Death Benefit

PART II
25.

COLUMBIA UNIVERSITY MEDICAL CENTER NEW YORK CITY MARCH 23, 2011, 12:02 P.M.

Tobias Rothman was happiest when he could work uninterrupted in the safe confines of the lab, with Dr. Yamamoto at his side. Yamamoto was like Rothman’s right arm. He could hold out a hand, and Yamamoto would know what he wanted without him having to ask for it. The two men communicated by looks and pointed fingers and sometimes, Rothman swore, by intuition. If Rothman could intuit anything as they worked together under the hood in the biosafety level-3 lab today, it was that his colleague didn’t feel so good because a couple of times he’d uncharacteristically missed Rothman’s cues. In truth, Rothman hadn’t been feeling particularly well himself for the last hour or so. He had some mild gastric distress but worse was a kind of light-headedness, as if he were walking on eggshells. It had started about an hour after their coffee break at nine. They’d been in the unit since six.

Rothman looked over at Yamamoto. He was facing the wall, resting his hands on the lab bench, breathing hard. Yamamoto turned to look at Rothman, and Rothman could see that he was shivering. With a hood and mask, all Rothman could see of Yamamoto’s face were his eyes, which reflected fear. Suddenly Rothman felt it too, and began to shiver himself. It was as if he’d just jumped into a bath of ice water, yet he was sweating, and he felt nauseous. It was impossible that what flashed through his mind could be happening-they’d taken all their usual precautions, and their safety record was perfect.

The next moment Yamamoto’s eyes rolled up in his head, and he collapsed limply onto the floor. Rothman tried to steady himself before going to Yamamoto’s aid, but he felt suddenly much worse. The room swam before him. He knew he was going to black out and just before he did, his hand reached for the red button on the wall.

Pia was sitting in her office comparing notes with Will and Lesley. It was crowded but quiet. They’d taken refuge in there despite its diminutive size as there was yet another workman in the lab proper, again working up in the ceiling with all the electrical wires. He’d briefly been in her office as well as Rothman’s but thankfully had left both. Luckily it wasn’t the same guy, Vance, who’d been such a pain weeks earlier.

The three students had formed an effective unit in their three weeks together and were making good progress with the temperature and pH issues with the organ baths. They’d spent almost all of their waking hours including weekends in the lab, but none of them begrudged a minute of it.

Then, in an instant, it was as if a riot had broken out at the door to the lab.

“What the hell?” Will said, as the three students piled out of Pia’s office.

From her vantage point, all Pia could see were people barging in through the door. The place was being invaded-she must have seen twenty people dressed in gowns, hats, masks, and booties rush toward the biosafety unit. Bringing up the rear was a pair of gurneys sprouting IV poles with plastic bags of IV fluid slapping against the metal poles, pushed by more gowned-up figures. The gurneys disappeared into the biosafety unit, whose door had been propped open with a doorstop. Pia felt a terrible sensation growing in the pit of her stomach.

One man stopped by Marsha’s desk and stood next to the terrified secretary, who had a hand clasped over her mouth; another blocked off the entrance door, which was again closed, denying access to the corridor and the rest of the medical center. The laboratory staff crowded into the center of the room and there was a ripple of loud conversation and shouted questions.

“Is this a drill?” Lesley said. “What’s going on?”

The figure by Marsha’s desk pulled down his mask. He was a fifty-something African-American man with skin as black as ebony; his voice was calm yet commanding.

“Okay, folks, this is not a drill. We have a situation, and I need you all to stay right here, right where you are. Is everyone in the lab accounted for?”

People looked around, checking for coworkers among the fifteen or so technicians and support staff standing around. Pia could see the maintenance man in his coveralls standing at the back of the room, gaping like everyone else.

“Everybody here? Okay. My name’s David Winston. I’m from hospital security. These other people are a mixed group from the hospital ER and the Department of Infectious Disease. I’ll give you more information when we have it. I am asking you to please remain in this area. Thank you for your cooperation.”

