Up in Smoke (6 page)

CHAPTER
8

Hamish Wakefield strode into his academic office at the rear of his lab at Caledonian Medical Centre. He locked the door behind him and dropped his briefcase onto the desk. He fumbled with the key as he struggled to unlock the tall, custom-made wardrobe. He got the door open and lifted out the ironing board. He extended its legs, then removed the iron and filled it with distilled water. He set the iron on the board and plugged it in, then slipped off his lab coat and wiped his sweaty hands with a towel. As the iron heated up, his anxiety began to subside.

He opened his briefcase and removed the folded shirt he'd placed there this morning before breakfast. As usual, this was an exact match to the shirt he'd been wearing all day. He always bought dress shirts in pairs. One for the mornings, its identical twin for the afternoons. He washed and ironed on Sundays, preparing for the week ahead. He loved the feeling of a clean, freshly pressed shirt. The only way to sustain that crispness, especially in a line of work that confronted him with a steady stream of germs, was to change his shirt twice a day. But a folded shirt lost its freshness when tucked into a briefcase. Creases slashed its front and wrinkled its sleeves. He fixed that with the hot iron. Today, his morning clinic had run late and delayed his ritual, had made him feel edgy. No one at the medical centre knew about his two-shirt habit, or the ironing apparatus locked in the wardrobe. People wouldn't understand. They would think he was overly fastidious. Or plain weird. And he had no interest in defending himself over something as calming as a warm, perfectly pressed shirt.

Al knew. And understood. Over the past six and a half months, he and Hamish had grown closer. Not in spite of each other's quirks, but because of a mutual delight in them. They'd first met during karaoke night at the Reluctant Lion pub. Hamish, a choir boy until his voice cracked at age fourteen, had hidden behind the beer glasses piling up on the table. But Al Mesic, a
Hamilton Spectator
reporter with a toned body and a Frank Sinatra voice, raised the audience to its feet with his first three bars of “The Music of the Night.” Since then, they'd been making music together. And not just in the living room with Al's karaoke machine.

Love of singing was not their only bond. Hamish reckoned they were both refugees. Hamish from the unrelenting attacks of the schoolyard bullies who never let him forget he was a . . . yes, a fairy. Al from the snipers, mortars, and hunger of the siege of Sarajevo in the nineties. They were both in the process of coming to terms with their pasts.

Hamish's pulse quickened as he buttoned the warm shirt. Al seemed keen that they move in together in the house Hamish's aunt had left him in her will. The old place had become vacant two months ago, after the tenant broke her hip and moved into a nursing home. It was a detached, two-storey fixer-upper in the wilds of North Hamilton, two blocks from Lake Ontario. Not an area he would have thought he'd ever live in. He and Al had toured the empty house together, then traded ideas with an architect who'd promised to deliver a set of preliminary sketches this week. With Al in his life, perhaps anything was possible. A renovated house, a renovated life, a part of town showing signs of rebirth?

He locked the wardrobe and opened the office door, then he sat at his desk and gave himself a few minutes to answer urgent emails waiting in his inbox.

Half an hour later, he was racking his brain again, thinking of those young people with galloping liver failure. Yesterday there'd been five of them. Today it was six. Until Friday, fifteen cases of strange-looking lip and fingers blisters had been an interesting medical puzzle. Now, with two teens lying in the Simcoe morgue with their livers kaput and those same undiagnosed sores on their mouths, the pressure to find the cause was excruciating. Natasha was convinced that the liver-failure cases, all students at Erie Christian Collegiate, had nothing in common with the lip and finger outbreak. She said that while the liver disease was highly focussed, involving a single school, the blister cases came from all over the region. But two puzzling outbreaks presenting simultaneously in the same part of Ontario? They had to be linked. There was no way around it.

