‘Is this really necessary?’ The city administrator asked the question, no doubt worrying over the logistics of such a move.
‘I’ve recently been in Africa where I saw at first hand the results of a really bad outbreak of the disease, with thousands of people affected and medical facilities stretched beyond their ability to cope. Here we’ve contained it, but unless we take steps now to eradicate all infected mosquitoes, it could become endemic in this region, so you start to get regular outbreaks. That would not only be disastrous for the local population but would severely damage the tourism industry, which provides employment as well as income for the region.’
‘Yes,’ the administrator said gloomily, ‘tourists won’t want to come if they think they might catch dengue.’
‘We can do both the evacuation and the spraying.’ Esther felt like kissing the Army man when he made this offer! ‘Airlift them to an army camp in the south—a camp with a hospital. We’d have to convince them of the need to go, of course.’
‘We have authority to make them go if they can’t be persuaded,’ the administrator said, ‘but don’t you have more problems? This has obviously spread beyond Robinson.’
He looked at Bill, no doubt because of the two new cases, and Esther hurried to offer her explanation.
‘The woman who cleans the apartment building where Bill lives comes from Robinson. I’ve only just discovered this so haven’t had time to ask Margie if she’s been feeling ill lately, but it seems possible she’s carried it to the apartment block.’
‘My mother was in the habit of taking Chloe down to the pool area. There’s a little paddling pool Chloe loved. It’s a tropical setting with palms and shrubs, perfect breeding ground for Aedes,’ Bill said. ‘Chloe in the pool—repellent washing off. Washing off my mother’s hands and arms as well.’
His voice was coming from far away as if working out how they had become infected was bringing the reality of their illness home to him.
‘And this Margie was the carrier,’ John said.
‘And Chloe and Gwyneth could then have been carriers for it since they were infected,’ Esther reminded everyone. ‘I know Gwyneth’s been shopping, and Chloe’s been to the crèche here at the hospital, but I doubt there’d have been mosquitoes at either venue, so hopefully they haven’t spread it further.’
‘But people like this woman who cleans the apartment block might be working anywhere in town, spreading it further and further,’ John said.
‘I doubt there are many potential carriers working in the city.’ It was the administrator who stopped the worry before it went any further. ‘The worst destruction was close to the beach among the most expensive houses in the city. That area, where you might expect people to have cleaning ladies, has all been evacuated. And we’re fortunate in another way. With the damage to roads and bridges, Robinson has been cut off from public transport, so people from there who would normally work in places like the hospital, or the one shopping centre we have operating, haven’t been able to get to work.’
‘Margie has,’ Bill reminded everyone.
‘She might have relatives in town, and been staying with them,’ Esther suggested. ‘Remember the few scattered pins in your map? They were people who had relatives in Robinson but lived in town.’
Bill nodded.
‘So we shift everyone out of Robinson and get rid of the mosquitoes,’ the Administrator summed up.
‘And put out radio warnings for people to be aware of the symptoms and report to the hospital with any sign of a sore throat, fever, back or joint pain,’ Esther said.
There was a general sigh, then a tap on the door heralded the arrival of morning tea. But before anyone could relax, Bill spoke again.
‘I think there’s one other measure we should take.’ Everyone turned expectantly towards him. ‘Apart from the Robinson people, who will be moved en masse, I think we should restrict travel out of the area for a month. That will stop any chance of spreading it to any other area.’
A month? Esther had just decided her job was almost done. Oh, she’d finish the epidemiology work and stay until Gwyneth and Chloe were out of danger, but a month?
Taking her over Christmas?
She couldn’t do it!
Couldn’t spend a Christmas with Bill…
‘Good idea,’ the administrator said. ‘And not too difficult to enforce, given that we’ve comparatively few people in the city anyway.’
‘Coffee, everyone?’ John said, but Esther shook her head and stood up. The panic inside her was so strong it was a wonder the others couldn’t see her vibrating.
‘I need to get back downstairs and check on our patients,’ she said, as Bill stood up beside her and also excused himself.
Which meant they walked out of the room together towards the elevators, Esther feeling embarrassment now as well as panic. She remembered the wild abandon of the previous evening, and Bill’s cold words to her earlier that day.
‘Your mother and Chloe must be holding their own,’ she said, desperate to break the tense silence between them as they waited. ‘Someone would have contacted you if there’d been a crisis.’
‘Holding their own,’ Bill repeated, as the elevator arrived and the doors slid open. ‘Not much of a comfort, is it?’
And suddenly Esther was furious.
‘Well, it was the best I could do. I’m not going to offer you false hope or tell you lies. You know as well as I do that if they can hold their own through this initial stage, they’ll pull through it.’
‘And if they don’t?’ he said, stepping out on the fourth floor.
‘They will,’ Esther said fiercely. ‘They damn well will.’
They headed for the scrub room to put on protective clothing, Bill standing aside for Esther to go first. But once inside he reached for her and pulled her into his arms, resting his chin against her head.
‘I’m sorry. I’m taking all my fear and anxiety out on you,’ he murmured, feeling the silkiness of her hair against her skin. ‘I guess I was tired to start off with, then the double whammy of Chloe and Ma and no sleep last night. I’m sorry, Esther.’