The staff stood in small groups and talked among themselves. Pia, unable to stay still, walked around in a small, tight circle. Whatever was happening, she knew it wasn’t good. A wave of anxiety washed over her.

The lab door opened abruptly and a tall, distinguished-looking man walked in quickly and made his way through the cordon toward the biosafety unit, conspicuously avoiding eye contact with anyone. He was dressed in protective clothing like the others except his mask hung down on his chest. Under the gown was a suit, not scrubs like the others. Pia knew this was the chief of Infectious Disease, Dr. Helmut Springer, as she had attended several lectures he’d given during second-year pathology.

The background buzz of conversation grew louder. Most recognized Dr. Springer. Everyone in the lab was well aware that they worked with highly virulent and contagious microorganisms. Was it possible there’d been some contamination of the lab? Where were Dr. Rothman and Dr. Yamamoto? Springer’s appearance only heightened the tension. The man by the door was on a cell, apparently quarterbacking whatever was happening. “We’re on our way, ETA five minutes,” he was heard to bark into his phone.

Quickly tying his mask in place, Springer pulled the biosafety unit door fully open. As if on cue, the gurneys reappeared, the one in front carrying Dr. Rothman, Dr. Yamamoto in the rear. Both men had IVs and were wearing oxygen masks. Rothman passed right in front of Pia, who pushed forward to take a look. She could see he was deathly pale and shivering violently. His eyes were fixed straight ahead, staring at the ceiling. He looked like death.

As fast as they had come, the cavalcade of medics was gone. Only Dr. Springer and Winston remained. Springer addressed the shell-shocked staff, a few of whom were clutching each other for comfort, others holding their hands over their mouths in disbelief at what they had just witnessed.

“As you can see, Doctors Rothman and Yamamoto have been taken ill. At first guess, we have to consider it to be severe typhoid fever. Both men are presenting the classic symptoms-fever, sudden prostration, abdominal distress, delirium, right lower quadrant borborygmi.” Springer counted off the symptoms on the fingers of his left hand as if he were on formal grand rounds. Once a professor always a professor, thought Pia. “Obviously, they were working in the biosafety unit. But can anyone tell me what they were working on exactly?”

Lab technician Panjit Singh stepped forward. “They were working on salmonella strains grown in the space station lab. I know that for a fact because I set everything up for them this morning. They’ve been working on it for weeks.”

“Okay, thanks, that’s very useful. Do you know if there are any antibiotic-sensitivity studies available for these special strains?”

“Yes, lots of them. I can get them for you.”

“That’s good, I’m going to need them, thank you. Mr. Winston here will talk to you about procedure a bit later, but here’s a thumbnail: no one is to go into the level-three lab until it’s cleared. The Rothman lab itself will be off-limits until further notice. I’ve already put in a call to the CDC to get their help on the epidemiology side so we can find out how this contamination occurred. Right now, everyone needs to follow me to the Infectious Disease Clinic, where you’ll be screened for typhoid fever. Everyone will also need to take a prophylactic course of antibiotics. This is very important. For the next week you’ll have to monitor your own temperature twice a day. Anything unusual, come in right away. A degree either side of normal, I want to see you. Any questions?”

“Who raised the alarm?” Singh asked.

“There’s a panic button in the biosafety lab,” Springer said. “One of the doctors must have hit it. We’ll check the tape.”

“Does everyone need to come to the clinic?” Pia asked. “Even people who haven’t been in the biosafety unit today?”

“Absolutely. And Mr. Winston will also be gathering names of everyone who’s been here delivering supplies or takeout or whatever. We want to see everyone who has set foot inside this lab. That’s it. Thank you for your cooperation.”

The din of conversation erupted again.

“Oh my God!” Lesley said. “Did you see how they looked? It must have come on fast.”

“Dr. Yamamoto told me he didn’t feel so hot this morning,” Will said. “But yeah, I saw how they looked. I guess we better go do what the man said.”

