Plague

CHAPTER 7

Samantha Bower sat on the white sand beach and absorbed the sun. She had been in the hospital collecting blood samples for two hours and figured she had earned this. Collecting blood samples for a viral infection that was suspected to be unknown was not an easy task.

She had to find vacu-containers in the supply closet with a nurse that had no intention of making her job easy. Then she needed anticoagulants and sodium hypochlorite. The hypochlorite was to wash the outside of the plastic bags the blood would be contained in. The risk of even a droplet of blood on the outside of the bags typically made the extraction of blood the most dangerous part of her job.

She had also taken throat swabs from both Erin and Clifford. Everything had been sent back to the labs at the CDC and would be analyzed by one of the most brilliant men she had ever met: Stephen W. Pushkin.

Stephen had begun work at the CDC as an undergraduate and returned every summer while completing his degree in biological engineering and microbiology at Harvard. He worked briefly at New Day Systems, designing heart valves and artificial limbs and whatever else caught his fancy, the company recognizing his brilliance and giving him free reign. He soon grew bored designing limbs and became obsessed with disease after being present in Guadalajara, Mexico, after a particularly brutal strand of dysentery killed over thirty people. That, and his background as an intern at the CDC, made him an ideal candidate for work in the laboratory.

Sam lay back on her towel and let the sun wash the stress out of her. She still felt the knots in her belly but the heat, at least, made her muscles relax. She was drifting off to sleep when she felt her iPhone buzz next to her. She picked it up, her eyes still closed behind her sunglasses.

“This is Sam.”

“Dr. Bower, it’s Jerry Amoy. From Queen’s.”

“Yes, hi.”

“Um, hi. I was calling because two more patients exhibiting symptoms came into the ER in the past hour.”

“What symptoms?”

“Fever, a rash, vomiting blood. One of the patients is having bloody diarrhea. He doesn’t seem to be able to control it. I noticed some dark splotches on his back that resembled the other two patients’.”

“Okay, I’ll be right down.”

Samantha changed and was at the hospital in less than twenty minutes. She went directly to the ER and had Amoy paged. He arrived a short while later and said, “They’re upstairs.”

The two of them rode the elevator up together and went through the procedure of cleaning and scrubbing themselves. Sam wasn’t as nervous this time and she couldn’t decide whether that was a good thing or a bad thing. Barricade nursing had been put in place and there was little chance of an exchange of body fluids. Samantha remembered another field agent at the CDC named Melissa who had been leaning over a patient with a suspected Marburg infection in Washington, DC, some three years ago. The man had suddenly vomited blood into her eyes. Luckily-or miraculously, Sam thought-the woman had not been infected with the virus, and the patient had survived.

The two new patients were set up in rooms across the hall from each other. Sam chose the one on the right and went in. He was a young man, no older than thirty, and was reading a paperback novel as he lay in bed. He looked up and she could see the discoloration in the conjunctiva of his eyes. The whites of his eyes had turned a dark red. A clear plastic sheet hung over his bed like a canopy except that it went all the way underneath the bed and wrapped around. The man was running his toes along it near the bottom.

Sam glanced down at the chart that Dr. Amoy had placed in her hand. She flipped through a few pages and said, “How are you doing, Jake?”

“Not so good.”

“What’s going on?”

“I’ve been throwing up blood.”

“When did it start?”

“Yesterday. It comes in waves, like, it’ll come every half hour and then stop for a few hours and then come again.”

“It says here you had a fever. When did you notice that?”

“Like two days ago. It wasn’t bad, though. I got headaches then too.”

“Jake, have you been to Africa or South America recently?”

“No.”

“Have you had any interactions with animals in the past few weeks?”

“Like what kinda animals?”

“Wild animals. Monkeys, birds, swine…”

“No, nothing like that. I got a dog. But that’s it.”

Sam noticed a handwritten note on the edge of a sheet of paper on his chart. It said, “Patient does not know Erin or Clifford.”

Sam read through the rest of the chart. It had been thrown together hastily by the nurse and Amoy. It was subtle, and unless you had read several hundred charts, you wouldn’t have noticed it. But fear was creeping in. The nurses did not take the time to fill out the chart properly and ask all the questions that needed to be asked. They wanted less and less to do with these patients.

“Would you mind sitting up?” Sam said. “I’d like to take a look at the rashes on your back.”

Amoy helped her as she lifted Jake up to a sitting position on the bed. She saw his abdominal muscles and the striations in his shoulders and concluded that he was perhaps some sort of athlete or at the very least a gym rat. But she could already see the gray, sagging skin on his face and body, and the way it took two people to even help him sit up indicated that the disease, whatever it was, was multiplying at an enormously quick pace. He had displayed symptoms and almost immediately had to be admitted to the ER. Sam ran through a list of viral infections that could cause such a quick change. She could think of several, along with a host of their mutations: smallpox, influenza, meningitis, and Ebola…the list could go on and on.

The rash on his back was fading and she didn’t notice any pustules, but she did see a slight discoloration just over the lungs. His skin appeared shiny and black in jagged splotches. It seemed like a dark purple bruise covered his whole body. It was blood, just underneath the skin. His lungs were bleeding.

