Death Rounds

by Peter Clement

  But I couldn’t protect myself from remembering that sound. It had seemed so unforced, as though my cries for help had been a source of real amusement to him. This Phantom might claim to be avenging past cruelties, but that laugh was as sadistic as any I’d ever heard.

  * * * *

  I did tell Riley about hearing the elevator go up.

  Nevertheless, he made his men search the subbasement and walk through the asylum again. As I expected, they found nothing.

  “You sure there’s no place someone could hide?” pressed Riley when his team reported back to him. We were standing outside ER, waiting for Williams. “Sewers, passageways, septic tanks?”

  The men winced, and I saw one of them wrinkle his nose under his mask. “We didn’t see any sewers or septic tanks,” one of them answered, “but we went into everything a man could easily fit through. Besides, why would he bother to hole up there anyway?”

  The officer gestured toward his gown and tugged at his mask with his glove. “What with our costumes, I’ve never seen a better place to hide in plain sight”

  “Not if you’re already well known,” snapped Riley.

  I interjected. “That’s the point. It couldn’t have been Cam. I already told you I heard him take the elevator. That meant this guy did go upstairs to hide in plain sight. Like you said. Cam couldn’t have done that and counted on going unnoticed. He’d have had to stay well hidden somewhere else.”

  Riley spun around to face me. “If you’re going to go running after a murderer, Doctor, which by the way, nearly got your friend Williams in there killed, when are you going to learn to consider all the possibilities?” He was fuming, as usual his jaw muscles bulging under the straps of his mask as he pretended to give me a second to come up with an answer. “Think, Garnet! Mackie could have sent the elevator upstairs empty, as a ruse, then tiptoed off in the dark and retreated to his hiding place. Now for God’s sake, leave the physical pursuit of this maniac to me and concentrate on tracking down what your friend Popovitch found. I’ve got enough to worry about besides baby-sitting you!” He swung his fierce stare back to his men. “And one of my many worries, gentlemen, is whether you did a thorough search, given your obvious attitude that he wouldn’t be there anyway.”

  At 6:30, still stinging from Riley’s rebuke, I was back in the auditorium, alongside Williams and Fosse, facing the same group of supervisors and chiefs who had been here not four and a half hours ago. This time even Wild Bill Tippet had shown up, double masked of course. Only the board members were absent; they had presumably gone home to bed.

  Williams, up and about with a dressing on his head, elicited a little self-congratulatory cheer from the audience when he announced, “Good job, everyone. You’ve kept the quarantine intact so far.” But the mood quickly became somber again as he reviewed the arrangements to eventually relieve them of their duties taking care of patients and transfer them out to external quarantine facilities. “I doubt anything will happen before the end of the day. With the load we’ve already put on surrounding hospitals and medical personnel, it will be a while before we find enough staff to replace you and free up enough spaces to receive you.”

  As the meeting broke up, I heard someone mutter, “Where the hell’s Cam Mackie? Shouldn’t he be here?”

  Somebody else quipped, “Maybe he’s hiding in the fog, with the army.” The guy got a halfhearted laugh from his colleagues.

  * * * *

  Though Fosse had blocked outgoing phone calls, no one, it seemed, knew how to block E-mail. At 8:00 A.M. every electronic media outlet in Buffalo began reporting that they had received an anonymous message containing a threat against University Hospital. Bulletins followed about the place already being surrounded by both the police and the National Guard. Within minutes parts of the actual text were being read on air by a half-dozen radio stations.

  I have infected the staff with a bacteria called staphylococcus which I’ve made completely resistant to all known antibiotic treatments. This organism can be transmitted to patients by touch, and once it penetrates the body, is unstoppable, resulting in certain death. The first fifty carriers will become ill in the next twenty-four hours. Protect your loved ones. Evacuate the patients.

  At that moment all our plans to save UH came crashing down.

