Plague Ship (A Ballineau/Ross Medical Thriller)

by Goldberg, Leonard

  “I thought it best to put her in my room.”

  “Good.”

  “You should examine Juanita to see if she really has bird flu,” Karen suggested.

  “I will shortly,” David said. “But there is something very important I must do first.”

  “What?”

  “Find out if there’s any way to treat her,” David said and hurried into the elevator.

  fourteen

  There was a prolonged silence on the phone line connecting the Grand Atlantic with the Centers for Disease Control in Atlanta. David and Karen stared at the speakerphone and waited for a response.

  “They’re in a real quandary,” Karen whispered in David’s ear. “They’ve never encountered anything like this.”

  “Nor has anyone else,” David whispered back.

  They were sitting in a small communications room that was adjacent to the bridge. Except for an oval, teak table and chairs, the windowless room was unadorned, with no ornaments or special electronics other than a flashing green light atop the phone that indicated the line was secure. The room was designed to be private and used only for extraordinary circumstances.

  Suddenly a burst of static came over the speakerphone. In the background, they could hear isolated words, which sounded like isolation and quarantine. This was followed by a chorus of muttered, unintelligible phrases.

  Karen asked quietly, “Do you think they’re trying to come up with ways to get us ashore?”

  David shook his head. “More likely they’re devising plans to keep us out in the middle of the ocean.”

  “Can you imagine the public outcry if they learned the CDC was doing that to us?” Karen paused to swallow back her growing fear. “It would be like an execution order for everyone aboard this ship.”

  David shrugged. “The public won’t be that upset. It would be a choice of their survival or ours. Which do you think they’d choose?”

  Karen rested her head on David’s shoulder and said, “I’m getting scared out of my wits.”

  “Welcome to the club.”

  “You’re really not frightened, are you?” She glanced up at his face and studied it briefly. “How come you never show fear?”

  “It’s a genetic defect.”

  A faint smile came to Karen’s face, then faded. “Did they teach you how to do that in Special Forces?”

  “I guess,” David answered, but he knew the trick wasn’t to mask fear, but rather to push it into a side compartment of your brain and ignore it and not let it interfere with the task at hand. You can shake and scream later. Or have flashbacks. He felt Karen nestling her head against him, her warm breath brushing by his ear. For a moment, it caused him to shiver pleasantly. He peered over to Karen, with her gorgeous face and slim body, and again realized there would always be a part of him that was attracted to her. There was no getting around that. But, like fear, he would push the feeling into a side compartment of his brain and ignore it.

  Lawrence Lindberg’s voice came over the speakerphone. “Dr. Ballineau, I’m sorry about the delay, but we’re trying to develop a plan that will save as many passengers on the ship as possible yet keep the virus from spreading to the mainland. I think you can appreciate the difficulties we’re facing.”

  “Concern yourself with saving the lives of the passengers,” David said bluntly. “The virus can’t reach land as long as we’re at sea.”

  “Your point is well taken,” Lindberg said. “And of course our primary focus will be on the passengers aboard the Grand Atlantic.”

  Bullshit! David thought, but remained silent.

  “First, there are a number of questions we still have,” Lindberg went on. “And we need specific answers. If you don’t know, say so.”

  “Get on with it,” David growled impatiently.

  “Are you certain the sick passengers took their Tamiflu capsules?”

  “I’m certain the captain of the ship did,” David replied. “I asked him specifically, and, to be sure, I checked his blister pack of Tamiflu. The correct number of capsules were missing. And the little boy who died was started on the drug within twenty-four hours of his initial symptoms.”

  “What about the others?”

  “I’ll have to ask them,” David said. “But I’ll bet they did because they’re really frightened. They’re facing death and they know it.”

  “Please check for us.”

  “I will.”

  “And keep in mind that Tamiflu is not a cure,” Lindberg continued on. “In most patients it will only make their illness somewhat shorter and less severe. Now that may not seem like much, but it could make the difference between life and death.”

  “What about other antiviral agents if the virus proves to be resistant to Tamiflu?” David asked, glancing down at a list of questions he had for the experts at the CDC.

  “The virus is being tested against a variety of such agents, including Relenza, Ribavirin, and M2 ion channel blockers,” Lindberg said. “Hopefully, the virus won’t show resistance to these as well.”

  “And if it does?”

  “Then our problem becomes magnified a hundredfold.”

  David and Karen exchanged knowing glances. The prospects for their survival were looking dimmer and dimmer.

  “But even in that case, it is still possible to avoid the disease,” Lindberg went on. “The N-95 masks can be very protective. They’re not perfect, but they will be your best chance to keep the virus at bay.”

  David leaned toward the speakerphone, bothered by Lindberg’s phrase They’re not perfect. “When we talked initially, I was told the N-95 masks offered excellent protection. Has something happened to change that?”

  “Not really. The masks are quite good, but not perfect.”

  “Define ‘quite good,’” David pressed.

  “In the best-controlled study from China, the masks protected 75 percent of the individuals exposed to the influenza virus.”

  “Were they exposed to the high concentration of virus that the passengers aboard the Grand Atlantic will encounter?”