He ran through the list of viruses he'd looked for in the skin samples of the fifteen blister patients he'd seen in the past six weeks. No sign of herpes simplex, the cold sore virus; no varicella zoster, the chicken-pox and shingles virus; no adenovirus, the ear-nose-and-throat virus; no Coxsackie, the hand-foot-and-mouth virus; no Echovirus, the causes-almost-anything virus; and no human papilloma virus, the culprit in warts and cancers of the mouth, throat, and genitals. He'd even checked for orf, a blistering disease goat farmers sometimes contracted from their livestock. It wasn't even syphilis, known through the ages as The Great Mimicker.

He'd asked for every test but electron microscopy. The local
EM
machine used for clinical samples was under repair, awaiting a part being manufactured to order. If he wanted
EM
results this side of Christmas, he'd have to send his samples to the federal microbiology laboratory in Winnipeg, half a continent away. Even then, the results would take ages. The kids at that school needed answers today.

A short bear lumbering along the corridor outside his doorway caught his eye. Striped suspenders held up the blue jeans hugging his ample hips. Despite his rounded, bent-over back, curly chest hair escaping through the collar of his red lumberjack shirt, and his booming baritone laugh, Wilf Dickinson was no grouchy grizzly. Not even a miniature one. He was more like a playful cub. Wilf had earned his Ph.D. in cell biology. As an undergrad he'd studied the oboe, which he continued to play in the university's orchestra. Hamish had no idea how Wilf got his stumpy mitts around the slender woodwind without choking it.

Wilf had an electron microscope, funded purely as a research tool for his studies of Alzheimer's disease. Could he be persuaded to run a few clinical samples that had nothing to do with brain disease? Probably not. Basic-science researchers never took kindly to invitations to go zebra-hunting, no matter how exotic and fascinating a diagnostic conundrum Hamish wanted to present them with. Non-clinical types weren't used to getting their emotions entangled with direct patient care. They'd chosen the purity, the detachment, the safety of the ivory tower and they weren't prepared to leave it. And, as Wilf often said, he wasn't licensed to handle clinical specimens and could not possibly comment on anything his investigative tools might turn up.

Hamish pulled his specimens from the freezer and set them on a tray. It had to be worth a try, and from the way Wilf was whistling, he might be in an accommodating mood.

“Come on, Hamish,” Wilf told him a few minutes later, “you don't actually expect me to see anything but junk in those specimens?”

“I froze them immediately. In sterile containers.”

“And what preservative did you use?

Hamish felt his cheeks flushing. The technical aspects of electron microscopy were alien territory. “Well . . . none.”

“I rest my case.”

Hamish lifted the small plastic jars containing the crusted blisters of two of his patients with lip and finger eruption. “See? The lesions are still intact.”

“Look like decapitated zits to me. What do you expect me to find?”

“A virus, maybe. Or a fungus? Remnants of atypical mycobacteria, perhaps?”

“Don't tell me you're hunting for leprosy.”

“I have an open mind.”

Wilf gestured to the clutter that filled his laboratory: books, academic journals, glassware, pipetting tools, coffee mugs, centrifuges, water baths, bottles of every shape and size and colour. Despite the mess, he was known for his enviable publishing record. “And my mind is not?”

Hamish pointed to his tray of specimens. “Not if you're sure, without even looking, that every one of these is worthless.”

Wilf stroked his chin with two stocky digits. “Where are they from, again?”

“A group of kids dying from liver failure.” He was stretching the truth. As far has he knew, only two of the liver failure cases had exhibited the skin lesions. But that was enough. The two jaundiced kids brought to Simcoe Emerg this morning could easily have the lesions. He hadn't examined them yet.

“Drug addicts?” Wilf said.

“High school students. At a Christian collegiate. Norfolk County.”

“Not that place on Highway
3
, a few klicks shy of Simcoe?”

“You know it?”

Wilf's face darkened. “That's where they found Tammy's body. In that vicinity, anyway.”

