“I hope I’m not interrupting,” she said, perplexed. She didn’t know Ezra knew Hodis.
“You’re never interrupting, my dear,” Hodis replied politely, but there was something in his voice that told her this was no ordinary conversation. She could feel a certain tension in the room, as though the static charge in the air was particularly strong.
“There’s a plague case up in San Francisco,” Ezra said flatly. “Antibiotic-resistant. The patient died yesterday morning.”
A little kernel of dread formed in Susan’s gut. Antibiotic resistance in San Francisco didn’t equate to antibiotic resistance in Los Angeles, but still, the timing was bad.
“The Chief of Infectious Disease at UCSF called me to give me a head’s up,” Hodis explained. “Not sure if you knew, but she and I worked together on some early sequencing research. She’s hoping we can sequence this antibiotic-resistant strain pretty quickly so that we can figure out what we’re up against.”
He gave Susan a quick rundown on Yoshiki Yahagi, the contacts the boy had had before they put him in isolation, and what the local public health authorities were doing about it. Susan frowned. “I’m assuming you know about our case the other day, if Ezra’s here.”
Hodis’s face turned grave. “Ezra alerted me.”
“We didn’t send a full sensitivities panel, but now I’m thinking we should have—"
“Susan,” Ezra interrupted. “We’ve done all that. There’s another case today.”
“From Arrowhead?”
“No, one of our own,” Ezra said grimly. “Jenna Niven is sick as shit. She’s in the ICU.”
Six
Reno’s still an armpit, George Mack decided as he drove through the center of town. Although the city had recently seen much needed revitalization where the Truckee River meandered through downtown, the outlying areas retained the whiff of hard times that Mack had always associated with his adopted hometown. Cheap motels lined the interstate, and huge barbed wire lots waited patiently for construction. Even some of the casinos were showing their age.
Like many Reno residents who weren’t employed by the gambling industry, Mack ventured into casinos only for meetings and the occasional massive buffet. As an outdoorsman, he vastly preferred life outside Reno, in the towering Sierra to the west or the austere desert mountains to the north.
Mack allowed his mind to drift as he cruised onto Interstate 80. He imagined fishing crystal-clear Donner Lake in the summer days ahead, but it seemed an inappropriate contemplation given the plague cases, and he pushed Donner Lake from his mind. He reached in his front pocket for the packet of cigarettes, glumly put one in his mouth, and felt for his lighter.
Damn county cars, he thought irritably. Can’t have a cigarette lighter in the car, for Christ’s sake. Wouldn’t fit the county’s new commitment to health. Ha, Mack thought. As if Reno ever had a fighting day’s chance in hell of becoming a healthy place. It was, at its core, a city devoted to the basest of human instincts: gambling, legalized prostitution, alcohol.
He lit the cigarette, cracked the window, and pressed the accelerator. Only ten minutes to get back to the office in time for the damned phone call with the Centers for Disease Control officer. He wasn’t looking forward to the conversation. Many of the epidemic investigation officers were young residency grads looking to flex their public health muscles. Mack had hoped for a more senior investigator but was disappointed to be assigned a thirty-year-old freshly-minted Johns Hopkins internist who had been with the CDC’s Epidemic Intelligence Service less than a year.
It was a mess. Six cases of plague, now, all in vicinity: the Japanese kid, Jason Tippett, the ER doc, his wife and son, and the ER nurse who treated the index case. Three of them now with documented drug-resistant Yersinia pestis, with the likelihood that the other three would yield the same strain when their drug-sensitivity panels came back. If that wasn’t enough to make you shit your pants, Mack wasn’t sure what was.
Mack drove with both hands on the steering wheel, grimly staring at the traffic on Interstate 80. He was doing eighty now, but he knew the state troopers in town. They’d pull him over, but they’d never give him a ticket.
