Contagion

29

Detective Lieutenant Lou Soldano pulled his unmarked Chevy Caprice into the parking area at the loading bay of the medical examiner’s office. He parked behind Dr. Harold Bingham’s official car and took the keys out of the ignition. He gave them to the security man in case the car had to be moved. Lou was a frequent visitor to the morgue, although he hadn’t been there for over a month.

He got on the elevator and pushed five. He was on his way to Laurie’s office. He’d gotten her message earlier but hadn’t been able to call until a few minutes ago as he was on his way across the Queensboro Bridge. He’d been over in Queens supervising the investigation on a homicide of a prominent banker.

Laurie had been telling him about one of the medical examiners when Lou had interrupted to tell her he was in the neighborhood and could stop by. She’d immediately agreed, telling him she’d be waiting in her office.

Lou got off the elevator and walked down the hall. It brought back memories. There had been a time when he’d thought that he and Laurie could have had a future together. But it hadn’t worked out. Too many differences in their backgrounds, Lou thought.

“Hey, Laur,” Lou called out when he caught sight of her working at her desk. Every time he saw her she looked better to him. Her auburn hair fell over her shoulders in a way that reminded him of shampoo commercials. “Laur” was the nickname his son had given her the first time he’d met her. The name had stuck.

Laurie got up and gave Lou a big hug.

“You’re looking great,” she said.

Lou shrugged self-consciously. “I’m feeling okay,” he said.

“And the children?” Laurie asked.

“Children?” Lou commented. “My daughter is sixteen now going on thirty. She’s boy crazy, and it’s driving me crazy.”

Laurie lifted some journals off the spare chair she and her officemate shared. She gestured for Lou to sit down.

“It’s good to see you, Laurie,” Lou said.

“It’s good to see you too,” she agreed. “We shouldn’t let so much time go by without getting together.”

“So what’s this big problem you wanted to talk to me about?” Lou asked. He wanted to steer the conversation away from potentially painful arenas.

“I don’t know how big it is,” Laurie said. She got up and closed her office door. “One of the new doctors on staff would like to talk to you off the record. I’d mentioned that you and I were friends. Unfortunately, he’s not around at the moment. I checked when you said you were coming over. In fact, no one knows where he is.”

“Any idea what it’s about?” Lou asked.

“Not specifically,” Laurie said. “But I’m worried about him.”

“Oh?” Lou settled back.

“He asked me to do two autopsies this morning. One on a twenty-eight-year-old Caucasian woman who’d been a microbiology tech over at the General. She’d been shot in her apartment last night. The second was on a twenty-five-year-old African-American who’d been shot in Central Park. Before I did the cases he suggested that I try to see if the two were in any way related: through hair, fiber, blood…”

“And?” Lou asked.

“I found some blood on his jacket which preliminarily matches the woman’s,” Laurie said. “Now that’s just by serology. The DNA is pending. But it’s not a common type: B negative.”

Lou raised his eyebrows. “Did this medical examiner give any explanation for his suspicion?” he asked.

“He said it was a hunch,” Laurie said. “But there’s more. I know for a fact that he’d been beaten up recently by some New York gang members-at least once, maybe twice. When he showed up this morning he looked to me like it might have happened again, although he denied it.”

“Why was he beaten up?” Lou asked.

“Supposedly as a warning for him not to go to the Manhattan General Hospital,” Laurie said.

“Whoa!” Lou said. “What are you talking about?”

“I don’t know the details,” Laurie said. “But I do know he’s been irritating a lot of people over there, and for that matter, over here as well. Dr. Bingham has been ready to fire him on several occasions.”

“How’s he been irritating everyone?” Lou asked.

“He has it in his mind that a series of infectious diseases that have appeared over at the General have been spread intentionally.”

“You mean like by a terrorist or something?” Lou asked.

“I suppose,” Laurie said.

“You know this is sounding familiar,” Lou said.

Laurie nodded. “I remember how I felt about that series of overdoses five years ago and the fact that no one believed me.”

“What do you think of your friend’s theory?” Lou said. “By the way, what’s his name?”

“Jack Stapleton,” Laurie said. “As to his theory, I don’t really have all the facts.”

“Come on, Laurie,” Lou said. “I know you better than that. Tell me your opinion.”

“I think he’s seeing conspiracy because he wants to see conspiracy,” Laurie said. “His officemate told me he has a long-standing grudge against the health-care giant AmeriCare, which owns the General.”

“But even so, that doesn’t explain the gang connection or the fact that he might have knowledge of the woman’s murder. What’re the names of the homicide victims?”

“Elizabeth Holderness and Reginald Winthrope,” Laurie said.

Lou wrote down the names in the small black notebook he carried.

“There wasn’t much criminologist work done on either case,” Laurie said.

“You of all people know how limited our personnel is,” Lou said. “Did they have a preliminary motive for the woman?”

“Robbery,” Laurie said.

“Rape?”

“No.”

“How about the man?” Lou asked.

“He was a member of a gang,” Laurie said. “He was shot in the head at relatively close range.”

“Unfortunately, that’s all too common,” Lou said. “We don’t spend a lot of time investigating those. Did the autopsies show anything?”

“Nothing unusual,” Laurie said.

“Do you think your friend Dr. Stapleton comprehends how dangerous these gangs can be?” Lou asked. “I have a feeling that he’s walking on the edge.”

“I don’t know much about him,” Laurie said. “But he’s not a New Yorker. He’s from the Midwest.”

“Uh-oh,” Lou said. “I think I’d better have a talk with him about the realities of city life, and I’d better do it sooner rather than later. He might not be around long.”

“Don’t say that,” Laurie said.

“Is your interest in him more than professional?” Lou asked.

“Now let’s not get into that kind of discussion,” Laurie said. “But the answer is no.”

“Don’t get steamed up,” Lou said. “I just like to know the lay of the land.” He stood up. “Anyway, I’ll help the guy, and it sounds like he needs help.”

“Thank you, Lou,” Laurie said. She got up herself and gave the detective another hug. “I’ll have him call you.”

“Do that,” Lou said.

Leaving Laurie’s office, Lou took the elevator down to the first floor. Walking through the communications area, he stopped in to see Sergeant Murphy, who was permanently assigned to the medical examiner’s office. After they talked for a while about the prospects of the Yankees and the Mets in the upcoming baseball season, Lou sat down and put his feet up on the corner of the sergeant’s desk.