The air between them hung like an out-of-tune tuba. Dr. Tammy Holt, a research scientist working in the lab next to Wilf's, had been young, single, and vivacious. Always ready with a humorous anecdote and a kind word, Tammy was an expert baker who took cake decoration to a high art. She combined taste and whimsy to spectacular effect. Without fail, she brought in elaborate, personalized cakes for the laboratory staff on their birthdays. For Hamish — the
bug
doctor — she'd brought in his favourite carrot cake festooned with grasshoppers and dragonflies. For Mr. Singh, the Punjabi janitor, she replicated the Golden Temple in Amritsar in lemon pound cake. A bit over the top, but that was Tammy. A plant expert with a doctorate in genetics, she always seemed to have plenty of grant money for her projects. While most researchers at Caledonian were fairly forthcoming about the basic nature of their work, Tammy was tight-lipped to the extreme. She would talk about anything except her work. “Plants and genetics” was all she would say. And though her results never got published in academic journals, they led to numerous patents probably worth a tidy sum. No one was certain which plant species she worked with. And no one spoke of the irony that her life had met its end in a field full of plants. Tobacco plants.

On a Monday morning in August last year, Tammy didn't show up for work. The days went by. People thought she must have gone to a conference and had forgotten to tell anyone. When her family reported her missing, everyone started to worry. A few days later, a farmer in Norfolk County found her body dumped near Highway
3
, about half an hour's drive from Tammy's home on Grand Basin Reserve. After the Ontario Provincial Police forensics team finished its cursory examination of her laboratory, a guy in a suit showed up with a couple of heavy lifters and two security guards. They stripped the workbenches clean and carted out everything but the curtains and floor tiles. And refused to talk to anyone.

The police wouldn't release many details of Tammy's death, but did admit she'd been sexually assaulted and suffered one or more gunshot wounds. There were rumours that it was an execution-style killing, and people speculated about Mohawk gangs and the Korean mafia operating on her reserve. In the research corridors at Caledonian University, the unresolved murder of a simpatico and accomplished colleague was still extremely painful. Staff birthdays felt awkward and tinged with sadness whenever a store-bought cake showed up instead of one of Tammy's creations. The subtext that no one dared mention played again in Hamish's mind: Tammy's murder was yet another setback in the long struggle of First Nations people to achieve full status as valued professionals.

Wilf blew his nose with a striped handkerchief then eyed Hamish's containers. “They're skin lesions in there? Fingers and what else?”

“Lips.”

“Hmm.”

“Yeah.” Hamish forced a smile.

“And you got nothing on culture or
DNA
testing?”

Hamish shook his head.

“What about blood tests?”

“Nothing.”

“Have the pathologists had a look?”

“Didn't see anything diagnostic. Even with special stains.”

Wilf's gaze swept his laboratory. Though it was cluttered, it was quiet. Perhaps Hamish had come at a good time. Wilf pulled back his sleeve and checked his watch. He seemed satisfied with what he saw. “That mean we're chasing another of your zebras?”

Hamish pushed the tray of specimens toward the smiling bear cub and allowed himself a restrained grin in return. “I knew you'd come through.”

“Don't get excited. I'm not going to see diddly. But I guess I can't refuse that choir-boy face.”

During the three years since Hamish had arrived at Caledonian, he and Wilf had traded stories of their days as boy sopranos. Unlike Hamish, Wilf had enjoyed his church choir experience. Probably because he was a natural-born musician and too burly to elicit sexual advances from his choir master. Or maybe he'd just been lucky. “How many samples you got there?”

“Twelve. I had three others but —”

“A dozen? That's an entire Serengeti full of zebras. Geez, Hamish, you can't be serious.”

Hamish pulled his business card from his wallet. “Get me on my cell. Any time, day or night, soon as you're done. This evening, maybe?”

“Don't push it, Choir Boy. I've got orchestra practice at six-thirty.”

CHAPTER
9

It was the end of a long day at the office. They'd given him more space here in Simcoe, but the view through Zol's window was an abomination. It confronted him with a string of obscenities scrawled onto a concrete wall behind a line of garbage bins. The town fathers and mothers had sandwiched their health unit between a muffler shop and a pizza joint at the back side of a strip mall. They'd awarded the prime riverside location downtown to the
LCBO
, the government-run liquor store. At least he knew the local priorities without having to ask.