Goddamn lodge, he thought. It was all linked to that lodge. The innkeeper’s dog had come back positive for plague, as did the dog’s fleas and at least one of the ground squirrels that Bob Sparks had caught in his squirrel cages. It’s a bad focus, thought Mack. An inn that housed as many as forty people a night. Who knew how many people had been exposed? Who knew how many of the wild rodents in the area harbored plague? More than a thousand people lived on Donner Summit, and thousands more lived in the Truckee area down the hill.
Mack pulled onto the Blitzen Boulevard exit and drove down to the plain gray building that housed the Washoe County government offices, including the nondescript county public health office. He parked his car in his official spot, dropped the butt of his cigarette onto the ground, stomped on it, and went into the building.
Once inside, Mack avoided Harold Pincher’s office. He liked the county’s Deputy Director of Public Health, but Pincher was wrapped up in a measles outbreak, and Mack didn’t have time to hear the latest quarantine and vaccination news. Pincher is coming off the case, anyway, Mack thought. They needed more people now, especially if his imminent phone call ended the way he expected.
Mack pushed his way into his office, sank into an old wooden chair that creaked beneath his weight, and dialed the number the CDC secretary had given him.
A female voice, surprisingly close-sounding, answered. “Dr. Nesbitt’s Office.”
“Yeah, it’s George Mack from Reno, Nevada calling.”
“Oh,” said the woman, “Dr. Nesbitt is expecting you. One moment.” A click sounded, followed by hold music. Mack felt around in his pocket for his cigarettes, pulled out the pack, and saw that it was empty. He crumpled it up and tossed it at the garbage can.
The line clicked again. “George?” It was Nesbitt. Despite himself, Mack felt his hackles rise. In general, he wasn’t a stickler for formality, but the way the younger man called Mack by his first name without ever having met him grated on his nerves.
“Yeah, Jeremy, it’s me. How’s life in Atlanta?” said Mack, hoping he had remembered Nesbitt’s first name correctly.
“Good. Lots of work. But sounds like you have the most interesting outbreak going currently.”
“Imagine that,” Mack said.
“I’m glad you called us. Drug-resistant Yersinia pestis, huh? That makes a first in the States. We’ll want to be aggressively on top of it, right?”
Mack despised Nesbitt’s superior tone. He knew Nesbitt and his type: Ivy League grads. Private schools. Expensive cars that the salary of an EIS officer could never pay for. “We’ve closed the inn that was the point source. Placer County is arranging to have the place dusted for fleas. Our preliminary wild rodent surveys show two out of five animals positive for plague. We’ll be expanding that to include animals from Donner Lake and the surrounding environs.”
“Donner Lake?”
“You ever been to Lake Tahoe, Nesbitt?”
“No,” said the younger man. “Always wanted to. I hear there’s good skiing out there—”
Mack cut him off. “Donner Lake is down the hill from Donner Summit, about ten miles. We’ll be surveying animals in a thirty-mile radius around the lodge. We’re also tracking down the guest list at the lodge for the week when the Japanese kid and the inn worker got sick. So far, no reports of further illness, but we haven’t gone through the list yet.”
“Well, we’ll be lucky if we nip this in the bud. I hate to think of the public relations implications of drug-resistant plague.”
Mack waited, his breath momentarily suspended. Something was coming.
Nesbitt continued, “I mean, there could be a real panic. We wouldn’t want a panic.”
“No, we wouldn’t want a panic.”
“So, I think it’s imperative that we’re all on the same page h
ere. You know what I mean, George?”
“What page would that be?”
“I think we keep the fact that it’s drug-resistant under wraps for now, until we get a little better handle on the situation.”
Mack’s mouth fell open.
“I mean, go ahead and do all the public education stuff. Tell people to report dead rodents, dust their dogs and cats for fleas, and to present to the doctor if they start feeling any of the symptoms of plague. You know the drill,” said Nesbitt. “But let’s defer releasing the information that it’s drug-resistant for now. A panic is the last thing we need to fight an epidemic. Besides, it sounds like you guys have a good handle on the situation. I don’t anticipate, with the correct public health measures, that we’ll have much more of a problem with this.”
Mack was astounded. “You know, the Japanese kid died, and it looks like the doc who cared for him is going to die, too.”
