Death Benefit (23 page)

The lab door opened abruptly and a tall, distinguished-looking man walked in quickly and made his way through the cordon toward the biosafety unit, conspicuously avoiding eye contact with anyone. He was dressed in protective clothing like the others except his mask hung down on his chest. Under the gown was a suit, not scrubs like the others. Pia knew this was the chief of Infectious Disease, Dr. Helmut Springer, as she had attended several lectures he’d given during second-year pathology.

The background buzz of conversation grew louder. Most recognized Dr. Springer. Everyone in the lab was well aware that they worked with highly virulent and contagious microorganisms. Was it possible there’d been some contamination of the lab? Where were Dr. Rothman and Dr. Yamamoto? Springer’s appearance only heightened the tension. The man by the door was on a cell, apparently quarterbacking whatever was happening. “We’re on our way, ETA five minutes,” he was heard to bark into his phone.

Quickly tying his mask in place, Springer pulled the biosafety unit door fully open. As if on cue, the gurneys reappeared, the one in front carrying Dr. Rothman, Dr. Yamamoto in the rear. Both men had IVs and were wearing oxygen masks. Rothman passed right in front of Pia, who pushed forward to take a look. She could see he was deathly pale and shivering violently. His eyes were fixed straight ahead, staring at the ceiling. He looked like death.

As fast as they had come, the cavalcade of medics was gone. Only Dr. Springer and Winston remained. Springer addressed the shell-shocked staff, a few of whom were clutching each other for comfort, others holding their hands over their mouths in disbelief at what they had just witnessed.

“As you can see, Doctors Rothman and Yamamoto have been taken ill. At first guess, we have to consider it to be severe typhoid fever. Both men are presenting the classic symptoms—fever, sudden prostration, abdominal distress, delirium, right lower quadrant borborygmi.” Springer counted off the symptoms on the fingers of his left hand as if he were on formal grand rounds. Once a professor always a professor, thought Pia. “Obviously, they were working in the biosafety unit. But can anyone tell me what they were working on exactly?”

Lab technician Panjit Singh stepped forward. “They were working on salmonella strains grown in the space station lab. I know that for a fact because I set everything up for them this morning. They’ve been working on it for weeks.”

“Okay, thanks, that’s very useful. Do you know if there are any antibiotic-sensitivity studies available for these special strains?”

“Yes, lots of them. I can get them for you.”

“That’s good, I’m going to need them, thank you. Mr. Winston here will talk to you about procedure a bit later, but here’s a thumbnail: no one is to go into the level-three lab until it’s cleared. The Rothman lab itself will be off-limits until further notice. I’ve already put in a call to the CDC to get their help on the epidemiology side so we can find out how this contamination occurred. Right now, everyone needs to follow me to the Infectious Disease Clinic, where you’ll be screened for typhoid fever. Everyone will also need to take a prophylactic course of antibiotics. This is very important. For the next week you’ll have to monitor your own temperature twice a day. Anything unusual, come in right away. A degree either side of normal, I want to see you. Any questions?”

“Who raised the alarm?” Singh asked.

“There’s a panic button in the biosafety lab,” Springer said. “One of the doctors must have hit it. We’ll check the tape.”

“Does everyone need to come to the clinic?” Pia asked. “Even people who haven’t been in the biosafety unit today?”

“Absolutely. And Mr. Winston will also be gathering names of everyone who’s been here delivering supplies or takeout or whatever. We want to see everyone who has set foot inside this lab. That’s it. Thank you for your cooperation.”

The din of conversation erupted again.

“Oh my God!” Lesley said. “Did you see how they looked? It must have come on fast.”

“Dr. Yamamoto told me he didn’t feel so hot this morning,” Will said. “But yeah, I saw how they looked. I guess we better go do what the man said.”

Pia looked around. The maintenance man was hanging back, and though Pia didn’t want to talk to him, she knew he needed to follow the protocol.

“There’s a medical issue,” she said to the man. His temporary name tag read “O’Meary.” “You have to come to the clinic with everyone else.”

O’Meary looked nervous and didn’t say anything. Winston called out to Pia.

“Time to go,” he said. “We’re locking down.” There was clearly no room for argument. Pia waited for O’Meary to leave and exited in front of Winston. As the last person out, Winston pulled the door shut and talked to two figures in full hazmat suits standing outside.

“No one gets in,” Winston said. “Put up the caution tape.” The men in the hazmat suits nodded and set to work.

As they made their way to the elevator, Pia could see that the whole floor was being cleared, with other personnel being led down the stairs. There were more people in hazmat suits that looked like robots. On the elevator ride down, Pia could feel her heart beating too fast, and she had to concentrate on breathing deeply. She felt some dizziness from her shallow breathing. As she walked along the sidewalk she was gripped by what felt like panic—everything around her felt very close and incredibly far away at the same time. She had stopped walking and was holding on to someone. Voices were loud in her ear.

Pia looked up. She was sitting on the ground on 168th Street with traffic passing by. Winston was supporting her with his hand, looking down at her.

“You okay?”

“Yes, I think so.”

“You fainted. Or almost fainted. You’re not perspiring, so I don’t think you have a fever. I think you’re okay. Ready to get up?”

Pia waited a second and allowed Winston to pull her to her feet. Then she remembered where she was and what had just happened. With disturbing clarity she saw Rothman lying on the gurney, his face looking like death, and the image terrified her. Over the course of three and a half years she’d come to rely more and more on the man’s strange friendship, particularly after their heartfelt conversation a few weeks ago. Up until then, their relationship had been akin to two people comfortably wandering around in a darkened room, occasionally sensing each other’s presence but not much else. But after the conversation and the personal revelations, she felt they’d moved to another level. Rothman had become the ersatz father she’d always pined for. Most important, she’d allowed herself to begin to trust Rothman despite having learned not to trust anyone, not to allow anyone into a position where they could betray her, like so many had done.