All he needed to do now was gather the files he planned to review at home this evening with his single malt. Tonight, it would be a Balvenie, the Doublewood. In an hour, he'd be home with Max, who was usually at his best at the dinner table and a lively tonic against the workday's curveballs and nasties. An enthusiastic talker and eater, Max knew more about the herbs and spices of international cuisine than was probably seemly for a ten-year-old. They shopped together at Four Corners Fine Foods, across Concession Street from his old office. The lady at the confections counter handed Max a different assortment of European chocolates at every visit. The boy was now an authority on the differences between Swiss, Dutch, Belgian, and German chocolate.

Max was certain to be attentive at supper, thanks to Zol's no-electronics rule. As soon as the food hit the table, no cellphone, no computer tablet, no video games were allowed. Not for either of them. Nothing was permitted to inhibit the fine art of conversation. For tonight's supper, Zol had asked Ermalinda to prepare spaghettini with clam sauce. She was a fantastic nanny and housekeeper, but not much of a cook. She did do a nice enough job with tinned clams, and Zol had taught her how to cook pasta al dente. All he'd have to do was pull salad greens from the fridge, add toasted almonds and dried cranberries, and zap the clam casserole in the microwave.

The desk phone started ringing beside him. Who the hell was calling at five-fifteen? Probably someone with a complaint best left to the answering machine. He waited six more rings, but couldn't stand the noise any longer.

“Answering for Dr. Szabo,” he said. Anyone who didn't yet know his voice would think they were dealing with an underling and might be persuaded to have their concerns addressed by the big cheese first thing tomorrow.

“Zol?”

That voice, even with some sort of commotion in the background at her end, was unmistakable. It had seared itself forever into his brain.

Shit. What did she want? Francine never called to chat. She'd never spoken to Max since she'd deserted the two of them nine years ago — with five minutes' warning. Zol had been a surgical trainee at the time, standing gowned and gloved in the operating room. Francine paged him to say she was on her way out the door and leaving for good, and by the way, Max was asleep in his crib and would soon be wanting lunch. Zol raced home, and while Max flung canned spaghetti at the walls, Zol called his program director. They arranged his immediate transfer to a public-health traineeship, where the working hours might be more predictable. That wasn't exactly the case, but he'd never looked back.

The last time she'd called was over a year ago, from an ashram in India, with a crazy plan to travel halfway across the planet to take Max away for a weekend. Of course she didn't show up. Sometimes she wanted money via Western Union. Never very much. It was faster to send a couple of hundred bucks than to argue.

He cleared his throat. “Where are you?”

“Cambodia.”

Thank God. Half the world away. But what was she doing in a Buddhist country? Wasn't she hooked on Hindu mysticism? Well, she didn't stick at anything for long.

“Zol?”

“I'm still here.”

“I'm flying into Toronto. For a conference and retreat.”

Who was she trying to kid? Francine wasn't the conference type, and any retreat she might attend would be stoked with so much weed she'd never remember what happened.

“I have my ticket. October twenty-sixth. It's a Wednesday.”

He rolled his eyes. Just in time for Halloween. How appropriate. Was she coming in on a broom?

“And I'd like to see Max.”

His heart rate doubled. “Remember what the judge said.”

Any visit had to be supervised. “I understand, Zol. I'll do whatever you say.”

He'd never heard her so compliant. In the two years they'd been married she'd never agreed with him. Not even once. What was she on?

“They have ashrams in Cambodia?”

“Monasteries. I'm a Buddhist nun and have learned a lot about myself and my place in this life and the next. And I'm ready to see Max. All of him. And hug him. And hold his . . . you know.”