“Tell me something, Murph,” Lou said. “What’s your honest take on this new doctor by the name of Jack Stapleton?”

After having fled from the drugstore, Jack had run the length of the alley and then another four blocks before stopping. When he had, he was winded from the exertion. In between breaths he heard the undulating wails of converging police sirens. He assumed the police were on their way to the store. He hoped that Slam had fared as well as he.

Jack walked until both his breathing and his pulse were back to a semblance of normal. He was still shaking. The experience in the store had unnerved him as much as the ordeal in the park, even though the store episode had taken only seconds. The knowledge that once again he’d been stalked in an attempt to kill him was mind numbing.

Additional sirens now competed with the normal clatter of the city, and Jack wondered if he should go back to the scene to talk to the police and perhaps help if anyone had been struck with a bullet. But Warren’s admonitions about talking to the police about gang affairs came to mind. After all, Warren had been right about Jack needing his protection. If it had not been for Slam, Jack sensed he would have been killed.

Jack shuddered. There had been a time in the not-too-distant past when he’d not cared particularly if he lived or died. But now, having come close to death twice, he felt differently. He wanted to live, and that desire made him question why the Black Kings wanted him dead. Who was paying them? Did they think Jack knew something that he didn’t, or was it just because of his suspicions concerning the outbreaks at the Manhattan General?

Jack had no answer to these questions, but this second attempt on his life made him more confident that his suspicions were correct. Now he had only to prove them.

In the middle of these musings Jack found himself in front of a second drugstore. But in contrast to the first, it was a small, neighborhood concern. Entering, Jack approached the pharmacist who was manning the store by himself. His name tag said simply “Herman.”

“Do you carry rimantadine?” Jack asked.

“We did last time I looked,” Herman said with a smile. “But it’s a prescription item.”

“I’m a doctor,” Jack said. “I’ll need a script.”

“Can I see some identification?” Herman asked.

Jack showed him his New York State medical license.

“How much do you want?”

“Enough for at least a couple of weeks,” Jack said. “Why don’t you give me fifty tablets. I might as well err on the plus side.”

“You got it,” Herman said. He started working behind a counter.

“How long will it take?” Jack asked.

“How long does it take to count to fifty?” Herman replied.

“The last store I was in told me it would take twenty minutes,” Jack said.

“It was a chain store, right?” Herman said.

Jack nodded.

“Those chain stores don’t care a whit about service,” Herman said. “It’s a crime. And for all their poor service, they’re still forcing us independents out of business. It’s got me angrier than hell.”

Jack nodded. He knew the feeling well. These days no part of the medical landscape was sacrosanct.

Herman came out from behind his counter carrying a small plastic vial of orange tablets. He plunked it next to the cash register. “Is this for you?” he asked.

Jack nodded again.

Herman rattled off a list of possible side effects as well as contraindications. Jack was impressed. After Jack paid for the drug, he asked Herman for a glass of water. Herman gave him some in a small paper cup. Jack took one of the tablets.

“Come again,” Herman said as Jack left the store.

With the rimantadine coursing through his system, Jack decided it was time to visit Gloria Hernandez from central supply.

Stepping out into the street, Jack caught a cab. At first the driver demurred about going up into Harlem, but he agreed after Jack reminded him of the rules posted on the back of the front seat.

Jack sat back as the taxi first headed north and then across town on St. Nicholas Avenue after passing Central Park. He looked out the window as Harlem changed from predominantly African-American neighborhoods to Hispanic ones. Eventually all the signs were in Spanish.

When the cab pulled up to his destination, Jack paid the fare and stepped out into a street alive with people. He looked up at the building he was about to enter. At one time it had been a fine, proud single-family home in the middle of an upscale neighborhood. Now it had seen better days, much like Jack’s own tenement.

A few people eyed Jack curiously as he mounted the brownstone steps and entered the foyer. The black-and-white mosaic on the floor was missing tiles.

The names on a broken line of mailboxes indicated that the Hernandez family lived on the third floor. Jack pushed the doorbell for that apartment even though his sense was that it didn’t work. Next he tried the inner door. Just as in his own building, the lock on the door had been broken long ago and never repaired.

Having climbed the stairs to the third floor, Jack knocked on the Hernandezes’ door. When no one answered he knocked again, only louder. Finally he heard a child’s voice ask who was there. Jack called out he was a doctor and wanted to speak with Gloria Hernandez.

After a short, muffled discussion that Jack could hear through the door, the door was pulled open to the limit of a chain lock. Jack saw two faces. Above was a middle-aged woman with disheveled, bleached-blond hair. Her eyes were red and sunken with dark shadows. She was wearing a quilted bathrobe and was coughing intermittently. Her lips had a slight purplish cast.

Below was a cherubic child of nine or ten. Jack wasn’t sure if it was a boy or a girl. The child’s hair was shoulder length, coal black, and combed straight back from the forehead.

“Mrs. Hernandez?” Jack questioned the blond-haired woman.

After Jack showed his medical examiner’s badge and explained he’d just come from Kathy McBane’s office at the Manhattan General, Mrs. Hernandez opened the door and invited him inside.

The apartment was stuffy and small, although an attempt had been made to decorate it with bright colors and movie posters in Spanish. Gloria immediately retreated to the couch where she’d apparently been resting when Jack knocked. She drew a blanket up around her neck and shivered.

“I’m sorry you are so sick,” Jack said.

“It’s terrible,” Gloria said. Jack was relieved that she spoke English. His Spanish was rusty at best.

“I don’t mean to disturb you,” Jack said. “But as you know, lately people from your department have become ill with serious diseases.”

Gloria’s eyes opened wide. “I just have the flu, don’t I?” she asked with alarm.

“I’m sure that’s correct,” Jack said. “Katherine Mueller, Maria Lopez, Carmen Chavez, and Imogene Philbertson had completely different illnesses than you have, that is certain.”

“Thank the Lord,” Gloria said. She made the sign of the cross with the index finger of her right hand. “May their souls rest in peace.”

“What concerns me,” Jack continued, “is that there was a patient by the name of Kevin Carpenter on the orthopedic floor last night who possibly had an illness similar to your own. Does that name mean anything to you? Did you have any contact with him?”

“No,” Gloria said. “I work in central supply.”

“I’m aware of that,” Jack said. “And so did those other unfortunate women I just mentioned. But in each case there had been a patient with the same illness the women caught. There has to be a connection, and I’m hoping you can help me figure out what it is.”

