She asked the aide on duty behind the desk to put her through to the CEO and made arrangements to meet him an hour later.
‘If you could get hold of the administrator and the senior man from the army as well, it would be good,’ Esther told him. ‘I think we’ve got to formulate a plan to stop this spreading.’
The man sounded a little a put out at being told what to do by an outsider, but agreed to do what he could and to phone Esther back if there was any change to the arrangements.
Satisfied she’d set things in motion, she went through to the small office just off the ward, set aside for use by the doctor on duty. From there, she phoned Geoff to discuss measures they could take to isolate potential carriers. He’d worked in epidemics for far longer than she had, and had far more on-the-ground experience than she did.
She took notes of his suggestions and was pleased when he offered to phone the hospital CEO in advance of her meeting with him. Having someone else stress the urgency would strengthen Esther’s position.
Back on the ward, she went first to Chloe’s room, drawn there by her dread for the baby girl. She looked again at the chart, and the notes from Pathology, and, possibly because B was such a rare group, only ten per cent of European people having it, and possibly because she knew Bill’s group, she went back to the desk, pulled off her mask and phoned Pathology, telling them she was sending more blood and asking them to cross-match a second sample.
They’d think she was paranoid—which she was. There was no reason on earth why Marcie wouldn’t be B and have passed on her blood group to her daughter. But double-checking was better than having a catastrophic accident, and endangering Chloe’s life further by giving her the wrong blood.
She might not even need whole blood, Esther reminded herself, but seeing how weak the little girl was, not moving as Esther took more blood from her, she knew she probably would eventually.
The second test gave her the same result, and she asked for cross-matched blood to be sent up—not to be used immediately but to be on hand should it be needed. As soon as Gwyneth was cross-matched, she’d order some for her as well. After her experience with Mr Risk she knew that when patients went downhill, they went fast.
The blood arrived as she was about to leave for her appointment with the CEO, and she stopped by the desk, and asked the sister there to check the details with her—the grouping and sub-groupings matching those on the pathology test results for Chloe’s blood. Satisfied they had it right, Esther marked Chloe’s name on the bag in thick black letters and was handing the bag to the sister to put in the refrigerator when Gwyneth was wheeled into the room, accompanied by Bill and the doctor from A and E.
The orderlies and the doctor had evidently stopped outside the doors of the ICU to put on protective clothing, and Bill had been wearing his, so it looked like a procession of aliens clustered around the wheeled bed.
A nurse appeared from the vacant room and gestured them towards it, and as they went that way, Bill peeled off and crossed to the desk. Esther turned so she could speak quietly to him without the conversation being overheard.
‘Do you think you should contact Chloe’s mother?’ she said, resting her hand on his arm in the only way she knew to show him she was there for him.
‘Contact Marcie?’ he queried, his voice strident with disbelief. ‘Why on earth would I want to do that?’
So much for keeping the conversation private, Esther thought, but aloud she said, ‘To let her know Chloe’s ill? Your mother was a friend of her parents—they’re sure to hear, and then she’ll hear and wonder why you didn’t let her know.’
‘You think she’d wonder. That’s just your assumption.’ Bill’s voice was cold, no doubt because Esther was trespassing on private property in his emotions, and he moved so her hand slid off his arm, but Esther stuck stubbornly to her guns.
‘It’s the right thing to do,’ she persisted, causing Bill to turn on her, his usually full lips thinned with anger.
‘Do you think she’d care?’ he demanded. ‘Do you really imagine a woman who gave up her child on the day she was born would care whether that child lived or died? Well, I don’t. Believe me, she’d not give one good goddam!’
He paused, then, in even colder tones than he’d used earlier, he added, ‘Ironic, isn’t it? I had one wife who left me because she lost a baby, and the next one left me because she had one.’
The words hit Esther like a blow to the stomach, so hard and heavy she gasped with the force of it.
‘She left you because you got her pregnant?’ Esther said, forgetting they had an audience who’d probably heard enough of Bill’s conversation to be all ears. ‘Had the baby and left?’
‘Tell the world, why don’t you?’ Bill snapped at her, then he walked away, into Chloe’s room.
He propped himself beside Chloe’s crib and looked down at the sleeping baby.
He shouldn’t have walked away. That was Esther’s way, not his. He’d always said they should talk—discuss their problems—but the thought of contacting Marcie had made him feel physically ill. There was no way he could speak to her without revealing the anger and anguish he still felt over her desertion, not of him but of Chloe.
And there was no way he could explain to Esther how stressed he was feeling right now. About her, about Chloe, about Ma, about his entire life, which seemed, at the moment, to be heading straight down the toilet.
But, even with all of this, he shouldn’t have snapped at Esther either. Her caring, compassionate, unselfish disposition was the antithesis of Marcie’s grasping, self-obsessed nature, and there was no way he could explain that to a woman who thought the best of everyone without sounding harsh, and bitter, and hateful.
Now Esther probably thought he didn’t want to contact Marcie out of spite, and thought less of him because of that.
If she could possibly think less of him than she must already.
