Plague Ship (A Ballineau/Ross Medical Thriller)

by Goldberg, Leonard

  David walked slowly, staying in the center of the passageway, until he came to the rows of pipes and wires. Bending at the waist, he spotted the outer edge of the blanket-nest Will had built. He pulled the nest out and saw the motionless goose, with one of its wings drooped awkwardly off to one side. The sick bird looked dead. David unfolded the large plastic bag, then, using long forceps, grabbed the bird by its neck and lifted it up. The bird made a weak, squawk-like sound, but offered no resistance. David quickly deposited the dying bird into the large plastic bag, and spun the bag shut before clamping it tightly with a thin wire. Then he started up the stairs, holding the bird well off to the side. The bird began to move, and David wondered if it was strong enough to peck its way through the plastic. I should have killed the damn thing, he thought miserably. It still would have served its intended purpose.

  At the top of the stairs, David pounded on the steel door. Rutherford promptly opened it and handed in a large suitcase. Hurriedly David opened it and stuffed the bird in, then closed and locked it.

  “Rope!” David yelled.

  Rutherford tossed in the end of a long rope that David tied securely to the handle of the suitcase. He tested the knot to make certain it was firm.

  “Is the deck clear?” David called out.

  “All clear!” Rutherford called back.

  David kicked off the soaked towels on his feet, wiggled out of his hospital gown, and ripped away his masks, cap, goggles, and finally his gloves. Then he dashed out onto the deck, holding the rope attached to the suitcase well away from his body. The door slammed behind him.

  He sprinted across the deck to the railing and hoisted the suitcase over the side. Slowly he lowered it, giving out the rope a few yards at a time. Only now did he become aware of the large crowd that had gathered less than a hundred feet away. They watched in dead silence, all sensing that something terrible was happening or about to happen.

  David let the rope out a final five yards before tying it tightly to the railing. Then he trained his eyes on the horizon and waited.

  “Please, captain!” A voice pleaded from the crowd. “Tell us what’s going on.”

  Rutherford paid no attention to the request, and like David, kept looking out at the open sea.

  “Did a terrorist put a bomb aboard?” another voice in the crowd asked.

  “No, it’s not a bomb,” someone answered. “They would have just thrown it into the ocean if it was a bomb.”

  “Then what?”

  That question was met with silence.

  David glanced down at his wet tennis shoes and wondered if the virus had penetrated through the soaked towels. Shit! He groused and kicked the shoes overboard. Better safe than sorry, he reminded himself, thinking he’d do the same with the rest of his clothes as soon as he got the chance.

  David checked his watch. The Navy was late and twilight was setting in. If it became too dark, the Navy would have to abort the mission. And that would put them ten more hours behind, which could mean the difference between life and death to a lot of people.

  In the distance, David heard the sound of an approaching helicopter. He focused his hearing and picked up the distinctive putt-putt noise of a Seahawk. The Navy was sending in one of its rescue teams! A speck on the horizon grew larger and larger as the noise intensified. Then the helicopter appeared and swooped down a hundred yards starboard of the Grand Atlantic. It hovered over the ocean while a rescue team dropped into the sea, followed by an inflatable Zodiac. Moments later, the team was speeding toward the luxury liner.

  The crowd began to applaud, as if the Navy was coming to solve whatever problem existed.

  The rescue team came alongside the hull and signaled up to begin lowering the suitcase. David untied the knot from the railing and slowly began to let out the rope. The Navy team opened a large metal container and guided it into a position that allowed the suitcase to drop directly into it. Then the container was closed and hermetically sealed. Another Zodiac came up, carrying a stack of big cardboard boxes. One by one, over the course of ten minutes, the boxes were attached to dangling ropes and hauled up onto the deck of the Grand Atlantic. When the last carton was aboard, David gave the Navy team a thumbs-up signal and watched them speed away to their waiting helicopter.

  Rutherford moved in next to David and said quietly, “We’ve got to tell the passengers something. They won’t stand for our silence much longer.”

