by Ross Pennie
Hamish’s cheeks flushed. Furrows creased his brow. “What?”
“Head cheese isn’t cheese.”
“What do you mean?”
Zol tapped his own cheek. “It comes from the head.”
“What?”
“Pig’s head. It’s pickled pork. A sort of sausage made from tongues and cheeks and snouts.” He stuck out his tongue and touched his nose with his forefinger.
Hamish shivered and looked away. “Yuck! No wonder Brenda wouldn’t touch it.” He straightened his tie, then patted the pockets of his shirt and suit coat. “Can’t find my pen. Can I borrow yours for a sec?”
Zol handed him his fountain pen.
Hamish drew a line through head cheese and printed pork sausage above it. “This pen writes pretty nicely,” he said, clearly anxious to change the subject. He wasn’t used to being caught out on the job. “I’ve seen this before. Weren’t you using it last night? It must be an antique.”
“Eighteen ninety-five. The first leak-proof model that could be carried in a pocket. It’s a Parker. Belonged to William Osler.”
Hamish fondled the black ebonite shaft, ran his fingers along the sterling silver clip. “William Osler? The William Osler? The internist who founded Johns Hopkins medical school?”
“And wrote the first medical textbook. Of course, you know he grew up right here. From my back yard, I can look over the Escarpment and imagine I see the street where his father’s church used to be. It sounds silly, but when I’m holding Osler’s pen I feel inspired to go that extra mile,” Zol said, surprising himself with this stirring of emotion. “But back to bangers and blended meals. Hugh McEwen was into ground meat in a big way. For more than a decade.”
“It sounds like we’re on the right track, eh? With Hugh and his English bangers? Patel and Joanna Vanderven were immigrants; if they’ve got connections to England we might get this solved before your boss gets back from his retreat.”
Zol threw him a puzzled frown. “How did you —”
Hamish laughed. “Know about the retreat?” He was enjoying the moment, feeling good about stealing the upper hand. “Your secretary told me.”
“Yeah. Trinnock’s up in cottage country for the next few days. He and all the other health-unit bosses are meeting in Muskoka. And thank goodness, too. It’ll give us a little breathing room. I just couldn’t face him when I saw his name light up last night on my Call Display.”
Zol glanced at his watch. With any luck, Natasha would have found Mrs. Patel by now. His pulse quickened as he pictured Natasha, her graceful fingers poised over her notepad, her sharp mind discovering the unlikely thread that would link the vegetarian car salesman with the Rhodes Scholar dentist.
The phone rang, its red flashing light indicating that Anne was calling from her desk at the reception area in front of Trinnock’s office. She might have been classed as a secretary, but she was the administrative heart of the health unit. She never interrupted if she knew Zol had a visitor. A knot of apprehension gripped his stomach, banishing his sense of euphoria.
“Sorry to disturb you, Dr. Szabo.” Anne sounded rattled. “I know you’re busy with Dr. Wakefield. But there’s a man on the line. He said — he said I’d be sorry if — if I didn’t put him through immediately.”
“Did he give his name?”
“No. He sounds like an older man, with an accent. European, I think.”
“Did he say what he wants?”
“I tried to take a message, but he won’t speak to anyone but you.”
“I guess you’d better put him on.” Zol cupped the mouthpiece with his palm and turned to Hamish. “This sounds like a touchy relative from Shalom Acres. Everyone’s been pretty upset over there lately. I’d better speak to him.”
Hamish scanned his notes as if hunting for unfinished business. “No problem. I’ll catch up with you later.”
“I have a feeling,” said Zol, “we’re going to be dumped from our frying pans into a whole lot of fires before this roast gets carved.”
CHAPTER 4
On the way back to Caledonian Medical Centre on Mud Street in the far southeast of the city, Hamish stopped at the car wash to collect his thoughts while three men lathered the road salt and street grime from his Saab. When he’d interviewed for the position at Caledonian two years ago, he’d been enormously relieved to find that Mud Street was no muddier than any other street in the city.
