Left unsaid, again, was how they’d stop anyone who tried.
He then explained that each supervisor would be accompanied back to his or her ward by two police officers. More could be summoned in an instant if the so-called punishers didn’t agree to come along to the wing that Fosse had designated for them.
We even managed to convince ourselves that we could avoid transferring out the patients, for the moment. While new admissions and emergencies would be directed to other hospitals as of now, in the morning Fosse would stress to the media that these safeguards were precautionary measures only, that the patients already here would be perfectly safe, and that staff using reverse isolation techniques would continue to care for them. The “threats,” he would emphasize, were only against specific hospital personnel, all of whom had been taken off duty and placed in isolation for their own protection.
Planning for beyond the morning was more problematic.
“...direct the day shift away from UH to alternative quarantine facilities...”
“…what about separating out the punishers from this group as well—they’re most at risk to be carriers…”
“…live-in contacts of all our staff should be screened, maybe quarantined…”
“...contact all workers who are at home before they start coming in. Instruct them where to report...”
“...we’ll need a communications team. Some clerical staff will have to be called in to help us here...”
The strategy slowly took shape, the amount that needed doing outside the hospital being clearly greater than what we had to accomplish within, with one exception.
“But the killer may be locked in quarantine here with us,” protested a young nurse in the front row. Her lone voice brought absolute silence to the room.
Then someone else asked, “Do the police know anything about who’s doing this or how he’s managing to infect people?”
“The police are investigating,” Fosse replied coolly.
The evasion prompted someone to yell, “There’s a fucking maniac on the loose. Fosse. We’ve got a right to know when the police think they’ll nab him.”
“Right!”
“What are the police doing about this psycho?”
“How the hell can you say it’s safe for any of us to stay here?”
Noisy shouts of agreement and demands to be told what the police knew continued to come from everywhere in the room. Unruliness was threatening to erupt again when Riley got a nod from one of his superiors and hopped up on the stage.
“Hold it!” he yelled, his hand up to the group as if they were oncoming traffic. “I’m Detective Riley and am leading the investigation into who’s responsible for the threats made against people in your hospital. We’ve got two jobs to do here. One’s in your hands— to keep everyone safe from this bacteria. Mine’s to nail the creep, as Dr. Garnet so appropriately called him. I also think Dr. Garnet’s plan is the best way for the moment to keep everyone safe from this killer. Within the confines of your own wards, you’ll immediately know if an outsider has entered your area and we can grab anyone who shouldn’t be there in seconds. I suggest the sooner you get back to your floors and get organized, the quicker we’ll make it impossible for whoever’s doing this to get to you. To answer your question about what we are doing to apprehend him, we’ve called up every available police officer in the city to work on this case and have even alerted the FBI, requesting that they check their national files for any individual or group with a history of terrorizing hospitals. As for pursuing local leads, we intend to start interviewing your staff in groups, floor by floor, tonight”
He must have had a lot of practice in settling down a crowd. A low rumble of mutterings rolled through the room, then once more voices of reason replaced voices of rage.
“...what if we also move the staff that is here now away from UH, once outside sites are provided for everyone not yet in quarantine. That would take away the killer’s hunting ground...”
“...pull all our staff from patient care immediately...”
“…It’ll take days to round up enough staff from other institutions to replace them all, but if the patients knew we were working toward that end, they might be reassured enough we wouldn’t have to move them at all...”
“Where’s Dr. Mackie? Why isn’t he here by now?” someone called out from the middle of me audience. I recognized him as one of the department heads at UH but couldn’t recall his name.
Fosse answered without hesitation, the lie at the ready. “We haven’t been able to locate Dr. Mackie to inform him what’s happening yet.”
The meeting was then adjourned, and everyone started to file out the door. Out of the general noise I heard one voice murmur, “Doesn’t this sort of remind you of that Phantom business two years ago?”
* * * *
“It’s not how the Phantom infected all those people that I’m asking you about. I want to know how you two would do it,” Riley demanded. He’d asked Williams and me to stay behind in the auditorium for a few minutes. While Williams was half sitting on a large table at the far end of the stage sipping a coffee, I was leaning against the podium, and the detective was pacing the distance between us. All three of us were squabbling over the best way to stop a killer.
“Shit!” growled Williams. “How he did it or how we’d do it, what’s the difference?” He kept glancing at his watch, making it obvious he had far more pressing things to do. “I told you; we don’t know.”
I also had no time for whatever distinction Riley was trying to make, its usefulness escaping me entirely. I was already angry that the meeting had delayed my own attempt to discover Michael’s find.
“Look, Riley,” I began, trying to keep my impatience from souring what little civility was left in the room, “I told you before that lives may depend on our figuring out how he plants the staph organism on his victims. What little time we may still have to use that information is running out fast. If either Dr. Williams or I have any new ideas, we’ll page you immediately—”
“No, you look, damn it!” Riley interrupted. “Catching this creep will save lives. Mackie’s nowhere to be found in the hospital, and we had no better results when a dozen of my men searched the asylum. Unless this Phantom of yours is so stupid that he’s hanging around waiting to get caught, the only way we’ll get him is if you two help me learn how he works. I’ve got to know what he thinks, what he needs, and how he has to prepare in order to strike his victims. With information like that maybe I can anticipate his moves and ambush him.”
