Fatal Impact (8 page)

‘There’s bound to be a simple explanation. Maybe she’d been up all night on call and got the date wrong in her mind. I’ll see her tomorrow anyway, and call Damien to let him know she’s fine.’

Bob’s phone chimed a song from Herman’s Hermits. ‘It’s Evelyn,’ he whispered to Anya. He listened for a moment. ‘You did the right thing calling the ambulance and me .
. .’
His eyes widened. ‘I’ll go straight to the hospital.’

Anya grabbed her bag and caught the eye of the waitress for the bill.

‘I don’t understand it,’ Bob said. ‘She had a bit of an upset stomach when I left. Lucky her neighbour checked. She was on the floor, bleeding.’

11

T
hey arrived in emergency as the ambulance transporting Evelyn pulled into the bay. She was pale, lying flat with fluid infusions in both arms. Blood stained a section of her hair and shoulder. Visibly shaken by his cousin’s appearance, Bob bent over and held her hand. One look at the patient and the triage sister rushed them inside, ambulance officers describing the vital signs as they went.

Bob was asked to speak to another nurse. They needed Evelyn’s medical history and details. Anya stayed with him.

‘When can I see her?’ he repeatedly asked.

‘The doctors are assessing her, then you’ll be allowed in.’

As they spoke a large man pushed past them.

‘Excuse me,’ the nurse said, and quietly asked a ward clerk to call security. ‘Sir, before you leave, I need to take that cannula out of your arm.’

The man responded with a choice set of expletives directed at the staff and ripped out the tube, spilling blood on the floor. Another nurse ran to his aid wearing gloves and holding a dressing pad. He pushed her aside and staggered off. Bob watched in disbelief.

‘A Friday night special?’ Anya asked.

‘And it isn’t even a full moon. They’re starting early tonight. Drunks, drugs, who knows what else?’ the nurse attending them said. ‘Sorry you had to see that.’

Bob was distracted. ‘Will Evie be okay?’

‘She’s in the best place,’ Anya comforted. After giving the admission details, they retreated to the waiting room and found the only two vacant seats. Bob sat, face in his hands.

He and Evelyn had grown up a street apart and were closer than most brothers and sisters. Anya finished quizzing him on any medical details he knew about his favourite cousin. He stressed how many close relatives had died of heart attacks at an early age and how Evie had tried hard to prevent developing it with a healthy lifestyle.

Anya had enough to at least give the doctors a list of Evelyn’s medications and major conditions. She excused herself to speak with the registrar or specialist on duty. The triage nurse looked her up and down. ‘They’re very busy.’

‘I’m a doctor. I have some background on the woman who was just brought in.’

The ward clerk dialled the phone on her desk and said something Anya couldn’t hear over the waiting-room noise.

‘I’ll take you through,’ she said through the glass window. ‘Meet you round the side. Dr Saba’s the specialist on duty.’

When they entered through the plastic doors, they were greeted by a petite woman with short black hair, stethoscope and pen dangling from her neck.

‘Dr Anya Crichton.’ The pair shook hands.

‘I know. I saw you speak this morning,’ the woman said.

It made sense an emergency specialist would attend the conference.

‘Ranu Saba. What brings you here?’

‘Miss Reynolds. Found collapsed on her floor. My father is her cousin and next of kin. He’s been staying with her for a couple of days. Only meds we know of are antihypertensives and cholesterol tablets.’ Anya handed over a piece of paper with the names of the treatments. ‘I can check the doses later.’

‘What is her normal health status?’

Phones rang at the desk behind them. Every bed appeared full. Someone moaned in pain behind a curtain.

‘She’s fully independent, works full-time as a special needs teacher, doesn’t drink alcohol, is a non-smoker and is allergic to penicillin. Strong family history of ischaemic heart disease. Both parents and a brother died of myocardial infarcts in their forties. Dad says she complained of stomachache earlier and thought she had a virus. He wasn’t there when she collapsed.’

‘She hit her head when she fell and needs sutures, so we’re trying to assess her neurological function. However, she is hypotensive and tachycardic. Any history of inflammatory bowel disease, ulcers?’

‘No, as far as I know, she’s otherwise healthy and doesn’t take NSAIDs or aspirin.’