  “I know,” David agreed. “Let me do it.”

  David approached the crowd of onlookers. He stared at them for a moment, carefully choosing his words and deciding to be as direct as possible. The crowd stared back, all expecting the worst.

  “Listen up!” David said in a commanding voice. “I’m Dr. Ballineau, and I’ve got good news and bad news. The bad news is that we believe there’s been an outbreak of bird flu aboard the Grand Atlantic. It’s already sickened six people, and it’s likely to infect a lot more.”

  A string of loud murmurs went through the crowd.

  “Oh, Jesus!”

  “We’re all going to die!”

  “I want off this damn ship!”

  David held up his hands and quieted the crowd before continuing. “The good news is that the Navy has delivered us a good supply of specialized masks, which we’ll all wear and which will prevent us from catching or transmitting the virus.”

  “The hell with that!” a voice bellowed. “I want off this goddamn boat now!”

  A chorus of onlookers joined in, all demanding to be let off the luxury liner.

  David ignored the outburst and went on, “In addition, the Navy dropped off a large supply of Tamiflu, which of course protects the individual against the influenza family of viruses. It’s a pill, easy to take, and has no side effects.”

  The crowd murmured its approval. Some applauded.

  “All right!”

  “Now you’re talking!”

  “I took it before. It worked like a charm on my flu.”

  The mood lightened even further. More and more people in the crowd applauded, delighted with the good news.

  But David didn’t join in. Lawrence Lindberg had told him that a sizable proportion of patients with avian influenza didn’t respond to Tamiflu or any other antiviral agent. They just got sicker and sicker and, despite all measures, they died.

  ten

  The turnout of doctors from the passenger list was disappointingly small. Carolyn glanced at the two physicians sitting at the conference table and again decided that neither would be of much help. One was an elderly, retired surgeon who’d had a stroke and required a walker to get around, the other a middle-aged radiologist who never saw patients, only their x-rays. And no nurses, Carolyn grumbled to herself. If the virus continued to spread, patients would stack up, and there’d be far too few personnel to start IVs and check vital signs and adjust oxygen flow rates and perform a dozen other critical functions. God! Let the Tamiflu work!

  “What’s the delay?” the old surgeon demanded. “You don’t need specialists to pass out some pills.”

  “I know,” Carolyn said soothingly. “But Dr. Ballineau thought it best to gather as many experienced hands as possible.” Then she added in a more somber tone, “Just in case there’s a need.”

  “And who is this Dr. Ballineau?”

  “He’s director of the emergency room at University Hospital.”

  The surgeon straightened up in his chair. “University Hospital in Los Angeles?”

  “Yes.”

  The surgeon and the radiologist exchanged firm nods, a silent message passing between them.

  Oh yes! Carolyn thought without expression. University Hospital in Los Angeles were magic words to any medical professional. Like the Mayo Clinic and Johns Hopkins, University Hospital was among the very elite of medicine, and everybody knew it. But so what? Carolyn thought on. In the situ
ation they were in, reputation didn’t matter a damn, particularly to a killer virus.

  There was a brief knock on the door.

  “Ah! A third,” Carolyn murmured to herself, hoping for an internist with experience in critical care.

  The door opened, and a strikingly attractive woman entered the conference room. She was in her late thirties, with deep blue eyes and ash-blond hair that was held back in a ponytail. Her tight-

  fitting tennis outfit revealed graceful legs and a curvaceous figure.

  Carolyn was stunned speechless. It took her a moment to collect herself. “Hi, Karen.”

  “Hey, Carolyn!” Karen Kellerman flashed a smile that showed pearly white, perfectly even teeth. “I didn’t expect to find you aboard the Grand Atlantic.”

  “Nor I you.”

  “Is—ah—David with you?”

  “He sure is,” Carolyn said and wished that David had bought her a diamond ring at Bulgari on the shopping level of the ship rather than waiting for them to return to Los Angeles. God! She’d love to show it now and watch Karen Kellerman’s reaction. “But he’s tied up with some very sick people.”