  Ten minutes later an assembly of media trucks, reporters, and TV cameras had rushed in to take up positions outside the army and police lines. Beyond them was an ever growing gallery of people— hundreds of them, some still in dressing gowns, some with children, and more arriving by the minute. The gray morning light had thinned out the fog enough that I could see all the way to the edge of the grounds. Past that point the newcomers seemed to materialize out of the mist.

  What I couldn’t hear or see from my vantage point—the third floor window I’d been at previously—I learned from the cacophony of all the radios and TVs around me.

  “…increasing numbers of people here, all of them calling out names, presumably those of loved ones inside, whether patients or staff...”

  “…we are trying to confirm that a terrorist has contaminated University Hospital...”

  “...while we have no casualty numbers yet in this fast-breaking story, we’ve learned that it could be a disgruntled employee who has released bacteria into the water supply...”

  People near me huddled in small groups, watching and listening to the various broadcasts, their expressions showing more alarm by the minute. I could see all our work to keep people calm coming undone before my eyes.

  “It’s not true,” I started to protest. “They’ve got it wrong, all wrong!” But the more I implored them to stay calm, the more it seemed the newscasters pumped up their fears, and the more panicky some of them became.

  On the TV screens cameras had zoomed in on patients at windows holding up signs written on sheets saying GET ME OUT OF HERE ! SAVE US! HELP US! The effect on the crowd was electric. A roar went up outside that I could hear through the glass in front of me and over the nearby TV and radio noise. The sound quickly organized into a chant. “Get them out! Get them out!” The rows and rows of people weaved back and forth in the mist for a few minutes, seemingly undecided, then surged forward, pressing in on the lines of soldiers. The reporters were caught between the two and didn’t seem to know in which direction to point their microphones and cameras.

  “Get them out! Get them out!” The cry became a cadence for the mob’s advance.

  The troops started to back up, but rifles were unshouldered and pointed upward, over the heads of the oncoming men, women, and in some cases kids, probably in their teens. I could now hear the cries of the officers. “Steady, men. Steady!”

  The inner line of police had linked arms, and more officers were standing firm across the parking lots in front of the hospital as the soldiers backed toward them. Gone were the police hats; they’d been replaced by helmets. And the ranks of officers held their riot sticks out in front of them.

  “Get them out! Get them out!”

  Most everyone around me grew still as we watched the nightmare unfold below us.

  “Someone do something!” murmured a woman at my side.

  The lines drew closer together.

  “Oh, God! Stop them!” cried a man standing behind me.

  From down the hallway came a shriek, “That’s my husband! And my son!”

  The PA overhead howled with electrical interference, then boomed, “Your attention please, everyone! For the sake of your families outside, settle down, move away from the windows, and take down those signs! This is Dr. Douglas Williams, of the CDC. I’m about to be patched into every radio and TV station out there, and my voice will be carried over the PA systems on their mobile units...”

  As if to give credence to his claim, the excited chatter of the commentators from all the nearby portable radios and screens suddenly gave way to his voice, and Williams was speaking at us from hundreds of sources. More electronic howls filled the air outside, and the man’s mess
age rolled over the grounds like the word of God.

  “Everyone stop! Stop now. Your family members and friends in University Hospital are safe. Look up! They’ve moved away from the windows because they don’t want you to rush the hospital and endanger yourselves.”

  While he talked, the TV cameras zoomed in on the now dark panes of glass, showing that no one was standing directly behind them. As they held there, new signs began to appear: STOP! DON’T DO THIS! WE’RE OKAY!

  The chanting down below was diminishing. Most faces in the crowd were upturned, and people had stopped moving forward. The inner lines of soldiers and police stood fast.

  Williams’s voice continued to work its miracle. “First of all, no one is even infected yet. We are simply doing cultures on everyone...”

  As I stood by the window I began to breathe again. It looked like we’d dodged another bullet... well, another rocket.

  But another one was already on its way.

