reassured them that while aggressive, this bacteria was still sensitive to vancomycin and could be treated.
Soon a rumor about the “Ontario strain” swept through St. Paul’s and rapidly established itself as the official “secret” reason behind the patient recall and the need to quarantine some of the personnel. By 2:30 the rumor had been on the news, frightening people enough to come in, but, since the newscaster stressed the organism could be treated, the panic that Williams had feared was avoided. By 3:00 compliance was soaring, but the lawyers upstairs, I was told, continued to wrangle.
“I couldn’t have planted a better story if I’d tried,” Williams commented, grinning in relief when we finally had a private word together late in the afternoon. We were standing in the corridor outside the auditorium. Patients were arriving, everything at the testing stations was running smoothly for the moment, and there was a lull in the incessant demands on both of us. I’d asked him to meet me, determined to convince him about the connection between Sanders and the other Legionella cases.
But it was not to be.
“Dr. Williams,” Hurst interrupted from twenty feet away. He strode up to us, ignoring me but taking Williams by the arm. “Your CDC colleagues have just arrived from Atlanta. They’re waiting for you upstairs,” he informed him curtly.
Williams excused himself and quickly walked toward the elevators. Hurst waited until the man was far enough down the hall not to hear. Then he glared at me and said very softly, “My only consolation in this mess that you’ve caused is that I’ll finally be rid of you.” Then he pivoted and hurried after Williams.
* * * *
“That’s about what it was like here, except mothers with newborn babies are a whole lot more panicky,” Janet said over the phone after I’d described my own day’s activity. I’d called her during a break for supper. As a member of the Infection Control Committee at University Hospital, she’d received the same confidential briefing about the superbug that morning as I had and had spent the day taking cultures much as I had done. She was tired, her voice sounded strained, and like me, she was frightened.
“What about the rest of your staff members?” I asked.
“Much the same as at St. Paul’s—a few women showing symptoms of what is probably the flu are spending forty-eight hours here in a closed ward as a precaution until the cultures are finished. But we got one break. For the past few months since the Legionella cases, Cam had stepped up screening programs for all possible hospital-acquired infections, and the most frequent testing was for MRSA. All the personnel on the obstetrical unit were checked five weeks ago and everyone was negative then, including Sanders. That meant she’d only been a potential risk as a carrier going near patients and other staff for the three weeks before her vacation.”
“That also narrows when she herself was infected,” I added. “If we traced her activity in that period, we might get some idea as to how she contracted either Legionella or staph.”
“Yeah, if we can ever get any of these CDC types to consider she was murdered. That kind of ‘tracing’ needs a lot of work hours.”
“Did you talk to any of them about the Legionella cases?”
She sighed. “Not yet. And there’s no way anyone’s going to consider anything today but the superbug. I figure we’ll have a better chance when the initial screenings are done and everyone’s sitting around waiting for results. But I think Michael’s fina
lly as worried about the connection between the three nurses as we are. He attended our ID meeting this morning. After Cam dropped the bombshell about Sanders’s staph organism, Michael leaned over and apologized for rejecting my scenarios simply because they were bizarre and previously unheard of. He looked quite shaken and asked where the records of the Phantom’s previous victims were. I’ve been too busy reassuring mothers and culturing tiny noses to see how he’s doing.”
I felt a flash of alarm. “Should he be down there alone?”
“Hey, I still can’t tell that friend of yours anything. I asked him the same question. He laughed, and said, ‘No Phantom’s going to make a move with the CDC all over the place. These guys are like the cavalry,’ ” Janet mimicked, catching the impatient tone Michael used when anyone opposed him. “I suppose he’s right,” she added, sounding nervous.
Maybe, I thought, maybe not. The cavalry wasn’t looking for the Phantom, didn’t even know he existed, and that could still leave him room enough to be dangerous, especially if all the scrutiny was making him feel threatened.
Janet interrupted my thoughts. “Right now I’ve got to get back to work. By the way, my secretary told me there was a bunch of flowers in my office this morning. I never got there to read the card. Did you send them?”
“No.” I laughed. “They’re part of Michael’s apology.”
“Ah, too bad. And here I was ready to meet you in the parking lot, as a show of my appreciation, and fool around with you in the back of your car. We would have worn masks, gloves, and gowns, of course, but nothing underneath.”
* * * *
By 9:00 P.M. we were finished screening for the day. Attempts to reach those who had been missed were to be continued on Saturday. The dozen people with the flu who were in quarantine had finally accepted the wisdom of their being there, though none were aware yet that they were waiting for cultures of an untreatable organism. But what to do with all the rest of the staff while we waited the forty-eight hours for our culture results was less clear.
“If they are carrying the organism somewhere—under their nails or secluded far up a nostril—and they go home to infants or children who might have a cut or scrape on their skin, then they theoretically could be putting those children at risk,” Williams had explained gravely during our morning session,
A flash of alarm had shot through my chest as I immediately thought of Brendan. Had I already exposed him?
“I suggest a second facility be set aside for those staff members who may wish a voluntary quarantine,” he’d continued, “away from those already at risk.”
