Vy Virginia West felt like it. She lay in bed, lights out, a hot water bottle held close as contractions prepared her for birth for no good cause. Ever since she was fourteen, she'd gone into labor once a month, some episodes worse than others. On occasion, the pain was debilitating enough to send her home from school, a date, or work, lying about what was wrong as she gulped Midol. After a sullen Raines, the paramedic, had dropped her off, she'd taken four Motrin, a little too late. Hadn't Dr. Bourgeois told her to take two hundred milligrams of ibuprofen four times a day three days before trouble started so it could be prevented, and don't cut yourself or get a nosebleed, Virginia? West, as usual, had gotten too busy to bother with anything so mundane, so trivial, as her health. Niles recognized the cyclical emergency and responded, curling around his owner's neck and head, keeping her warm. He was pleased she wasn't going anywhere and he didn't have to share their bed.
Chief Judy Hammer was having morbid premonitions and was bedside, too, in the Surgical Intensive Care Unit (SICU) of Carolinas Medical Center, where Seth's condition was serious and on the wrong side of getting better. Hammer was in shock, dressed in gown, mask and gloves, sitting by his bed. High dose penicillin, clindamycin, and immunic globulin dripped into her husband's veins in an effort to counter necrotizing fasciitis (NF). It was a rare infection, and associated with systemic infection, and a fulminant course, according to Hammer's personal observations and the notes she had been taking every time Dr. Cabel, the infectious disease doctor, spoke.
This was all somehow related to everyday group A beta-hemolytic streptococci and Staphylococcus aureus, which Hammer could not comprehend beyond figuring out that the microscopic bastards were eating her husband alive. Meanwhile, Seth's oxygen content in his bloodstream had dropped below normal, and the medical center was in a panic. Personnel had made Seth, the V. I. P, a top priority, and specialists were in and out. Hammer could not keep them straight. She could not think as she stared at her husband's slack, feverish face and smelled his death through the mask she wore.
During the Civil War, surgeons would have diagnosed her husband's condition as simple gangrene. No fancy Latin term changed the reality of flesh turning black and green at a wound site, with limbs, and eventually the person, rotting alive. The only treatment for NF was antibiotics, surgery, and amputation. About a third of the three to five hundred people who got the disease in the US annually died, or approximately thirty percent, according to what Hammer had found through searches on America Online.
Nothing she had discovered about the disease had consoled or given hope. The deadly bacteria burst upon the scene in recent years when it killed eleven people in Great Britain. KILLER BUG ATE MY FACE, screamed the Daily Star. DEADLY FLESH EATING BACTERIA, other tabloids proclaimed. It had killed Jim Henson of the Muppets, Hammer had discovered on the Internet, and was believed to be a virulent form of a strep that had caused scarlet fever in the 1800s. In some cases, NF spread too rapidly for antibiotics to work, and it was feared that Seth would be the latest statistic. His V. I. P status had insured aggressive treatment since admission, so the problem lay not in the hospital, but in his general condition.
Seth had poor nutrition. He was clinically depressed. He had a history of heavy drinking and arteriosclerotic vascular disease. He had received a trauma resulting in an open wound, and a foreign body that could not be removed. Seth, according to Dr. Cabel, was immunosuppressed, and was losing approximately a pound of flesh per hour. This did not include layers lost by surgeons file ting to the next level of healthy, bleeding tissue, which soon after turned black and green, despite all efforts and prayers. Hammer was motionless in her chair, reliving every word she'd ever spoken to her husband, every deed that had been angry or unkind. None of his flaws would come to her now.
This was all her fault. It had been her. 38 special, her Remington hollowpoint +P cartridge. It had been her order that he root under the sheets for that gun and hand it over to her this minute. It had been Hammer giving him the ultimatum about his weight, and she halfway believed that what he suffered from now was no coincidence, but a functional illness. Seth was melting before her eyes, an inch smaller every hour, slabs lighter after every surgery. This was not the weight-loss plan she would have wished for him. He was punishing her for all those years he had lived in her shadow, the wind beneath her wings, her inspiration and biggest fan.