The car wash was the perfect place to think without interruptions. Impenetrable to pagers and mobile phones, it was a haven from an intrusive world. Zol’s outburst over what Hamish said to Brenda McEwen had been a slap in the face. Unfair and totally uncalled for. Hamish picked at his cuticles. He had the feeling Zol knew more than he was letting on, that he didn’t believe the English beef connection. Hamish peered through the suds on the windshield. The white noise of the water jets, usually so soothing, did nothing to quell his trepidations. When the fans shut down, he left the car wash and turned cautiously into Stone Church Road.
His cellphone trilled immediately.
“Hamish Wakefield speaking.”
“Hi, Hamish, it’s Jeff Suszek.” One of the Emerg docs at Caledonian. “Got a case for you. But I can hardly hear you.”
“This is as loud as I get.”
“Oh, yeah. Sorry,” he said, then explained that he had a farmer who’d arrived at the Emergency Department earlier with an infection in his right arm. He’d been bitten by one of his mink. The entire upper limb was infected — red, swollen, and extremely painful. The man had a fever but wasn’t delirious.
“By the look of the wounds, the mink must have been pretty mad about the idea of being turned into a winter coat,” Suszek said with a chuckle. “But seriously, I need to know what antibiotics to start him on. Do mink carry any kind of exotic diseases?”
“Extremely painful, eh?” said Hamish.
“Won’t let me near his arm.”
“Sounds pretty bad. Give him a tetanus shot, and I’ll be there in ten minutes. What’s his name?”
“Aah, you got me there. Too many names on every shift. I never remember them.” There was the sound of rustling paper as Suszek checked his notes. “Here it is: Krooner, Ned Krooner. You’ll find him in zone two.”
Hamish rang off. He started to call his resident but remembered the guy was on holiday. The trainees were always on holiday. He closed the phone, placed it on the passenger seat, and reviewed the few facts he’d been given.
He’d never treated a mink bite. He wondered how many mink farms there were in this part of Ontario. With all the anti-fur rhetoric in the news, mink farmers didn’t exactly erect billboards offering guided tours of their operations. Did they vaccinate mink against rabies? Did mink’s teeth carry the same bacteria that cause cat- and dog-bite infections? And what about TME, transmissible mink encephalopathy? He remembered an outbreak reported from a mink ranch somewhere in the American Midwest. Minnesota, was it? Or Wisconsin? But that was a brain infection in the mink, not in people. It had nothing to do with infected wounds among animal handlers. One thing did bother him. Suszek said the wound was extremely painful. Hamish shuddered, noted the green traffic light ahead, and pressed the accelerator to the floor.
A hint of barnyard odour hung like a stain in the air as Hamish entered zone two, the Emergency Department’s eight-bed examination room. And when he opened the privacy curtains and entered Ned Krooner’s cubicle, the stench of manure hit him like a punch in the chest. A wild-looking man lay propped on the bed, and two tall men stood on either side of him. For an instant, Hamish braced himself against the expected taunts of the burly trio. Hamish had been the short kid on the block who sang in the church choir three times every Sunday, and hazing had been a fact of his life. These days, it rarely happened, not with patients anyway. His status as the specialist protected him. But old feelings never died. Instead, they gained power with age.
The man on the bed held his right arm against his bare chest. He cradled the limb — brui
sed, bloated, and covered in punctures — as though it were a wounded animal. A week’s growth of whiskers grizzled his face. His bloodshot eyes crinkled with pain and fatigue. His cheeks were flushed with fever, and his dark hair was matted to his sweaty forehead. Clods of mud from his work boots soiled the bedsheet.
The man on the right stood trim and neatly groomed, his jaw square and clean-shaven. His blue jeans bore a crisp crease, his loafers a recent polish. He looked the youngest of the three. He smiled without humour and shot out his hand, shaking Hamish’s with firm confidence. “Lanny Krooner,” he said. He pointed to the even taller man standing on the far side of the bed. “My brother Morty.”
Morty, his long hair wild, his clothing smeared with mud and who knew what else, had the stooped posture of a shy man too tall for his self-esteem. He stared in the direction of Hamish’s knees and grunted.
“And of course this here’s my brother Ned,” Lanny said. He narrowed his eyes and stared straight into Hamish’s. “You’re gonna make sure he doesn’t lose his arm, eh, Doc?”