It had probably been an overreaction, but I’d immediately called Amy and ordered her to bathe Brendan for an hour, scrub the rails on his crib, and hot wash every article of clothing, bedding, toy, or anything else that might touch him. Then, after thinking about it more coolly all day, I decided to play it safe in a more logical way and told Janet that I was staying in the hospital. But once I was alone in a barren room outfitted with nothing more than a bed and mattress rolled out of storage, I felt so forlorn I nearly changed my mind. The musty, stale odors of a disused building permeated the ward, though it had been hastily cleaned and just as hurriedly heated. Not many people had accepted Hurst’s accommodation, but occasionally in the interior stillness I heard the hollow sound of someone’s cough or a toilet flush. Outside a storm was brewing again. The wind rattled panes of glass and whistled through gaps in me wooden frames around the windows; those noises didn’t help my mood any. Yet instead of running home from that stark place, I lay there and forced myself to arrange the fragmented thoughts I’d been struggling with all day into some kind of logical perspective.
It seemed clear to me that natural conjugation couldn’t have produced the superbug in Sanders. I remembered reading or hearing somewhere in premed statistics that random chance virtually never was responsible for two rare events occurring simultaneously. The odds against a new organism selecting Phyllis Sanders as its first victim over the nearly four billion other souls on earth were just that—four billion to one. The odds of an organism appearing by chance for the first time ever on the planet in the middle of a deliberately inflicted Legionella infection—in itself a previously unheard of phenomenon—were ludicrous beyond consideration. For these two extraordinary events to have happened in the same individual, something had to have made them happen together, and the obvious “maker” in this instance was the killer. But how to convince Williams of this? Or anyone else?
Whoever this killer was, I suspected he had to have access to a genetic laboratory with the capacity to alter the gene structure of bacterial DNA or at least to the end products of such a place. Nobody at St. Paul’s that I knew of, not even Rossit and certainly not Hurst, would normally have the opportunity to even get near that kind of esoteric equipment let alone possess the skills to use it. I’d have to ask Janet if she knew of anybody at UH with that kind of expertise. I also had no idea if any work of that nature was being done at the university and would have to check there as well.
Droplets of rain pinged against the windows. In the harsh reflection of the overhead lights they looked like oblique scratches being slashed across the pane.
I thought of Michael’s suggestion that the Phantom would have already retreated into the darkness with the arrival of the ID experts. I doubted it No one else even knew he existed, and we’d spent the day carrying out a drill never intended to trap him. Our running about probably seemed to him as if we were scrambling around on a web of his making, the pattern unknown to us, while he lurked at its edge, out of sight, waiting, and gloating.
I was startled by a sharp sound. Was it a rap on my door? A product of the raging storm outside? Or something... someone I wanted to avoid?
I’d taken off my protective gear. Instead of putting everything back on to see if somebody was there, I called out, “Yes?”
No answer.
I immediately thought of a dark figure and the sound of breathing. “Who’s there?” I yelled again, trying to remember if I’d snapped the lock shut or not. As I got off the bed I quickly looked around for some kind of weapon, but the room held nothing, not even a phone. Feeling both foolish and increasingly frightened, I picked up one of my shoes and held it up in the air by the toe while I started to creep forward. I was holding my breath, and all I could hear was my own heart as I moved my hand toward the lock. I froze midway. The handle was slowly turning, the door opening.
“Shit!” I muttered, scurrying backward, my shoe still held on high, until my back pressed against the wall behind me. Standing in the dark corridor was a tall slender figure wearing a surgical mask, gown, and gloves who was taking off a lab coat.
Janet gave a low chuckle and said softly, “Now that’s no way to greet a lady who’s come to offer you a little affection.” She stepped into the room, then came toward me, dropping her coat as I put down my shoe.
“You scared me half to death,” I whispered, slipping my arms around her. I quickly discovered she’d dressed exactly as she had promised, the feel of her naked body under her greens making me catch my breath and quickly igniting my hunger for her. We kissed greedily. As I slid my hands lightly over her back and down between her hips, she stood on her tiptoes, letting my fingertips feel her heat and readiness, even from behind. Her own hands reached for mine, then glided them up across her stomach to circle around and touch her nipples, already erect from my kisses. We continued to propel our desire for each other with our hands, our mouths, and our words. By the time we were on the bed, she was trembling. She slid me into her with a deep thrust that unleashed a long low growl from her throat; the sound and feel of her seared through me like lightning. While outside the storm surged and shrieked, we writhed, rode, and urged each other up ever higher waves of ecstasy, until, fused in a glorious instant, we lifted ourselves over the top and descended, clinging together, into the freeing, pulsing release that comes to souls whose joining is blessed by love and driven by a healthy dose of lust.<
br />
“I don’t suppose this place has room service” was Janet’s first comment after we had breath enough to talk.
“I wouldn’t even drink the tap water. It’s brown with God knows what from the pipes.”
“Well,” she exclaimed, throwing off the covers and hastily starting to pull her greens back on. “This lady of the night is going back to UH where I can at least have a shower.”
Outside the storm continued as intense as ever, the wind buffeting against the windows and peppering the panes with rain so driven it sounded like particles of sand blasting the glass.
“By the way, I may have at least one piece of good news,” she informed me as I watched her continue dressing. “Harold Miller was at our ID meeting this morning. He’d come in after Cam had notified him at home about the organism that killed his mother. Cam made a point of stressing to us that the only way this organism could be stopped was by decolonizing it from contaminated surfaces in the hospital and from human carriers. He was looking right at Miller when he reemphasized that once this particular bug took hold clinically, there wasn’t anything anyone could do to stop it. Obviously he was calling on us to be vigilant, but I also got the impression he was specifically telling Harold to stop tormenting himself with the idea that his mother might have been saved if you hadn’t sent her home.”
I winced, but I was also relieved that at least Cam seemed to be on my side. His support might prove important if Miller took me to court. “So what’s the good news?” I asked, immediately regretting how harshly I threw the question at Janet.
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