"Chief Hammer?"
She realized someone was speaking, and her eyes focused on Dr. Cabel, in surgical greens, cap, mask, gloves, and shoe covers. He was no older than Jude. God help me, Hammer thought with a deep, quiet breath as, once again, she got out of her chair.
If you'll give me a minute with him," Dr. Cabel said to her.
Hammer went out into the antiseptic, bright corridor. She watched nurses, doctors, family members, and friends alight on different rooms where more suffering lay tethered to narrow hydraulic beds, and machines monitored the life force as it struggled on. She stood, in a daze, until Dr. Cabel returned, slipping Seth's chart in the envelope on the back of the door.
"How is he?" Hammer asked the same question, pulling her mask down around her neck.
Dr. Cabel left his mask on. He took no chances, and didn't even shower at home anymore without lathering from head to toe with antibacterial soap. He shut Seth's door, eyes troubled. Hammer was shrewd, and not interested in further euphemisms, convolutions, and evasions. If this young infectious disease doctor thought he could hide the truth from her, she was about to add to his education.
"We're going to take him back into surgery," Seth's doctor said.
"Which is fairly typical at this point."
"And which point is this point, exactly?" Hammer wanted to know.
"Day two of progressive streptococcal gangrene and necrotizing fasciitis," he replied.
"The necrosis is visibly beyond the margins of the original debridement."
While Dr. Cabel respected Chief Hammer, he did not want to deal with her. He cast about for a nurse. Shit. All were busy elsewhere.
"I need to get started," he said.
"No so fast," Hammer let him know.
"Exactly what are you going to do in surgery?"
"We'll know better when we go in."
"How about hazarding a guess." She might slap him.
"Generally, at this stage, the wound is debrided again down to bleeding, healthy tissue. We'll probably irrigate with saline and pack the wound with Nu-Gauze. We'll continue with hyperbaric oxygen therapy twice a day, and I recommend total parenteral nutrition."
"Multivitamins then," she said.
"Well, yes." He was mildly surprised by her ability to connect the dots.
Hammer had been buying vitamins for years and failed to see anything special about the suggestion. Dr. Cabel started to walk off. She snatched him back by his greens.
"Let's cut to the chase," she said.
"Seth has had strep throat a dozen times in his life. Why has it turned into this now?
Aside from his lousy immune system. "
"It's not exactly the same thing as the strep that causes a sore throat."
"Clearly."
This lady was not going to let him go. Dr. Cabel felt sorry for Seth in a different way, now. Living with this woman would wear out anybody.
Imagine asking her to fetch coffee or take your word for it? When all else failed, Dr. Cabel switched to the language that only his super race understood.
"It's quite possible strep has acquired new genetic information, picked up genes. This can happen through infection by abacteriophage," Dr. Cabel informed her.
"What's abacteriophage?" She wouldn't give up.
"Uh, a virus that can incorporate its DNA into abacterial host," he said.
"The hypothesis is, that some Ml strain of group A strep, in approximately forty percent of recent invasive infections, seems to have acquired genetic material from a phage. This is according to WHO. "
"Whoi' Hammer frowned.
"Exactly." He
looked at his watch long enough to give her a broad hint.
"Who the hell is wboY She would get an answer.
"World Health Organization. They have a strep reference laboratory.
The long and short of it, this may all be connected to a gene that encodes a toxin called super antigen which is widely believed to be connected to toxic-shock syndrome. "
"My husband has the same thing you get from a tampon?" Hammer raised her voice.
"A distant cousin."
"And since when do you amputate for that?" she demanded as passerbys glanced curiously at the two people in greens arguing in the spotless, well-lit corridor.
"No, no." He had to get away from this woman, so he, the English major, threw Shakespeare at her.