  “Dr. Garnet,” said a nurse at my elbow. “I was sent to get you.” She led me away from the window. I didn’t like the look in her eye. “About a dozen people in the special quarantine ward seem to be coming down with Legionella,” she told me in a hushed voice.

  * * * *

  I scribbled a message to Riley. Get more men on the door to special quarantine. It’s starting! I gave it to the nurse who had found me and told her it was for his eyes only.

  The wing Fosse had opened up contained two wards, each with twenty rooms, four beds to a room. I noticed a few newcomers were being led to these quarters. “Day people,” explained a nurse. “They weren’t contacted in time to be directed elsewhere.”

  Even through my mask I could tell the place was beginning to have the odor of too many people not having had a shower. Fosse would have to arrange for changes of clothes and toilet articles to be brought in for everyone here as soon as possible. Civility often started with a bar of soap.

  Two members of Cam’s department who hadn’t been in the archives had already confined the suspect cases I was to see in three rooms at the end of a corridor. As I got near, no one had to tell me that their symptoms included diarrhea.

  “We’re sorry to call you, Dr. Garnet,” said the younger of the two physicians after they’d both introduced themselves, “but we know you’ve seen the only other case involving both organisms—the Sanders woman—and, well, the whole situation is so bizarre we wanted your opinion, to make sure we weren’t overdiagnosing anyone.”

  They weren’t. While none of the twelve was very ill yet and they all had flulike symptoms similar to those of the three nurses I’d seen last night, they also demonstrated postural hypotension and the slightly abnormal blood results—namely low sodiums and albumins, with slightly elevated white cell counts—characteristic of early Legionella.

  None of them could believe something so serious could begin so benignly. Over and over I heard, “Except for a bit of dizziness when I stand up and the occasional runs, I don’t feel that bad, Doctor.” But they were scared. “Will I be all right?” they kept asking.

  “I’m certain you will,” I kept saying.

  Some studied my eyes, and I’m sure they saw the lie. My dread of what would become of them in the next twenty-four hours was so strong that they couldn’t have helped but sense it.

  After examining everyone, I huddled in the corridor with the two ID specialists. I knew there was nothing I could tell them about the conventional treatment of Legionella or staph that they didn’t already know. What they wanted from me were my observations on how these particular Legionella and staph infections varied from the norm. “Smokers will get it the worst, of course, but even the young ones could be in trouble. The usual age ranges don’t seem to apply,” I advised them.

  The older of the two—I estimated he was about my age—raised a skeptical eyebrow. “That’s hard to believe.” His junior colleague flushed above his mask. I suddenly sensed that there was a dispute between the two men and I’d been called in as a third opinion.

  “Look, I’m just telling you what I’ve seen,” I said to the skeptical one. “Like you, I can’t explain how these people are being infected.”

  The younger specialist whistled. “Man, however this creep’s doing it, he must be giving them a hell of a dose over a protracted period of time—”

  “What else?” the older man asked me, cutting off the speculation of his younger colleague.

  I answered quickly, not wanting to get drawn into their fight. “Even to know whether the oral erythromycin we started them on last night has some attenuating effect, we’ll have to wait and see. However, I think you can expect the IV treatments they’re on now to work well with the nonsmokers, as far as the Legionella infections are concerned. But staph remains the real problem for them all. The first sign of it will be their sputum turning purulent. At that point, they’re terminal.”

  * * * *

  While I wrote my clinical notes—the other staff confined to the ward had prepared charts for each of their sick colleagues—I could tell the nasal lavaging had begun. Gagging noises started coming from the direction of the rooms I’d just left, and as I endured the sound, it was all I could do to keep myself from retching.

  No sooner had I walked out of the ward and headed for the exit than a figure ran toward me from the opposite hallway. “Dr. Garnet,” yelled an unpleasantly familiar voice. “Wait, please!”

  She came right up to me and grabbed the front of my gown. Her eyes looked frantic. “Please, Dr. Garnet, I don’t belong here. They didn’t reach me at home in time to direct me somewhere else. Now that I’m here, they say I’ve got to stay. You’ve got to make them let me out!”