He was startled to hear a growl, and even more startled when he realised he had made it. He looked anxiously at Chloe, but she didn’t seem to have heard.
‘Are we so unlovable, Chloe?’ he asked quietly, but she didn’t seem to hear that either.
Esther watched Bill go, her heart aching for him—for the pain he must have suffered when his second marriage had ended like that. As if she, Esther, hadn’t hurt him enough, running from her grief—and from him—because she’d known no other way to handle it. Only you couldn’t run away from grief. It accompanied you wherever you went. All you could do was shut it away inside yourself, behind the armour Bill had talked about.
Bill! This was about him—about now, not the past.
He was teetering on the brink of collapse from exhaustion, Esther guessed, but how could she get him to rest when his mother and his child were so ill? Although right now, she reminded herself, she had no time to brood over Bill. Telling the sister at the desk where she’d be, she went in to see Gwyneth before heading off to meet the CEO and plan the mass evacuation of the people of Robinson.
Gwyneth was conscious but obviously most uncomfortable, complaining of the pain in her back. Esther remembered something she’d read in the research she’d done on the Internet. Cortisone had been used in some severe dengue cases and, though no studies had been done to prove or disprove its efficacy, individual case results suggested it sometimes helped the pain associated with the disease.
Back in the small doctor’s office she found her notes and checked on suggested dosage, returning to Gwyneth’s room to give instructions to the sister on duty there.
Running late now, Esther was hastily stripping off her protective clothing when she realised she had no idea where the main hospital offices were located, but rather than dress and go back in to the ICU, she went down to the ground floor and asked at the desk in the foyer.
Back up on six, she was told, which meant it was a little after ten when she finally met the man who ran the business side of the hospital.
‘I heard Bill’s mother and daughter h
ave joined the victims,’ John Sandon said when he’d introduced himself and offered her a chair. ‘Means it’s spreading beyond where we thought it would. Your boss phoned me and impressed on me that you know your stuff, so how about a cup of coffee and we talk about it before the others get here?’
‘Good idea,’ Esther said, pleased to have a chance to sit down for a few minutes. ‘Especially if the coffee could come with a pastry or sandwich or something. I can’t remember when I last had a proper meal.’
But as she said it, she did remember—the beautiful salad Gwyneth had left for her lunch the previous day.
‘Then you’d better have one now,’ John said. He bustled round his desk and called down an order to the kitchen for a full breakfast and a pot of coffee.
‘And in about an hour, coffee and biscuits for six,’ he added, then, before Esther could query who was coming to make up the six people, he was talking again, though this time to her.
‘So where are we here in the hospital as far as handling things goes?’
‘I think we’re on top of it—or we were until Gwyneth and Chloe Jackson came in. Even the seriously ill patients are rallying. One patient will be discharged today. Bill sent blood samples down to the labs in Brisbane and they’ve been trying to transmit this particular strain from animal to animal without an insect carrier, and so far haven’t been able to do it.’
Esther looked at him, knowing his background would be business and figures and wondering how much medicine he understood.
‘So Bill’s fears it could be passed on through contact with an infected person can be laid to rest?’ He answered her thoughts with his question.
‘Maybe not quite yet,’ Esther said. ‘Though it does look highly unlikely. We’ve still got everyone in contact with the patients wearing full protective clothing as a precautionary measure.’
‘So, the hospital side of things is all right?’ John persisted, and Esther had to agree, although she hoped this wouldn’t diminish his interest in stopping the spread.
Stopping the spread was vital!
She was relieved when he said, ‘That’s good as far as it goes, but with our limited resources stretched anyway we don’t want any more cases—or as few as possible. Which, I’m assuming, is why you wanted this council of war.’
Esther nodded, pleased he was looking at the broader picture, even if it was still with his hospital in mind.
Before they could discuss it further, her breakfast arrived. Looking at it, she wondered if she could have lifted a phone down in the ICU and ordered the same for Bill. She doubted he’d eaten since yesterday lunchtime either—if then.
John cleared a space on his desk for her to put her meal, then excused himself to give some work to his secretary, leaving her to eat her meal in peace.
And think of Bill.
Bill had been unique in her experience, not just because he was an American, with a different background and culture and way of speaking. He had been unique in the way he had cared about her, as well as loving her. Oh, she’d railed against his protectiveness, and argued against what she saw as fussing. She’d teased him as old-fashioned—the archetype of a perfect Southern gentleman—but nothing she’d done or said had ever stopped Bill standing when she’d walked into a room, opening car doors for her, holding her chair as she’d sat down to dinner, waiting up if she’d worked late so he could drive her home, performing a thousand little politenesses that were bred so deeply into him they were innate to his nature.
She had just finished the last bite of toast and was sipping her coffee when she heard the door open behind her. No doubt John returning, she thought, putting her dirty plate and cup back on the tray before turning to speak to him.
And seeing a mirage—a figure she’d somehow summoned up with her thoughts.
‘Bill?’