A younger doctor brought a green bowl with fresh blood in it.

‘Bed nine just had a haematemesis and dropped her BP.’

‘Get two units of O-negative ready for transfusion and cross-match her for four. I’ll call the gastro registrar. She’ll need an urgent scope.’

‘Dr Saba, we’re ready for the lumbar puncture.’ A fresh-faced male stood proud in a white coat, but his forehead was damp with perspiration. He was either a student or an intern.

‘I’ll be there shortly. You scrub.’

The month was January, when new doctors began working, and residents rotated to new departments. A month ago, many of the doctors on duty would have been at least a year more experienced.

‘We’re doing fourteen-hour shifts for the first month to cover the new interns. I’m sorry, doctor, but I need to go. Thank you for your assistance.’

A nurse handed Dr Saba a message. ‘Two more D&Vs, an MVA and a GI bleed coming in.’ Anya stepped back.

‘You might need to put the D&Vs in the holding room, for now,’ Dr Saba said.

D&V stood for diarrhoea and vomiting. Anya said quickly, ‘Can I ask, how many cases of gastro have you seen today?’

‘I think this will be four tonight. Why?’

A monitor alarmed for a few seconds then continued its regular beeping.

‘I was at the PM today of a child who died of what looks like Haemolytic Uraemic Syndrome.’

‘Were they in our intensive care?’

‘She never made it to hospital. Blood film had gram-negative organisms. The lab is trying to determine what strain of E. coli, but we have to wait for cultures.’

Dr Saba sighed. ‘Meanwhile other patients could be incubating. Any idea of the source?’

Another nurse interrupted. ‘Can you please write up another pethidine? The ankle fracture’s in distress and our favourite orthopaedic registrar forgot before disappearing back to theatre.’

Emergency medicine was multitasking at its best. The doctor obliged.

‘No. But she’d been on a raw foods diet.’

A heart monitor alarmed and Dr Saba moved to the bedside of a man on life support. A nurse handed her a printout of an ECG and a drug chart. ‘We’ll give him another 0.5 mg of atropine and repeat in two to three minutes if the rate doesn’t pick up.’

They moved out of the way of a radiographer with a portable X-ray machine who scanned the patient list near the desk.

‘Bed nine,’ Dr Saba instructed. ‘Tell me her BP.’

A buzzer rang three times. ‘I’m sorry, I have to go,’ Dr Saba said again. ‘We’ll do our best for your cousin.’ She disappeared behind a cubicle curtain followed by two nurses and two more doctors. It was a cardio-respiratory arrest.

A male nurse rushed past with a defibrillator on a trolley. A ward clerk showed Anya to a relatives’ kitchen where she could make a cup of tea. Staff would find her if there were any changes. A row of grey plastic chairs were outside and more private than the waiting room. It could be hours before they knew more.

On the way out of the department, Anya noticed the whiteboard with patient and bed names. Evelyn Reynolds was listed as bed nine.

Her father looked numb when she returned with two black coffees. ‘She was fine when I left, just an upset stomach. I mean, she’s never even taken a sick day. Is it her heart?’

‘No. She just vomited blood so they’re going to have to do an endoscopy, to look inside her food pipe and stomach, to make sure she’s not bleeding from an ulcer. They’re organising it now.’

They sat for a moment in silence. Four cases of gastroenteritis brought in tonight so far. Anya was beginning to be more fearful that the organism that had killed Emily hadn’t come from the Quaid garden. ‘Dad, it’s possible she has a kind of food poisoning. Can you remember what you’ve each eaten over the last few days?’

If they had eaten the same thing, he, too, could be incubating the bacteria. ‘Meat, vegetables, salads, anything that may not have been properly cooked.’

She pulled out a notebook and a pen from her bag. ‘Jot down what comes to mind, and where Evie gets her groceries from, if you know.’ Bob silently took notes. They’d bought food at the local supermarket.

Anya remembered the hairdresser talking about Jenny volunteering at the food exchange for the farmers’ market.

‘Does she eat much organic or fresh food?’

‘She gets those from the fresh food market on the weekend. Lamb and vegies.’

