The Blood Betrayal

by Don Donaldson

  “That’s why I left Artisan.”

  Carl had wanted to start pumping her for information about her hometown as soon as he saw her. But he wasn’t a clod. He knew there was a rhythm to these things. Still, now that she had introduced the subject, he jumped in.

  “How long have you lived in Artisan?” he asked, backing out of his parking slot.

  “We moved there when I was fifteen.”

  “Where’d you live before that?”

  “Davenport, Iowa.”

  Carl put the car in drive and pulled into the street. “What brought your family to Artisan?”

  “My father was a cabinet maker, and there was an opening at the furniture plant. We’d had our house broken into in Davenport, and he wanted to move to a safer place. The insularity of Artisan appealed to him.”

  “Any brothers or sisters?”

  “No. I’m it. What about you?”

  “I guess when my parents saw what they were capable of producing, they decided one was enough.”

  “Did you always want to be a doctor?”

  “Yeah, I think I did.”

  “What kind of doctor are you? I mean what’s your specialty?”

  “Internal medicine and hematology.”

  “Hematology . . . I know that word. So some of your patients are people with blood problems.”

  “They were when I was still seeing patients.”

  “Why aren’t you seeing them now?”

  Carl glanced over his shoulder, then changed lanes to get around a dawdling vehicle whose driver was so short his head barely came to the top of the steering wheel. “I’ve moved into a research career rather than direct patient care.”

  “What kind of research?”

  “I’m trying to develop an artificial blood that can be stored as a dry powder at room temperature and won’t require compatibility testing before it’s used on someone.“

  “That sounds worthwhile. But do you miss the patients?”

  Carl hesitated. He tried not to think about his former life much. But now Beth had asked the question, he realized he did miss that part of it. “A little, I guess.”

  “Would you ever go back to practicing again?”

  “I can’t.”

  “Why not?”

  “Someone in my care died from a bacterially contaminated blood transfusion.”

  “Is that common . . . for blood to be contaminated?”

  “Very rare.”

  “How could you have known something was wrong before you used it? Can you look at the blood and tell?”

  Carl hesitated. “Maybe.”

  “What do you mean?”

  “It’s not a clear solution, so any turbidity would be difficult to see.”

  “And bacteria produce turbidity?”

  “Usually.”

  “Is there no test to detect bacteria in blood before it’s put into someone?”

  “None that any blood bank in this country uses.”

  “Were you in charge of the blood bank?”

  “No.”

  “So how are you responsible?”

  “It was my patient.”

  “Forgive me for butting into something that’s none of my business, but I don’t believe you were to blame for what happened. The system didn’t allow you to avoid that death.”

  “I know, but I just don’t want to be part of anything like that again.”

  “Can bacteria grow in a dry powder?”

  “Highly unlikely.”

  “Well then, when you finish your research, what happened to your patient will never occur again.”

  “Exactly.” Carl couldn’t believe he’d just told a woman he’d known for only a few hours something that personal. How had the conversation turned so completely from the direction he’d intended?

  He turned into the parking lot of Little Saigon and pulled up to an open slot next to the restaurant’s narrow herb garden between the asphalt and the paint store next door.

  Inside, they were greeted by a chunky Vietnamese woman who had waited on Carl so often that she always welcomed him with an effusive barrage of confusing chatter. She showed them to a non-smoking booth on the far side of a tall aquarium full of goldfish by the door and gave them menus. She once again launched into some incomprehensible joke that seemed to be about Carl’s fondness for egg foo young, then, still laughing about it, said, “Wha’ you lit’ a drink?”

  Carl looked at Beth to let her respond first, then seeing the confused look on her face, he translated. “Would you like iced tea, hot tea, soft drink?”

  “Hot tea, please.”

  “Same for me.”

  When the waitress was out of earshot, Beth leaned across the table and whispered, “Where did you learn to speak Vietnamese?”

  “I think that was English,” Carl whispered back. “I still only get about ten percent of what she says. So I smile and nod a lot when I’m talking to her.”

  Beth opened the menu and gasped. “There are so many choices. What should I have?”

  “The egg foo young is good.”

  “What’s that?”

  “It’s sort of like an omelet only different.”

  “I think I want something more exotic.”

  “How about shrimp in chili sauce with lemon grass?”

  “Yes,” Beth replied, her eyes wide with anticipation. “I’ll have that.”

  The waitress brought their tea and took their orders, merely nodding when Carl ordered the shrimp for Beth, but chuckling when he requested egg foo young for himself.

  As Beth’s eyes traveled over the restaurant’s décor, which actually wasn’t all that special, her face radiated pleasure. Though he wanted to get back to the subject of Artisan, Carl sat for a few moments just enjoying watching her.

  Finally, finished with her perusal of the place, she looked at him. “Thank you for bringing me here. I love it.”

  “My pleasure.”

  When Carl first met Beth, she’d seemed reluctant to talk about Patrick Meggs. Hoping that she might now be more willing, Carl broached the subject again. “How well do you know Meggs?”

