Contagion (32 page)

     “No,” Jack said. “That was a minor factor to begin with, but my interest in the matter has gone way beyond that. I told you last time that I thought something strange was going on. I feel even more strongly now, and the people over there are continuing to act defensive.”

     “Defensive? Bingham questioned querulously. “I was told that you accused the General’s lab director of spreading these illnesses.”

     “That story has been blown way out of proportion,” Jack said. He then explained to Bingham that he’d merely implied as much by reminding the lab director that he, the director, was disgruntled about the budget AmeriCare was giving him.

     “The man was acting like an ass,” Jack added. “I was trying to ask his opinion about the possible intentional spread of these illnesses, but he never gave me a chance, and I got mad at him. I suppose I shouldn’t have said what I did, but sometimes I can’t help myself.”

     “So you’re convinced about this idea yourself.” Bingham asked.

     “I don’t know if I’m convinced,” Jack admitted. “But it is hard to ascribe them all to coincidence. On top of that is the way people at the General have been acting, from the administrator on down.” Jack thought about telling Bingham about his being beaten up and threatened, but he decided against it. He feared it might get him grounded altogether.

     “After Commissioner Markham called me,” Bingham said, “I asked her to have the chief epidemiologist, Dr. Abelard, get in touch with me. When he did, I asked him what he thought of this intentional spread idea. You want to know what he said?”

     “I can’t wait,” Jack said.

     “He said except for the plague case, which he still cannot explain but is working on with the CDC, he feels the others all have very reasonable explanations. The Hard woman had been in contact with wild rabbits, and Mr. Lagenthorpe had been out in the desert in Texas. And as far as meningococcus is concerned, it’s the season for that.”

     “I don’t think the time sequences are correct,” Jack said. “Nor are the clinical courses consistent with—“

     “Hold on,” Bingham interrupted. “Let me remind you that Dr. Abelard is an epidemiologist. He’s got a Ph.D. as well as an M.D. His whole job is to figure out the where and the why of disease.”

     “I don’t doubt his credentials,” Jack said. “Just his conclusions. He didn’t impress me from the start.”

     “You certainly are opinionated,” Bingham said.

     “I might have ruffled feathers on past visits to the General,” Jack admitted, “but this time all I did was talk to the supervisor of central supply and one of the microbiology techs.”

     “From the calls I got you were deliberately hampering their efforts to deal with the meningococcal outbreak,” Bingham said.

     “God is my witness,” Jack said, holding up his hand. “All I did was talk to Ms. Zarelli and Ms. Holderness, who happen to be two pleasant, cooperative people.”

     “You do have a way of rubbing people the wrong way,” Bingham said. “I suppose you know that”.

     “Usually, I only have that effect on those I intend to provoke,” Jack said.

     “I get the feeling I’m one of those people,” Bingham snapped.

     “Quite the contrary,” Jack said. “Irritating you is entirely unintentional.”

     “I wouldn’t have known,” Bingham said.

     “In speaking with Ms. Holderness, the lab tech, I did uncover an interesting fact,” Jack said. “I learned that just about anyone with reasonable credit can call up and order pathological bacteria. The company doesn’t do any background check.”

     “You don’t need a license or a permit?” Bingham asked.

     “Apparently not,” Jack said.

     “I suppose I’d never thought about it,” Bingham said.

     “Nor had I,” Jack said. “Needless to say, thought-provoking.”

     “Indeed,” Bingham said. He appeared to ponder this for a moment as his rheumy eyes glazed over. But then they quickly cleared.

     “Seems to me you’ve managed to get this conversation off track,” he said, regaining his gruff posture. “The issue here is what to do with you.”

     “You could always send me on vacation to the Caribbean,” Jack suggested. “It’s nice down there this time of year.”

     “Enough of your impertinent humor,” Bingham snapped. “I’m trying to be serious with you.”

     “I’ll try to control myself,” Jack said. “My problem is that during the last five years of my life cynicism has led to reflex sarcasm.”

