The Virus (2 page)

Lowell Kaplan was met at Kennedy Airport by Dr Charles Graham, an old friend. Where Kaplan had ended up at the Center for Disease Control in Atlanta, Graham — who was a New Yorker, anyway — had gone to the Division of Tropical Medicine at Columbia University.

As they rode into the city together, Graham filled in the details.

“I don’t know how much they told you,” he began, “but I’ll begin from the beginning and try and give you the whole picture.”

“Go ahead. All I’ve had so far is a brief talk on the telephone with New York City’s Chief Medical Officer. And he sounded worried as hell. Then I left at once for the airport. Delta had to hold the plane, even then.”

As they joined the stream of traffic coming into the city in the early evening, Graham reviewed the history of the case so far.

“What we’ve got is a young female student — around nineteen years old — who’s been spending the summer in Europe. She returned from Brussels a few days ago, came straight to her apartment in the city and went to bed. One morning, six days later, she had a pain in her throat and could barely swallow. She consulted her doctor, who examined her and found several blisters on her neck and yellowish ulcers in the back of her throat and inside each cheek. She had a fever and seemed unusually nervous.

“During the next three days her temperature soared; she began bleeding under the skin, there was swelling in her neck, she appeared unusually weak and drowsy, her speech grew slurred, her mouth was dry, she had great difficulty in swallowing and her face alternately flushed and turned pale. By then her doctor was extremely alarmed. He called us up and we had her brought in to Columbia-Presbyterian Hospital. That was four days ago. Since then we’ve had her in an isolation ward.”

The traffic thickened as they crossed the Triborough Bridge and waited impatiently for the line of cars to pass the toll booth. At last their driver threw his handful of coins at the basket and the light went green for them.

“And how is she now?” asked Kaplan.

“Bad. In fact, I don’t think she’s going to make it. She’s lost twenty pounds in two days and most of her hair. I could weep. She must have been a real looker before this happened.”

“I know. That’s the worst part of this job. You’re dealing with people, not just patients.”

As they passed through Harlem on their way to the hospital, Kaplan looked out at the crumbling red-brick tenement blocks, the garbage piled high on the street-corners, the tattered store-fronts. If ever there was a place ripe for the spread of disease, this was it. He shivered.

They parked in the hospital forecourt, walked down the long main corridor to the bank of elevators at the end and rode up to the isolation ward. Outside the ward they donned gowns, masks and gloves. They entered the room and stood beside the bed. For a long minute, neither of them spoke.

At last Dr Graham said: “I don’t think there’s much else we can do. We’ve tried to keep her hydrated but she loses it as fast as we put it in. She’s quiet now, but before you came she was literally writhing in agony. She was sweating so much you could have driven a steam engine.”

Kaplan looked at the wasted, shrivelled figure on the bed. It was hard to recognize what a beautiful girl she must once have been. Her blond hair had come out in handfuls, her skin had dried out and cracked, her face was contorted.

“Heart?” Kaplan asked.

“Not good. She’s been under terrific strain. Personally, I don’t think she’s going to last the night.”

“Is she sleeping now, or is she in a coma?”

“I’m not sure. She moves in and out.”

As they spoke the girl stirred on the bed. She tossed her head from side to side and mumbled a few words.

Kaplan tried to make out what she was saying.

“Mon . . . mon . . . monkeys,” the girl said, suddenly audible. “Green monkeys.” Suddenly, she rolled back her head and appeared once more to drop into a trance.

Kaplan looked at Graham with amazement. “What do you make of that?”

Graham shrugged. “She babbles quite a lot. Often about animals. I haven’t heard her talk about green monkeys before.”

After they had scrubbed up, they went to Dr Graham’s room.

“We’ve run all the tests we can do here,” Graham said. “And there’s nothing we can pin-point as the specific cause of the disease. We don’t know what we are dealing with. We think it could be something tropical in origin, but we’re not sure.”

“Had she been to Africa before coming back to the States?”

“Not as far as we know. But maybe she was in contact with someone. We are trying to track down her family at the moment to see if we can learn anything about her movements.”