"Ma'am, with what your husband's got, surgery remains the most effective treatment.
"Be bloody, bold and resolute," he quoted.
"King Lear."
"Macbeth," Hammer, who loved the theater, said as Dr. Cabel hurried off.
She lingered long enough to see her husband wheeled back to the OR, then Hammer went home. By nine o'clock, she had collapsed in bed, too exhausted and distressed to remain in a conscious state effectively.
She and her deputy chief, in their respective homes, one with a pet, one without, slept fitfully the rest of the night.
Brazil tossed and yanked sheets this way and that, over his feet, under them, back over them again, on his side, on his belly. Finally, he lay on his back, staring up into the dark, listening to the TV murmur through the wall as his mother lay passed out on the couch again.
He kept thinking about what West had said. He should move out, find an apartment. Yet whenever he followed this scary, exciting path a few steps further, he always ran slam into the same scarecrow that sent him fleeing the other way. What was he supposed to do about his mother? What would happen to her if he left her alone? He supposed he could still bring by groceries, stop in to check on her, fix things, and run errands. Brazil worried as he thrashed in bed, listening to the eerie strains of what must have been some three a. m. half-a-star horror flick. He thought about West and felt depressed again.
Brazil decided that he did not like West in the least.
She was not the kind, enlightened woman that Hammer was. One day, Brazil would find someone like Hammer. They would enjoy and respect each other, and play tennis, run, work out with weights, cook, fix the cars, go to the beach, read good fiction and poetry, and do everything together, except when they needed space. What did West know about any of this? She built fences. She cut her own grass with a rider mower because she was too lazy to use a push one, and her yard was barely half an acre. She had disgusting eating habits. She smoked. Brazil turned over again, hanging his arms off either side of the mattress, miserable.
At five, he gave up and went back to the track to run again. He clipped off eight more miles and could have gone farther, but he got bored and wanted to get downtown. It was strange. He'd gone from exhaustion to hyperactivity in a matter of days. Brazil could remember no other time in his life when his chemistry had swung him around like this. One minute he was dragging, the next he was high and excited with no explanation. He contemplated the possibility that his hormones were going through a phase, which he expected would be normal for one his age. It was true that if the male did not give in to his drives between the ages of sixteen and twenty, biology would punish him.
His primary care physician had told him exactly that. Dr. Rush, whose family practice was in Cornelius, had warned Brazil about this very phenomenon when Brazil had a team check-up his freshman year at Davidson. Dr. Rush, recognizing that Brazil had no father and needed guidance, said many young men made tragic mistakes because their bodies were in a procreation mode. This, said Dr. Rush, was nothing more than a throwback to colonial times when sixteen was more than half of the male's life expectancy, assuming Indians or neighbors didn't get him first. When viewed in this fashion, sexual urges, albeit primitive, made perfect sense, and Brazil was to do his best not to act on them.
Brazil would be twenty-three next May, and the urges had not lessened with time. He had been faithful to Dr. Rush, who, according to local gossip, was not faithful to his wife and never had been. Brazil thought about his sexuality as he ran a few sprints before trotting home. It seemed to him that love and sex were connected but maybe shouldn't be. Love made him sweet and thoughtful. Love prompted him to notice flowers and want to pick them. Love crafted his finest poetry, while sex throbbed in powerful, earthy pentameters he would never show to anyone or submit for publication.
He hurried home and took a longer than usual shower. At five past eight, he was moving through the cafeteria line in the Knight-Ridder building. He was in jeans, pager on his belt, people staring curiously at the boy wonder reporter who played police and always seemed alone.
Brazil selected Raisin Bran and blueberries as the intercom piped in WBT's wildly popular and irreverent Don't Go Into Morning show, with Dave and Dave.
"In a fast-breaking story last night," Dave was saying in his deep radio voice, 'it was revealed that even our city's mayor won't go downtown at night right now. "
"Question is, why would he anyway?" quipped Dave.
