“Am I going to die?”
He chuckled. “Eventually. But not from this. You’re going to be fine, I promise.” He flinched. He knew it was coming even as he said it.
“You promised about Mom.”
“Your mother was very . . . unlucky.” He was immediately disappointed in himself. Unlucky was the word Sharon’s oncologist had used. Unlucky! That was a term for cards. Dominoes. Roulette. Josh still resented the doctor for saying it. He still resented God for letting it happen.
“If I got unlucky, I’d get to see Mom. Would I be buried here?”
He stroked his daughter’s ponytail. “You know what? Your mother is the reason you are going to be fine. You have an angel who’s looking over you.”
The moon bathed the graveyard in light as they made their way back to the car. He spent the ride home praying: Don’t let us be unlucky again. Don’t let us go zero for two. Don’t let me break my promise to Sharon.
Katie stuck her bad leg out from underneath the covers when he tucked her into bed.
She stared at it. She flexed her quadriceps, her calf muscle, wiggled her toes. “Daddy,” she said as her eyes filled with tears, “I’m scared.”
At one time he might have said, “I promise you’ll be fine.” But Katie deserved better than that. Instead, he wrapped his arms around his sobbing daughter, cradled her head against his breaking heart and made a vow he knew he could keep. “I’ll take care of you,” he said.
In time, her sobs quieted. “Can I still go to soccer camp?”
Pepper’s order echoed in his head. Screw him, Josh thought. Pepper had the same problem as Sharon’s doctors. They saw the illness, not the patient. Sharon was a cancerous breast to them, not a person. So it was the cancerous breast they had treated, not the wife, the mother, the woman. Even when there was no hope, they had gone about the business of treating the cancer while prolonging, even exacerbating Sharon’s suffering. Her last three weeks were a delirious, vomiting hell. Wouldn’t she have traded them for a quicker, easier end? Or for one more good week at the beginning? Screw the witch doctors!
“Please, Daddy. Can I go? I’ll do the dishes for a month. You’ll never have to remind me to clean my room or get off the phone or . . .”
“A regular Cinderella,” he laughed. “Go ahead. Have a blast.”
Katie threw her arms around her father’s neck. “I love you, Daddy.”
He remembered the wise counsel he’d received from Allison. “But just for the first session. You’re going to the hospital as soon as you get back.”
“I understand.”
He waited until he was sure Katie was asleep then crept quietly to his room and collapsed on his bed. He prayed he was doing the right thing.
Chapter Seventeen
Friday evening Josh and Katie shared a pizza and packed the last of her things for camp. Then she chatted on the computer with—he hoped and trusted—her known friends and played her flute. At 10 p.m. she called from her bedroom and said she was ready to say goodnight.
He found her on the bed holding the framed color photo of The Black Ravens. “The best team ever,” she said. “Fifth grade. I remember what I was thinking when they took this picture.”
“What?”
“I do not have a worry in the world.”
A moment passed before she said, “Thanks for letting me go to camp, Dad.” She ran her hand down her leg. “I’m going to be okay. And next year, I’m gonna be all-state.”
Just after 8 a.m. Saturday the last sleeping bags were loaded, the last soccer balls stowed, the last goodbyes said. The bus for Camp Kanawha ground into gear, belched a smelly, black cloud of diesel exhaust and pulled away—the campers inside already transported to their new world. Parents stopped waving and drifted back to their cars, except for Josh who stood unmoving until the bus was out of sight.
He closed his eyes and did his best to summon the memory of Katie—beaming face pressed against the bus window, baseball cap on backwards, mouthing the words “thank you.” The vision appeared and he savored it and filed it away, along with the others he had started so consciously preserving.
“You made the right decision.”
Josh turned around. It was Allison. He wiped his eyes. “She looked so happy.”
“I’ll say.”
“Thanks for coming. You didn’t have to give her your cell number.”
“Just in case. She’ll be fine, I’m sure.” She looked him up and down with a diagnostic eye. He was care-worn, haggard, exhausted. Katie’s cancer was already taking a toll. “You had breakfast?”