She relaxed against him, then wrapped her arms around him and gave him a tight hug.
‘Whatever works for you, Bill,’ she said huskily, and he knew her well enough to guess she was crying inside again. ‘You go right on taking it out on me, if that’s what you need to do to get through this.’
His own arms tightened, drawing her so close he could feel her chest move as she drew in air.
‘Thank you,’ he said, and dropped a kiss on the silky hair, then reluctantly he let her go and pulled on the protective clothes he still felt they should all wear when in contact with the patients.
‘You stay with your mother and Chloe,’ Esther suggested. ‘I’ll do the doctoring.’
‘Hopefully not much will be needed,’ he said, but he didn’t argue, feeling he’d already been away from his family invalids far too long. But though Esther might be in charge of them, the doctor in him stopped at the main desk, picking up the long strips of paper the monitors behind the desk rolled out. Chloe’s heartbeat and respiration showed she was sleeping, and had been since he’d left the ward. His mother’s, though, was erratic, though the more recent readings were better.
‘Esther had suggested we try cortisone with your mother. She said tests hadn’t proved conclusively that it helped shorten the progress of the disease, but it had never done any harm. Your mother was obviously in pain and she thought it might help.’
The sister indicated a point on the paper just before the lines settled down. ‘That’s when we gave it to her,’ she said. Nine fifty-five, just before Esther went to the meeting.’
Bill looked around for Esther, wanting to talk about the treatment with her, but he could see her through a glass window, bent over Mr Armstrong, whose monitor, now Bill looked, suggested he was having another crisis.
‘Convulsing,’ Esther said over her shoulder, apparently divini
ng by some sixth sense that he’d entered the room. ‘He lost consciousness almost immediately.’
‘Encephalitis?’ Bill suggested, and Esther nodded, saying sadly, ‘Just when you thought this variant wouldn’t proceed to an inflammation of the brain.’
‘There’s nothing you can do except wait it out,’ he said, although he knew she’d know that.
She nodded, then touched him on the arm.
‘Go and sit with your mother or Chloe, there’s nothing you can do either.’ Nothing he could do about so many things, he thought sadly as he did as he was bidden, checking first on his mother who was sleeping then going to sit beside his daughter’s crib, taking the cloth from the nurse who was there and sponging the feverish little body.
Esther drew a little cerebrospinal fluid from Mr Armstrong’s back, just above his pelvis. She had no doubt it was encephalitis, the infection secondary to the dengue, but the fluid would be tested to confirm her diagnosis.
But in this case the confirmation wasn’t going to help because there was no magic pill or potion that would decrease the swelling around his brain. Well, there were cerebral dehydrating agents which could reduce the swelling, but they were a short-term proposition and were not part of the normal protocol for dealing with adult encephalopathy.
She took a blood sample for testing, increased the percentage of oxygen flowing into his mask, checked his fluid intake and output levels on the chart, knowing nothing much would have changed since she’d looked earlier, but something like this left a doctor feeling useless and she needed to feel she was doing something.
Checking the other patients would be doing something, she reminded herself, and she walked into the next room to visit Mr Risk. He was lying still, but apparently heard her come in, for his eyes opened and his hand lifted in a weak salute.
‘You look as if you’re feeling better,’ Esther said to him, and he lifted his mask off so he could answer her properly.
‘Better enough for you to take all these tubes and wires off now,’ he said.
‘I’ll think about it when we see how you are later today,’ Esther promised, remembering how quickly his condition had deteriorated.
But seeing one patient so improved cheered her immensely, and she visited the rest with a lighter step and brighter smile.
‘Something must be working—maybe the sun coming out,’ she said to Bill a little later when she joined him in Chloe’s room to report on the patients. ‘Mr Armstrong is a problem but Mr Risk is demanding he come off the monitors, and the other two patients who were down here in ICU when I first arrived are both heaps better.’
‘Heaps better?’ Bill queried. ‘Good medical term, that!’
‘Well, they are. I’ve taken one—the one with an unpronounceable name that starts with G—off the monitors and promised the other I’d have another look at him this afternoon.’
Bill was sitting in a chair by Chloe’s crib, but he’d taken the infant out of the crib and was nursing her in his arms. She was sleeping, her flushed face pressed against his chest.
‘And speaking of monitors?’ she added, raising an eyebrow towards the baby.
‘She doesn’t need to be on them if I’m here with her. And she was restless, couldn’t sleep, and was thrashing around and tangling the leads.’
‘Far better she sleeps, however we achieve it,’ Esther agreed, ‘but from time to time you might need a break.’
Bill smiled at her.
‘Like right now,’ he said, then he hesitated, and Esther, knowing what he’d been about to ask, and knowing also he couldn’t ask it, made the offer.
‘Give her to me, I could do with a little sit-down. Do what you have to do and spend some time with your mother as well. I’ll take good care of her.’
Bill stood up and passed the sleeping child into her arms. Chloe shifted and made a little bird-like noise, then settled again as Esther sank down into the chair, still warm from Bill’s body.
The baby was surprisingly heavy, she realised, but it was a weight that felt good in her arms.