  “How many?” Karen asked at once.

  “Six, but only one with full-blown avian flu,” Carolyn replied. “But there’ll be a lot more if the virus spreads like David thinks it will.”

  “But we’ve got Tamiflu now,” the old surgeon interrupted.

  “Right, you are,” Carolyn said, annoyed that she’d been so loose-tongued. “I was only doing a worst-case scenario.”

  “Well, let’s wait for Dr. Ballineau to give us facts instead of your off-the-cuff scenario,” the surgeon huffed. “We need an expert here, not a nurse.”

  Carolyn’s face colored. Fucking surgeons! They always have to be in control, even when they’re not in control. And the old doctor was probably ignorant as could be about avian flu and how it could spread and how ineffective most treatments were. Carolyn took a deep breath and let her anger pass, remembering that the elderly surgeon came from another generation in which nurses wore caps and white, starched uniforms, and followed physician’s orders with obedient nods, and never voiced an opinion unless asked. That wasn’t another generation. That was another world.

  Her gaze drifted over to the oval conference table in the center of the room. The two male physicians were introducing themselves to Karen Kellerman and drooling over her. Karen did that to men, all men, including David. The two had once been lovers until David discovered that Karen was a liar and a thief. The co-director of anesthesiology at University Hospital was so pretty and, according to David, so dishonest. And so stupid, Carolyn added on, to lose David over an invention Karen could easily have shared with him.

  Carolyn thought back to the distasteful episode that she’d first heard about in hospital gossip. David had filled in the details later. He had come up with an idea for a portable cooling blanket that would be particularly useful in MedEvac helicopters transporting patients with sky-high fevers. Unbeknownst to David, Karen took the idea, redesigned the blanket with a few modifications, and sold the patent to a large corporation that manufactured medical equipment. David was furious at her dishonesty, and from that point on he rarely spoke to her and only when he absolutely had to. He vowed never to forgive her, and never had.

  The door to the conference room suddenly opened and David hurried in. He was carrying a carton of N-95 high-filtration masks and a handful of Tamiflu packets. He quickly counted the backs of the heads at the conference table and dashed over to Carolyn.

  “Is that all we’ve got?” David asked in a whisper.

  Carolyn nodded and whispered back, “And two of them aren’t going to be of much help. One is an old, retired surgeon who has had a stroke, the second is a radiologist.”

  “Shit,” David muttered. “And the third?”

  “Surprise of all surprises. It’s Karen Kellerman.”

  David jerked his head around and stared at the anesthesiologist for a few seconds before waiting. “Hello, Karen,” he said neutrally.

  “Hello, David,” she said back and gave him her best smile. “It’s nice to see you again.”

  David nodded indifferently, disliking her as much as ever, but still struck by her beauty. “Are you traveling alone?”

  “Yes, as a matter of fact, I am,” she said, with a mischievous lilt.

  “That’s unfortunate,” David said. “It would help us if you were traveling with another doctor from University Hospital.”

  “I’ll keep that in mind next time I board a luxury liner,” Karen retorted. “Just in case there’s an outbreak.”

  She was still very quick, David thought. Too bad some of her other qualities were so unappealing.

  Karen crossed her legs and her tennis skirt slipped farther on her thighs. David was careful to keep his eyes trained on her face. But despite his effort, his gaze dropped and he felt himself stir. Quickly David turned to the other physicians.

  “We’ll save the introductions for later,” he began. “For now, I’ll pass out packets of Tamiflu, which you should take as directed. I also have N-95 masks, which should filter out viruses. Please wear them at all times until further notice.”

  “Are the masks really necessary?” the old surgeon asked, fumbling with the duck-billed mask because of his palsied hand. “The Tamiflu should protect us since we’re all still asymptomatic.”