Francine had freaked at the distortion of Max's left arm caused by the stroke at the time of his birth. The doctors blamed her cocaine addiction for Max's isolated brain injury. She'd never properly cuddled him, rarely changed his diapers, and flatly refused to touch his spastic left hand.

“Have you thought about where you're going to stay?” It didn't matter. Her plans were always half-baked.

“I'm not sure yet. Probably with Allie.”

She'd said that last time and nothing happened. “Tell Allie to call me.”

“You'll let me see Max?”

He couldn't stop her. But he wouldn't tell Max about the visit until he was certain it was going to happen.

They ended the call, and he pulled two loonies from his blazer. He flipped the coins and took deliberate, even breaths until his heart rate began to slow. It was amazing how quickly that woman got under his skin.

He was still flipping the loonies when the phone rang again. The call display showed a Toronto area code. His gut tightened when he recognized the number: the Ministry of Health head office.

“Szabo,” said Dr. Elliott York. “I got a call from Jed Conroy. Reeve of Norfolk County. Holds Simcoe Health Unit's purse strings. That means, after me, he's your boss.”

Zol squirmed on his chair. A complaint already? But what was the reeve of Norfolk County doing talking to Zol's boss in Toronto?

“Jed's in my brother-in-law's poker group,” Elliott York continued. “Apparently six or seven kids in his county have come down with liver failure. A couple of deaths. All at —”

“Yes, it's six cases, all at one high school. Erie Christian Collegiate. Natasha Sharma, our best field epidemiologist, made a site visit there first thing this morning. We've got a big meeting planned with everyone concerned tomorrow, bright and early.”

“Jed wanted me to pass along a little friendly advice.” If Elliott York was impressed at Zol's command of the details, his voice wasn't showing it. “He says that school is in tiger territory.”

“I don't think I understand, sir?”

“For heaven's sake, man. Do I have to spell it out?”

“Dr. York?”

“Lots of Native kids there. From Grand Basin Reserve. With parents who know their rights. And know how to work the system.”

“And that makes a difference to our work?”

“I'm just saying . . . Be careful.”

“I think I always work carefully.”

“For God's sake, Szabo. I'm not talking science.” York was now whispering into the phone. “You find anything implicating the shenanigans we all know go on at Grand Basin, you'd be wise to tread carefully. Very carefully.” Zol pictured Elliott York dwarfed by the enormous rosewood desk he somehow kept free of clutter. The desk was legendary, as was his thing for blown-glass kitsch, which he displayed in his office on every other possible surface. “Sometimes it's better to turn a blind eye than to get the other one poked out.”

The chief
MOH
for the province of Ontario was telling him to turn a blind eye to what had killed two teenagers and might kill who knows how many more? “I'm not sure I understand, sir.”

“Jed doesn't want another standoff with the Indians. And neither do I. Not another bust-up like that business at Dover Creek Estates. Or another Ipperwash. One more unarmed Indian killed by a cop and the current government won't get re-elected for a generation.”

Zol was too stunned to answer. How could the man talk like that? It was one thing to be realistic about the troubles facing Native communities across the country, but quite another to hold such blatant hatred and express it to a subordinate.

Elliott York had no trouble filling the silence. “Between you and me, I think Jed's twitchy after that explosion at the
ROM
. Those were Mohawk artifacts that got stolen. Jed Conroy seems to think they were repatriated to Grand Basin, a sign the Indians are restless. Not a good time for you to be doing a high-handed epidemiological investigation.”

Zol felt his whole body flush with anger. His throat tightened.

He planted his feet on the carpet and felt the resolute firmness of the floor beneath him. “We'll be certain to be respectful, sir.” He paused and swallowed hard. “But we'll be thorough. And don't expect me to be timid.”

“As I say, you could be looking at a powder keg. Consider yourself warned. Officially.”

Elliott York hung up, and two seconds later Zol's cellphone buzzed against his belt.

Now what?

“Hamish? What's up?”

“Let me put it this way. I'm hopeful.”

Hamish was rarely hopeful about anything. “Seriously?”