“But that’s why you’ve got to let me at those records—”
He cut me off with an impatient wave of his hand. “I’ve got a man checking regularly with that group of ID specialists who are down in the archives. They keep saying it’s slow work. Hell, your friend took two days to find whatever it is we’re after. I need information right now!”
“So?” said Williams. “Your little pep talk doesn’t change the fact we don’t know how he does it. And every minute you keep us here, the greater the chance this quarantine will fall apart.”
The sides of Riley’s jaw muscles bulged against the ties of his surgical mask. “Let me tell you how cops work. Doctor,” he replied through what sounded like clenched teeth. “When we don’t know how a crook has done a job, sometimes we go to the scene and figure out a way to do the crime ourselves.”
Williams snorted, “Well that explains a lot.”
Oh, Jesus! I thought. “Come on, Douglas! We’re all tired and scared. We don’t need to start snarling at each other.”
“Sorry,” he said immediately, “but I have to get upstairs.” He stepped away from the table. “And I’m afraid I’ve got to bring you with me. You did a fantastic job of settling people down here tonight when I wasn’t able to, but that was just a preview. No one on the floors is going to take the news that they’ve been slapped into quarantine any better. We’re both going to have to run all over the building talking down reactions ju
st like the one you saw here. We blow it, and there’ll be a major stampede out of the hospital.”
“No!” I started to object. “You can’t keep me from the chart search—”
“For Christ’s sake, Earl,” Williams snapped, brusquely silencing me, “get the priorities straight!” Before I could say anything in reply, he spun around and laced into Riley. “As for you. Detective, I know you’ve got to be as scared as I am about what can happen if a few hundred people charge that police line. We also both know that despite orders not to hurt them, all it takes for a disaster is one nervous rookie who unholsters a gun, or a panicky citizen who struggles too long in a choke hold. Even a worse possibility. Lord help us, is that someone does get safely through and carries the bug into the city. By the time we’d track down anyone who was a carrier, who knows how many times he or she has picked their nose, then reached out and touched someone.”
Riley put new levels of stress on the ties of his mask. “All the more reason. Doctor, to give me what I need now,” he insisted in a quiet voice, showing remarkable restraint. “Those people upstairs are going to be a whole lot easier to keep in line about the super-bug if they expect we’re about to nail this—how did they put it?— ‘maniac.’ You got a pretty good preview of that reaction as well!”
Williams crossed his arms in front of his chest, still gripping his now empty cup, and glared at Riley. From the eyes up he looked anything but happy, yet he stayed put
Riley continued. “As I was saying, solving the same problems that the crook had to solve in order to carry out his crime can put us on a similar wave length.”
Williams groaned.
Riley stepped up to within a foot of him and became even more pedantic. “Occasionally it makes us do the same as the guy we’re after—walk where he walked, touch what he touched, that kind of thing. Who knows what traces of himself he left behind—a hair, a torn fingernail, a shoe print even. The point is, when we can get that close to where our quarry’s been standing, sitting, climbing, and so on, there’s no telling what we’ll discover about how he committed his crime.” He was eye to eye with Williams. “Now let’s get to work. As you can see, you’re not the only one with things to do tonight!”
Williams let his exasperation show by heaving a huge sigh. “Your little game won’t change the fact that we don’t—”
Riley pivoted to face me. “How would you get the bugs?” he snapped.
“What?”
“I said, how would you get this super bacteria he’s using?”
“I couldn’t,” I answered. “It would take some kind of skill in recombinant DNA techniques.” Concentrating on what Riley wanted became difficult as Williams’s grim warning about hysteria spreading throughout the hospital began to work on me. Any fleeting optimism I had that we might get control of the situation suddenly seemed stupidly naive.
“Is there anyone here or at the university who could do that kind of work?” pressed Riley.
I turned to Williams. “Is there?”
He continued to glare at Riley. “Not that I’m aware,” he replied. While his gaze transmitted a thousand volts of fury, to my surprise he actually sounded resigned to sitting through the exercise.
It was Riley’s turn to exhale with exasperation. “Try to focus on how you’d do it with what’s at hand,” he instructed, catching us both in a stern glower that probably only cops were licensed to use. “Stick to what’s here, what’s done as a matter of routine in the hospital. This guy’s bamboozled the lot of you with these bugs for a long time and used them to commit two murders without anyone knowing. That suggests his method was simple. Most brilliant crimes are. The more complex schemes tend to fall apart.”
Williams leaned back against the table again, cocked his head, and said, “Okay, I’ll play your little game, since that seems to be the only way you’ll let us out of here. If I were this creep and I wanted to make a superbug without getting too fancy, I’d think about using the natural way—conjugation. Bugs lying around together in a tube of shit—now that’s pretty low tech.” He crumpled his styrofoam cup and flung it the width of the stage into a cardboard box full of refuse.