"Same thing Senator Butler should have asked."
"Just checking on his constituents, Dave.
Trying to be of service. "
"And the eensy weensy spider crawled up his water spout…"
"Whoa, Dave. This is getting out of control."
"Hey, we're supposed to be able to say anything on this show. That's in the contract." Dave was his usual witty self, better than Howard Stern, really.
"Seriously. Mayor Search is asking everybody to help catch the Black Widow Killer," Dave said.
"And next up is Madonna, Amy Grant, and Rod Stewart…"
Brazil had stopped in the middle of the line, frozen as the radio played on and people made their way around him. Packer was walking in, heading straight towards him. Brazil's world was Humpty Dumpty off the wall, cracks happening everywhere at once. He paid for his breakfast, and turned around to face his ruination.
"What's going on?" he said before his grim editor could tell him.
"Upstairs now," Packer said.
"We got a problem."
Brazil did not run up the escalator. He did not speak to Packer, who had nothing more to say. Packer wanted no part of this. He wasn't going to insert his foot in his mouth. The great Richard Panesa could fix this one. That's why Knight-Ridder paid Panesa those big bucks.
Brazil had been marched to the principal's office only twice during his early school years. In neither case had he really done anything wrong. The first time he had poked his finger into the hamster cage and had gotten bitten. The second time of trouble occurred when he inserted his finger into the hole at the top of his clipboard and had gotten stuck.
Mr. Kenny used wire cutters to free young Brazil, who had been humiliated and heartbroken. The blue Formica clipboard with its map of the United States was destroyed. Mr. Kenny threw it into the trash while Brazil stood bravely by, refusing to cry, knowing his mother could not afford to buy him another one. Brazil had meekly asked if he could stay after school for a week, dusting erasers on back steps, to earn enough to buy something new to hold notebook paper and write on. That had been okay with all.
Brazil wondered what he could offer to Panesa to make up for whatever he had done to cause such a problem. When he walked into the publisher's intimidating glass office, Panesa was sitting behind his mahogany desk, in his fine Italian suit and leather chair. Panesa didn't get up or acknowledge Brazil directly, but continued reading a printout of the editorial for the Sunday paper, which slammed Mayor Search for his glib, albeit true, comment about his reluctance to travel downtown these nights.
"You might want to shut the door," Panesa quietly said to his young reporter.
Brazil did and took a seat across from his boss.
"Andy," he said, 'do you watch television? " His
confusion grew.
"I rarely have time…"
"Then you may not know that you are being scooped right and left."
The dragon inside Brazil woke up.
"Meaning?" Panesa saw fire in his eyes. Good. The only way this sensitive, brilliant young talent was going to last in this criminal world was if he were a fighter, like Panesa was. Panesa wasn't going to give him a breath of comfort. Andy Brazil, welcome to Hell School, the publisher thought as he picked up a remote control from his mighty desk.
"Meaning' - Panesa hit a button, and a screen unrolled from the ceiling 'that the last four or five major stories you've done have been aired on television the night before they ran in the paper, usually on the eleven o'clock news." He pressed another button, and the overhead projector turned on.
"Then the radio stations pick them up first thing in the morning. Before most people get a chance to read what we've plastered on the front page of our paper."
Brazil shot up from his chair, horrified and homicidal.
"That can't be! No one's even around when I'm out there!" he exclaimed, fists balled by his sides.
Panesa pointed the remote control, pressed another but ton, and instantly Webb's face was huge in the room.
'. in a Channel Three exclusive interview said she returns to the scene of the crash late at night and sits in her car and weeps.
Johnson, who turned in her badge this morning, said she wishes she had been killed, too. "
Panesa looked at Brazil. Brazil was speechless, his fury toward Webb coalescing into hatred for all. Moments passed before the young police reporter could gather his wits.
"Was this after my story?" Brazil asked, though he knew better.
"Before," Panesa replied, watching him carefully, and assessing.
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