Now, as she stumbled along the street, Pia was overwhelmed by the thought that just when she’d allowed Rothman into her world, he was going to abandon her. Why was he doing this? And why now? It was irrational to think so, but did he do this to spite her? Did he purposely set her up? After all, he’d admitted to being depressed. She was almost paralyzed with anxiety.

At the Infectious Disease Clinic, Pia was shaking when she was handed the Z-Pak prophylactic antibiotic. She sat down in the waiting area and her head started to clear. She was aware that several people had tried to talk to her, but she didn’t hear them.

“Miss Grazdani!” a nurse called out sharply, standing directly in front of Pia. She was on the brink of calling the ER if the young woman continued in her fugue-like state, thinking Pia might have to be admitted.

Not quite awakening, Pia sat up straighter and focused on the nurse’s face.

“I’m here,” Pia voiced. “I’m sorry. What did you say?”

“I said that you can’t go back to the lab. It’s going to be closed until the CDC epidemiologists get here from Atlanta and declare it clean. What you should do, as we have advised the others, is go home, start your antibiotics, and watch your temperature. Is there someone we can call who can meet you there? Miss Grazdani? Are you okay, Miss Grazdani?”

“I’m just fine,” Pia assured her.

 

 

I
t wasn’t a warm day, but Pia had wanted to sit outside. She had found a bench set in a small rectangle of public cement, what in New York City is called a park, and sat down, hands in her coat pockets, her chin down, hood pulled over her eyes. Her mind played over the scene she had just witnessed several times. There was a surreal quality to it, like it was one of her nightmares. Unfortunately it was real.

After she had gotten herself reasonably calmed down, Pia got up from the bench and started to walk toward the dorm. She got halfway, changed her mind, and turned and headed back to the hospital. There she took the first two of her antibiotic tablets at a water fountain before heading to the internal medicine floor.

At the main nurses’ station, she asked for Dr. Rothman and was directed to the infectious disease wing a floor above, where Rothman and Yamamoto had been admitted. She wanted to check on Rothman’s status, hoping that he’d revived with treatment, and if so, she wanted to ask him if he knew how he and Yamamoto had become contaminated. Pia knew the epidemiologists would certainly be asking the same questions, but she had a personal reason for finding out—the crazy thought that he’d done it on purpose, an idea she knew to be irrational but which demanded, in her mind, to be investigated.

Pia had another concern. Experience had taught her to absolutely distrust authority in any institution and to assume that nothing would happen the way it should. She knew Rothman was disliked by almost one hundred percent of his colleagues in the medical center. He was rude, seemingly arrogant, and antisocial. While medical protocol and simple human decency demanded that each patient receive the undivided attention of medical staff and the best care available, she couldn’t help but think Rothman’s reputation might degrade the standards.

Pia used her medical student credentials to get on the floor and found that the two researchers were in adjoining, negative-pressure rooms where air flowed in but not out. They were in strict isolation but there was no one guarding the rooms. Pia started to put on the isolation gear in the anteroom—the gown, hat, mask, gloves, and booties—but just as she was about to put on her mask, Dr. Springer emerged from Rothman’s room. He undid his mask and stared at Pia.

“What on earth are you doing here? You’re Rothman’s student, aren’t you? You’re supposed to be home.”

“I took my antibiotics and my temperature’s fine. I know I’m clean—I wasn’t in the biosafety unit today, or even in contact with Dr. Rothman or Dr. Yamamoto. It’s very important I speak with Dr. Rothman.”

“Good God! Of course you can’t speak with him. The only people allowed in are medical staff assigned to his case. No family, no friends, and certainly no medical students.”

“There’s no one in there looking at him now. Are you sure of the diagnosis? Is this the best place to treat his condition?”

“What do you mean, ‘is this the best place?’” Springer shook his head in disbelief.

“I know what people around here think of Dr. Rothman—”

“Young lady, I don’t know what you’re implying but everyone at Columbia Medical Center gets the same superb care as everyone else, friend or foe, rich or poor. It makes no difference whatsoever. And I happen to like Dr. Rothman.”

“Okay, okay. Sorry, I’m just upset.” Pia didn’t want to get thrown off the floor. “I’ve been working with both men for more than three years on the salmonella strains that are probably involved, and I thought I might be able to help.”

“Okay,” said Springer. He relaxed a degree. He sensed Pia’s intentions were good even if totally unrealistic.

“I have to tell you that both men are delirious. Even if I let you in there, you wouldn’t get anything out of Dr. Rothman. Follow me.” Springer took off the protective gear and tossed it into the covered hamper. Pia did the same.

Springer took Pia back to the nurses’ station and, sitting down, itemized the laundry list of tests that had been ordered, including a complete blood count, electrolytes, blood cultures, urine cultures, stool cultures, stat DNA microbiology tests, and the appropriate X-rays. At that point the tests that had come back confirmed that the infectious agent was one of the salmonella strains Rothman and Yamamoto were working on, which Rothman had named the alpha strain, the most virulent of the three grown in space. He also mentioned that the white cell count showed a mild leukopenia, meaning the white cell count was mildly depressed, something often seen with typhoid fever. He declared the electrolytes, meaning primarily sodium, chloride, calcium, and potassium, were normal. Springer concluded by telling Pia that Rothman’s and Yamamoto’s temperature, heart rate, blood pressure, degree of oxygenation of blood, urine output, and central venous pressure were being monitored, and that at the moment the only thing abnormal was the temperature.

“They’re both in bad shape, especially considering how quickly the illness came on,” Springer added.

“What antibiotic are they on?” As Pia knew from her studies with Rothman, there was debate about which was the best to use in serious salmonella cases.