Contagion (30 page)

     “It’s shocking,” Jack said. “Especially since it’s so unusual. As you said last time I was here, no one in this department had ever caught anything serious before.”

     Gladys raised her uplifted hands. “What can you do?” she said. “It’s in God’s hands.”

     “It might be in God’s hands,” Jack said. “But usually there is some way to explain this kind of contagion. Have you given it any thought at all?”

     Gladys nodded vigorously. “I’ve thought about it until I was blue in the face,” she said. “I don’t have a clue. Even if I didn’t want to think about it, I’ve had to because everybody has been asking me the same question.”

     “Really,” Jack said with a twinge of disappointment. He’d had the idea he was exploring virginal territory.

     “Dr. Zimmerman was in here right after you on Thursday,” Gladys said. “She came with this cute little man who kept sticking his chin out as if his collar button were too tight.”

     “That sounds like Dr. Clint Abelard,” Jack said, realizing he truly was strolling a beaten path.

     “That was his name,” Gladys said. “He sure could ask a lot of questions. And they’ve been back each time someone else has gotten sick.

     That’s why we’re all wearing our masks. They even had Mr. Eversharp down here from engineering, thinking there might have been something messed up with our air-conditioning system, but apparently that’s fine.”

     “So they haven’t come up with any explanation?” Jack said.

     “Nope,” Gladys said. “Unless they haven’t told me. But I doubt that. It’s been like Grand Central in here. Used to be no one came. Some of these doctors, though, they’re a little strange.”

     “How so?” Jack asked.

     “Just weird,” Gladys said. “Like the doctor from the lab. He’s come down here plenty of times lately.”

     “Is that Dr. Cheveau?” Jack asked.

     “I think so,” Gladys said.

     “In what way was he strange?” Jack asked.

     “Just unfriendly,” Gladys said. She lowered her voice as if telling a secret. “I asked him if I could help him a couple of times, and he bites my head off. He says he just wants to be left alone. But, you know, this is my department. I’m responsible for all this inventory. I don’t like people wandering around, even doctors. I had to tell him.”

     “Who else has been around?” Jack asked.

     “A bunch of the bigwigs,” Gladys said. “Even Mr. Kelley. Usually I’d only see him at the Christmas party. Last couple of days he’s been down here three or four times, always with a bunch of people. Once with that little doctor.”

     “Dr. Abelard?” Jack asked.

     “That’s the one,” Gladys said. “I can never remember his name.”

     “I hate to ask you the same questions as the others,” Jack said. “But did the women who died perform similar tasks? I mean, did they share some specific job?”

     “Like I told you last time,” Gladys said, “we all pitch in.”

     “None of them went up to the patients’ rooms who died of the same illnesses?” Jack asked.

     “No, nothing like that,” Gladys said. “That was the first thing that Dr. Zimmerman checked.”

     “Last time I was here you printed out a big list of all the stuff that you’d sent up to the seventh floor,” Jack said. “Could you make the same list for an individual patient?”

     “That would be more difficult,” Gladys said. “The order usually comes from the floor, and then it is the floor that enters it into the patient’s data.”

     “Is there any way you could come up with such a list?” Jack asked.

     “I suppose,” Gladys said. “When we do inventory there is a way of double-checking through billing. I could tell billing I’m doing that kind of check even though we’re not officially doing inventory.”

     “I’d appreciate it,” Jack said. He took out one of his cards. “You could either call me or just send it over.”

     Gladys took the card and examined it. “I’ll do anything that might help,” she said.

     “One other thing,” Jack said. “I’ve had my own run-in with Mr. Cheveau and even a few of the other people around here. I’d appreciate it if this was just between you and me.”

     “Isn’t he weird!” Gladys said. “Sure, I won’t tell anybody.”

     Easing out from in front of Gladys’s desk, Jack bid good-bye to the robust woman and exited central supply. He wasn’t in the best of moods.

     After beginning with high expectations, the only thing of note he’d been told was something he already knew: Martin Cheveau was irascible.

