Exposed (36 page)

Sunday, September 30, 2007
The Slammer

Maggie stood in the small but private shower, letting the hot water dismantle the chill that had seeped deep inside her, down to her bones. Then she put on a fresh hospital gown—there was a stack of them in the bathroom. She tried not to count them, tried not to think how long they expected to keep her here.

Hair still damp, she lay down on the bed and managed to dose off between the stiff bedsheets. She wasn’t sure how long she slept. She had convinced herself to close her eyes. Just for a minute or two. Staring at the computer screen all day had given her a headache. That was all it was. Eyestrain. Sleep deprivation. Stress. Not a parasitic virus duplicating itself throughout her bloodstream.

She wouldn’t let herself think about it. She couldn’t, and yet, visions invaded her sleep. It was like an old jerky, film projector with colorful purple and pink amoebas that joggled from side to side, bumping each other and splitting into two. Another bump, another split. Dozens turning into hundreds.

Her eyelids fluttered open several times before she noticed him. He stood on the other side of the glass wall, watching her, watching over her. That’s what it felt like. Warm brown eyes—serious, soulful eyes—keeping watch, and for a second or two in that half-asleep, dreamlike state she could almost convince herself that he could protect her.

He smiled when he saw that she was awake, but he didn’t move, didn’t shift, didn’t wave her over. He just stood there, arms folded over his chest, his smile the only movement. His smile and his eyes.

She sat up on the edge of the bed, disappointed to hear that throbbing in the back of her head was still there, joined by a quickened heartbeat that the amoebas had caused. Rest had not relieved her.

They picked up the phone at the same time, already a synchronized deliberation between them.

“I didn’t expect to see you again so soon.”

“Are you kidding? You’re my favorite patient.”

For an Army colonel he certainly could be charming. The dimples only added to the effect.

“How are you feeling?” Face serious again, eyes still soft, genuine, caring. Meaning no more jokes.

“I have a headache.” It wasn’t something she would normally complain about, but she knew he needed to know, to make a checklist.

“Tell me where exactly.”

She sat down. He followed her. She closed her eyes and listened to the throbbing. “Back of the head,” she said, eyes still closed. “At the base of the skull. Right above the neck. The pain’s a throb more than an ache.”

She opened her eyes, met his. Only she couldn’t assess what he was thinking. She automatically reminded herself that he was good at hiding alarm. He was a doctor and soldier, a combination sure to disguise and dissuade emotion. Only something about his eyes gave him away, told her that it wasn’t all that easy, that it was a constant challenge.

“Your blood is still not showing any indication of the virus. You’re not breaking with any of the symptoms. Usually the headache is behind the eyes, circling inside the head, like someone knocking against the inside of your forehead. Chances are what you’re experiencing is stress and fatigue. You haven’t eaten much, either. I’ll have them send up whatever sounds good. Get something into your immune system. We need to keep you strong. And I’ll have Dr. Drummond bring you some Advil gelcaps.”

Dr. Drummond. She found herself realizing she had never been given a name for the woman in the blue space suit. Only now, after almost two days, she wondered why she had never asked.

Being a professional cynic, Maggie examined Platt, looking for cracks in his facade, indications that he might be keeping something from her.

“You don’t believe me,” he said, startling her. She didn’t realize her skepticism was so obvious.

“I’ve read the virus can lie dormant within a host.” Maggie said it quickly. Go ahead and hit him with your best shot. No apologies. It was her life they were batting around, after all.

He hesitated. Did she know too much? Was he sorry he had been so straightforward with her before?

“The virus lives somewhere in Africa and yes, we believe it must lie dormant in a perfect host though we’re not sure what that perfect host is. There’s speculation that it could be bats. Scientists have practically swept every foot of places like Kitum Cave at the base of Mount Elgon in Kenya and Uganda, looking for any signs of where Ebola lives when it’s not jumping to primates and humans. But here’s the thing…” He waited until he was certain he had her full attention or maybe he wanted to make certain that she believed him. “Ebola doesn’t lie dormant in primates and humans. It devastates them and it does it quickly.”

“But there’s an incubation period. Anywhere from two to twenty-one days. Does that mean I could have been exposed and not know it for twenty-one days?”