Then he gave me a sly wink and cracked, “Trouble is, I’d have to hang around a lot of assholes waiting for the product.”
Riley exploded. “Goddamn it, Williams, if you don’t start cooperating, I’ll slap an obstruction—”
“We’re wasting time!”
“I’m warning you, obstruction of justice...”
Williams’s smart remark had set off an idea. I tuned out his wrangling with Riley and quickly thought it through. After what was admittedly a brief analysis, I began to feel in my bones it was an idea that could work. “Oh my God!” I exclaimed, my excitement erupting.
Williams and Riley immediately stopped arguing and stared at me. “What?” asked Riley.
“You’re right, Douglas. Conjugation—Cam could use it!” And so could Rossit, I thought fleetingly, rushing on with my explanation. “Just plate MRSA and VRE in the same petri dish and let them grow together. Keep growing the mix over and over, until sooner or later, it happens. The two organisms exchange genetic material...” My voice trailed off. It was so simple—so sick-in-the-pit-of-my-stomach, chillingly simple.
“Jesus Christ, Garnet, that’s it,” exclaimed Williams, slamming his hand on the table and jumping up out of his slouch. “Routine screening for MRSA and VRE could have given Mackie the organisms he needed to start with.”
“What do you mean?” demanded Riley.
Williams ignored him and kept right on talking to me. “Suppose you or I were culturing someone with MRSA. What’s to stop us from keeping a swab on the side and culturing up our own private stock of the organism? We could do the same while working up a carrier with VRE. We’d have the ingredients.”
Turning my way this time, Riley insisted, “Explain, damn it!”
I was pumped. My mind raced through the next steps of how it could work. I picked up where Williams left off. “Plate the two organisms on a culture dish together. Let them grow side by side. Then add a dose of vancomycin. If any staph bacteria survived, he’ d know that his MRSA had acquired the VanA or VanB gene from the resistant enterococci and that he had the superbug. It could take a lot of tries, but sooner or later, he might find that it had happened. All that’d remain for him to do would be to plate more and more cultures of the surviving staph organism, and presto, he’d have his supply—enough superbug to infect this whole hospital.”
“Jesus!” repeated Williams. “He could do it in a couple of petri dishes slipped in among the hundreds done here daily. Or even if he had kept it off-site of the lab, he could hide a supply out of the way and wouldn’t require much more than an incubator like the ones kids use to hatch baby chicks. The whole setup’s at the level of a school science project.”
“He could move it around on a cart,” I added, thinking about my encounter in the subbasement.
“What about the Legionella?” Riley asked. He’d stopped trying to get explanations of the technical jargon. He must have decided he’d finally gotten Williams and me on too good a roll for him to keep interrupting us.
“Same way,” answered Williams. All his hostility toward the detective vanished. It had been replaced by the exuberance of discovery. “Screening. Water supply sites are notorious for harboring that bug; we find it even in hospitals that claim they’re clean.”
I remembered Michael’s telling me the same thing—a week ago back in my office when he’d insisted that he come here to investigate the source of the nurses’ infections. It seemed a lifetime ago.
“It wouldn’t be impossible to find a contaminated water source,” Williams continued, “confirm it by special culture, then let the organism multiply in samples of the water. As long as he kept them from being heated past seventy-seven degrees centigrade—that’s the temperature Legionella’s killed at—he could end up with a super-concentrated solution of the stuff by simply letting his specime
ns sit around, not too hot, not too cold.”
“One more question,” Riley said. “Why go to the trouble of making the superbug? Why not be content with killing people by using Legionella?”
It was a good question, but I was able to answer it without hesitation because once having climbed inside the Phantom’s way of thinking, it was possible to see things from his point of view. “Legionella offers a chance to be treated,” I said with unseemly excitement. “The superbug is a sentence to certain death. If the purpose, besides killing, is to increase the terror of the victims, what’s more horrifying than knowing that you’re going to die within days, and that-you’ll die choking? If your purpose is to panic an entire hospital, hell, the choice is obvious. Legionella’s scary. The superbug’s the stuff of nightmares.”
I caught Williams staring at me and nodding in agreement. His eyes conveyed incredulity as he admitted, “I’m amazed we managed to figure out so much!” He even apologized to Riley. ‘That’s a hell of a neat trick you have there, getting people to know what they think they don’t know,” he said in a very sincere tone, then couldn’t appreciate why Riley and I were laughing at him.
But not even Riley had tricks enough that we could solve how the Phantom managed to infect people with these bugs.
* * * *
The three of us were headed upstairs. We were hurrying along the corridor leading away from the auditorium when I asked the detective what he figured were the chances of picking up Cam in short order.
“If he’s alive, not bad.”
“What?”
None of us broke stride, but Williams matched his step to Riley’s and mine, placing the detective between us. “Explain,” he said curtly.
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