Anya pulled her iPad out of her bag and accessed the photos of Jenny Quaid’s kitchen. Tomatoes, carrots and spinach were in the vegetable drawers. No processed meats, just a small pack of sausages. Anya hoped the swabs came back quickly, so they could at least identify the source and recall whatever carried the bacteria. Or at least warn people and whoever produced it.

The emergency ward clerk left her office again, this time asking Anya if Dr Saba could see her – alone.

She left Bob and re-entered the ward.

Dr Saba peeled off surgical gloves and stood at the sink. ‘Thought you should know. There’s another confirmed case, a seventy-five-year-old man who came in a couple of hours ago. Blood film shows E. coli. His daughter called an ambulance when he didn’t answer the phone.’

‘Is he from anywhere near Huonville?’ Anya hoped he may have been part of Jenny Quaid’s food exchange. That would at least limit the number of people potentially exposed to the contaminated food.

‘No, Battery Point, here in Hobart. Why?’

Anya sighed. The source was unlikely to have come from the vegetables Jenny Quaid had grown.

‘Can you find out what he’s eaten and where? We need to identify the source.’

Dr Saba shook her head. ‘I’m sorry. He was in renal failure when he arrived. He died five minutes ago.’

12

A
nya returned to the hotel and slept for a couple of hours. Bob remained by Evelyn’s side in the high dependency unit. The gastroscopy showed tearing in the oesophagus from the strain of vomiting. Bloody diarrhoea had begun a couple of hours ago. By then Evelyn had developed kidney failure and fluid on the lungs. Her condition was critical, but stable. For the moment.

Further, a blood smear had confirmed an E. coli infection. Through Dr Saba, Anya now knew of five confirmed cases, including two new cases that had come in overnight in Hobart alone. So far, the death count was two. She hoped Evelyn and the others could survive.

Her father had given her a key to Evelyn’s home, so in the early morning light she drove over to collect a change of clothes for him. A knock on the door at 8 am was a food inspector from the department of health. She appeared at the door with a large box briefcase containing forms, swabs and collection packs.

She handed across a piece of paper. ‘The information on here informs you what I have to do. Can you tell me where the kitchen is?’

Anya showed her through. The woman was no-nonsense, and didn’t bother with small talk. Anya appreciated that.
‘I guess you won’t be wanting a glass of water, tea or a coffee.’

‘Never eat or drink on the job.’

It was easy to see why. The purpose of visits was to swab for potentially lethal infections.

The stainless-steel fridge was immaculately clean, with not even a finger mark on the door. Different from Anya’s white fridge, adorned with artwork by Ben and pictures of them together.

On the top shelf was a plastic bowl covered in cling wrap, half-filled with lamb stir-fry, one of Bob’s favourites. The inspector used plastic tweezers to take a sample from the centre and placed it into a small sealed container. She labelled the location, date and time. Sauces were lined up in a slide-out container. None of them were of interest to the inspector. Grapes half-filled a dessert bowl. A number of grapes were collected, this time with fresh tweezers.

‘Do you know if the resident has visited a petting zoo or dairy farm recently?’ The woman scratched her neatly trimmed grey hair with a plastic pen.

‘Not as far as I know.’

‘Any unpasteurised products? Milk, cider?’ Anya checked the inside of the door: supermarket-lite milk, and orange juice in a one-litre container, unopened. ‘No.’

‘What’s in the freezer?’

Homemade frozen lasagne, dairy-free mango gelato, and half a spinach quiche accompanied a pack of frozen plain pizza bases. A mango-marinated flat chicken lay in its original packaging. The health inspector selected samples from the quiche and lasagne. Two fillets of supermarket fish caught her attention.

‘Confidentially,’ she said, ‘I’ve swabbed cholera on fish like this.’ She opened the pack with gloved hands. ‘Imported from Thailand. The water was infected and froze along with the fish. That’s why it’s worth identifying as soon as possible, even on a Saturday.’

Cholera infection had never occurred to Anya. As far as she knew, it hadn’t ever caused infection within Australia, instead being found in people who had returned from endemic areas.

Inside the vegetable drawer were tomatoes, capsicum, corn on the cob, eggplant and broccoli, which were all sampled. ‘We all get worried about meat not cooked properly. Most people forget that vermin and insects defecate on the foliage. Can’t tell you how many times broccoli, sprouts and spinach cause trouble. Being an island, at least we don’t have to deal with cockroaches here. Did you know they vomit on food?’