Gloria looked confused. She turned to her child, whom she addressed as “Juan.” Juan began speaking in rapid Spanish. Jack gathered he was translating for him; Gloria had not quite understood what he’d said.

Gloria nodded and said “si” many times while Juan spoke. But as soon as Juan finished, Gloria looked up at Jack, shook her head, and said: “No!”

“No?” Jack asked. After so many yeses he didn’t expect such a definitive no.

“No connection,” Gloria said. “We don’t see patients.”

“You never go to patient floors?” Jack asked.

“No,” Gloria said.

Jack’s mind raced. He tried to think what else to ask. Finally he said: “Did you do anything out of the ordinary last night?”

Gloria shrugged and again said no.

“Can you remember what you did do?” Jack asked. “Try to give me an idea of your shift.”

Gloria started to speak, but the effort brought on a serious bout of coughing. At one point Jack was about to pound her on her back, but she raised her hand to indicate she was all right. Juan got her a glass of water, which she drank thirstily.

Once she could speak, she tried to recall everything she’d done the evening before. As she described her duties, Jack struggled to think if any of her activities put her in contact with Carpenter’s virus. But he couldn’t. Gloria insisted she had not left central supply for the entire shift.

When Jack could not think of any more questions, he asked if he could call if something else came to mind. She agreed. Jack then insisted she call Dr. Zimmerman at the General to let her know how sick she was.

“What could she do?” Gloria asked.

“She might want to put you on a particular medication,” Jack said. “As well as the rest of your family.” He knew that rimantadine not only could prevent flu, but if it was started early enough in an established case, it might reduce the duration and possibly the severity of symptoms by as much as fifty percent. The problem was, it wasn’t cheap, and Jack knew that AmeriCare was loath to spend money on patient care it didn’t feel it had to.

Jack left the Hernandez apartment and headed toward Broadway where he thought he could catch a cab. Now, on top of being agitated from the attempt on his life, he was also discouraged. The visit to Gloria had accomplished nothing other than to expose him to Gloria’s influenza, which he feared might be the strain that so readily killed Kevin Carpenter.

Jack’s only consolation was that he’d started his own course of rimantadine. The problem was, he knew rimantadine wasn’t one hundred percent effective in preventing infection, particularly with a virulent strain.

It was late afternoon by the time Jack was dropped off at the medical examiner’s office. Feeling stressed and despondent, he entered and allowed himself to be buzzed in. As he passed the ID area, he did a double take. In one of the small rooms set aside for families identifying their dead, Jack saw David. He didn’t know David’s last name, but it was the same David who had driven Jack and Spit back to the neighborhood after the episode in the park.

David also caught sight of Jack, and for the second their eyes made contact, Jack sensed anger and contempt.

Resisting the impulse to approach, Jack immediately descended to the morgue level. With his heels echoing loudly on the cement floor he walked around the refrigerated compartments, fearful of what he was going to find. There in the hall was a single gurney bearing a newly dead body. It was directly beneath the harsh glare of a hooded overhead light.

The sheets had been arranged so that only the face could be seen. It had been so posed for a Polaroid picture to be taken. Such a picture was the current method for families to identify their dead. Photographs were considered more humane than having the bereaved families view the often mutilated remains.

A lump formed in Jack’s throat as he looked down on Slam’s placid face. His eyes were closed; he truly appeared to be asleep. In death he looked even younger than he had in life. Jack would have guessed around fourteen.

Depressed beyond words, Jack took the elevator up to his office. He was thankful that Chet was not in. He slammed his door, sat down at his desk, and held his head in his hands. He felt like crying, but no tears came. He knew indirectly he was responsible for yet another individual’s death.

Before he’d had a chance to wallow in guilt, there was a knock on his door. At first Jack ignored it, hoping whoever it was would go away. But then the would-be visitor knocked again. Finally he called out irritably for whoever it was to come in.

Laurie opened the door hesitantly. “I don’t mean to be a bother,” she said. She could sense Jack’s agitation immediately. His eyes were fierce, like the needle ends of darts.

“What do you want?” Jack asked.

“Just to let you know that I spoke with Detective Lou Soldano,” Laurie said. “As you asked me to do.” She took several steps into the room and placed Lou’s phone number on the edge of Jack’s desk. “He’s expecting your call.”

“Thanks, Laurie,” Jack said. “But I don’t think at the moment I am in the mood to talk to anyone.”

“I think he could help,” Laurie said. “In fact-”

“Laurie!” Jack called out sharply to interrupt her. Then, in a softer tone, he said: “Please, just leave me alone.”

“Sure,” Laurie said soothingly. She backed out and closed the door behind her. For a second she stared at the door. Her concerns skyrocketed. She’d never seen Jack this way. It was a far cry from his normally flippant demeanor and reckless, seemingly carefree ways.

Hurrying back to her own office, Laurie closed her door and called Lou immediately.

“Dr. Stapleton just came in a few minutes ago,” she said.

“Fine,” Lou said. “Have him give me a call. I’ll be here for at least another hour.”

“I’m afraid he’s not going to call,” Laurie said. “He’s acting worse now than he was this morning. Something has happened. I’m sure of it.”

“Why won’t he call?” Lou said.

“I don’t know,” Laurie said. “He won’t even talk to me. And as we speak there is another apparent gang murder down in the morgue. The shooting took place in the vicinity of the Manhattan General.”

“You think it involved him in some way?” Lou asked.

“I don’t know what to think,” Laurie admitted. “I’m just worried. I’m afraid something terrible is about to happen.”

“All right, calm down,” Lou advised. “Leave it up to me. I’ll think of something.”

“Promise?” Laurie asked.

“Have I ever let you down?” Lou questioned.

Jack rubbed his eyes forcibly, then blinked them open. He glanced around at the profusion of unfinished autopsy cases that littered his desk. He knew there was no chance he’d be able to concentrate enough to work on them.

Then his eyes focused on two unfamiliar envelopes. One was a large manila envelope, the other was business size. Jack opened the manila one first. It contained the copy of a hospital chart. There was also a note from Bart Arnold saying that he’d taken it upon himself to get a copy of Kevin Carpenter’s chart to add to the others Jack had requested.

Jack was pleased and impressed. Such initiative was commendable and spoke well for the entire PA investigative team. Jack opened the chart and glanced through it. Kevin had been admitted for an ACL repair of the right knee, which had gone smoothly Monday morning.