“Victims usually break with symptoms within one to three days. The incubation period refers to the time it takes for the virus to run its course from symptoms to illness to organ failure to—”

“Crash and bleed,” she finished for him.

“Yes,” he said. Then continued, “Understand I’m not saying that it’s impossible to be exposed, to show no symptoms and then break with the virus on day twenty-one. I’m telling you what is statistically probable. What is known evidence and what I’ve seen myself. This virus usually can’t just sit in humans. It’s instinct is to replicate itself and to do it quickly.”

She nodded. Her eyes wandered before she could stop them. His face told her he knew he wasn’t convincing her. His straight talk brought no comfort. She was beginning to think the throbbing might actually have moved to behind her eyes. Her focus blurred a bit. She didn’t care that he was staring at her.

He sat forward, tugged at the crew neck of his sweatshirt as if he was suddenly too warm. He took a deep breath, blew it out, kept it from rattling through the phone’s receiver.

“Even if you break with symptoms it doesn’t mean it’s fatal.”

“Ebola Zaire? The ‘slate wiper’?” She raised an eyebrow to let him know she really had done her homework. He wasn’t gaining any points here.

She wasn’t sure why she was throwing around so much cynicism, first at Gwen, now Platt. Her own survival instinct kicking in perhaps. Fear had the tendency to make her look over her shoulder and search every shadow rather than sit back and wait for a lifeline to be tossed to her. And inside this airtight, air-locked, air-sealed room she could do nothing but search through the shadows.

Platt let out another sigh. But it was exhaustion. Not frustration. He rubbed at his jaw and swept a hand over his face. Maggie took notice of his long fingers, manicured nails, veins and tendons taut, a strong hand but gentle as he massaged his temple. He mistook her examination for contemplation. He must have thought he finally had her attention. Those intense eyes held hers for a long minute before he said, “You need to trust me.”

He let that statement sit. When she didn’t respond, didn’t object, he added, “There’s a vaccine. It hasn’t been approved yet by the FDA. It’s proven to be safe and effective in primates. We’ve had only a few opportunities to use it in human cases, lab-research settings where a scientist accidentally got exposed and infected.”

This time Maggie sat up. She hadn’t read anything about a vaccine. Treatment, in all of the literature she had accessed, talked only about “supportive care” and making the patient comfortable for the inevitable.

“It’s most effective,” Platt continued, “if it’s given in a series of injections. Sort of like rabies. It helps the immune system fight off the invading virus. But it also depends how soon the injections are administered after the exposure. I’m not going to lie to you. There’s only a fifty-fifty chance if the immune system has already been compromised or if symptoms have already started. But that’s not the situation in your case.”

Maggie didn’t need to ask. She knew that was the case for Ms. Kellerman. Was it for Mary Louise, too? Cunningham?

“I want to use the vaccine on you. I don’t have the FDA’s approval to use it on civilians, so I can’t unless you sign a release that—”

“I’ll sign whatever you need,” she interrupted. She didn’t need to think about it.

He looked surprised that compliance would be that easy. But he didn’t question her, didn’t ask if she needed time to think about it. She knew there wasn’t time for any more questions.

“Dr. Drummond will be in shortly to administer the first injection.” He stood, finished. “I’ll also have someone bring you something to eat. You have to eat. Any requests?”

“I do have a request,” Maggie said. “But it’s not food.” He nodded and waited. “I want to see Assistant Director Cunningham.”

“That’s not possible.”

“Why? Is he not here at this facility?”

“No, he’s here. Why would you think he’s not here?”

“I don’t have to talk to him. I just…I want to see him.” It looked like Platt wasn’t going to budge. “I need to see him. See that he’s okay.”

He shifted his weight from one foot to the other and Maggie could see his jaw start to clench. She knew the argument—patient confidentiality. There was a privacy issue. He couldn’t divulge anything about any of their cases. They were probably classified. They wouldn’t even let Maggie tell anyone where she was. That’s what she believed the colonel was struggling with in trying to decide. Whether or not to break the rules and let two of his patients see each other.

“I can’t let you see him.” Platt said. “Because he’s not okay.”