Pia looked around. The maintenance man was hanging back, and though Pia didn’t want to talk to him, she knew he needed to follow the protocol.

“There’s a medical issue,” she said to the man. His temporary name tag read “O’Meary.” “You have to come to the clinic with everyone else.”

O’Meary looked nervous and didn’t say anything. Winston called out to Pia.

“Time to go,” he said. “We’re locking down.” There was clearly no room for argument. Pia waited for O’Meary to leave and exited in front of Winston. As the last person out, Winston pulled the door shut and talked to two figures in full hazmat suits standing outside.

“No one gets in,” Winston said. “Put up the caution tape.” The men in the hazmat suits nodded and set to work.

As they made their way to the elevator, Pia could see that the whole floor was being cleared, with other personnel being led down the stairs. There were more people in hazmat suits that looked like robots. On the elevator ride down, Pia could feel her heart beating too fast, and she had to concentrate on breathing deeply. She felt some dizziness from her shallow breathing. As she walked along the sidewalk she was gripped by what felt like panic-everything around her felt very close and incredibly far away at the same time. She had stopped walking and was holding on to someone. Voices were loud in her ear.

“Come with me,” a woman is saying. It’s a hot sunny day but Pia’s freezing cold. The woman has a nice smile and she’s holding Pia’s hand. This is a new place, Pia knows that. She hasn’t been here long. This is the first smile she’s seen, though it’s odd now-grown-ups don’t keep smiles on their faces the whole time. Pia and the woman have come inside and they’re walking up to a large door. It feels like they’re walking uphill. “This is the headmaster’s office,” the woman says. She opens the door and pushes her in. Pia can hear the lock being turned. “Hello, Pia,” says the man. He’s smiling too but it’s a twisted smile, not a smile of welcome….

Pia looked up. She was sitting on the ground on 168th Street with traffic passing by. Winston was supporting her with his hand, looking down at her.

“You okay?”

“Yes, I think so.”

“You fainted. Or almost fainted. You’re not perspiring, so I don’t think you have a fever. I think you’re okay. Ready to get up?”

Pia waited a second and allowed Winston to pull her to her feet. Then she remembered where she was and what had just happened. With disturbing clarity she saw Rothman lying on the gurney, his face looking like death, and the image terrified her. Over the course of three and a half years she’d come to rely more and more on the man’s strange friendship, particularly after their heartfelt conversation a few weeks ago. Up until then, their relationship had been akin to two people comfortably wandering around in a darkened room, occasionally sensing each other’s presence but not much else. But after the conversation and the personal revelations, she felt they’d moved to another level. Rothman had become the ersatz father she’d always pined for. Most important, she’d allowed herself to begin to trust Rothman despite having learned not to trust anyone, not to allow anyone into a position where they could betray her, like so many had done.

Now, as she stumbled along the street, Pia was overwhelmed by the thought that just when she’d allowed Rothman into her world, he was going to abandon her. Why was he doing this? And why now? It was irrational to think so, but did he do this to spite her? Did he purposely set her up? After all, he’d admitted to being depressed. She was almost paralyzed with anxiety.

At the Infectious Disease Clinic, Pia was shaking when she was handed the Z-Pak prophylactic antibiotic. She sat down in the waiting area and her head started to clear. She was aware that several people had tried to talk to her, but she didn’t hear them.

“Miss Grazdani!” a nurse called out sharply, standing directly in front of Pia. She was on the brink of calling the ER if the young woman continued in her fugue-like state, thinking Pia might have to be admitted.

Not quite awakening, Pia sat up straighter and focused on the nurse’s face.

“I’m here,” Pia voiced. “I’m sorry. What did you say?”

“I said that you can’t go back to the lab. It’s going to be closed until the CDC epidemiologists get here from Atlanta and declare it clean. What you should do, as we have advised the others, is go home, start your antibiotics, and watch your temperature. Is there someone we can call who can meet you there? Miss Grazdani? Are you okay, Miss Grazdani?”

“I’m just fine,” Pia assured her.