‘Little baby, little baby, you are rocking in my arms,’ she sang softly, remembering songs from a tape she’d bought for her baby and had played as she’d decorated the nursery. And, as she sang, something cracked and broke inside her, and tears she didn’t think she’d ever shed slid down her cheeks, splashing onto Chloe.
‘Healing tears, little Chloe, for another baby,’ she whispered, wiping them away though more fell to replace them. ‘Maybe they’ll heal you as well.’
And she sang again, more songs from the tape, holding Bill’s child in her arms at last.
CHAPTER EIGHT
UNFORTUNATELY, the magic that Esther had attributed to the sunshine didn’t extend to Gwyneth, whose condition was deteriorating rapidly. Esther ordered platelets for her, and later in the afternoon whole blood.
‘Damn it, Gwyneth,’ she said, standing by the comatose woman’s bed late that afternoon, ‘you are not going to die on me. I won’t let that happen. How do you think Bill would feel? And who’s going to look after Chloe?’
Chloe!
Esther felt her heart thud a little faster. Chloe wasn’t faring much better than her grandmother and although Esther told herself infants usually went downhill fast in the early stages of any illness but recovered more quickly than adults, she still feared for the baby.
And for Bill if anything happened to either of them.
She’d sent Bill to have a sleep, promising to wake him if there was any change in either of his womenfolk, or at six if all was well. A nurse was in with Chloe, and with fewer patients on monitors, one of the sisters was in with Gwyneth.
‘You’ve done all you can,’ this woman said to Esther, who realised she was still standing scowling ferociously at her patient.
‘I can’t believe that,’ Esther said. ‘I can’t believe there’s not more I can do. That there’s not something to help patients through the crisis. I mean, this is a disease that’s been around for hundreds of years, and all we can do is treat its symptoms? What happened to advances in medicine? Is it just because it mainly affects poorer countries that we haven’t bothered to find a cure—or a preventative?’
The woman smiled.
‘I guess you don’t really want answers to those questions, and if you do, I can’t give you any, but it’s like a lot of things, isn’t it? We just do the best we can in whatever circumstances we find ourselves. Look at the cyclone. All those people evacuated to who knows where, families separated for the holiday season. Now, they can cry and complain and carry on, or they can get on with things and make the most of being alive. When you consider the destruction, and only ten people died in the actual storm—that’s a miracle in itself.’
Esther nodded. ‘You’re right. And I guess if Jamestown’s had one miracle, maybe it can have another. You hear that, Gwyneth, we need a miracle—an instant improvement in your health, if you wouldn’t mind!’
‘Dr Shaw, there’s someone to see you down in the foyer.’
A nurse poked her head in the door to deliver the message, and Esther grinned at the sister.
‘Maybe someone delivering miracles?’
The other woman smiled and Esther left the room. She doubted Byron would be delivering miracles, but he might have information that would help her make sense of the disease.
He had news of some kind—that much was obvious from the wide smile that lit his features as Esther came out of the elevator.
‘I think I’ve found where it came from,’ he said excitedly. ‘And you know those people who didn’t live in Robinson, well, I had time to talk to them, too, and it all fits in.’
‘You’re doing my job better than I was doing it,’ Esther said, waving to some comfortable-looking chairs over by the wall of the foyer. ‘Let’s sit down.’
They sat, and Byron opened the folder and showed her the completed questionnaires.
One by one, they went through them, and though Esther knew she’d have to draw charts
to trace relationships she could see patterns emerging from the information.
‘These people,’ Byron said, pulling out three pages he’d marked with asterisks, ‘all visited relatives on a particular island in Torres Strait in the month before the cyclone. This one was sick not long after she came home, and this one…’ he searched through the papers for another sheet ‘…came out from town to nurse her.’
Esther recognised the name of one of the few women who’d been sick, and also saw the address—in the city, not Robinson.
‘So they’re all linked together,’ Esther said, ‘and I’m reasonably sure that island is the one that had a couple of dengue patients flown to Cairns last year. It means we’ll have to do follow-up work on the spot, and see what’s happening with mosquito eradication up there. The Health Department should have started something after the earlier cases, but it’s something for me to chase up.’
She was so pleased to have the epidemiology part of things falling into place, she turned impulsively to Byron and planted a kiss on his cheek.
‘Thank you for doing that. It’s taken a big load off my shoulders.’
Unfortunately, just as she said it, she was aware of another pair of shoulders, moving away from her from the direction of the elevators through the foyer towards the canteen. Very familiar shoulders. Shoulders she’d promised to shake awake at six and it was now five forty-five.
She dismissed the twinge of anxiety seeing Bill had caused, thanked Byron again and gathered up the papers. Back on the fourth floor, she put them in the little office, promising herself she’d get a chance to look more closely at them later. She was hungry and realised it had been a long time since her big breakfast in John’s office, but she didn’t feel like going back down to the canteen.
Stale sandwiches from the fridge in the on-duty room would have to keep her going again.
But first a patient check. The sister at the desk had said all was well, but she needed to see the patients for herself. She found four of them in one room, well enough to be engaged in what looked like a very serious card game.
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