Plague (3 page)

After her father’s death late in life, her mother seemed invincible raising four children on her own. To see her shrink away to nearly nothing and not even know who Sam was most of the time tore her guts out, but she couldn’t stop coming. Her mother had been there when she needed
her
and she was going to return the favor no matter what.

Sam called her sister again but again there was no answer.
As she pulled the phone away from her ear,
she
saw
that the voicemail icon had a one
next to it. She clicked on it and listened to the message:

This
is
Gale with CDC dispatch
.
P
lease
call
Dr. Ralph Wilson immediately.

The time display on the message said she had received it at 3:17 a
.
m.

Sam called the CDC mainline as she leisurely strolled down the sidewalk. It was going to be hot today but for now the temperature was perfect in a cloudless sky. She could see the park
no more than two blocks
away
and throngs of children were already there. Occasionally, she would sit on the benches and watch them for long periods of time.

“CDC dispatch, this is Monique
.”

“Hi
,
Monique
, this is Samantha.”

“Oh
,
hi
,
D
r.
Bower. How are you?”

“Good. I got a message from Gale that Ralph needed to speak to me.”

“Yup.
I’ll put you through.”

After
a click
,
Dr.
Ralph
Wilson, one of the most influential men in public health, sneezed, swore under his breath, and said,
“My wife doesn’t r
eturn my calls either,”
by way of greeting.

“Sorry, I was up until one in the morning working on something for Nancy.”

“Yeah, she’ll do that to you. What was it for?”

“The report you wanted on the influenza outbreak in Khovd.”

“Shelve that. I got something I want you to look in to.”

“What is it?”

“Could be nothing, but
could be something. I know it’s Saturday but you’re the agent on call right now I think.”

“I am. We alternate weeks.”

“It’s an emergency room
physician in Honolulu.
Gerald Amoy.
Goes by Jerry.
Do you have a pen?”

“No.”

“I’ll text you his information. Give him a call. He’s put in a request for help so I took the liberty of booking your flight for two this afternoon. You okay with that?”

“Sure, I didn’t have any plans for today,” she said calmly, hiding her excitement for a free trip to Hawaii.

“I figured you wouldn’t mind. I’ll send his information over now.”

Sam got to the park and sat on a bench
in front of the swing set. A young girl was bei
ng pushed by her mother and Sam
watched the young girl’s smile and the way she would squeal when she got pushed just a bit too high. Sam didn’t notice that her phone had vibrated with an incoming text and when she glanced down at it
she saw that
ten minutes had passed.

She clicked on the number displayed in the text.

“Queen
’
s Medical Center Emergency.”

“Hi, this is Dr.
Samantha Bower with the
Centers for Disease Control. I
need to speak with a
Dr.
Gerald Amoy. I’m returning his call.”

“Let me page him.”

She was put on hold and heard a ukulele with a soft voice singing over it. The lyrics were in Hawaiian and it excited her even more. She hadn’t been on a r
eal vacation
…
well, ever. She had worked her way through medical school at the University of Arizona and
had
no time off during her surgical residency.

Just thinking of the hours she put into her residency in a busy hospital in the suburbs of Chicago
sent a chill up her back. As a matter of course
she would be in the hospital over a hundred hours a week, leaving no more than six hours a day to eat, sleep, drive, shower, spend time exercising, reading, talking with her family, and anything else she might have had to do. Within the first two weeks, she knew she no longer wanted to be a surgeon.

Luckily, she had met the chief of infectious disease research at the University of Chicago’s Department of Biology
at a CME course for physicians. He’d shown up half-drunk and hit on her and then, seemingly to impress her,
indicated he was looking to replace one of the physicians on his staff that was leaving the program due to substance abuse issues. She jumped at the opportunity.
She applied and got the position after just one interview. The fact that it paid half what the average medical school graduate could expect to earn didn’t hurt
,
as there were only seven other applicants.

The nine-to-five research schedule made her feel as if she had been freed
from prison. She completed
three years and was going to take a position with a prestigious clinic in her hometown of San Francisco when she discovered the world
of epidemiology on the job
, and, almost without any effort,
received an offer from the CDC through her connections at the University of Chicago.

“This is Amoy.”

“This is Samantha Bower from the Cen
ters for
Disease Control. I’m just responding to a request we received.”

“Oh, I’m glad you called. Just a second.” There was some shuffling and she could hear him give instructions to somebody. “Sorry about that.”

“No problem. So what can we do for you, Dr. Amoy?”

“I have two patients here that are displaying symptoms of an unknown viral infection. One of them is in critical care
—
I don’t think he’s going to
last much longer. The other has
just started displaying symptoms. We have them both in isolation here in the hospital.”

“What are their symptoms?”