Chicago

Dr. Claire Antonelli leaned her forehead against the window looking into the NICU. The babies, including Baby Boy Haney, didn’t look any different, still pink and wiggling just as they had been twenty-four hours ago. But now, because of her, the entire ward had been included in the quarantine.

Claire had spent the night as part of a team drawing blood samples from everyone who may have been exposed to Markus Schroder. The CDC’s early report had left the few administers and doctors who knew about the case in shock. Dr. Miles was pushing for a press conference to warn all those who may have been to the hospital in the last several days. The administration wanted to wait. The CDC wanted to wait. No one wanted to create a panic. But Claire could feel one already brewing in silent glances, shrugs that replaced answers, a nervous tension that already shortened tempers. It wouldn’t take long. Employees would be telling spouses that they wouldn’t be home after their shift ended. Families would start demanding explanations for why they couldn’t visit loved ones. Parents would insist on seeing their newborns. No, Claire knew it wouldn’t take long for the panic to begin.

The CDC representative, Roger Bix, had arrived at four in the morning, wearing an Atlanta Braves jacket and pointed-toe cowboy boots. He looked more like a sports agent than a CDC infectious-disease specialist. And he was young—too young, Claire thought. Young and cocky, giving orders before he even introduced himself. Not a good combination.

She had taken a break and come to the NICU, not to be reminded that these precious babies may have been exposed to a deadly virus, but because she wanted to be reminded of goodness and innocence. Dr. Miles had asked her to think where Markus Schroder may have contracted the virus. The CDC wouldn’t confirm until Monday what exactly the virus was, but Miles had already told Claire they were almost certain it was Ebola.

Days ago, when she was hunting for a clue, she had been over and over with Vera where Markus might have contracted something unusual. But the only trips the two made were to Terre Haute, Indiana, to check on a business that had been in Vera’s family for years. There was nothing remotely close to a safari in Africa or a tour of a research facility. Nothing that could have put Markus in contact with something like Ebola.

Now Vera sat quietly by Markus’s bedside, Markus unconscious and Vera taking on his earlier expressionless mask. She barely responded to outside stimuli, let alone any more questions.

But Vera, Claire was quick to note and to bring to Miles’s attention, didn’t seem to have the virus. Or at least she had no symptoms. They’d find out soon enough from her blood sample—the most difficult sample Claire had drawn all night. Vera had refused at first. Had told Claire that she didn’t want her touching her or her husband. Then she’d relinquished, sticking out her arm and whispering to Claire—fear momentarily cutting through her mask—that she didn’t want to go through what Markus was going through.

“You okay?” Dr. Miles asked from behind her. She hadn’t heard him come up the hall. Hadn’t even noticed his reflection in the glass.

“Tired. But not bad.” She rubbed her neck as she glanced back at him. “How about you?”

“I’m good.”

He gestured for her to walk with him. This ward was quiet, interrupted by the occasional baby cry, unlike the simmering chaos back in the surgery center and critical-care unit.

“Anyone who’s followed procedure,” he began, “should be safe. If they’ve gloved up, disposed of Schroder’s body fluids properly, kept basic protocol, there shouldn’t be a problem.”

“Mr. Bix confirmed that the virus most likely is not spread through airborne particles, but only direct contact with body fluids.”

“That should be a relief, but we both know there are a few who take shortcuts.”

“I know, but there won’t be any denying it this time if they did take a shortcut. I’ve got the unit secretary calling every single person who was in and out of Schroder’s room since he’s checked in, even if it was to change a lightbulb.”

Claire realized he was leading them in a circle around the NICU, a privacy buffer of sleeping babies.

“Surgery’s a different story.” He glanced down at her but kept walking. “We’ve both seen what this virus can do. There was a helluva lot of blood. We all had our hands soaked in it. Hopefully no ruptures in our gloves, no leaks, no swipes at an itch.” At this he smiled. “What a way to test procedure, right?”

“You said body fluids?” Claire tried to retrieve her other examinations of Markus. Did she wear gloves every single time? Then she remembered the black vomit. The alarm must have registered on her face and Dr. Miles noticed.

“Look, Claire, the hospital is letting the CDC call the shots. That’s their business.” He lowered his voice. “Out of all of us, you spent the most time with Schroder. The emergency ward’s setting up an area for employees’ families to come get tested. Get your son in here as soon as you can.”