“I know. Ten people a year die from plague.” Nesbitt sounded patronizing. “It’s a bad disease, George. I’m not disagreeing with you. I’m just talking from a public management perspective. The last thing we need is a panic. It won’t help your containment measures, I can assure you. You’ll be doing everything by the book. We’re just leaving out a little bit of information until we have a better handle on the situation.”
There was a moment of silence.
“You want us to send one of our officers out there, George? You need some help with this?” said Nesbitt.
Mack stubbed out his cigarette in the ashtray on his desk. “No, Nesbitt. I think we can manage a little outbreak like this.”
“Good, I knew I could count on you. We’ll be in touch.”
“Right,” said Mack. The line clicked. Mack placed the phone back in its cradle and stared at it for a moment before the profanity burst out of him. “Fuck!”
Just then, the department secretary walked in. “You’re not going to like this,” she said, dropping a message on his desk before walking back out.
Mack picked up the old-fashioned pink slip of paper, which said While You Were Out on top. It was a message from Tyrone Hayden, the investigative reporter from Channel 6.
Alan Wheeler stared at the fish tank.
The Chairman of the Wheeler Corporation never really understood why aquariums were so popular. He found the mindless swimming of fish boring. But if he had to listen to Brooke any longer, he thought he would lose his mind. She peppered the doctors with questions, making them repeat themselves over and over.
What it all boiled down to was this: Jason was dying. And Alan was certain that if the Wheeler Foundation hadn’t been such a generous donor to the Norris Comprehensive Cancer Center, the doctors would have stopped answering Brooke’s questions long ago.
Alan tapped on the glass of the fish tank, which stood on a pedestal next to the waiting area. He wanted to startle the fish into some other swimming pattern, but they seemed oblivious. Failure to achieve complete remission. That’s what the doctors had said. The chemo hadn’t worked. Jason still had cancer. They were talking about bone marrow transplant now, about if they could successfully achieve complete remission with an experimental chemotherapeutic regimen.
Brooke made them repeat themselves, and Alan thought he would die.
It had all happened so quickly. Jason had stopped playing basketball, saying he was too tired. At first, they thought he had some virus. Maybe mononucleosis? But when the mono test came back negative and Jason remained listless, they’d thought he might have been depressed. It was only when he’d begun to look pale and his gums and nose had started to bleed that they had realized they had a disaster on their hands.
Acute lymphoblastic leukemia. Unusual in a 14-year-old. Much more common in younger children. Don’t worry, the doctors had said. It’s a completely treatable cancer.
Except it hadn’t been. All the prognostic signs were bad. Jason was 14, older than the usual child leukemic. A CT scan of his head showed cancer in his brain. And his blood was crammed with cancer cells.
How did we miss this? Alan wondered. Was there anything that we could have seen earlier that might have made this different?
Four weeks of chemo had followed. They’d watched Jason’s hair fall out, had seen their previously robust teenager lose weight from the constant nausea. But the numbers were good. Jason’s blood counts had come down. The peripheral blood smears, whatever those were, looked normal. The doctors said they were optimistic that Jason would beat this thing.
Brooke had been ferocious through it all. She’d pushed the nurses, in her sweet but commanding way, to make sure that Jason got his nausea medications on time. She never hesitated to identify herself as Mrs. Wheeler, knowing that the hospital administrators were terrified of losing the Foundation’s support and thus would treat her son as a VIP.
Alan knew that he couldn’t have survived this long without her. He only wished that she wouldn’t ask the same questions over and over. It was as if she couldn’t comprehend the answers unless they were the ones she wanted.
Not that he blamed her. Jason was their only child, the product of years of effort and countless fertility treatments. In a world of cherished children, Jason was an extraordinarily cherished child. Brooke had turned the full force of her being into raising him, making sure he attended the best schools, belonged to the best athletic clubs, had an active and supported social life. And despite all this lavish attention, or maybe because of it, Jason was a great kid. Alan felt like he was choking.
“Alan.”