Jack stopped reading and thought about the fact that Kevin had been immediately postoperative when he’d come down with his symptoms. Putting Kevin’s chart aside, he picked up Susanne Hard’s and confirmed that she, too, had been immediately post-op, having had a cesarean section. Looking at Pacini’s, he confirmed the same.

Jack wondered if having had surgery had anything to do with their having contracted their respective illnesses. It didn’t seem probable, since neither Nodelman nor Lagenthorpe had undergone surgery. Even so, Jack thought he’d keep the operative connection in mind.

Going back to Kevin’s chart, Jack learned that the flu symptoms started abruptly at six P.M. and progressed steadily and relentlessly until a little after nine. At that time they were considered worrisome enough to warrant transferring the patient to the intensive-care unit. In the unit he developed the respiratory distress syndrome that ultimately led to his death.

Jack closed the chart and put it on the stack with the others. Opening the smaller envelope-addressed simply to “Dr. Stapleton”-Jack found a computer printout and a Post-it note from Kathy McBane. The note simply thanked him again for his attention to the affairs of the General. In a short postscript Kathy added that she hoped the enclosed printout would help him.

Jack opened the printout. It was a copy of everything that had been sent from central supply to a patient by the name of Broderick Humphrey. The man’s diagnosis wasn’t mentioned, but his age was: forty-eight.

The list was just as long as the lists he had for the infectious disease index cases. Like the other lists, it appeared to be random. It was not in alphabetical order, nor were similar products or equipment lumped together. Jack guessed the list was generated in the sequence the items were ordered. That idea was bolstered by the fact that all five lists started out identically, presumably because as each patient was admitted, he required standard, routine equipment.

The random nature of the lists made them hard to compare. Jack’s interest was finding any ways that the control list differed from the others. After spending fifteen wasted minutes going back and forth among the lists, Jack decided to use the computer.

The first thing he did was create separate files for each patient. Into each file he copied each list. Since he was hardly the world’s best typist, this activity took him a considerable amount of time.

Several hours drifted by. In the middle of the transcription process Laurie again knocked on his door to say good night and to see if she could do anything for him. Jack was preoccupied, but he assured her that he was fine.

When all the data were entered, Jack asked the computer to list the ways the infectious cases differed from the control case. What he got was disheartening: another long list! Looking at it, he realized the problem. In contrast to the control case, all five infectious cases had had sojourns in the intensive-care unit. In addition, all five infectious cases had died and the control hadn’t.

For a few minutes Jack thought that his painstaking efforts had been for naught, but then he got another idea. Since he’d typed the lists into the computer in the same order they’d been originally, he asked the computer to make the comparison prior to the first product used in the ICU.

As soon as Jack pushed his execute button the computer flashed its answer. The word “humidifier” appeared on the screen. Jack stared. Apparently the infectious cases had all used humidifiers from central supply; the control hadn’t. But was it a significant difference? From Jack’s childhood, he remembered his mother had put a humidifier in his room when he’d had the croup. He remembered the device as a small, boiling cauldron that sputtered and steamed at his bedside. So Jack could not imagine a humidifier having anything to do with spreading bacteria. At 212° Fahrenheit, it would boil bacteria.

But then Jack remembered the newer type of humidifier: the ultrasonic, cold humidifier. That, he realized, could be a totally different story.

Jack snatched up his phone and called the General. He asked to be put through to central supply. Mrs. Zarelli was off, so he asked to speak to the evening supervisor. Her name was Darlene Springborn. Jack explained who he was and then asked if central supply at the General handled the humidifiers.

“Certainly do,” Darlene said. “Especially during the winter months.”

“What kind does the hospital use?” Jack asked. “The steam type or the cold type?”

“The cold type almost exclusively,” Darlene said.

“When a humidifier comes back from a patient room what happens to it?” Jack asked.

“We take care of it,” Darlene said.

“Do you clean it?” Jack asked.

“Certainly,” Darlene said. “Plus we run them for a while to be sure they still function normally. Then we empty them and scrub them out. Why?”

“Are they always cleaned in the same location?” Jack asked.

“They are,” Darlene said. “We keep them in a small storeroom that has its own sink. Has there been a problem with the humidifiers?”

“I’m not sure,” Jack said. “But if so, I’ll let you or Mrs. Zarelli know.”

“I’d appreciate it,” Darlene said.

Jack disconnected but kept the phone in the crook of his shoulder while he got out Gloria Hernandez’s phone number. He punched in the digits and waited. A man answered who could speak only Spanish. After Jack struggled with a few broken phrases, the man told Jack to wait.

A younger voice came on the line. Jack assumed it was Juan. He asked the boy if he could speak to his mother.

“She’s very sick,” Juan said. “She’s coughing a lot and having trouble breathing.”

“Did she call the hospital like I urged?” Jack asked.

“No, she didn’t,” Juan said. “She said she didn’t want to bother anybody.”

“I’m going to call an ambulance to come and get her,” Jack said without hesitation. “You tell her to hold on, okay?”

“Okay,” Juan said.

“Meanwhile, could you ask her one question,” Jack said. “Could you ask her if she cleaned any humidifiers last night? You know what humidifiers are, don’t you?”

“Yeah, I know,” Juan said. “Just a minute.”

Jack waited nervously, tapping his fingers on top of Kevin Carpenter’s chart. To add to his guilt, he thought he should have followed up on his suggestion for Gloria to call Zimmerman. Juan came back on the line.

“She says thank you about the ambulance,” Juan said. “She was afraid to call herself because AmeriCare doesn’t pay unless a doctor says okay.”

“What about the humidifiers?” Jack asked.

“Yeah, she said she cleaned two or three. She couldn’t remember exactly.”

After Jack hung up from talking to the Hernandez boy he called 911 and dispatched an ambulance to the Hernandez residence. He told the dispatcher to inform the EMTs that it was an infectious case and that they should at least wear masks. He also told her that the patient should go to the Manhattan General and no place else.

With growing excitement, Jack placed a call to Kathy McBane. As late as it was, he didn’t expect to get her, but he was pleasantly surprised. She was still in her office. When Jack commented on the fact that she was still there after six, she said she’d probably be there for some time.

“What’s going on?” Jack asked.