“No.”
“Come. I’m buying.”
Between them, Josh figured he and Allison knew half the people in the Winston Diner. He nodded to Mark Cotter, the funeral home owner. Spotting a t-shirt that read “Remember Wounded Knee,” he moved to where he could be seen by pressman Jimmy Mayes and signed “hi.” Dismissing a slight worry that their joint appearance on a Saturday morning might cause talk, Allison stopped to speak with the mayor who sipped coffee at the counter before joining Josh in a booth that overlooked Main Street.
Josh savored two eggs over easy, link sausage and a biscuit. That he hadn’t cooked it and wouldn’t need to do the dishes made the meal particularly delicious. When Allison finished her stack of blueberry pancakes and ordered another rasher of bacon, he said, “How’s breakfast?”
She flashed a coquettish smile and flipped her hair. “Are you horrified?”
“No,” he said before catching himself. “I like a woman who eats.” He felt himself flush. Are we flirting? “I mean, it’s just . . . where do you put it?”
“Genes,” Allison said. “My mom—tall, five-nine at least—ate like a horse. One hundred twenty pounds all her life.” She took a bite of pancakes. “She died in 1983. I was eleven.”
Josh reeled.
“Yeah,” she said. “I know.”
An insistent buzz emanated from beneath the table. Allison signaled for the check, picked up her cell phone and scrolled through a text message from Coretha. Rick Scruggs was at the clinic. She showed it to Josh.
“So,” he observed. “One of the body jewelry people finally shows up.”
Chapter Eighteen
Body jewelry people. As she hurried to the clinic from breakfast Saturday morning, Allison considered the tag Josh had invented for her tissue death patients.
She reviewed the known commonalities among Pringle, Scruggs, Cloninger and Faggart. All were white, although she could think of no race-related disease that could cause the symptoms she was seeing. All lived in the same area, meaning there was a chance their paths could have crossed—a notion supported by Faggart’s recollection of working with someone named Candi or Candy at the Sternwheeler. Indeed, the Sternwheeler was popular enough that it could be a place where all four lives had intersected.
But she didn’t know that all her patients wore “body” jewelry—except in the sense that all jewelry was body jewelry. Sure, Scruggs sported a nipple ring and Cloninger a tongue stud. But as far as she could see Pringle wore only what was considered more conventional jewelry—a necklace, the earrings—although why earrings were conventional and nipple rings weren’t, Allison couldn’t say. As far as Faggart’s jewelry use, she hadn’t noticed.
So Josh’s tag of “body jewelry people” was a headline that didn’t quite fit. “Jewelry people” certainly applied to at least three. But where did that get you? The term fit close to one hundred percent of women and, if you counted wedding rings and fancy watches, a majority of men.
Her own suspicions had focused not on the jewelry but on the hole—Scruggs’s kitchen-table nipple job, Pringle’s pierced ears, a hypothetical, unremembered cut on Faggart’s toe, Cloninger’s pierced tongue. All breaches of the skin, even old ones like Pringle’s ear piercings, could be welcoming homes for a variety of opportunistic
bugs.
One of the bugs was Methicillin-resistant Staphylococcus aureus, known commonly as MRSA. She blamed herself for not considering it sooner.
If it was MRSA, she and her patients were in for a battle. MRSA could cause the creeping destruction of tissue like she had observed, even pneumonia and death. Not for nothing had it been referred to in the popular press as a “flesh-eating superbug.”
The problem was that over the years, MRSA had become resistant to antibiotics that once destroyed it—including the antibiotics she had prescribed for her patients. If MRSA were involved, they would not be getting better.
She knew MRSA was being seen more and more in hospitals. A sick patient, susceptible to infection because of a compromised immune system, would touch something on which the pathogen resided—a telephone, a nurse call button, a TV remote or another person. Others in the hospital would touch the infected patient. The superbug would take hold.