  There was a long pause before Lindberg answered, “Probably not.”

  David groaned inwardly. The N-95 masks weren’t working nearly as well as he had hoped. With a sky-high concentration of avian flu virus in the air, the infection rate on the ship could easily surpass 50 percent. That would amount to over four hundred very sick patients. Shit!

  “Ballineau? Are you still there?”

  “Still here,” David said, coming out of his reverie. “Are you finished with your questions?”

  “Yes.”

  “Good, because I’ve got a lot of things to discuss with you.” David again glanced down at the list he’d prepared earlier. “First, we need more N-95 masks. The passengers are taking them off because the filters become clogged and they can’t breathe through them.”

  “Oh, no!” Lindberg raised his voice. “They must keep them on at all times!”

  “Have you ever tried to breathe through a mask that’s filled with bloody sputum?”

  “I’ll see that you’re supplied ASAP.”

  “Next, we’ve already had one death, and there are surely more to follow. We should keep them isolated so they don’t serve as a reservoir that continually contaminates the ship. Unfortunately, we don’t have a satisfactory storage area, and burial at sea doesn’t sound like a good idea.”

  “No burials at sea!” Lindberg demanded sharply.

  “That’s what I figured,” David said. “Do you think it could infect the ocean’s food chain?”

  “Perhaps,” Lindberg told him. “But an equally terrifying prospect is that migratory birds might see the floating bodies and decide to feed on them. Then we’d have infected birds flying to all the continents.”

  David shuddered at the thought of infected birds travelin
g up and down the great flyways of North and South America. The birds would represent the perfect way to start and perpetuate a worldwide pandemic. And, as long as there were birds, the disease would persist. A nightmare! A nightmare come true!

  David refocused his mind on solving the body problem. “The safest way to deal with the dead is to place them in body bags, which you’ll have to supply us with.”

  “Done.”

  David’s eyes went to the last item on his list. “And finally, I’ve set up a quasi-isolation plan for the ship, which consists of the following. All infected passengers will stay in their rooms and have food and medicines delivered to them. The others will be told to avoid any gatherings or crowds and wear their N-95 masks at all times.”

  “How will you keep an accurate record of those who are sick and should be confined to their rooms?”

  “Let me think about that for a moment.”

  “Take your time,” Lindberg said. “But also come up with a mechanism to alert everyone that a particular room has a sick person in it and will be heavily contaminated with the virus.”

  David concentrated his mind for several seconds, then nodded to himself. “I’ll have the doors of the sick marked with a splash of red paint.”

  “Kind of like Passover,” Lindberg remarked without humor.

  David nodded again as he recalled the Jewish holiday of Passover, in which God punished Pharaoh by instructing the Angel of Death to kill the firstborn male of every Egyptian family. Those to be spared had their doors splashed with the blood from a lamb and would be passed over. But aboard the Grand Atlantic, the Angel of Death would be visiting those with a red mark on their door.

  At length, David said, “And I have one final request. As you can imagine, the medical staff we have is already overwhelmed with the sick and dying. Besides myself, there’s only a nurse, a radiologist, an anesthesiologist, and the ship’s doctor who is old and a bit fragile. Add to that a poorly equipped sick bay, and you can see the problem we’re facing.”

  “I guess there are some ways we could arrange for some ventilators and monitoring equipment to be delivered—”

  “That won’t help!” David cut him off. “All the equipment in the world won’t help, because we don’t have the staff to set it all up and monitor the patients. From a clinical standpoint, only the nurse, the anesthesiologist, and I can look after the really sick patients. What we need is more medical personnel.”

  There was a very long pause before Lindberg spoke. “I’m afraid that won’t be possible until we know whether the virus is sensitive to the agents we have available. For now, the only personnel who would be allowed to come aboard would have to be wearing Biosafety Level 4 outfits, which require space suits and an external oxygen supply. It simply can’t be done.”

  “Yeah, I guess,” David said, making no effort to hide his disappointment.

  “Let’s hope the virus responds to one of our antiviral agents,” Lindberg said tonelessly. “Until we know the results of our studies, you’ll have to get by on your own. We’ll of course be available 24/7 to help with any new problems.”

  “Get back to us on those test results ASAP.”

  “Will do.”

  The phone line went silent. The light atop the speakerphone stopped flashing and turned from green to red.

  Karen looked over to David and asked, “What do you think?”

  “I think Lindberg just told us that we’re all dead.”

  fifteen

  “Breathe through your mouth,” David instructed the nanny. “Take long, deep breaths.”

  Juanita inhaled deeply, then exhaled slowly. She repeated the cycle twice before her cough kicked in. After swallowing back her sputum, she adjusted her N-95 mask and mumbled, “Sorry, Dr. Ballineau.”

  “No problem,” David said and continued listening to her chest with a stethoscope. He heard some scattered, coarse rhonchi, but only a few wheezes. And again he noticed that her skin color was good. He put his stethoscope in his pocket and smiled at the nanny, who was dressed in a bathrobe and sitting on the edge of her bed. “Your lungs sound good.”