“
T
he first victim
had a rash
that’s now displaying on the second.
The first victim is h
emorrhaging sub-
dermally
.
In the last ten hours or so the skin has begun falling off in sheets. There’s been dark hemorrhaging from the eyes, ears,
penis
,
and anus. We’ve had him on almost constant blood transfusion but it’s not affecting him anymore. I
nfection is spreading through
his body on the portions where the skin has come off. I called
be
cause I didn’t think he’d survive more than another day or two and thought you might want to look at him.”

“I won’t be there until tonight. Can I call you when I land?”

“Sure, I’m heading out
right now but I’m on a twenty-
four-
hour
shift starting at eleven. Just leave a message if I don’t answer right away.”

“Okay, thanks
,
Doctor.”

“No, thank you.”

Sam hung up and took a deep breath as she put her phone away. The symptomology of the victims indicated a severe viral infection. There were any number of
known
viruses that could cause those symptoms, and many more that science hadn’t discovered yet.
Of course, she’d seen similar symptoms before and it had been a false alarm. The patient displayed Marburg virus type symptoms and it turned out that they had smoked a bad batch of methamphetamine, cut with dozens of poisonous substances, over the course of a week. An actual unknown viral infection that could cause those symptoms was extremely rare and the likelihood was that this was something else.

Still, h
er belly tingled with excitement and anticipation, and also fear. This was why she had gone into epidemiology in the first place. She looked at the young girl and smiled at her before rising and heading back to her house to pack.

CHAPTER 5

The layover at LAX took two hours and Sam perused the magazines and books in the gift shop. She had her iPad with her and refused to read any book in paper form that could be found electronically, but there was something relaxing
about
the actual feel of a book in her hand
s
,
the smell of the pages as she flipped through them.

She got a salad with extra cheese and an apple juice from a café at the airport and spent her time reading the
New England Journal of Medicine
near a window, glancing over occasionally as a plane landed or took off. They called her flight and then delayed it another twenty minutes before she was finally
let
on the plane.

It wasn’t until past midnight that she stepped onto the tarmac of Honolulu International. Traveling over the ocean at night had been an experience she hadn’t expected. The moon lit the water a dim white and it looked like a flashlight shining in a pool of black oil. A ship was on the sea underneath the plane and she watched it until it disappeared into the murk of the Pacific at night.

She grabbed her two bags and went to the curb to hail a cab. Rather than finding a hotel, she went straight to the hospital.

Honolulu struck her as a resort town created specifically to cater to tourists. The restaurants, bars, shopping malls
,
and even convenience stores looked uniquely islander. The air had the salty taste of the ocean and it was humid, but pleasant. She kept her window rolled down on the cab ride over and tipped the driver well before getting out.

She stood
,
staring up at Queen’s Medical Center. It too appeared like a resort rather than a hospital. The valet area was lit with the soft glow of
tiki torches
and the
building itself resembled an upscale
hotel. She had read about it on the plane and knew that
, with over five hundred rooms,
it was the largest hospital in the state.

As she walked through the ER
’s
sliding glass doors, she was struck by the familiar smell of hospital antiseptic. Rather than a nostalgic, warm feeling as many physicians had upon entering a hospital when they had not been practicing in the profession, it brought up images of being so exhausted
she
couldn’t keep
her
eyes open and would fall asleep at a cafeteria table. Or of being yelled at by the
attending
or the
chief
for minor errors brought about by the exhaustion, or of turning down dates because there simply wasn’t enough time to sit down for dinner at a restaurant without being called in.

She went to the reception and asked for Dr. Amoy. While waiting, she set her bags down on one of the waiting room chairs and stretched her arms over her head and rolled her neck. She had missed her run today and it was a ritual
that, if ignored, would throw
off her enti
re rhythm and
cause insomnia at night.

“
Dr.
Bower?
”

She turned to see a man in blue scrubs
and
a
white coat approach her. He was tall and lean. Clearly of Hawaiian decent but with light skin and sandy hair. They shook hands and she picked up her bags.

“I’m Jerry
. Nice
to meet you.”

“Nice to meet you,” she said.

“
I take it you haven’t checked into a hotel yet
?”

“No, not yet.”

“You can leave your bags behind the reception desk. The first patient isn’t doing well
. We’d
better head up there as soon as we can.”

She dropped her bags off but took out a legal pad and pen. It was what she always used for notes on field assignments because she could copy them into her iPad before leaving the scene and then throw away the notebook in case it had been exposed to any pathogens.
Such a risk was
minimal but it helped her feel better and was certainly worth the
two-dollar
price tag for a pack of legal pads every few months.

Dr. Amoy took her up the plush elevators to the third floor where there were women’s locker rooms. She changed i
nto scrubs and was given a face
mask, gloves
,
and booties. After changing, she looked at herself in the mirror. Sometimes it struck her how odd a job she really had.
She
was like a fireman that ran into a burning building when everyone else was running out. It was counter-intuitive and certainly anti-evolutionary. Biologically, humans were not set up to expose themselves willing
ly
to disease. If she didn’t control her thoughts and her breathing, panic could strike her as easily as
it would
anyone.