One of her medical journals had recently detailed increased infection levels among groups with lots of skin-to-skin contact like team athletes, military recruits, and prisoners. And MRSA was spreading so fast in the general population that a new term—Community Associated (CA)-MRSA—had been developed to describe it. Perhaps her patients had been in contact.
MRSA’s preferred medium was organic matter—flesh and blood. But the superbug could survive on non-organic surfaces for as long as three days. If people could get MRSA by touching hospital equipment that had the bacteria on it, Allison reasoned, they could get it from kitchen equipment at a hotel. Or, to Josh’s point, from jewelry. A problem with the jewelry and a MRSA theory weren’t inconsistent.
Or perhaps her patients had garden-variety staph infections, not MRSA.
Or maybe there was a different problem—allergic reactions to cheap metal, for instance, although the odds of so many people suddenly having the same uncommon allergy had to be small. Or perhaps the infection and tissue death cases were entirely unrelated, had no connection at all.
If jewelry was the tissue death culprit, she hoped she was dealing with allergies or simple staph. MRSA was nasty. And with thousands of people descending on the town for the festival, an epidemic could overwhelm her. Either way, she concluded as she arrived at the clinic, she couldn’t rule out Josh’s jewelry idea. Lab tests would be needed.
For years, the Winston Medical clinic didn’t open Saturdays. Allison’s father had restricted his weekend practice to emergencies and to those whose work schedule simply wouldn’t permit another appointment. For Horace Wright, Saturday was for personal pursuits—golf, fishing or hunting, depending on the season. Having never been invited along and therefore having developed no such interests, his daughter had opened the clinic Saturdays, starting at 8:30 a.m. Not that she wanted to work all weekend, or even thought it was a good thing. But when someone needed treatment on a weekend, Allison didn’t have anything that took priority.
Coretha dabbed a drop of syrup from Allison’s blouse and handed her a lab coat.
“Coretha, do you remember if Wanda Faggart wore jewelry?” Allison asked.
“I’m guessing ‘yes.’ What woman doesn’t?”
“Don’t guess,” Allison snapped, immediately scolding herself for failing to suppress the impatience she’d despised in her father, a man who made no apology for prizing intellectual discipline over people’s feelings. She tried to make amends. “Look, I don’t remember, either. In any case, bring her back in. I want to write her a new script.”
Allison buttoned the lab coat and entered the examination room where Ricky Scruggs waited. “Thanks for coming,” she said.
“Had to.” He peeled off his shirt. “It’s acting up again.”
Allison pulled on gloves, carefully removed the dressing Scruggs had improvised. She probed the badly inflamed nipple with her fingers. Scruggs yelped as the pressure of her fingers expressed pus from the wound. She saved a sample and drew blood. The whole process took fifteen minutes.
“Where’s the ring?”
Scruggs hopped off the table, reached into his jeans pocket, extracted the ring and dropped it with a clink into a stainless steel pan Allison held.
“I’m guessing you wore it again after you left here,” Allison said.
“Until yesterday.”
She decided there was no point in reminding Scruggs that he’d disobeyed doctor’s orders. “I’d like to test it,” she said.
“Why?”
“To see if it’s causing your problems.” She rubbed the ring with a swab and put the swab and the ring in separate sterile lab containers.
There was a knock on the door. Coretha stuck her head in. “I have that information you wanted,” she said. Allison excused herself and stepped into the hallway.
“Faggart says she wears the normal stuff—necklaces, bracelets, a wedding ring,” Coretha reported. “Plus, get this, she used to wear a toe ring her grandchildren gave her.”
“Which toe?”
“I knew you’d ask. Fourth toe on the right foot. Maybe it was too tight and cut off circulation.”
“Could be. Or it may have had staph on it. Or it could be unrelated. The best we can say now is that all the patients did indeed wear jewelry. But like you say, who doesn’t? It’s not much of a connection. Have her bring it when she comes.”
“Too late,” Coretha said. “She sold it when she began having toe problems.”
Allison frowned.