Kaplan stood up and walked over to the window. Far below, the cars were streaming northwards and out of the city. The last rays of the sun glinted on the Hudson River.

He turned back to his colleague.

“We should expect to have other reports, here or around the world, if this is a known disease. We’ve contacted the World Health Organization — WHO — in Geneva. So far, nothing.”

“What did she say to her doctor?”

“Not much, apparently. She was pretty sick by then.”

“I might go and talk to him. Do you know where he lives?”

“His office is in Washington Square, down in the Village. And we have the keys to her apartment if you wanted to visit that.”

Kaplan was in a sombre mood as he caught a cab downtown. There was something in what he had just seen that had moved him deeply. A head on a pillow; a form on a bed. Pipes and tubes. Masks. Temperature charts. All the paraphernalia of sickness. Yet once there had been an identifiable personality there, a face to be known and loved.

He went to the apartment first. Detective work was part of his job — often a large part — but he always felt awkward moving around among someone else’s possessions. The place was larger than he had imagined. Diane Verusio, as he had learned the girl was called, lived in a rather graceful house on Bank Street, a couple of blocks from the river. Her apartment was on the first floor.

The first room he entered was a spacious sitting-room, giving out onto the street. It was prettily decorated and lined with books and pictures. The dominant theme was wildlife of every kind. Over the mantelpiece was a huge photograph of Nrongoro crater at sunset, with a cheetah’s head in the foreground poking out above the grass. There was also a photograph of Treetops with a group of elephants at the waterhole. Next to it stood a smaller picture of a girl in a safari outfit. A young, attractive face with a wide smile and honest eyes. It was hard for Kaplan to link the face in the photograph with the wasted form he had seen on the bed in Columbia Presbyterian.

On the table in the middle of the room was a stack of papers and reports. Kaplan glanced through them quickly. One in particular caught his attention. It was entitled: “PRELIMINARY DRAFT OF REPORT BY THE INTERNATIONAL CAMPAIGN AGAINST VIVISECTION — The Use of Monkeys in Medical Research.”

Monkeys! He remembered the words Diane Verusio had gasped out during his visit to the hospital. There must be a clue here, he thought. He put the report in his pocket. He would find time to read it later.

Still with an uneasy sense of being an intruder in another person’s life, Kaplan moved from the sitting-room into the bedroom adjoining. The bed was unmade and clothes were strewn about the room.

His eyes fell on an airplane ticket lying on the floor. He picked it up and examined the remains of a return coupon: Brussels — New York. The outward flight had been May 5th and the return was dated June 6th. That was twelve days ago. He made a note of the flight numbers and dates and put the ticket in his wallet.

He stood there for a moment beside the bed, thinking. In his experience, most exotic tropical diseases had relatively short incubation periods. The girl had entered hospital four days ago. She had, according to Dr Graham, experienced the onset of her illness two days before that when she complained of a sore throat and a headache. With an incubation period of, say, six days, Diane Verusio could have become infected on the very day she travelled. Well, thought Kaplan, that figured. Airports, particularly in the summer months of mass travel, were the breeding grounds of diseases. A great tide of humanity flowed through them. With the new standby system, people often packed the terminals waiting for places on overcrowded planes. In the most literal sense, they breathed in each other’s germs.

He lingered for a few minutes in the bedroom, suddenly overwhelmed by the sadness of it all. The girl was going to die. He was sure of that. Who was going to come and clear up, pack up the clothes, fold away the sheets? Who was next of kin?

On a small table next to the bed was a framed colour photograph. Two smiling girls stood side by side, their arms about each other. One of them was clearly Diane Verusio. Who was the other? Kaplan wondered.

He picked up the photograph and studied it carefully. There was a strong family resemblance between the two faces. The other girl was younger and darker than Diane, brunette rather than blond. A younger sister, perhaps? A cousin? Kaplan looked at the picture for a full ten seconds; looked especially at the younger girl. He had a strange, almost psychic feeling that the soft brown eyes were saying something to him, pleading with him almost.

Later that evening, after he had left the apartment on Bank Street, Kaplan called on Diane Verusio’s medical practitioner.