“Plenty,” Kathy said. “Kim Spensor has been admitted into the intensive care unit with respiratory distress syndrome. George Haselton is also in the hospital and is worsening. I’m afraid your fears were well grounded.”

Jack quickly added that Gloria Hernandez would be coming to the emergency room soon. He also recommended that the contacts of all these patients be immediately started on rimantadine.

“I don’t know if Dr. Zimmerman will go for the rimantadine for contacts,” Kathy said. “But at least I’ve talked her into isolating these patients. We’ve set up a special ward.”

“That might help,” Jack said. “It’s certainly worth a try. What about the microbiology tech?”

“He’s on his way in at the moment,” Kathy said.

“I hope by ambulance rather than public transportation,” Jack said.

“That was my recommendation,” Kathy said. “But Dr. Zimmerman followed up on it. I honestly don’t know what the final decision was.”

“That printout you sent over was helpful,” Jack said, finally getting around to why he’d called. “Remember when you told me about the General’s nebulizers getting contaminated in the intensive-care unit three months ago? I think there might have been a similar problem with the hospital’s humidifiers.”

Jack told Kathy how he’d come to this conclusion, particularly about Gloria Hernandez having admitted to handling humidifiers the previous evening.

“What should I do?” Kathy said with alarm.

“At the moment I don’t want you to do anything,” Jack said.

“But I should at least take the humidifiers out of service until their safety is assured,” Kathy said.

“The problem is I don’t want you to become involved,” Jack said. “I’m afraid doing something like that might be dangerous.”

“What are you talking about?” Kathy demanded angrily. “I am already involved.”

“Don’t get upset,” Jack said soothingly. “I apologize. I’m afraid I’m handling this badly.” Jack had not wanted to draw anyone else into the web of his suspicions for fear of their safety, yet at the moment he didn’t seem to have any choice. Kathy was right: the humidifiers had to be taken out of service.

“Listen, Kathy,” Jack said. Then, as succinctly as possible, he explained his theory about the recent illnesses being intentionally spread. He also told her there was a possibility Beth Holderness had been killed because he’d asked her to search the microbiology lab for the offending agents.

“That’s a rather extraordinary story,” Kathy said haltingly. Then she added: “It’s a little hard to swallow all at once.”

“I’m not asking you necessarily to subscribe to it,” Jack said. “My only interest in telling you now is for your safety. Whatever you do or say to anyone, please keep what I have told you in mind. And for God’s sake, don’t mention my theory to anyone. Even if I’m right, I have no idea who’s behind it.”

“Well,” Kathy said with a sigh. “I don’t know what to say.”

“You don’t have to say anything,” Jack said. “But if you want to help, there is something you could do.”

“Like what?” Kathy asked warily.

“Get some bacterial culture medium and viral transport medium from the microbiology lab,” Jack said. “But don’t tell anyone why you want them. Then get someone from engineering to open the elbow drain below the sink in the storeroom where the humidifiers are kept. Put aliquots from the trap into the two mediums and take them to the city reference lab. Ask them to see if they can isolate any one of the five agents.”

“You think some of the microorganisms would still be there?” Kathy asked.

“It’s a possibility,” Jack said. “It’s a long shot, but I’m trying to find proof whatever way I can. At any rate, what I’m suggesting you do is not going to hurt anyone except possibly yourself if you are not careful.”

“I’ll think about it,” Kathy said.

“I’d do it myself except for the reception I invariably get over there,” Jack said. “I was able to get away with visiting your office, but trying to get bacterial samples out of a trap in central supply is another thing entirely.”

“I’d have to agree with you there,” Kathy said.

After he hung up, Jack wondered about Kathy’s reaction to his revelations. From the moment he’d voiced his suspicions she’d sounded subdued, almost wary. Jack shrugged. At the moment there wasn’t anything else he could say to convince her. All he could do was hope she’d heed his warnings.

Jack had one more call to make, and as he dialed the long-distance number he superstitiously crossed the middle and index fingers of his left hand. He was calling Nicole Marquette at the CDC, and Jack was hoping for two things. First, he wanted to hear that the sample had arrived. Second, he wanted Nicole to say that the titer was high, meaning there were enough viral particles to test without having to wait to grow it out.

As the call went through Jack glanced at his watch. It was nearing seven P.M. He scolded himself for not having called earlier, thinking he’d have to wait until morning to reach Nicole. But after dialing the extension for the influenza unit, he got Nicole immediately.

“It arrived here fine,” Nicole said in response to his query. “And I have to give you credit for packing it so well. The refrigerant pack and the Styrofoam kept the sample well preserved.”

“What about the titer?” Jack asked.

“I was impressed with that too,” Nicole said. “Where was this sample from?”

“Bronchiole washings,” Jack said.

Nicole gave a short whistle. “With this concentration of virus it’s got to be one hell of a virulent strain. Either that, or a compromised host.”

“It’s a virulent strain all right,” Jack said. “The victim was a young healthy male. Besides that, one of the nurses taking care of him is already in the ICU herself in acute respiratory distress. That’s in less than twenty-four hours after exposure.”

“Wow! I’d better do this typing immediately. In fact, I’ll stay here tonight. Are there any more cases besides the nurse?”

“Three others that I know about,” Jack said.

“I’ll call in the morning,” Nicole said. Then she hung up.

Jack was mildly taken aback by the precipitous end to the conversation, but he was pleased that Nicole was as motivated as she’d apparently become.

Jack replaced the phone receiver, and as he did so, he noticed the tremble of his hand. He took a few deep breaths and tried to decide what to do. He was concerned about going home. He had no way of gauging Warren’s reaction to Slam’s death. He also wondered if yet another assassin would be sent after him.

The unexpected ring of the telephone interrupted his thoughts. He reached for the phone but didn’t pick it up while he tried to think who it could be. As late as it was, he had to shake off some irrational thoughts, like the worry it might be the man who’d tried to kill him that afternoon.

Finally, Jack picked up the phone. To his relief, it was Terese.

“You promised you would call,” she said accusingly. “I hope you’re not going to tell me you forgot.”

“I’ve been on the phone,” Jack said. “In fact, I just this second got off.”

“Well, all right,” Terese said. “But I’ve been ready to eat for an hour. Why don’t you come to the restaurant directly from work?”

“Oh, jeez, Terese,” Jack voiced. With everything that had happened he’d totally forgotten about their dinner plans.

“Don’t tell me you are going to try to cop out,” Terese said.