Hamish couldn’t be certain of anything about this new patient. He’d barely caught sight of the injured limb, let alone given it his professional observation and careful thought. So far, the only thing he’d assessed was the reek of the man’s clothing. “I don’t know yet. Give me a chance, eh?” Hamish said. “I just walked in, for heaven’s sake.” He regretted his tone immediately. Worrying that his voice and eyes had betrayed his annoyance, he countered with a forced smile, hoping it conveyed enough empathy to keep these muscular men from turning on him.
He donned the pair of gloves he’d pulled from a box mounted on the wall and took a step toward Ned.
“Don’t touch it,” Ned shouted, his voice full of fear. “It — it really hurts.”
“I’ll be careful,” said Hamish, leaning in to pry Ned’s fingers away from his chest so he could examine the palm of his hand.
Lanny pounced, forcing his arm between doctor and patient. “He told you — don’t touch it.”
Hamish recoiled and stood perfectly still. He felt like a sapper disarming a time bomb.
“I’m serious,” Ned said. “Please . . .” He sniffed, tears spilling onto his cheeks. “Don’t touch it. Nowheres.”
Hamish had seen this before with flesh-eating disease. The pain, beyond excruciating, reduced tough men to tearful waifs and their families to Rottweilers. He made a show of withdrawing his hands. “Okay. Sorry. Okay, I won’t touch.”
Lanny fired a warning glare and withdrew his arm.
Hamish eased forward again, his hands by his sides. “I’ll just look.”
Ned’s right upper limb had swollen to twice its normal size. Every crimson slash and puncture pouted with pus. The bloated fingers were the size of sausages.
“Quite a mess, eh?” said Hamish, hoping to break the ice by stating the obvious.
The three men nodded. Ned pleaded with his eyes.
“Now, Ned,” Hamish said, speaking slowly and with as much reassurance in his voice as he could muster. “I want you to roll your hand forward like this.” He inverted his own palm, like a panhandler on a street corner. “I need to see your palm.”
Ned grimaced. “Can’t. Hurts too much.”
“You can do it. Just take it slowly.”
Bit by bit, holding his tongue between his teeth, Ned rolled his palm away from his chest and exposed the fleshy underbelly of his forearm.
Hamish leaned in. There it was: a telling strip of purple-grey flesh, partially hidden on the inner surface of the forearm. It was time to get the detailed history, the nuts and bolts that would assemble this ugly picture into a complete diagnosis. “When was the attack?”
Lanny did the answering. “Tuesday.”
Good God. They had let this arm fester for more than a week. “You mean a week ago?”
Lanny glowered. “Yeah, and don’t you gimme a hard time about it. Heard enough from that nurse.” He jabbed his thumb in the direction of the nurses’ station on the other side of the curtain.
Hamish put up his hands. He tried to clear his throat with a couple of coughs. “All right, no problem,” he said, his voice croaky. He tried to see into the injured man’s face, but Ned kept his head down. “Tell me, Ned,” he asked, “have you been bitten like this before?”
“Never,” Lanny replied. “Not in twenty years o’ mink farming.” Lanny scanned the cubicle as if to confirm they were still alone. “The mink that done this was acting strange. Restless, eh? Funny look in its eyes for a couple o’ days.”
A wave of apprehension filled Hamish’s chest. “Did it have rabies?”
“Impossible. All them mink are vaccinated. Besides, I keep ’em in sheds, eh? Locked in cages.”
Despite Lanny’s assertion, rabies was lethal and potentially contagious. It would have to be ruled out for certain. “We should send the animal to the federal lab in Ottawa. They can test the brain for rabies virus. Just to be sure.”
“It’s already dead,” Lanny said. He folded his arms. “We burned it.” His eyes dared Hamish to make a federal case of it.
“Okay,” said Hamish. “No problem.” The real issue wasn’t rabies, anyway. It was the terrible state of this arm. “How long has Ned been in this much pain?”
Lanny shifted on his feet and wiped his mouth with his palm. “We thought it was just scratched and bruised, eh? Until the fever started. A couple o’ days ago.”
