Death Rounds (22 page)

“No.” I laughed. “They’re part of Michael’s apology.”

“Ah, too bad. And here I was ready to meet you in the parking lot, as a show of my appreciation, and fool around with you in the back of your car. We would have worn masks, gloves, and gowns, of course, but nothing underneath.”

* * * *

By 9:00
P
.
M
. we were finished screening for the day. Attempts to reach those who had been missed were to be continued on Saturday. The dozen people with the flu who were in quarantine had finally accepted the wisdom of their being there, though none were aware yet that they were waiting for cultures of an untreatable organism. But what to do with all the rest of the staff while we waited the forty-eight hours for our culture results was less clear.

“If they are carrying the organism somewhere—under their nails or secluded far up a nostril—and they go home to infants or children who might have a cut or scrape on their skin, then they theoretically could be putting those children at risk,” Williams had explained gravely during our morning session,

A flash of alarm had shot through my chest as I immediately thought of Brendan. Had I already exposed him?

“I suggest a second facility be set aside for those staff members who may wish a voluntary quarantine,” he’d continued, “away from those already at risk.”

It had probably been an overreaction, but I’d immediately called Amy and ordered her to bathe Brendan for an hour, scrub the rails on his crib, and hot wash every article of clothing, bedding, toy, or anything else that might touch him. Then, after thinking about it more coolly all day, I decided to play it safe in a more logical way and told Janet that I was staying in the hospital. But once I was alone in a barren room outfitted with nothing more than a bed and mattress rolled out of storage, I felt so forlorn I nearly changed my mind. The musty, stale odors of a disused building permeated the ward, though it had been hastily cleaned and just as hurriedly heated. Not many people had accepted Hurst’s accommodation, but occasionally in the interior stillness I heard the hollow sound of someone’s cough or a toilet flush. Outside a storm was brewing again. The wind rattled panes of glass and whistled through gaps in me wooden frames around the windows; those noises didn’t help my mood any. Yet instead of running home from that stark place, I lay there and forced myself to arrange the fragmented thoughts I’d been struggling with all day into some kind of logical perspective.

It seemed clear to me that natural conjugation couldn’t have produced the superbug in Sanders. I remembered reading or hearing somewhere in premed statistics that random chance virtually never was responsible for two rare events occurring simultaneously. The odds against a new organism selecting Phyllis Sanders as its first victim over the nearly four billion other souls on earth were just that—four billion to one. The odds of an organism appearing by chance for the first time ever on the planet in the middle of a deliberately inflicted
Legionella
infection—in itself a previously unheard of phenomenon—were ludicrous beyond consideration. For these two extraordinary events to have happened in the same individual, something had to have made them happen together, and the obvious “maker” in this instance was the killer. But how to convince Williams of this? Or anyone else?

Whoever this killer was, I suspected he had to have access to a genetic laboratory with the capacity to alter the gene structure of bacterial DNA or at least to the end products of such a place. Nobody at St. Paul’s that I knew of, not even Rossit and certainly not Hurst, would normally have the opportunity to even get near that kind of esoteric equipment let alone possess the skills to use it. I’d have to ask Janet if she knew of anybody at UH with that kind of expertise. I also had no idea if any work of that nature was being done at the university and would have to check there as well.

Droplets of rain pinged against the windows. In the harsh reflection of the overhead lights they looked like oblique scratches being slashed across the pane.

I thought of Michael’s suggestion that the Phantom would have already retreated into the darkness with the arrival of the ID experts. I doubted it No one else even knew he existed, and we’d spent the day carrying out a drill never intended to trap him. Our running about probably seemed to him as if we were scrambling around on a web of his making, the pattern unknown to us, while he lurked at its edge, out of sight, waiting, and gloating.

I was startled by a sharp sound. Was it a rap on my door? A product of the raging storm outside? Or something... someone I wanted to avoid?

I’d taken off my protective gear. Instead of putting everything back on to see if somebody was there, I called out, “Yes?”