“I’ve had a wicked day,” Jack said.

“So have I,” Terese countered. “You promised, and as I said this morning, you have to eat. Tell me, did you have lunch?”

“No,” Jack said.

“Well, there you go,” Terese said. “You can’t skip dinner as well as lunch. Come on! I’ll understand if you have to go back to work. I might myself.”

Terese was making a lot of sense. He needed to eat something even if he wasn’t hungry, and he needed to relax. Besides, knowing Terese’s persistence he didn’t expect she’d take no for an answer, and Jack did not have the energy for an argument.

“Are you thinking or what?” Terese asked impatiently. “Jack, please! I’ve been looking forward to seeing you all day. We can compare war stories and have a vote whose day was the worst.”

Jack was weakening. Suddenly having dinner with Terese sounded wonderfully appealing. He was concerned about putting her at risk simply through proximity, but he doubted anyone was trailing him now. If they were, he could certainly shake them on the way to the restaurant.

“What’s the name of the restaurant?” Jack asked finally.

“Thank you,” Terese said. “I knew you’d come through. It’s called Positano. It’s just up the street from me on Madison. You’ll love it. It’s small and very relaxing. Very un-New-Yorkish.”

“I’ll meet you there in a half hour,” Jack said.

“Perfect,” Terese said. “I’m really looking forward to this. It’s been a stressful few days.”

“I can attest to that,” Jack said.

Jack locked up his office and went down to the first floor. He did not know how to ensure that no one followed him, but he thought that he should at least glance out the front to see if anyone suspicious was lurking there. As he passed through communications he noticed that Sergeant Murphy was still in his cubbyhole talking with someone Jack didn’t recognize.

Jack and the sergeant exchanged waves. Jack wondered if there had been an unusual number of unidentified dead over the last several days. Murphy usually left at five like clockwork.

Reaching the front door, Jack scanned the area outside. He immediately recognized the futility of what he was doing. Particularly with the homeless facility next door in the old Bellevue Hospital building, there were any number of people loitering who could have qualified as suspicious.

For a few moments Jack watched the activity on First Avenue. Rush hour was still in full swing with bumper-to-bumper traffic heading north. The buses were all filled to overflowing. All the cabs were occupied.

Jack debated what to do. The idea of standing in the street, trying to catch a taxi, had no appeal whatsoever. He’d be too exposed. Someone might even attack him right there, especially if they had been willing to try to shoot him in a drugstore.

A passing delivery van gave Jack an idea. Turning back into the building, he descended to the morgue floor and walked into the mortuary office. Marvin Fletcher, one of the evening mortuary techs, was having coffee and doughnuts.

“Marvin, I have a favor to ask,” Jack said.

“What’s that?” Marvin asked, washing down a mouthful with a gulp of his coffee.

“I don’t want you to tell anyone about this,” Jack said. “It’s personal.”

“Yeah?” Marvin questioned. His eyes opened wider than usual. He was interested.

“I need a ride up to New York Hospital,” Jack said. “Could you take me in one of the mortuary vans?”

“I’m not supposed to drive-” Marvin began.

“There’s a good reason,” Jack said, interrupting Marvin. “I’m trying to duck a girlfriend, and I’m afraid she’s outside. I’m sure a good-looking guy like you has had similar problems.”

Marvin laughed. “I suppose,” he said.

“It will only take a second,” Jack said. “We shoot up First and cut over to York. You’ll be back here in a flash, and here’s a ten-spot for your trouble.” Jack laid a ten-dollar bill on the desk.

Marvin eyed the bill and looked up at Jack. “When do you want to go?”

“Right now,” Jack said.

Jack climbed into the passenger-side door of the van and then stepped back into the van’s cargo area. He held on to whatever handhold he could find while Marvin backed out onto Thirtieth Street. As they waited for the light at the corner of First Avenue, Jack made sure he stayed well out of sight.

Despite the traffic they made good time to New York Hospital. Marvin dropped Jack off at the busy front entrance, and Jack immediately went inside. Within the lobby he stood off to the side for five minutes. When no one even vaguely suspicious entered, Jack headed for the emergency room.

Having been in the hospital on multiple occasions, Jack had no trouble finding his way. Once in the emergency room he stepped out on the receiving dock and waited for a cab to bring in a patient. He didn’t have to wait long.

As soon as the patient got out of the cab, Jack got in. He told the cabdriver to take him to the Third Avenue entrance of Bloomingdale’s.

Bloomingdale’s was as crowded as Jack assumed it would be. Jack rapidly traversed the store’s main floor, emerging on Lexington where he caught a second cab. He had this taxi drop him off a block away from Positano.

To be a hundred percent certain he was safe, Jack stood within the entrance of a shoe store for another five minutes. The vehicular traffic on Madison Avenue was moderate, as was the number of pedestrians. In contrast to the area around the morgue, everyone was dressed nattily. Jack saw no one he would have thought was a gang member.

Feeling confident and patting himself on the back for his ingenuity, Jack set out for the restaurant. What he didn’t know was that two men sat waiting inside a shiny black Cadillac that had recently parked between the shoe store and Positano. As Jack walked past he couldn’t see inside because the windows were tinted dark enough to make them appear like mirrors.

Jack opened the door to the restaurant and entered a canvas tent of sorts designed to keep the winter chill away from the people seated near the entrance.

Pulling a canvas flap aside, Jack found himself in a warm, comfortable environment. To his left was a small mahogany bar. The dining tables were grouped to the right and they extended back into the depths of the restaurant. The walls and ceiling were covered with white lattice into which was woven silk ivy that looked astonishingly real. It was as if Jack had suddenly walked into a garden restaurant in Italy.

From the savory aroma that informed the place, Jack could tell that the chef had the same respect for garlic that he had. Earlier Jack had felt he wasn’t hungry. Now he was famished.

The restaurant was crowded but without the frenzied atmosphere of many New York restaurants. With the lattice on the ceiling the sounds of the patrons’ conversations and the clink of the china were muted. Jack assumed that the peacefulness of the place was what Terese had meant when she said it was un-New-Yorkish.

The maître d’ greeted Jack and asked if he could be of assistance. Jack said he was to meet a Ms. Hagen. The waiter bowed and gestured for Jack to follow him. He showed Jack to a table against the wall just beyond the bar.

Terese rose to give Jack a hug. When she saw his face, she paused.