“There is some good news,” Coretha said hopefully. “The hotel got back to me. Candi Cloninger did work as a waitress until a couple of weeks ago. But the only address they have is the same P.O. box we have for her.”
Allison didn’t think it was good news at all. The implications of a MRSA infection at the Sternwheeler were frightening. Hundreds of people might have been exposed—might still be being exposed—particularly if the bug was inhabiting the food-handling area. The miracle was that she’d seen only four cases. But that could be because most of the people at the hotel were just passing through. Any infections wouldn’t become apparent until they had returned home. She’d need to get the Sternwheeler to contact employees and recent guests. If management proved reluctant, which was possible, she’d have to appeal to the notoriously understaffed state department of public health.
On the other hand, there wasn’t enough evidence to ring the alarm bell just yet. Any alarm, even a false one, could put the place out of business. She needed more to go on. The MRSA determination needed to be made as soon as possible.
Allison made herself a note to have Coretha ask the hotel if they had had an employee named Audrey Pringle. She collected her thoughts and returned to the examination room. She checked Scruggs’s glands—they weren’t swollen—and stuck a thermometer under his tongue.
“Ever been to the Sternwheeler?” she asked.
Her stomach jumped when Scruggs nodded that he had.
The thermometer beeped. Scruggs had a slightly elevated temperature of 100.5 degrees.
“Recently?”
“You asking me out for a drink?”
“I have three other patients with infections like yours. Two of them work or used to work at the Sternwheeler. When were you last there?”
Scruggs looked at the ceiling. “Two years, at least.”
Relief mixed with concern. The hotel still should be checked for MRSA; Cloninger had worked there. But because Scruggs obviously had not acquired his infection there, she was back to square one. Perhaps her patients had indeed crossed paths—but somewhere else.
Aware she was likely violating patient privacy regulations, she asked Scruggs if he knew Faggart, Pringle, or Cloninger.
He didn’t.
Allison considered another tack and settled on Josh’s suggestion that jewelry tied her tissue death patients together. Unlikely as the theory was, it was true that Pringle wore earrings and had infected ear lobe
s, Cloninger had presented with bleeding and inflammation around her tongue stud and Faggart had lost the toe where she had worn a ring. “How did you acquire your nipple ring?” she asked Scruggs.
“What’s that got to do with anything?”
“Maybe nothing but there’s always a chance it’s the problem. I’d like to get back to the source and everyone they’ve sold to.”
“You’d like to get to the source? I paid two hundred dollars to that asshole!”
“Who?”
“Dude at the tattoo parlor—Spike—makes the pieces himself and sells ’em out of his car. Cheaper than the stuff they sell inside but just as good. Supposedly.”
“Lil’ Bob’s Body Art?” Everyone—likely including her patients—knew the place.
“That’s it.”
She finished cutting away the dead skin from Scruggs’s areola, stitched things back together in a way that would result in a minimum of scarring and gave Scruggs a more potent version of Bactroban that was thought to still be effective on MRSA. Just in case. She told him the lab would pick up his tests Monday, that they would take several days to process and that she’d call with the results.
“When do I get the ring back?”
“When we determine it’s safe.”
Allison called Josh at the paper as soon as Scruggs left.
“What are you doing tonight? I need to go to Lil’ Bob’s. I don’t want to go alone.”
“Getting a tattoo?”
“Hardly.” She explained her MRSA infection theory.
Josh weighed an evening home alone against another adventure with Allison and said, “I’ll be there.”
Allison’s last patient was Carl McGraw, a regional officer with the department of fish and game who had been snagged by a fishhook. Allison extracted the hook, gave McGraw a tetanus shot and applied a bandage—no stitches required and no charge. Allison was happy to accept McGraw’s thanks, but the truth was, hassling with the state reimbursement program was more trouble than it was worth.
As soon as the clinic closed, Allison slipped out of her khaki skirt and lab coat and into a snug pair of faded jeans and an Old Fashioned River Days t-shirt from three years back. She tossed Josh her keys when he arrived. “You drive.”
Fallout Page 9