No
answer.

I immediately thought of a dark figure and the sound of breathing. “Who’s there?” I yelled again, trying to remember if I’d snapped the lock shut or not. As I got off the bed I quickly looked around for some kind of weapon, but the room held nothing, not even a phone. Feeling both foolish and increasingly frightened, I picked up one of my shoes and held it up in the air by the toe while I started to creep forward. I was holding my breath, and all I could hear was my own heart as I moved my hand toward the lock. I froze midway. The handle was slowly turning, the door opening.

“Shit!” I muttered, scurrying backward, my shoe still held on high, until my back pressed against the wall behind me. Standing in the dark corridor was a tall slender figure wearing a surgical mask, gown, and gloves who was taking off a lab coat.

Janet gave a low chuckle and said softly, “Now that’s no way to greet a lady who’s come to offer you a little affection.” She stepped into the room, then came toward me, dropping her coat as I put down my shoe.

“You scared me half to death,” I whispered, slipping my arms around her. I quickly discovered she’d dressed exactly as she had promised, the feel of her naked body under her greens making me catch my breath and quickly igniting my hunger for her. We kissed greedily. As I slid my hands lightly over her back and down between her hips, she stood on her tiptoes, letting my fingertips feel her heat and readiness, even from behind. Her own hands reached for mine, then glided them up across her stomach to circle around and touch her nipples, already erect from my kisses. We continued to propel our desire for each other with our hands, our mouths, and our words. By the time we were on the bed, she was trembling. She slid me into her with a deep thrust that unleashed a long low growl from her throat; the sound and feel of her seared through me like lightning. While outside the storm surged and shrieked, we writhed, rode, and urged each other up ever higher waves of ecstasy, until, fused in a glorious instant, we lifted ourselves over the top and descended, clinging together, into the freeing, pulsing release that comes to souls whose joining is blessed by love and driven by a healthy dose of lust.

“I don’t suppose this place has room service” was Janet’s first comment after we had breath enough to talk.

“I wouldn’t even drink the tap water. It’s brown with God knows what from the pipes.”

“Well,” she exclaimed, throwing off the covers and hastily starting to pull her greens back on. “This lady of the night is going back to UH where I can at least have a shower.”

Outside the storm continued as intense as ever, the wind buffeting against the windows and peppering the panes with rain so driven it sounded like particles of sand blasting the glass.

“By the way, I may have at least one piece of good news,” she informed me as I watched her continue dressing. “Harold Miller was at our ID meeting this morning. He’d come in after Cam had notified him at home about the organism that killed his mother. Cam made a point of stressing to us that the only way this organism could be stopped was by decolonizing it from contaminated surfaces in the hospital and from human carriers. He was looking right at Miller when he reemphasized that once this particular bug took hold clinically, there wasn’t anything anyone could do to stop it. Obviously he was calling on us to be vigilant, but I also got the impression he was specifically telling Harold to stop tormenting himself with the idea that his mother might have been saved if you hadn’t sent her home.”

I winced, but I was also relieved that at least Cam seemed to be on my side. His support might prove important if Miller took me to court. “So what’s the good news?” I asked, immediately regretting how harshly I threw the question at Janet.

“Hey, I’m not the bad guy here, and neither are you,” she reproached me gently as she finished pulling on her white lab coat over her otherwise revealing garb.

“Sorry, Janet,” I said, reaching for her hand.

She sat down on the side of the bed and continued to speak while stroking my head. “The good news is that after the meeting. Miller came up to me and asked that I tell you he’s sorry for reacting so harshly. He didn’t say anything more and he’s of course still looking pretty shaken about his mother’s death, but I think he may be seriously reconsidering his initial anger toward you. In fact, he seems instead to be focusing that anger more toward the organism we’re up against. He insisted on coming back to help set up all the screening that had to be done, and the man worked like a demon all day, pitching in with taking samples whenever he wasn’t running off to deal with some snag or other in the lab. I suppose it’s his way of striking back at what killed his mother.” She leaned over me, gave me a soft kiss, her lips still full from our lovemaking. “So you see, as I told you, things might work out with him after all,” she whispered.