  I reflexively put my hands on hers and tried to pull them off me. “Really Miss Brown, this is not appropriate. Whatever you think, this is for your own safety—”

  “Safety!” she shrieked. “I just found out that whoever’s doing this—some are saying it’s the Phantom again—has already tried to kill me once, that he gave me my Legionella infection. I’ve got to get away. He’ll get me again, I know he will!”

  “Miss Brown!” I said as loudly and as sternly as I could without actually yelling. “Get a grip on yourself, and think. He can’t get you with Legionella. It has a way of granting immunity, through your white cells, and you’re protected. But he’s also got a staph organism that no one can treat, and your safest place right now is here. Remember, you got ill last time when you were on vacation. We don’t know that he didn’t infect you outside of the hospital. In this ward you’re under guard.”

  “No, please,” she persisted, holding my hands in a viselike grip, “I’m sorry about what happened to your wife. Please, it was an accident. I never meant that to happen. I never ever wanted that!”

  All at once I felt so angry that I had to use every ounce of self-control I possessed not to tell her how much she disgusted me. “I told you, get hold of yourself!” I was shocked by the hardness that I heard in my own voice. Over her shoulder I saw Miller and his team of technicians being allowed past the guards and into the hallway where Brown and I were standing.

  I don’t know if he heard much of our exchange, but he stepped over and said, “Hi, Dr. Garnet. Quite the job, isn’t it?” His mask couldn’t completely hide the pouches that had formed below his eyes from lack of sleep, but there was no evidence of fatigue in his voice. “Can I be of any help?”

  I nodded at him, then suggested, “I’m sure Nurse Brown would appreciate it if you did the screenings on her yourself.” I released her hands and stepped away. She looked from me to Harold Miller, her fear still very evident in her eyes.

  Miller stepped over to her, took her by the elbow, and gently said, “I’ll be glad to. Come, we can do it over here on this bench.”

  While I discarded my protective gear at the doorway in exchange for a clean set, I watched Miller carefully help the woman off with her gloves and begin culturing her left hand. She nervously raised her right fingers to her mouth and started b
iting on her nails. He shook his head and pulled her arm back down in her lap. I could hear him talking quietly as he worked, and though I couldn’t make out the words, he must have been saying the right things, because I thought I saw Brown’s shoulders relax a little.

  * * * *

  I quickly ran to ICU and again checked on Janet. Once more her vitals were stable and her sputum remained nonpurulent, but this time I sensed all the nurses were more guarded in their replies to me. I knew why instantly. Lurking unspoken among them was the knowledge that today or tomorrow, as the pneumonia ran its course, they’d know whether Janet had also been infected with staph. They were instinctively taking their professional distance from both of us, preparing themselves to have the clinical objectivity they’d need if the worst happened. Janet was awake when I went into her cubicle.

  “From the eyes up, you look worse than me,” she said hoarsely, then started coughing uncontrollably.

  I ran through the night’s events, but not wanting to frighten her more, I left out the attack on me and Williams. Fosse had had the telephone lines reestablished, so we then called Amy at home. She was desperate for word of us, having watched all the TV coverage, but we settled her down with multiple reassurances that we were okay. When she held the receiver up to Brendan, we made tender noises at our son and listened to his happy babble, escaping for a few blissful minutes the nightmare that had trapped us. After hanging up, the feeling of being cut off from him hit me like a weight. From the desolate expression in Janet’s eyes I knew she was battling a similar feeling. I don’t know who broke into tears first, but we held each other for what seemed like a long time before either of us could stop.

  “Call and check on Michael,” Janet quietly ordered me when we’d both dealt with our sniffles in the aftermath.

  I punched in the number for St. Paul’s intensive care unit and endured the usual wait for someone to pick up the phone.

  “ICU,” answered a woman’s voice.