     Jack pushed the down button at the bank of elevators while he pondered his next move. He had two choices: either he could just leave and minimize his risk, or he could make a careful visit to the lab. Ultimately, he decided in favor of the lab. Chet’s comment about the Jack of availability of pathological bacteria carried the day, since it had raised a question Jack needed to answer.

     When the elevator doors opened, Jack started to board, but then he hesitated. Standing directly in front of the crowded car was Charles Kelley.

     Jack recognized him instantly despite his mask.

     Jack’s first impulse was to back away and let the elevator go. But such a move would have only drawn attention. Instead he put his head down, proceeded onto the elevator, and immediately turned to face the closing door. The administrator was standing right behind him. Jack half expected a tap on the shoulder.

     Luckily, Kelley had not recognized him. The administrator was deep in conversation with a colleague about how much it was costing the hospital to transport the ER patients by ambulance and the clinic patients by bus to their nearest facility. Kelley’s agitation was palpable. He said their self-imposed semi-quarantine would have to end.

     Kelley’s companion assured him that everything was being done that could be done, since the city and state regulatory people were all there making an evaluation.

     When the doors opened on the second floor, Jack exited with great relief, especially when Kelley didn’t get off as well. With such a close call, Jack wondered if he was doing the right thing, but after a moment of indecision he elected to continue with a quick visit to the lab. After all, he was right there.

     In contrast to the rest of the hospital, the lab was in full swing. The outer lobby area was thronged with hospital personnel, all of whom were masked.

     Jack was confused as to why so many hospital employees were there but thankful because it was easy to blend in with the crowd. With his mask and white lab coat he fit in perfectly. Since Martin’s office was just off this main reception, Jack had worried that he’d be apt to run into him. Now he felt the chances were next to nil.

     At the far end of the room was a series of cubicles used by the technicians to draw blood or obtain other samples from clinic patients. Near them the crowd concentrated. As Jack wormed his way past this area it dawned on him what was going on. The entire hospital staff was having throat cultures taken.

     Jack was impressed. It was an appropriate response to the current outbreak. Since most meningococcal epidemics resulted from a carrier state, there was always a chance the carrier was a hospital employee. It had happened in the past.

     A glance into the last cubicle made Jack do a double take. Despite a mask and even a surgical cap, Jack recognized Martin. He literally had his sleeves rolled up as he worked as a technician, swabbing throat after throat. Next to him on a tray the used swabs were piling up in an impressive pyramid. Obviously, everyone in the lab was pitching in.

     Feeling even more confident, Jack slipped through the doors into the lab itself. No one paid him any attention. In sharp contrast to the comparative pandemonium in reception, the lab’s interior was a study in automated solitude. The only sounds were a muted chorus of mechanical clicks and low-pitched beeps. There were no technicians in sight.

     Jack made a beeline for the microbiology section. His hope was to run across either the head tech, Richard, or the vivacious Beth Holderness. But when he arrived he found no one. The micro area appeared as deserted as the rest of the lab.

     Jack approached the spot where Beth had been working on his last visit. There he found something encouraging. A Bunsen burner was aflame. Next to it was a tray of throat culture swabs and a large stack of fresh agar plates. On the floor stood a plastic trash barrel brimming with discarded culture tubes.

     Sensing that Beth must be in the immediate area, Jack began to explore. The microbiology section was a room about thirty feet square divided by two rows of countertop. Jack walked down the center aisle.

     Along the back wall were several biosafety cabinets. Jack rounded the lab bench to his right and glanced into a small office. It had a desk and a file cabinet. On a bulletin board he could see some photos. Without going into the room, Jack recognized Richard, the head tech, in several of them.

     Moving on, Jack came abreast of several polished aluminum insulated doors that looked like walk-in refrigerators. Glancing over to the opposite side of the room, he saw a regular door that he thought could lead into a storeroom. As he was about to head in that direction one of the insulated doors opened with a loud click that made him jump.

     Beth Holderness emerged along with a waft of warm, moist air and nearly collided with Jack. “You scared me to death,” she said, pressing a hand to her chest.

     “I’m not sure who scared whom more,” Jack said. He then reintroduced himself.