“Oh, my!” she said. “Your face looks painful.”

“People have been saying that my whole life,” Jack quipped.

“Jack, please,” Terese said. “Don’t joke. I’m being serious. Are you really okay?”

“To tell you the honest truth,” Jack said. “I’d totally forgotten about my face.”

“It looks like it would be so tender,” Terese said. “I’d like to give you a kiss, but I’m afraid.”

“Nothing wrong with my lips,” Jack said.

Terese shook her head, smiled, and waved her hand at him. “You are too much,” she said. “I considered myself adept at repartee until I met you.”

They sat down.

“What do you think of the restaurant?” Terese asked as she repositioned her napkin and moved her work aside.

“I liked it immediately,” Jack said. “It’s cozy, and you can’t say that about too many restaurants in this city. I never would have known it was here. The sign outside is so subtle.”

“It’s one of my favorite places,” Terese said.

“Thanks for insisting I come out,” Jack said. “I hate to admit you were right, but you were. I’m starved.”

Over the next fifteen minutes they studied their respective menus, listened to a remarkably long list of special entrées from their waiter, and placed their orders.

“How about some wine?” Terese asked.

“Why not,” Jack said.

“Do you want to pick?” Terese asked, extending the wine list in his direction.

“I have a suspicion that you’ll know better than I what to order,” Jack said.

“Red or white?” Terese asked.

“I can go either way,” Jack said.

With the wine opened and two glasses poured, both Terese and Jack leaned back and tried to relax. Both were tense. In fact, Jack wondered if Terese wasn’t more tense than he. He caught her furtively glancing at her watch.

“I saw that,” Jack said.

“Saw what?” Terese asked innocently.

“I saw you looking at your watch,” Jack said. “I thought we were supposed to be relaxing. That’s why I’ve been purposefully avoiding asking about your day or telling you about mine.”

“I’m sorry,” Terese said. “You’re right. I shouldn’t be doing it. It’s just reflex. I know Colleen and the crew are still in the studio working, and I suppose I feel guilty being out here enjoying myself.”

“Should I ask how the campaign is going?” Jack asked.

“It’s going fine,” Terese said. “In fact, I got nervous today and called my contact over at National Health and had lunch with her. When I told her about the new campaign she was so excited she begged me to allow her to leak it to her CEO. She called back this afternoon to say that he liked it so much that he’s thinking of upping the advertising budget by another twenty percent.”

Jack made a mental calculation of what a twenty percent increase meant. It was millions, and it made him ill since he knew the money would essentially be coming from patient-care funds. But not wishing to spoil their evening, he did not let Terese know his thoughts. Instead, he congratulated her.

“Thank you,” she said.

“It hardly sounds like you had a bad day,” Jack commented.

“Well, hearing that the client likes the concept is just the beginning,” Terese said. “Now there is the reality of actually putting the presentation together and then actually doing the campaign itself. You have no idea of the problems that arise making a thirty-second TV spot.”

Terese took a sip of her wine. As she set her glass back on the table she again glanced at her watch.

“Terese!” Jack said with mock anger. “You did it again!”

“You’re right!” Terese said, slapping a hand to her forehead. “What am I going to do with myself. I’m an impossible workaholic. I admit it. But wait! I do know what I can do. I can take the damn thing off!” She unbuckled her wristwatch and slipped it into her purse. “How’s that?” she asked.

“Much better,” Jack said.

“The trouble is this dude is probably thinking he’s some kind of superman or something,” Twin said. “He’s probably saying those brothers don’t know what the hell they are doing. I mean, it’s all pissing me off. You know what I’m saying?”

“So why don’t you do this yourself?” Phil asked. “Why me?” Dots of perspiration stood out like cabochon diamonds along his hairline.

Twin was draped over the steering wheel of his Cadillac. Slowly he turned his head to regard his heir apparent in the half-light of the car’s interior. Headlights of the passing vehicles alternately illuminated Phil’s face.

“Be cool,” Twin warned. “You know I can’t walk in there. The doc would recognize me right off and the game would be over. The element of surprise is important.”

“But I was there in the doc’s apartment too,” Phil complained.

“But the mother wasn’t looking you in the eye,” Twin said. “Nor did you tag him with a sucker punch. He won’t remember you. Trust me.”

“But why me,” Phil whined. “BJ wanted to do it, especially after things got screwed up in the drugstore. He wants another chance.”

“After the drugstore the doc might recognize BJ,” Twin said. “Besides, it’s an opportunity for you. Some of the brothers have been complaining that you’ve never done anything like this and that you shouldn’t be next in line in the gang. Trust me, I know what I’m doing.”

“But I’m not good at this stuff,” Phil complained. “I’ve never shot anyone.”

“Hey, it’s easy,” Twin said. “First time maybe you wonder, but it’s easy. Pop! It’s over. In a way it’s kinda a letdown, because you get yourself all keyed up.”

“I’m keyed up, all right,” Phil admitted.

“Relax, kid,” Twin said. “All you have to do is walk in there and not say a word to anyone. Keep the gun in your pocket and don’t take it out until you are standing right in front of the doc. Then draw it out and pop! Then get your black ass outta there and away we go. It’s that easy.”

“What if the doc runs?” Phil asked.

“He won’t run,” Twin said. “He’ll be so surprised he won’t lift a finger. If a dude thinks he might be knocked off he has a chance, but if it comes out of the blue like a sucker punch, there’s no way. Nobody moves. I’ve seen it done ten times.”

“I’m nervous, though,” Phil admitted.

“Okay, so you’re a little nervous,” Twin said. “Let me look at you.” Twin reached over and pushed Phil’s shoulder back. “How’s your tie?”

Phil reached up and felt the knot in his tie. “I think it’s okay,” he said.

“You look great,” Twin said. “Looks like you’re on your way to church, man. You look like a damn banker or lawyer.” Twin laughed and slapped Phil repeatedly on the back.

Phil winced as he absorbed the blows. He hated this. It was the worst thing he’d ever done, and he wondered if it was worth it. Yet at this point he knew he didn’t have much choice. It was like going on the roller coaster and clanking up that first hill.

“Okay, man, it’s time to blow the mother away,” Twin said. He gave Phil a final pat, then reached in front of him to open the passenger-side door.

Phil got out onto rubbery legs.

“Phil,” Twin called.

Phil bent down and looked into the car.