“Okay,” she said, gently helping him back down. “You let us know if you need anything. We’re gonna have someone come take your blood in a minute and run some tests.”

“What is it, you think?”

“Viral infection of some sort. Did Dr. Amoy tell you there’re three other patients here with the same symptoms?”

“Yeah.”

“Well, we’re working as fast as we can to figure it out. In the meantime, you’re not going to be going anywhere, so if there’s anyone you’d like to call please buzz the nurse and she can do it for you. We have speaker phones and you’re free to use them.”

“Thanks.” He closed his eyes. “I feel like I’m getting hotter.”

“We’ll get you something cold to drink.”

Sam walked out of the room and Amoy followed. He appeared nervous and she wondered whether it was from the disease or the fact that it was his hospital that would be in all the newspapers.

She heard the ding of the elevators and two men in suits stepped off. One of them was pasty white with a slightly pink, balding head and orange hair just above the ears. He turned to Sam and Amoy and began walking toward them as the second man followed.

“Dr. Bower,” he said, stopping before her as she removed her facemask and gloves and threw them in a biohazard bin. “I’m Dr. Terry Whitman. I’m the director of Queen’s Medical.”

“Nice to meet you.”

He smiled widely. “You as well. Ah, do you mind if we talk for a bit? Maybe grab a soda in the cafeteria?”

“Sure. I just need to change.”

It took Sam less than ten minutes to change. She didn’t feel she had to, but she took a quick shower and scrubbed herself twice with a bar of soap she had brought.

When she stepped out into the corridor, she saw Whitman turn to the man behind him and nod. He then offered her the elevator first and she got on, noticing that Amoy and the other man stayed behind.

“Have you been to the island before?” he said on the ride down.

“No, first time.”

“Well,” he said, turning to her, a smile on his face, “it’s a fun island…if you have the proper guide. I’d be happy to show you around when we’re done with today.”

Sam looked down and noticed the wedding ring on his finger. He immediately curled his hand so it was out of view.

“I would appreciate that, Doctor, but I’m on a strict timeline. I don’t leave the hospital much.”

“Understood,” he said, the smile disappearing from his face as he looked forward.

The elevator opened and they walked across the first floor down a long corridor with island art up on the walls. A group of young men and women in green scrubs were standing around, talking, and as they saw Whitman, they straightened up and exchanged a few more words before disbursing. One wasn’t quick enough and remained leaning against the wall. Whitman stared him down as they passed.

“Medical students,” he said to Sam when they were alone.

“I remember what that was like. I usually looked as terrified as they did when a boss walked by.”

“Not me. I figured most of the other students were kiss-asses so I took a different approach and had balls. I always told the attending and the chief what I thought if I ever got the chance.”

“Did it work?”

“Not really. That’s why I went back and got my MBA and got into management instead. Too much bureaucratic BS in medicine nowadays. Especially with managed care and the government stepping in.”

They turned down another corridor and into the hospital cafeteria. It was clean and open with enough seating for at least a hundred people. They were serving Indian food and the smell of broiling chicken and spices filled the air. It reminded Sam that she hadn’t eaten today and she made a note to get a plate of Indian food as soon as they were done speaking.

Whitman got two juices out of a cooler and cut in line, paid with a five, and left the change. They sat down at a table by the window. The sun was bright and warmed Sam’s cheeks and neck as she opened the juice bottle and took a sip.

“So any word on a culprit?” Whitman said.

“No. I would expect that our labs are growing a culture from the samples right now and that’s going to take some time.”

“But you have to have some guess as to what it is.”

“I do.”

Neither of them spoke for a long moment.

“You’re not going to make this easy on me, are you?”

“Dr. Whitman, I’ve been in this situation before. I’ve been at this table with other chiefs and directors having this same conversation. I know what you want to ask me so just ask me.”

“And what exactly do you think I want to ask you?”

“You want to ask me not to get the media involved and to keep this as quiet as possible. No hospital wants to be the epicenter of an epidemic and I don’t blame you.”

“So?”

“What?”

“So what’s your answer?”

“I will try to keep this quiet as long as possible, but not because of the hospital’s bottom line. Because a viral epidemic causes panic and people can’t think when they’re panicked. It just makes things more difficult for us. But I will tell you that eventually word will get out and reporters will be all over this hospital. When it gets near that point, it’ll be much better if we control the message and hold a press conference. But that isn’t my department.”

“Whose department is it?”

“My boss’s, Deputy Director Wilson.”

He grimaced and took a long swig of the juice. “Then maybe he’s the one I should be talking to?”

“When we get the lab results, if it is anything to worry about, I promise you he’ll be on the next plane out here.”

Whitman leaned forward on his elbows. “You know why I became a doctor? I genuinely thought I could help people. Most people apply to med school for the prestige, but I thought that if I could really pick a good place to practice, somewhere without too many other physicians where I would really be needed, I thought I could make a difference.” He sighed. “But’s that’s just idealism. And idealism has no place in this.” He rose. “If word gets out prematurely, we will file a suit against you, the CDC, and the United States government. Make sure that it doesn’t.”