“Went zebra-hunting this afternoon. We may have bagged a zinger.”

“Bagged it with what?”

“
EM
.”

“Plain English?”

“An electron microscope.”

“And?”

“Let me set the stage.” Hamish was the master of the grand entrance, even over the phone. Zol pictured his friend in his spotless white lab coat, his pompous finger raised to its professorial position.

Hamish recapped the scenario. Fifteen people, half of them teenagers, presenting with large blistering lesions on their lips and fingertips unresponsive to treatment. No fever, fatigue, malaise, or organ malfunction except for two Erie Christian Collegiate students who'd succumbed last Friday from lightning fast liver failure.

“Okay,” Zol said. “I'm up to speed.”

“You ready?”

“Zing me.”

“Fragments of itty-bitty matchsticks. With helical elements.”

“Hamish, you're toying with me.”

“Not at all. Wilf Dickinson, a basic-science researcher down the hall from me, called me to his lab a few minutes ago. He spent this afternoon looking at the blisters from eight of my patients under his electron microscope. He was sure he'd find only junk, but there they were, clear as day. In all eight patients. Thousands of tiny broken matchsticks, each with a central spiral core.”

“Does he know what they are?”

“He won't say. His expertise is Alzheimer's, not microbiology.”

“Did he hazard a guess?”

“He won't go out on a limb at this stage. Says he wants to try a variety of tissue staining techniques and run the specimens again tomorrow. But . . .”

There was a lot of Oscar Wilde in Hamish's voice. He was bursting with something he could barely contain. “Hamish, I know you too well. You and your colleague have got a pretty good hunch. No point in denying it.”

“We . . . we think they may be infectious particles.”

“Bacteria?”

“Way too small for that.”

“So you've seen them too?”

“Yes.”

“So what do you think they are?”

“Nothing I've ever seen before. Not in a patient, not in a textbook. Something strange, but hopefully not contagious enough to become a plague.”

A plague? Zol's heart catapulted into his throat. Was Hamish serious or grandstanding? Everyone was getting under his skin today. He warned himself to keep his tone measured. With the first hint of derision, Hamish would hang up and pout for a week. “For heaven's sake, man. Give it to me straight. I promise not to shoot the messenger.”

“Microbiology class. U of T. Our second year. A Friday. You were snoring behind me. The prof was speculating about plagues and mutant organisms of the future.”

Thursday nights at medical school had been pub nights, Friday mornings a write-off. But how could he have slept through a lecture on plagues? “We're dealing with a — a plague? Ebola? The Black Death? Germ warfare?”

“No, no. Put your loonies back in your pocket. At least until we've got more information. Sorry. I spoke too soon. But I didn't want to keep anything from you.”

“These matchstick things, are they responsible for the liver failure?”

“Too soon to say. But probably not. Only one of the eight cases Wilf examined under his machine is a liver failure patient. That means almost ninety percent of people with those blisters have not come down with liver disease.”

“I was hoping for a breakthrough on the liver thing.”

“Stay tuned. We'll talk tomorrow.”

They hung up. He grabbed his paperwork and car keys. Forget the spaghettini with clams, he'd be heading straight for the Balvenie. Well, after he'd made his daily check-in call to Mum. She'd seemed a lot stronger when they'd spoken yesterday. Had even made it to church for the first time in weeks. It was as if getting the black-eyed loon pipe out of the house had taken a huge weight off her psyche.

He paused as he reached for his coat. Was it a relief that ninety percent of Hamish's blister cases were showing no signs of liver disease? More to the point, was the electron microscopy report a critical clue demanding a thorough understanding, or a confusing confounder irrelevant to the primary investigation? He had no idea. And despite Hamish's expertise in the realm of microbiology, he wasn't certain, either. Zol hated the anxiety that churned inside him during the early days of an outbreak. Lives were at stake, dozens of questions hung unanswered, and there was too little information of substance. God, he hoped the team would mine some answers tomorrow at that Christian school.