I felt a mix of relief, surprise, and puzzlement. “But if I’d clued in that first day, hit her with a dose of erythromycin before the staph took hold—”

She silenced me by gently placing her fingers on my lips. “Stop beating yourself up. Wait until they find out in Atlanta about the incubation and prodrome of this bug and if anything you might have done would have made any difference.” Then she got off the bed and let herself out of the room.

* * * *

By noon Saturday, we had taken culture specimens from most of the remaining patients who were recalled for screening. We had not yet reached about fifty cases but would follow them up by home visits.

By Saturday evening, preliminary culture results showed no vancomycin-resistant organisms in either staff or patients but suggested the possibility that a few of the hospital workers were carrying MRSA. Some of them were already under quarantine. Those at home were called in, and they all were subjected to bactericidal soaps and intranasal mupirocin ointment.

By Sunday afternoon, all the cultures taken on Friday were confirmed to be negative for staphylococcus resistant to both vancomycin and methicillin. And there wasn’t any evidence of the vancomycin-inhibiting strain that had been discovered in Japan. The only positive findings were confirmations of the MRSA carriers already identified by the preliminary results. The ER itself was given a clean bill of health and would open that evening.

All in all, as far as the men and women from Atlanta were concerned, it was an unbelievably good result. The superbug they’d been anticipating with such dread had come out of nowhere, claimed a single victim, and then vanished without a trace, at least without the sort of trace that could be detected by culturing nooks and crannies of rooms, sundry pieces of equipment, and the hands, nails, and nostrils of anyone who’d been near Sanders. At a 4:00
P
.
M
. wrap-up meeting, everyone was clearly buoyant with surprise and relief.

“We lucked out,” the gray-haired chairperson of their hospital infection group kept saying, slapping his colleagues on the back and congratulating them on a well-run operation. Rossit and Hurst watched this good cheer nervously at first, then seemed to realize that they were now likely to end up looking good, given how the operation had gone, and tentatively joined in the handshaking. For me, just getting to shed the protective gear we’d been stuck in for over two days was a cause for celebration. Particularly annoying had been the way my mask trapped the humidity from my breath, constantly steaming up my glasses.

I found Hurst’s demeanor toward me controlled and cold as usual. I hadn’t seen him since he’d muttered his threat to be rid of me, but there was no evidence this evening of the overt malice I’d felt then. I had to admit, the more I’d thought about the encounter, the more I’d found it puzzling. Hurst rarely attacked me or anyone else directly, let alone announced his intention to do so. His preference was to sandbag his adversaries from behind the scenes, in ways that were easily denied and hard to prove. I would have expected him to simply let the blame for the Sanders case give him the excuse he needed to dump me as chief, without ever having to confront me directly. Had the angry words slipped out spontaneously, spurred by his fury about all the negative publicity for St. Paul’s? Or had he deliberately tried to rattle me, as some sort of distraction? His steely expression gave me no answers.

Williams was nowhere to be seen. “Probably back with his ducks,” one young woman from the CDC team told me jokingly when I inquired where he was. Her crack at his expense produced a few other laughs from her colleagues, but I doubted they were mocking him. Rossit’s recognition of him two days ago, even with all the obsequious antics, had suggested there was much more to Williams than some obscure study of botulism in ducks.

The chairperson from the CDC called the meeting to order, but while some of the group excitedly reported on the work already under way in Atlanta to isolate VanA genes from the organism’s DNA, and others outlined the myriad studies that would be performed on the cultures and autopsy specimens taken from Phyllis Sanders, I was thinking of
Legionella
again.

I’d dropped by the labs just before the meeting. Over the weekend the protracted process of special cultures and immunofluorescent staining procedures that I’d ordered on Sanders’s sputum had finally produced a positive result, but the result had gone unnoticed in all the excitement.