  “I have the disease, don’t I?” Juanita asked, as if she already knew the answer.

  “I’m not sure,” David told her. “It could be just a routine virus.”

  “I have the disease,” Juanita repeated. “I am certain.”

  “Oh?” David raised an eyebrow. “Which medical school did you graduate from?”

  Juanita smiled weakly, then had another coughing spasm. She paused to catch her breath before saying, “You must not tell the Little One. It will cause her to worry and cry.”

  “I will tell her it’s only a cold,” David proposed.

  Juanita shook her head. “She will know you are not telling the truth. Like her mother before her, she will see right through you.”

  David nodded at the veracity of Juanita’s words. He had always considered himself a good liar, but Marianne could always sense he was not telling the truth. She said she could read it in his eyes. And apparently so could Carolyn, and so could Kit. “I will say you have a cold, but there’s a possibility it’s the disease.”

  “A half-truth,” Juanita sighed as she lay back on her pillow. “You will see to it that I am buried in Costa Rica.”

  “You are not going to die so soon.”

  “That’s for God to say, not you.”

  “Well, God isn’t talking to us,” David groused. “He must be on vacation because He sure as hell isn’t aboard this ship.”

  “Sacrilege!” Juanita raised her voice and made the sign of the cross.

  David shrugged. “Whatever.”

  Juanita began to cough again but, with effort, suppressed it. “I wish to be buried with my family in Cartago, which is just southeast of San José. You will remember?”

  “I will remember.”

  Juanita closed her eyes and said, “You should go look after the Little One.”

  David left the cabin and hurried down the passageway, still wondering if Juanita really had avian influenza. She wasn’t nearly as sick as the others, and her lungs sounded relatively good. But, then again, she would be in the early stages of the disease, and all hell could still break loose. And if she had the killer virus, she most likely caught it from her close contact with Will, while chaperoning Kit. But if that were the case, why didn’t Kit have the disease? Once more he tried to come up with reasons why Kit was being spared. Was she lucky? Or somehow immune to it? Or was the goddamn virus incubating inside her, waiting to explode? The last thought sent a giant shiver through David. For a moment, he envisioned Kit’s face turning purple as the vicious virus destroyed her lungs and deprived her of oxygen. He shook his head and forced the awful image from his mind.

  David came to Karen’s suite and, after taking a deep breath to compose himself, knocked on the door and entered. Kit and Karen were sitting on the sofa, thumbing through a fashion magazine. Kit’s raven hair had been braided into a ponytail, no doubt by Karen. Women! David mused to himself. They know how to push all the shit in life aside. That’s why they outlived men.

  “Hi, Dad!” Kit jumped up and dashed over to give him a tight hug.

  “Hi, sweetheart!” David hugged her back and gazed at her ponytail, as if giving it careful study. “Your new hairdo looks great!”

  “Karen did it for me.”

  “I figured.” David looked over at Karen and winked, then came back to Kit. “So tell me, how are you feeling?”

  “I’m fine,” Kit replied brightly.

  “No fever?”

  “No fever.”

  “No cough?”

  “No cough.”

  “Any scratchy—”

  “Dad!” She interrupted, now becoming exasperated. “I feel fine. Really!”

  “Just checking.”

  Kit stared up at
her father’s face and tried to read it. “You’re worried about Juanita, aren’t you?”

  “It might only be a cold,” David said evenly.

  “But you think she’s got the nasty virus, huh?”

  “We’ll see.”

  Kit studied his face even more intently, then tears welled up in her eyes. “Please don’t let anything bad happen to her, Dad. Please!”

  “She’s doing okay so far,” David said, trying to comfort her, “and that’s a good sign.”

  “But—but Will was okay too,” Kit countered. “At least he was at first.”

  She’s so damn smart, David thought before saying, “But his symptoms were different.”

  Kit nodded slowly, only half-convinced. “Is Will feeling any better?”

  David hesitated, not wanting to be the bearer of bad news. But Kit would learn of Will’s death from others soon enough, and it was better she heard it from him. “He didn’t make it, sweetheart. He passed away in his sleep.”

  The tears gushed out. Kit rushed back into his arms and sobbed, “Daddy! Oh, Daddy!”

  “He put up a brave fight,” David consoled softly, “but it was just too much for him.”

  “Do—do you think he’ll go to heaven, Dad?” Kit cried.

  “I’m sure of it,” David replied. “And I’ll bet God lets him take care of all the little animals up there.”

  Kit sniffed back her tears and smiled faintly. “Do you really think so?”

  “I really think so,” David reassured, then slowly ran his hand through her hair. “Now we have to take extra precautions to make sure we don’t catch the virus. Okay?”

  “Okay,” Kit said, wiping her runny nose with the back of her hand. “I’ll wear my mask all the time.”

  “Good,” David encouraged. “And remember to take your Tamiflu pills and to stay in here unless you absolutely have to go out.”

  “Should I check on Juanita?”

  “Nah. She’ll be sleeping most of the time anyway.” David took her hand and led her to the bedroom. “Why don’t you lie down now and take a little nap. It’ll be good for you.”