Anya had to learn to live with cockroaches in Newcastle, then Sydney. Despite being one of evolution’s most successful creations, they had not managed to infest Tasmania – yet.

Two green plastic bags were labelled
Livelonger Organics
and sealed with plastic bread ties. Inside one were spinach leaves. The other contained potatoes.

‘Aha. I’ve seen one of these before.’

‘In Bellamy?’ asked Anya.

‘No. At a place outside Signet.’ The inspector stopped. ‘How did you know I’ve been to Bellamy? That was late yesterday.’

‘I was at a house there when a body was found.’

‘You with the police?’

‘No, I’m a pathologist.’

The woman looked Anya up and down. ‘Don’t look like one, not that I’ve ever met any, come to think of it.’ She turned back to her work.

‘You don’t normally see potatoes in the fridge,’ she continued. ‘Unless there are vermin in the pantry. With all the recent rain, mice and rats are moving into roofs and cupboards.’

Decomposing and dismembered bodies didn’t bother Anya. The mere mention of rats and mice was another story.

After taking samples of all the vegetables, the inspector looked at the fruit in a wooden bowl on the table. Oranges, bananas, red and green apples provided a colourful display. Swabs of the apples were taken and meticulously labelled.

Anya opened the pantry. Generic plastic bags hung in a dispenser inside the door, and green bags were stacked inside one another on the floor. There was no sign of mice droppings. She opened the kitchen drawers. Inside the second one was a book titled
Budget
. Attached to the pages were grocery, clothes and bill receipts. Either money was tight, or her aunt had become more organised.

The inspector flicked through the food receipts. She photographed the ones for the past month with a digital camera. ‘Sometimes we can identify the batches from the factories via the codes on the receipts. Not often we get a month’s worth of receipts. With incubation being anything from one to ten days, sometimes we can’t confirm the source. Unless we can trace it back to one factory of smallgoods, or cheese, like they did with the recent listeria outbreak.’

The inspector moved to the bathroom, Anya suspected, to swab the toilet seat for E. coli. Not yet satisfied with her collection, she examined the kitchen bins and scraps container, before asking about the recycling and rubbish bins. To her frustration, they’d been collected the previous night.

Anya’s phone rang. Steve Schiller’s focus remained on Jenny and Mia. ‘As a priority, the stations have agreed to run TV ads asking for Jenny Quaid to come forward. Good thing you picked up her reading problem, ’cause the brass were planning to leak the story to newspapers in the hope she’d see it.’

‘There’ve been more cases.’

‘I heard. I also know you were at the hospital last night. Are you okay?’

‘My father’s cousin is in a critical condition. She’s one of the cases.’

‘Sorry. I had no idea there was a connection. If there’s anything I can do . . .’

Anya watched the food inspector check under the sink. Her neck ached from being in a hospital waiting room for so many hours. ‘Did you need me for anything?’

‘Oh, right. Wanted you to know I’ve been looking into that therapist’s background. He’s definitely a scammer. Weight-loss tea, miracle powders, new healing techniques. Stays a couple of years in one place, just long enough to gain trust and exploit people and then runs out. He deals in cash and kind, and has so far managed to stay under the tax man’s radar. So far, no one’s nailed him, but Jim’s doing some more digging. All those qualifications came from an alternative medicine school. Run and owned solely by him.’

It was no surprise to Anya. The information he had given Jenny about the raw food diets included the comment that diarrhoea was natural once the diet began, and was proof the body was detoxifying.

‘If he misrepresented himself as a qualified practitioner and gave out medical advice, we can charge him with fraud,’ Schiller concluded. ‘And he lied to us. The last number dialled from Jenny Quaid’s phone was to our Mr Heyes on Wednesday.’

Anya suspected that if the call was the reason Jenny hadn’t sought medical help for Emily, Heyes could be charged with manslaughter, or even negligent homicide. Then again, even with medical intervention, there was no guarantee every sufferer would survive. She thought about Evie Reynolds, whose organs were already shutting down.

‘He lied with his lawyer present as well.’

‘Jim and I will go back and interview him. Convenient that Jenny’s not around to tell her side of the story, don’t you think?’