     “I’m not going to fire you,” Bingham announced. “But I’ve got to warn you again, you’ve come very close. In fact when I hung up the phone from the mayor’s office, I was going to let you go. I’ve changed my mind for now. But there is one thing that we have to be clear on: You are to stay away from the General. Do we have an understanding?”

     “I think it’s finally getting through,” Jack said.

     “If you need more information, send the PAs,” Bingham said. “For chrissake that’s what they’re here for.”

     “I’ll try to remember that,” Jack said.

     “All right, get out of here,” Bingham said with a sweep of his hand.

     With relief Jack stood up and left Bingham’s office. He went straight up to his own. When he arrived he found Chet talking with George Fontworth. Jack squeezed by the two of them and draped his coat over the back of his chair.

     “Well?” Chet asked.

     “Well what?” Jack asked back.

     “The daily question,” Chet said. “Are you still employed here?”

     “Very funny,” Jack said. He was perplexed by the stack of four large manila envelopes at the center of his desk. He picked one up. It was about two inches thick. There were no markings on the exterior. Opening the latch, he slid out the contents. It was a copy of Susanne Hard’s hospital chart.

     “You’ve seen Bingham?” Chet asked.

     “I just came from there,” Jack said. “He was sweet. He wanted to commend me on my diagnoses of tularemia and Rocky Mountain spotted fever.”

     “Bull!” Chet exclaimed.

     “Honest,” Jack said with a chuckle. “Of course, he also bawled me out for going over to the General.” While Jack was talking, he took the contents out of all the manila envelopes. He now had copies of the hospital charts of the index cases of each outbreak.

     “Was your visit worth it?” Chet asked.

     “What do you mean, ‘worth it’?” Jack asked.

     “Did you learn enough to justify stirring up the pot once more?” Chet said. “We heard you got everyone over there angry again.”

     “Not a lot of secrets around here,” Jack commented. “But I did learn something that I didn’t know.” Jack explained to Chet and George about the ease of ordering pathological bacteria.

     “I knew that,” George said. “I worked in a micro lab during summers while I was in college. I remember the supervisor ordering a cholera culture. When it came in I picked it up and held it. It gave me a thrill.”

     Jack glanced at George. “A thrill?” he questioned. “You’re weirder than I thought.”

     “Seriously,” George said. “I know other people who had the same reaction. Comprehending how much pain, suffering, and death the little buggers had caused and could cause was both scary and stimulating at the same time, and holding it in my hand just blew me away.”

     “I guess my idea of a thrill and yours are a bit different,” Jack said. He went back to the charts and organized them chronologically so that Nodelman was on top.

     “I hope the mere availability of pathological bacteria doesn’t encourage your paranoid thinking,” Chet said. “I mean, that’s hardly proof of your theory.”

     “Umm hmm,” Jack murmured. He was already beginning to go over the charts. He planned to read through them rapidly to see if anything jumped out at him. Then he would go back over them in detail. What he was looking for was any way the cases could have been related that would suggest they were not random occurrences.

     Chet and George went back to their conversation when it was apparent Jack was preoccupied. Fifteen minutes later George got up and left.

     As soon as he did Chet went to the door and closed it. “Colleen called me a little while ago,” he said.

     “I’m happy for you,” Jack said, still trying to concentrate on the charts.

     “She told me what had happened over there at the agency,” Chet said. “I think it stinks. I can’t imagine one part of the same company undermining another. It doesn’t make sense.”

     Jack looked up from his reading. “It’s the business mentality,” he said. “Lust for power is the major motivator.”

     Chet sat down. “Colleen also told me that you gave Terese a terrific idea for a new campaign.”

     “Don’t remind me,” Jack said. He redirected his attention to the charts. “I really don’t want to be a part of it. I don’t know why she asked me. She knows how I feel about medical advertising.”

     “Colleen also said that you and Terese are hitting it off,” Chet said.

     “Really now?” Jack said.

     “She said that you two had gotten each other to open up. I think that is terrific for both of you.”

     “Did she give any specifics?” Jack asked.

     “I didn’t get the sense she had any specifics,” Chet said.

     “Thank God,” Jack said without looking up.

     When Jack answered Chet’s next few questions with mere grunts, it dawned on Chet that Jack was again engrossed in his reading. Chet gave up trying to have a conversation and turned his attention to his own work.