  She shrugged. “I see him three times a year for my physical, but other than that . . .”

  “Three times a year. Why so often?”

  “I don’t know. That’s just the way we do things.”

  “What’s your opinion of him?”

  “He’s okay. But I think he could have been more patient in explaining the cause of my husband’s illness when he died.”

  “What did he say was the problem?”

  “Something about an infection in his brain.”

  “Did he use the word meningitis?”

  “Yes. That’s what he said.”

  “So it all started with a fever, headache, and a stiff neck?”

  “No. We first noticed some sores on his legs, then spots of blood appeared in his eyes.”

  Sores on his legs? Carl leaned forward hard, his elbows on the table. “Do you remember if he said what kind of meningitis it was? Bacterial or viral?”

  “Bacterial.”

  “You’re positive?”

  Picking up on the skepticism in Carl’s question, Beth’s brow furrowed. “I’m sure of it.”

  “Did he put you on a course of antibiotics after your husband was diagnosed?”

  “No. What are you thinking?”

  “Bacterial meningitis is contagious, particularly between people who live in close relationship to each other. I don’t understand why he didn’t prescribe an antibiotic regimen for you to make sure you didn’t get it too. Unless . . .”

  “What?”

  “The symptoms you described are not those of meningitis.
If your husband actually had something else that wasn’t contagious, you wouldn’t have needed an antibiotic.”

  “You’re suggesting Meggs knowingly lied to me about what was going on?”

  “I can’t say. I suppose it’s possible he’s just a lousy doctor who not only misdiagnosed your husband’s illness, but also wasn’t aware of the proper procedures to follow for family members of people with meningitis.”

  “You believe that?”

  “No.”

  “Why not?”

  Carl hesitated. The symptoms she described were probably the way Benjamin Rasco’s DIC began. Was that a coincidence? It seemed unlikely. Coupled with the cryptic notes containing Meggs’s name in his father’s book, the reasons to be wary of this guy were quickly mounting. But he didn’t yet feel comfortable enough with her to get into all that. So he simply said, “I don’t even know the man. I shouldn’t be impugning his abilities or his character without direct knowledge of the details.”

  “That’s fair, but what you’ve said makes me wonder.”

  Further discussion of the matter was interrupted by the arrival of the food. Carl introduced Beth to the custom of sharing dishes, and she had to admit, egg foo young wasn’t much like an omelet at all.

  While they ate, Carl’s thoughts sifted and sorted what little he knew about Artisan and Meggs. But all he accomplished was to be a poor dinner companion. Beth seemed so interested in her food and the surroundings she appeared not to notice.

  Later, waiting for the bill, Carl again picked up the conversation. “I’m sorry for reminding you earlier about your husband. I’m sure that was a terrible time for you.”

  “It was. But in a way, the two years since it happened have been worse.”

  “You mean being by yourself?”

  “Yes. There are very few single people in Artisan, so when a husband or wife passes away, the remaining spouse has little choice but to remain alone or marry someone they aren’t really attracted to.”

  In apologizing, Carl had reintroduced the topic he was apologizing for. Feeling dumb about that, he tried to move to a different subject. “I didn’t see a school in Artisan. Considering how the town likes to keep to itself, I guess there must be one.”

  “There is, but it hasn’t been used in years.”

  “Why not?”

  “There aren’t any children in Artisan.”

  “None?”

  “The flu that killed the older people also took all the kids. And there haven’t been any born since. Apparently, everyone left is sterile.”

  Carl gripped the table. “Both the men and the women?”

  “Yes.”

  This news hit Carl with a jolt that gave him an idea. “Remember me telling you I came to Artisan to find out why Benjamin Rasco had such unusual blood cells?”

  “Yes.”

  “What you just said about the aftereffects of the flu on those who survived . . . Maybe the bug that caused that flu altered the survivor’s bone marrow, the place where the blood cells are made.”

  “I don’t know anything about such things, but it sounds reasonable.”

  “Would you be willing to help me find out?”

  “You want to look at my blood?”

  “It wouldn’t hurt. I’d just need a little from the tip of your finger.”

  “I’d like to know the answer to that question myself. When did you want to do it?”

  “How about right now?”

  Chapter 7

  CARL PAUSED AT Arkansas Pharm’s security checkpoint, rolled his window down, and let the night attendant identify him.

  “Hello, Dr. Martin. Go right on in.”

  “Thanks, Adam. Don’t get too chilly out here.” Carl pulled away from the gate and headed for his parking slot around on the left side of the building.

  “This is where you work?” Beth said, looking at the sprawling four-story structure, where lights were on in many of the labs. “It’s huge.”

  “One of the largest pharmaceutical companies in the world.”

  “How does it feel to be a part of something that big?”

  “I don’t think much about it. It’s like most things in life, once you’re involved in something, you just accept it as normal.”

  “Like living in Artisan.”

  “Same thing, I’m sure.”