Hamish asked a few more questions about Ned’s general health. He was forty-one, had never had a serious illness, didn’t take any medications, and smoked cigarettes and the occasional joint of marijuana.
Hamish pulled off his gloves and planted his feet in preparation for conveying his diagnosis. The cubicle pressed hot and close, the stench of sweat and manure almost overpowering. He tugged at his collar. “It’s going to sound like a big deal,” he said, concentrating on the choice of each word, “but I’ve got to tell you. This is flesh-eating disease.”
Ned jerked his head. “Shit.” His eyes were ablaze with fear and pain. “Shi-it.”
A shudder shocked Morty’s stooping hulk. He produced a disgusting noise from the back of his throat and swallowed hard.
“I knew it,” Lanny said, the pulse at his temple beating furiously. “I just knew it.” He set his jaw and clenched his fists. “But there’s no goddamn way you’re takin’ his arm.”
“It’s — it’s not that bad,” Hamish said, struggling to remain in the driver’s seat, to project a confidence he didn’t feel.
Lanny’s cheeks flushed to crimson. “What do you mean? You said it was flesh-eating. That means, you know . . .” He cupped his hand beside his lips and mouthed, “amputation.”
Hamish shook his head. “I’ve seen quite a few cases like this, and we’ve done pretty well with them.” He pointed to the back of Ned’s hand and along his arm where the tissues were inflamed but not too far gone. “There’s still some healthy enough flesh in that arm, but we can’t waste any time. Ned’s going to need surgery this afternoon.”
Ned raised his good fist like a club. “I don’t care what you do. Just get rid of the goddamn pain.”
“We’ve got a terrific plastic surgeon here. Dr. Blayne. He’ll open the wounds, clean them up, and trim away the worst of the damaged tissue. You’ll feel better almost immediately.”
Hamish paused. Should he make a promise he wasn’t certain would be kept? These men needed something firm to grasp or they’d spin out of control. “Ned, it’s not going to be pretty, but you won’t lose your arm.”
CHAPTER 5
At noon, Natasha sat alone at a table in the Nitty Gritty Café waiting for Zol. They’d agreed to debrief here in their usual spot after she’d met with Mrs. Patel. She flipped through her notepad and jotted in the margins, thrilled that her visit with the widow had mined a vein rich in helpful details. She couldn’t wait to share them with Zol.
Marcus, the café’s proprietor, reserved this isolated table at the rear of his establis
hment for the staff at the health unit. The café was a block and a half along Concession Street from the unit, a perfect location. The subdued lighting and eccentric South American décor, along with Marcus’s homemade sticky buns and exotic coffees, softened even the most heated debates. The stipulations of legislation, the concerns of an anxious population, the scarcity of funding, and the demands of self-serving politicians almost always forced contentious interpretations of the bare scientific facts. Marcus’s pastries increased the palatability of the discourse and the creative decisions that had to be made.
“Hi, Dr. Zol,” Natasha said as her boss approached. His eyes had lost their sparkle. “Is something wrong?”
“Just need a latte.” He pulled off his winter coat and hung it on the rack that screened their table from the others.
“I ordered one,” she said. “You can have it when it comes.”
“No — I can wait for mine.”
Marcus appeared like a red-haired genie bearing two frothy glasses on a polished tray. He wore his white apron over a black T-shirt and trousers. “Here you are, Dr. Szabo. Just in time, by the look of you.”
“Thanks, Marcus. You’ve got that right.” He took three sips from his glass. White foam clung to his bare upper lip, making him look more endearing to Natasha than ever. Especially today with that cast of anxiety troubling those deep green eyes.
Natasha sipped at her latte, doing her best to avoid a foamy moustache. She had enough difficulty with the real one that had to be waxed every three weeks. She stared at the menu without reading it. She found it awkward starting a conversation with a man. According to her mother, it was fine for a woman to mention the weather or small domestic matters, but a girl had to leave it to the man to initiate the meat in a conversation. Her mother was hopelessly old-fashioned but she was also shrewd, adept at turning the world to her bidding while appearing delicate and helpless. Natasha dabbed her lips with a serviette and studied the list of familiar menu offerings with greater intensity than it needed. “Do we have time for a sandwich?”