He didn’t hear her at first, and she repeated herself, still with that sweet voice, but more insistently now. “The doctors want to know if we want to go through with the bone marrow transplant.”
Such a great kid. My beautiful, wonderful kid. Alan’s voice sounded far away, like it belonged to someone else. “Yes.”
Jenna was shaking. She couldn’t help herself. It came over her in waves, a chill she felt to her bones. She pulled the blankets over her body and curled into the fetal position, trying to keep the IV tubing that extended from her forearm to the three hanging bags from kinking. She glanced up at the IV bags and thought, Three antibiotics. They must be scared.
It wasn’t official yet. The blood cultures weren’t back, but Ezra had come by, and he’d told her what the others wouldn’t admit to. They thought she had plague.
Thank god she had come in early, instead of waiting around like the Arrowhead contractor did. At least she would have the full benefit of the antibiotics.
Jenna looked out the hospital window listlessly. Outside, she heard the nursing aides wheeling their blood pressure cuffs and thermometers from room to room.
She wondered if she really had the plague. She sure felt like shit. Her body felt like it had gone through a meat grinder. Everything ached—her arms, her legs, her head, even her feet. And this fever was whipping her ass. 104 earlier, the nurse had said before they’d put the ice packs on her. They’d given her Tylenol and pumped her with antibiotics, and at first she had felt better, but the chills were back now, racking her body with waves of shivering.
She tried to force her mind back to the hours when the plague patient had first arrived. Hadn’t she worn a mask? It would have been foolhardy not to wear one. Arrowhead had warned them that they thought he had plague. But the truth was, Jenna couldn’t remember. She just felt so bad. It was hard to remember anything.
She began to cough, a wet strangling sound. If it’s not plague, it’s certainly pneumonia, she thought. I’ve heard this cough too many times in little old ladies from nursing homes. It was the death cough for them. She hoped it wasn’t the death cough for her.
Alan Wheeler and his wife sat together at the Twin Candles in Pasadena. Alan had never cared for the restaurant, but Brooke liked it. The restaurant belonged to the ex-wife of some movie star, and like many of the wives of the wealthy in Los Angeles, Brooke followed those things. Who was sleeping with whom. Who was getting divorced. Who was opening a restaurant after t
he divorce was final.
“Look, the night crowd is coming in,” said Brooke, as a small crowd of beautiful, tanned twenty-somethings walked in the front door. Alan looked at them and wondered if any of them had jobs.
They ate in silence, Alan picking at his lamb chops, Brooke carefully nibbling at her tahini salad.
Finally, she spoke up. “Alan, don’t be so gloomy. I’m as scared as you are, but you heard the doctors today. There’s still a chance for a cure.”
Alan wasn’t sure that was what they’d said. Had Brooke forced them to say that with her endless repeated questions?
Brooke went on. “We have to be there for Jason. His mental state is incredibly important to this, and he’ll never feel confident if you look so depressed all the time.”
Alan knew he should say something, some sort of acknowledgement that she was right, that a good attitude just might help cure Jason’s cancer, but he didn’t feel it. They had moved on to the experimental, and Alan knew what that meant. The Wheeler Foundation gave all sorts of money to support experiments. Some of them worked out. Most of them did not.
Instead he said, a grimace on his tanned face, “What is this sauce? It’s green.”
Brooke burst out laughing. “Chairman of Wheeler Corporation, head of the Wheeler Foundation, and you still have the taste for the backyard barbecue. It’s mint salsa, darling. It’s made with kiwis.”
Alan raised his eyebrows, and Brooke laughed again. She was a beautiful woman, he had to admit. Her smile was large with white teeth and full lips, and her skin remarkably smooth for a fifty-year-old woman. He wondered how much of that was real, and how much of that came from the dermatologist, whose bills arrived on his desk every three months like clockwork.
Suddenly he said, “Brooke, let’s take Jason camping. You know how he loves camping. We could make it a family thing.”
DRYP Trilogy | Book 1 | DRYP [The Final Pandemic] Page 9