  Carl parked, and they both got out and walked to the side entrance, where Carl slid his ID into the card reader. There was a buzzing sound as the lock on the glass doors disengaged.

  Inside, Beth was obviously overwhelmed by the amount of golden-hued granite on the walls and floor. “This is like a palace,” she gushed. “I can’t believe such a place exists so close to Artisan.”

  “She doesn’t get out much,” Carl said to the east wing night security guard watching them from behind his little fortress.

  “I’d like to find one like that myself,” the guard said.

  Carl ushered Beth into one of the waiting elevators and pushed the button for the third floor.

  Beth laughed at the sensation as they were swept upward. “That feels odd.”

  “Don’t tell me you’ve never been in an elevator before.”

  “There are a couple at the furniture plant, but they’re slow, so you don’t get this feeling.”

  When Carl opened the door to his lab a moment later and flicked on the lights, Beth was once again impressed. “This is all yours?”

  “Not really. It belongs to the company.”

  “But you’re in charge here.”

  “For as long as they allow me to be. We don’t usually take blood samples from humans in this lab, but I think we’ve got a few pin-stick devices on hand that’ll make it easy.”

  Four minutes later, they were staring down at a glass slide bearing a fresh smear of Beth’s blood.

  “We’ll wait a minute for the slide to dry,” Carl said. “Then we’ll put it on that machine over there, which I hope is ready to go.” He checked the staining apparatus and turned it on. “How long were you planning to be away from Artisan?”

  “Ten days if my money holds out. Then I must go back.”

  “Why?”

  “I just have to.”

  Seeing that she wasn’t going to tell him why she had to return in ten days, Carl didn’t pursue the point. “How will you get there?”

  “I hadn’t thought about it. Would a taxi take me?”

  “Probably. So you’ll be staying in town the whole time?”

  “I might. How does that staining machine work?”

  By the time Carl had explained the machine to her, the blood smear was ready for that step. As the slide moved slowly along the staining platform, Beth followed its progress as though it was the most interesting thing she’d ever seen. While she watched the slide, Carl watched her. She couldn’t have been more than twenty-two or twenty-three years old. He was thirty-six. Even without considering how sheltered she’d been growing up in Artisan, that was a huge difference.

  When the slide finally plinked into the collection box, Carl snatched it up and headed for the scope in his office. “C’mon. We’ll take a look at it back here.”

  At his scope, Carl flicked on the attached TV camera, turned on the scope’s light source, and put the slide on the mechanical stage. He sat down and moved the slide into the light path, then rotated the 4x objective into place and focused the scope.

  On the TV monitor, Beth saw a lot of tiny pink dots appear.

  With the scope properly lined up and focused, Carl made some additional adjustments that greatly increased the magnification. Almost immediately he breathed, “I’ll be damned.”

  On the monitor, the pink dots had become large circles. Never having seen a picture of a blood smear, Beth didn’t know what to make
of it. “What do you see?” she asked. “Is my blood like Benjamin’s?”

  “Exactly,” Carl replied, looking at the screen. He picked up a pencil and pointed at a bulge on one of the spheres. “Normal red cells don’t have these little blisters.”

  “What does it mean?”

  “I’m not sure. What did Meggs tell you about your health when you had your last physical?”

  “That I was fine.”

  “Is he aware of everyone’s sterility problem?”

  “Of course. He meant I was fine except for that. What’s wrong?”

  “When I asked him if Benjamin had any chronic health conditions, he said no. I’m just wondering why he forgot to mention sterility.”

  “It doesn’t affect the way anybody there feels on a daily basis. It’s just something in the background. Maybe that’s why he didn’t bring it up.”

  “He should have though.”

  “Did the flu cause our blood cells to change?”

  “We can’t be absolutely sure, but I’m thinking it did. Yesterday, I showed a picture of Benjamin’s red cells to another hematologist to see if she’d ever seen anything like them. She was as surprised and intrigued by their appearance as I was. She asked me to let her know if I found out anything about them. I’m going to run this by her and see what she thinks.”

  At the phone, Carl wondered which of Eve Chrisman’s numbers to try first, home or pager. If she wasn’t on call, her pager might be shut off. So home it was.

  While waiting to see if she’d pick up, he put his hand over the mouthpiece. “I know you don’t want to spend your evening here, but this shouldn’t take long, then we can go.”

  “Is there a restroom nearby?”

  “In the hall to the left, down about five doors.”

  “I’ll be right back.”

  As Beth headed for the door, Chrisman answered.

  “Hello, Eve . . . Carl Martin. I think I know what caused the red cell abnormality in that picture I showed you.”

  “What’s the verdict?” she asked

  “A few years ago there was a major flu epidemic in Artisan, the town where the patient lived. It killed a lot of the residents, primarily the young and the old, and made all the survivors sterile. I checked the blood of one of those survivors, and she has the same abnormality. I know two cases aren’t conclusive, but I think that’s the cause.”