     “Don’t worry, I remember you,” Beth said. “You caused quite a stir, and I don’t think you should be here.”

     “Oh?” Jack questioned innocently.

     “Dr. Cheveau is really mad at you,” Beth said.

     “Is he now?” Jack said. “I’ve noticed he’s been rather grumpy.”

     “He can be cranky,” Beth admitted. “But Richard said something about your accusing him of spreading the bacteria that we’ve been experiencing here at the General.”

     “Actually, I didn’t accuse your boss of anything,” Jack said. “It was only an implication I made after he irritated me. I’d come over here just to have a conversation with him. I really wanted his opinion about the plausibility of all these relatively rare illnesses having appeared so close together and at this time of year. But for reasons unknown to me, he was in as inhospitable a mood as he’d been on my previous visit.”

     “Well, I must admit I was surprised how he treated you the day we met,” Beth said. “Same with Mr. Kelley and Dr. Zimmerman. I just thought you were trying to help.”

     Jack had to restrain himself from giving this lively young woman a hug. It seemed as if she were the only person on the planet who appreciated what he was doing.

     “I was so sorry about your co-worker, Nancy Wiggens,” Jack said. “I imagine it’s been difficult for you all.”

     Beth’s cheerful face clouded over to the point just shy of tears.

     “Maybe I shouldn’t have said anything,” Jack said when he noticed her reaction.

     “It’s all right,” Beth managed. “But it was a terrible shock. We all worry about such a thing, but hope it will never happen. She was such a warm person, although she could be a bit reckless.”

     “How so?” Jack asked.

     “She just wasn’t as careful as she should have been,” Beth said. “She took chances, like not using one of the hoods when it was indicated or not wearing her goggles when she was supposed to.” Jack could understand that attitude.

     “She didn’t even take the antibiotic Dr. Zimmerman prescribed for her after the plague case,” Beth said.

     “How unfortunate,” Jack said. “That might have protected her against the Rocky Mountain spotted fever.”

     “I know,” Beth said. “I wish that I had tried harder to convince her. I mean, I took it, and I don’t think I was exposed.”

     “Did she happen to say she did anything different when she got samples from Lagenthorpe?” Jack asked.

     “No, she didn’t,” Beth said. “That’s why we feel she was exposed down here in the lab when she processed the samples. Rickettsia are notoriously dangerous in the lab.”

     Jack was about to respond when he noticed that Beth had begun to fidget and look over his shoulder. Jack glanced in the direction she was looking, but there was no one there.

     “I really should be getting back to work,” Beth said. “And I shouldn’t be talking with you. Dr. Cheveau told us specifically.”

     “Don’t you find that strange?” Jack said. “After all, I am a medical examiner in this city. Legally I have a right to investigate the deaths of the patients assigned to us.”

     “I guess I do,” Beth admitted. “But what can I say? I just work here.”

     She stepped around Jack and went back to her workstation.

     Jack followed her. “I don’t mean to be a pest,” he said. “But my intuition tells me something weird is going on here; that’s why I keep coming back. A number of people have been acting defensive, including your boss. Now there could be an explanation. AmeriCare and this hospital are a business, and these outbreaks have been tremendously disruptive economically. That’s reason enough for people to be acting strangely. But from my point of view it’s more than that.”

     “So what do you want from me?” Beth asked. She’d taken her seat and gone back to transferring the throat cultures to the agar plates.

     “I’d like to ask you to look around,” Jack said. “If pathological bacteria are being deliberately spread they have to come from somewhere, and the microbiology lab would be a good place to start looking. I mean, the equipment is here to store and handle the stuff. It’s not as if plague bacteria is something you’d find anywhere.”

     “It wouldn’t be so strange to find it on occasion in any standard lab,” Beth said.

     “Really?” Jack questioned. He’d assumed that outside of the CDC and maybe a few academic centers, plague bacteria would be a rarity.

     “Intermittently labs have to get cultures of all different bacteria to test the efficacy of their reagents,” Beth said as she continued to work. “Antibodies, which are often the main ingredient in many modern reagents, can deteriorate, and if they do the tests would give false negatives.”