  “Maybe it will, maybe it won’t,” David said, recalling Lawrence Lindberg’s words of caution. “The CDC still doesn’t know where the bird got infected or why this virus suddenly acquired the ability to infect humans so readily.”

  “What the hell does the origin of the virus have to do with anything?” the old surgeon groused.

  “Well,” David said slowly, “let me give you the nightmare picture. There is currently an ordinary influenza A virus in Scandinavia that has become resistant to Tamiflu. Maybe a pig picked up this human virus in Scandinavia, then combined it with the avian flu virus that was already in its body. Now you’ve got a mutant virus that’s half human flu virus and half bird flu virus, and it’s resistant to Tamiflu. The end result is a mutant that infects like the human flu virus and kills like the bird flu virus. And maybe the pig that has this mutant virus transmitted it to the infected bird that landed on the Grand Atlantic. That being the case, we could well be facing a highly contagious, deadly virus for which there is no treatment.”

  A chilled silence went through the room.

  “Are you saying this virus may be resistant to Tamiflu?” asked Thomas Steiner. The radiologist was a portly, balding man, with gray-brown hair and wire-rimmed glasses. He cleared his throat and asked again, “Is that what you’re saying?”

  “Yes,” David said straightforwardly. “That’s exactly what I’m saying.”

  “But that’s all hypothetical,” Steiner persisted. “Right?”

  “Right,” David answered. “But let me tell you what’s not hypothetical. We’ve got a deadly virus aboard this ship, and it can be transmitted person to person.”

  “Whoa!” Karen interrupted. “The only person who has the full-blown disease is the boy who had direct contact with the bird. All the others probably caught it through the ventilation system. And that problem has been solved since the infected bird is gone and no longer transmitting the virus via the ventilation ducts. Thus, there’s no evidence for person to person transmission.”

  “There you go!” Steiner agreed strongly. “The source of the virus is no longer on the ship, so transmission to passengers won’t be a problem.”

  “Damn masks won’t work anyway,” the old surgeon chimed in.

  “You’d better hope they do,” David warned. “Because there’s still a source of that virus that could reach the ventilation system.”

  “Which is?” Karen asked.

  “Anyone who is infected and coughing,” David replie
d. “If you can catch if from the ventilation system, that means the virus is airborne. And that means anybody coughing up virus-laden droplets can infect the person standing next to him. Which means person to person transmission any way you cut it.”

  “Which means we could all get infected with a Tamiflu-resistant virus,” Karen said, her face now horror-struck.

  “Yeah,” David said bluntly. “And that’s more than hypothetical, according to the CDC.”

  “When will we know if this virus is resistant to Tamiflu?” Steiner asked nervously.

  Karen replied, “When the CDC finishes its tests on the bird, however long that takes.”

  “Or maybe sooner,” David told the group. “If passengers taking Tamiflu start coming down with bird flu pneumonia, we’ll know the virus is resistant.”

  “And we’ll all know we’re aboard a plague ship,” Steiner added darkly.

  “This is not in any way the plague,” Karen corrected.

  “I was using the term plague ship in a generic form,” Steiner said. “In the Middle Ages, a plague ship carried either the dead or people dying with an infectious disease so as not to infect other members of society.”

  “But…but,” the old surgeon stammered, “when we make port, surely they’ll let us disembark so the sick can be attended to.”

  David shook his head slowly. “They’ll never let us in, not with the prospect of starting a pandemic caused by a Tamiflu-resistant, bird flu virus.”

  All eyes stayed fixed on David, but he had nothing more to say. Instead, he put on a high-filtration mask and secured it in place.

  The others quickly followed suit.

  eleven

  “Dad, can I go see Will?” Kit asked.

  “It’s best you don’t, sweetheart,” David replied. “He’s really sick with the flu and you sure don’t want to catch it.”

  Kit thought for a moment. “But I can visit him after he gets better, huh?”

  “Absolutely,” David lied, straight-faced.

  “Maybe I’ll just send him some candy for now.”