     By five-thirty Chet was ready to call it a day. He got up and stretched noisily, hoping that Jack would respond. Jack didn’t. In fact, Jack had not moved for the last hour or so except to turn pages and jot down more notes.

     Chet got his coat from the top drawer of his file cabinet and cleared his throat several times. Still Jack did not respond. Finally Chet resorted to speech.

     “Hey, old sport,” Chet called out. “How long are you going to work on that stuff?”

     “Until I’m done,” Jack said without looking up.

     “I’m meeting Colleen for a quick bite,” Chet said “We’re meeting at six. Are you interested? Maybe Terese could join us. Apparently they are planning to work most of the night.”

     “I’m sticking here,” Jack said. “Enjoy yourselves. Say hello for me.”

     Chet shrugged, pulled on his coat, and left.

     Jack had been through the charts twice. So far the only genuine similarity among the four cases was the fact that their infectious disease symptoms had started after they had been admitted for other complaints. But as Laurie had pointed out, by definition, only Nodelman was a nosocomial case. In the other three situations the symptoms had come on within forty-eight hours of admission.

     The only other possible similarity was the one that Jack had already considered: namely that all four patients were people who’d been hospitalized frequently and hence were economically undesirable in a capitated system. But other than that, Jack found nothing.

     The ages ranged from twenty-eight to sixty-three. Two had been on the medical ward, one in OB-GYN, and one in orthopedics. There were no medications common to them all. Two were on “keep open” IVs. Socially they ranged from lower- to upper-middle class, and there was no indication that any of the four knew any of the others. There was one female and three males. Even their blood types differed.

     Jack tossed his pen onto his desk and leaned back in his chair to stare at the ceiling. He didn’t know what he expected from the charts, but so far he hadn’t learned anything.

     “Knock, knock,” a voice called.

     Jack turned to see Laurie standing in the doorway.

     “I see you made it back from your foray to the General,” she said.

     “I don’t think I was in any danger until I got back here,” Jack said.

     “I know what you mean,” Laurie said. “Rumor had it that Bingham was fit to be tied.”

     “He wasn’t happy, but we managed to work it out,” Jack said.

     “Are you worried about the threat from the people who beat you up?” Laurie asked.

     “I suppose,” Jack said. “I haven’t thought too much about it. I’m sure I’ll feel differently when I get to my apartment.”

     “You’re welcome to come over to mine,” Laurie said. “I have a sad couch in my living room that pulls out into a decent bed.”

     “You’re kind to offer,” Jack said. “But I have to go home sometime. I’ll be careful.”

     “Did you learn anything to explain the central supply connection?” Laurie asked.

     “I wish,” Jack said. “Not only didn’t I learn anything, but I found out that a number of people, including the city epidemiologist and the hospital infection control officer, have been in there beating the bushes for clues. I had the mistaken notion it was a novel idea.”

     “Are you still thinking of the conspiracy slant?” Laurie asked.

     “In some form or fashion,” Jack admitted. “Unfortunately, it seems to be a lonely stance.”

     Laurie wished him good luck. He thanked her, and she left. A minute later she was back.

     “I’m planning on getting a bite on the way home,” Laurie said. “Are you interested?”

     “Thanks, but I’ve started on these charts, and I want to keep at it while the material is fresh in my mind.”

     “I understand. Good night.”

     “Good night, Laurie,” Jack said.

     No sooner had Jack opened Nodelman’s chart for the third time than the phone rang. It was Terese.

     “Colleen is about to leave to meet up with Chet,” Terese said. “Can I talk you into coming out for a quick dinner? We could all eat together.”

     Jack was amazed. For five years he’d been avoiding social attachments of any kind. Now suddenly two intelligent, attractive women were both asking him to dine with them on the same night.

     “I appreciate the offer,” Jack said. He then told Terese the same thing he’d told Laurie about the charts he was working on.

     “I keep hoping you’ll give up on that crusade,” Terese said. “It hardly seems worth the risks, since you’ve already been beaten up and threatened with the loss of your job.”