Isaac Reuben was an elderly gentleman, well into his sixties. When Kaplan entered the surgery on Washington Square, the doctor took his time in rising to his feet behind a cluttered desk. He walked round to greet his visitor and Kaplan warmed instinctively to what he saw. Isaac Reuben was of short but solid build; he had a pepperpot mixture of black and silver short curly hair. A grey cardigan was buttoned across a generous paunch. The fingers of his hands were short and stubby. Reuben wore a wedding ring, Kaplan noted, but from the general disarray of the doctor’s appearance and surroundings, Kaplan suspected that he was a widower.

It was the kindliness of Reuben’s expression that struck Kaplan immediately. His eyes, small and black, peered out from beneath black bushy eyebrows and Kaplan’s glance fell on a framed and faded photograph on the mantelpiece. Reuben, noticing, explained.

“My parents. Isaac and Miriam Rabinowitz, arriving at Ellis Island in 1897. We changed our name to Reuben during the First World War.”

It was typical of the man that he should put his visitor at ease in this way. There was something so natural and unforced in the doctor’s manner, that Kaplan had no difficulty in explaining who he was and why he had come.

It turned out that Reuben knew the Verusio family well.

“Our families were immigrants together. The Verusios came from Southern Italy.
We
came from Russia. But when we all reached New York, it didn’t make a damn bit of difference where we came from. We all had to pitch in together.” He returned to his seat behind the desk. “I knew the whole family well. It had its share of bad luck, I can tell you. The parents were killed in a plane crash some years back. Now there’s this business with Diane.”

He sat back to listen while Kaplan elucidated the various hypotheses regarding the source of Diane’s illness.

“Yes, she did tell me where she had been,” he volunteered, “but it wasn’t Africa or Asia or the Middle East. She only went as far as Belgium.”

Kaplan nodded in agreement. The air ticket which he had seen gave no indication of an itinerary extending beyond Europe.

Reuben continued: “I believe in looking first for causes nearer home. We can consider the exotic explanations later.”

“Did she have any cuts or lesions?”

“Not as far as I could see.”

“Did she mention any physical contact?”

The old doctor leaned forward across his desk.

“You’re talking about venereal transmission? Frankly, I don’t think she was that kind of girl.”

Kaplan felt suddenly ashamed. He remembered the homely nature of the apartment he had just visited, full of books and pictures of wildlife.

“No, of course not,” he said quickly. He changed the subject.

“One last question, doctor. We are going to have to try and trace her contacts. All her contacts. We’ll get onto the airline, though I’m not sure that will do us much good. You can’t rely much on the passenger manifest nowadays, particularly with these standby flights. In any case, with most exotic diseases, the infectious stage is linked to the first appearance of the symptoms. My guess is that she wasn’t in a position to transmit the infection, whatever it is, to anyone else until after she got back to her apartment. Do you know if she saw anyone there?”

“I asked her. I think the answer is probably no. There’s no doorman in her building. She told me she went straight to bed when she reached home. When she called me, I went round to her.”

Kaplan smiled. “You must be one of the last doctors to make house-calls.”

The old man smiled. “I know I’m a bit old-fashioned. But when someone says they’re ill, I don’t believe in making them drag themselves through the streets.”

Kaplan stood up to go. He had made a decision.

“Dr Reuben, I hope you won’t think I’m making a lot of unnecessary fuss, but I think you should come into the hospital yourself. As a precaution.”

The old man looked surprised. “Whatever for?”

Kaplan explained. “Look at it this way. On present showing, it looks as though Diane Verusio — somewhere, somehow — has contacted a dangerous exotic disease. The girl is very sick. Very sick indeed. She’s probably going to die. We don’t know, or at least we don’t know yet, what the disease is. And we don’t know how to treat it. We know it’s infectious because Diane Verusio caught it from someone or something. She wasn’t born with it. The likelihood is that you were the only unprotected person with whom she was in contact during the infectious phase.”

“What do you mean?”

“I mean that when you had her moved from here five days ago, she was taken by ambulance under sterile conditions to the Columbia-Presbyterian Hospital. At the hospital, she has been in the maximum isolation ward.”