“Remember,” Twin said. “Thirty seconds from the time you go in the door, I’ll be pulling up to the restaurant. You get out of there fast and into the car. Got it?”

“I guess so,” Phil said.

Phil straightened up and began walking toward the restaurant. He could feel the pistol bumping up against his thigh. He had it in his right hip pocket.

When Jack had first met Terese he’d had the impression that she was so goal oriented, she’d be incapable of small talk. But he had to admit he’d been wrong. When he’d started to tease her unmercifully about her inability to leave her work behind, she’d not only borne the brunt of the gibes with equanimity but had been able to dish out as good as he gave. By their second glasses of wine they had each other laughing heartily.

“I certainly didn’t think I’d be laughing like this earlier today,” Jack said.

“I’ll take that as a compliment,” Terese said.

“And indeed you should,” Jack said.

“Excuse me,” Terese said as she folded her napkin. “I imagine our entrées will be out momentarily. If you don’t mind, I’d like to use the ladies’ room before they get here.”

“By all means,” Jack said. He grasped the edge of the table and pulled it toward him to give Terese more room to get out. There was not much space between tables.

“I’ll be right back,” Terese said. She gave Jack’s shoulder a squeeze. “Don’t go away,” she teased.

Jack watched her approach the maître d’, who listened to her and then pointed toward the rear of the restaurant. Jack continued to watch her as she gracefully weaved her way down the length of the room. As usual, she was wearing a simple, tailored suit that limned her slim, athletic body. It wasn’t hard for Jack to imagine that she approached physical exercise with the same dogged determination she devoted to her career.

When Terese disappeared from view Jack turned his attention back to the table. He picked up his wine and took a sip. Someplace he’d read that red wine was capable of killing viruses. That thought made him think of something he hadn’t considered but perhaps should have. He’d been exposed to influenza, and while he felt confident given the measures he was taking regarding his health, he certainly didn’t want to expose anyone else to it, particularly not Terese.

Thinking about the possibility, Jack reasoned that since he didn’t have any symptoms, he could not be manufacturing virus. Therefore, he could not be infective. At least he hoped that to be the case. Thinking of influenza reminded him of his rimantadine. Reaching into his pocket, he took out the plastic vial, extracted one of the orange tablets, and took it with a swallow of water.

After putting the drug away, Jack let his eyes roam around the restaurant. He was impressed that every table was occupied, yet the waiters seemed to maintain a leisurely pace. Jack attributed it to good planning and training.

Looking to the right, Jack saw that there were a few couples and single men having drinks at the bar, possibly waiting for tables. Just then, he noticed that the canvas curtain at the entrance was thrown aside as a smartly dressed, young, African-American man stepped into the restaurant.

Jack wasn’t sure why the individual caught his attention. At first he thought it might have been because the man was tall and thin; he reminded Jack of several of the men he played ball with. But whatever the reason was, Jack continued to watch the man as he hesitated at the door, then began to walk down the central aisle, apparently searching for friends.

The gait wasn’t the high-stepping, springy, jaunty playground walk. It was more of a shuffle, as if the man were carrying a load on his back. His right hand was thrust into his trouser pocket while his left hung down stiffly at his side. Jack couldn’t help but notice the left arm didn’t swing. It was as if it were a prosthesis instead of a real arm.

Captivated by the individual, Jack watched as the man’s head swung from side to side. The man had advanced twenty feet when the maître d’ intercepted him, and they had a conversation.

The conversation was short. The maître d’ bowed and gestured into the restaurant. The man started forward once again, continuing his search.

Jack lifted his wineglass to his lips and took a sip. As he did so the man’s eyes locked onto his. To Jack’s surprise the man headed directly for him. Jack slowly put his wineglass down. The man came up to the table.

As if in a dream Jack saw the man start to raise his right hand. In it was a gun. Before Jack could even take a breath the barrel was aimed straight at him.

Within the confines of the narrow restaurant the sound of a pistol seemed deafening. By reflex Jack’s hands had grasped the tablecloth and pulled it toward him as if he could hide behind it. In the process he knocked the wineglasses and the wine bottle to the floor, where they shattered.

The concussion of the gunshot and the shattering of glass was followed by stunned silence. A moment later, the body fell forward onto the table. The gun clattered to the floor.

“Police,” a voice called out. A man rushed to the center of the room, holding a police badge aloft. In his other hand he held a.38 detective special. “No one move. Do not panic!”

With a sense of disgust Jack pushed the table away. It was pinning him against the wall. When he did so the man rolled off the side and fell heavily to the floor.

The policeman holstered his gun and pocketed his badge before quickly kneeling at the side of the body. He felt for a pulse, then barked an order for someone to call 911 for an ambulance.

Only then did the restaurant erupt with screams and sobs. Terrified diners began to stand up. A few in the front of the restaurant fled out the door.

“Stay in your seats,” the policeman commanded to those remaining. “Everything is under control.”

Some people followed his orders and sat. Others stood immobilized, their eyes wide.

Having regained a semblance of composure, Jack squatted beside the policeman.

“I’m a doctor,” Jack said.

“Yeah, I know,” the policeman said. “Give a check. I’m afraid he’s a goner.”

Jack felt for a pulse while wondering how the policeman knew he was a doctor. There was no pulse.

“I didn’t have a lot of choice,” the policeman said defensively. “It happened so fast and with so many people around, I shot him in the left side of his chest. I must have hit the heart.”

Jack and the policeman stood up.

The policeman looked Jack up and down. “Are you all right?” he asked.

In shocked disbelief, Jack examined himself. He could have been shot without having felt it. “I guess so,” he said.

The policeman shook his head. “That was a close one,” he said. “I never expected anything to happen to you in here.”

“What do you mean?” Jack asked.

“If there was to be trouble, I expected it to be after you left the restaurant,” the policeman said.

“I don’t know what you are talking about,” Jack said. “But I’m awfully glad you happened to be here.”

“Don’t thank me,” the policeman said. “Thank Lou Soldano.”

Terese came out of the rest room, confused as to what was going on. She hurried back to the table. When she saw the body her hands flew to her face to cover her mouth. Aghast, she looked at Jack.

“What happened?” she asked. “You’re as white as a ghost.”

“At least I’m alive,” Jack said. “Thanks to this policeman.”

In confusion Terese turned to the policeman for an explanation, but the sound of multiple sirens could be heard converging on the restaurant, and the policeman began moving people out of the way and urging them to sit down.