He nodded coolly, as he might to a not-too-close colleague, and Esther, bamboozled by how he looked—showered, shaven, refreshed and neatly dressed in a clean shirt and tie—as much as by his presence, continued to gape at him.
‘I am acting-superintendent of the hospital,’ he said, settling into one of the chairs John had ready for his visitors. Unfortunately, it was the one beside Esther, though right now she had matters other than his immediate proximity on her mind.
‘Yes, but you’ve been up all night—Chloe and your mother—you look different…’
Esther realised at this stage of her garbled reply she’d have been better off keeping her mouth shut. She told herself she would from now on. Where Bill was concerned at least.
Fortunately, John returned, leading in two other men and a young woman clutching a steno pad and a small tape recorder. He nodded to Bill, asked how Chloe and Gwyneth were doing, but wasn’t surprised to see him.
Had John asked Bill to sit in? Because he wanted his input or because he wasn’t sure about Esther’s qualifications to be advising on the problem?
‘It’s not because you’re a woman, so don’t be paranoid about this,’ Bill murmured to her, and she scowled at him, furious he’d been able to read her mind. ‘I’m here to back you up.’
‘You don’t even know what I’m going to suggest,’ Esther whispered furiously at him, under cover of the others getting settled and the secretary setting up her machine.
‘No, but I’m sure it’s sensible.’
Esther shifted so she could look at his face to see if she was even a twentieth as good at mind-reading, but he turned away from her to speak to the administrator and all she could see was his cheek and ear and a tiny scar just beneath the ear. An inappropriate memory of how erotically sensitive that scar was flashed into her mind, and she felt her body heat with remembered passion.
‘Dr Esther Shaw,’ John was saying, obviously introducing her to the newcomers, though Esther had missed all the names.
She nodded acknowledgement and said a general hello, then waited.
‘You’re on,’ Bill whispered. ‘They’re eager to hear your plan.’
Plan! Did she have a plan? Thoughts skittered through her mind like mice feet scrabbling on glass, then Bill said, ‘Maybe I could begin with an outline of where we were before Esther’s arrival.’
She should have been grateful, but instead felt furious, aware she’d been proven as inadequate as John must have thought her, to have insisted Bill be present.
But as she listened to Bill telling these people what he knew, her mind clicked back into gear, and suddenly they were a team again, united against the common enemy of a potentially deadly epidemic.
‘Esther has been looking into the origins of the outbreak and has come up with some likely sources. But with my mother and child falling ill, the disease is obviously spreading further than the confines of Robinson—’
‘And maybe spreading through other ways than the mosquito? Could you have passed the disease to them, without being sick yourself?’ The army man interrupted Bill with the question and, knowing the same fears must be haunting Bill, Esther rushed to answer.
‘No, that’s so highly unlikely as to be in the impossible class. The disease progressed so rapidly to the haemorrhagic fever stage that originally Bill feared it might be the case, and sent blood samples to the lab where I work in Brisbane. I was speaking to my boss this morning and he said, no matter how hard they’ve tried, they haven’t been able to spread the disease from one lab animal to another without an incubation period in a mosquito. They’ve tried other insect carriers like ticks and fleas, and every possible way of transmission—air, blood, other body fluids, even from pregnant mice to their progeny—and can’t spread it. They are continuing tests but I think we could safely say that while it’s a new and particularly vicious variant of dengue, it is still transmitted in the same way.’
She knew Bill had turned towards her, and could see his relief in the way his body slumped in the chair, but she couldn’t afford to be thinking of Bill—she had to push home her point with these men.
‘By mosquitoes,’ the administrator said,
and Esther nodded.
‘So we’ve got to do better with the eradication programme—’ the man said.
‘And find some way to contain it in the meantime,’ Esther cut in. Briefly she explained the cycle of transmission.
‘Within the area, there are probably any number of people already infected but not yet sick. You have to begin by looking at those who’ve had mild forms of the disease but didn’t come to the hospital, We’re not certain how many fit into the latter category, but I’m beginning to believe the people you’ve had at the hospital are a minority. In fact, of thirty families interviewed yesterday, twelve had family members who have had flu-like symptoms in the past month but haven’t been sick enough to seek medical treatment. Now, if only half of these people were bitten during the infectious stage—early on in their illness—then you have to extrapolate that out—infected mosquitoes biting other people in the area—and the possible number of infected people escalates exponentially.’
‘What can we do?’ It was the army man who asked the question, which pleased Esther as one possible solution involved a big commitment by the army.
‘I’d like to shift everyone in Robinson out, preferably to somewhere further south where climatic conditions make it impossible for Aedes mosquitoes to breed. They would have to be kept there for at least two weeks, which would cover the longest possible incubation period for the disease. There’d have to be access to a hospital and we’d send details of the treatment regimes we’ve used here direct to that hospital. During the time the people are away, we would need a saturation spraying not only of Robinson but of the whole city in an effort to eradicate any mosquitoes already carrying dengue. Aedes are cunning little beasties and tend to hide away under houses, so aerial spraying from equipment mounted on a truck might not be enough. You might need people going door to door, spraying under houses and wherever there are shrubs.’
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