Weapon of Choice (16 page)

The paramedic retreated to the rear of the plane, but remained standing, keeping his patient in sight.

“They don't call it that anymore, Matthew. They call it acquired human immunodeficiency syndrome.” Victor leaned closer, keeping his voice low. “But yes, I think that is what you have. And we're going to a hospital in D.C. where they have all the resources to deal with it.”

“AIDS,” Matthew said, the tears starting to seep. “I knew guys in San Francisco who died from it. I know how bad it is.” The cardiac monitor alarm sounded. Victor reached for a handful of tissues from a box attached to the wall. Dabbing the tears from Matthew's face, he replaced the oxygen mask over his nose and mouth, ending their conversation. Victor felt his heart might break as his muffled sobs blended with those of his son until the jet's wheels set down on the tarmac in D.C.

T
HURSDAY
, N
OVEMBER
28
T
HANKSGIVING
D
AY

Despite holiday traffic and extra highway police on the roads, Laura ignored the speed limit, passing every vehicle on Route 41 from Bradenton to Tampa. What could have gone so drastically wrong since she'd left home feeling mildly concerned about Natalie, but with her life on an otherwise even keel? Now, Natalie's symptoms alarmed Tim enough for him to rush her to the E.R? Three patients in her surgical ICU—or was it four?—had a strange infection. She'd been too upset to concentrate properly on what she'd heard. Her daughter needed her.

Laura headed straight from her reserved parking spot to the emergency room. The charge nurse stood, holding open the door. “This way, Dr. Nelson.” Without another word, she ushered Laura into a small, but private examining room. Another chief of surgery perk.

“Natalie!” Her daughter lay on a gurney, looking pale but not in acute distress.

Tim sat in the lone chair at her side and rose as Laura approached. “Laura, I hope I didn't overreact, but when Natalie spiked a fever—”

“You did the right thing, Tim,” Laura moved past him to her daughter. “Does she have an acute abdomen, or doesn't she? Appendicitis? Ovarian torsion? Do we have a diagnosis?” Natalie did have all the hallmarks of a surgical abdomen: abdominal pain,
vomiting, and now a fever. Something had to be done, and quickly, Laura thought. Why had they not prepped her for surgery?

So far Natalie had not said a word.

“Laura, Natalie has to tell you something,” Tim said, but stopped as Duncan Kellerman strode into the exam room.

Laura moved closer to Natalie as the three doctors crowded into the small space.

“Duncan. I just got here,” she said. “Give me a minute to examine Natalie.”

“Hi, sweetie,” she said as she placed her hands on her daughter's belly, automatically palpating, probing. But not finding what she'd feared.

“Mom, that hurts, but I—”

What was wrong? This didn't feel like a surgical abdomen
.

Kellerman spoke. “Thank God that you're here. All hell's breaking loose in the surgical ICU.”

Laura ignored Kellerman to focus her professional attention on her daughter. “Natalie, tell me exactly how you feel. I'm so sorry that I left you this morning. I thought—”

“Laura,” Kellerman's voice again, “now would be a good time to listen to what's happening in the hospital. I need you on the seventh floor.”

“Duncan, I'm with my daughter.”

“Mom, that's all right. I'm really okay. I'm sorry. I shouldn't have lied to you.”

Natalie was not making sense. Lied? Sorry? About what? That she'd disrupted their Thanksgiving plans? So typical of Natalie, concerned about others, not about herself.

“We've got real problems, Laura,” Kellerman insisted. “A bizarre infection of some sort.”

“Laura,” Tim said, “Natalie seems stable, so while we're waiting for her blood work, why don't you go with Dr. Kellerman. I'll stay here with Natalie.”

Laura turned to Tim for a fraction of a second. Why would he support Kellerman's request?

Before responding, Laura stroked Natalie's forehead: only a slight fever, not over 101.

“I'm okay, Mom. Just hurry back. I have to tell you something important. It's about Trey Standish.”

“Okay, Natalie, we need your CBC results before we decide what to do. I will be back very soon. You just rest here. Tim will stay with you.”

“I didn't get a chance to tell her,” Laura thought she heard Natalie say to Tim as she closed the exam room door. “She needs to know about Trey because—”

Trey Standish? Now that had made no sense. Standish? She tried to concentrate. Kellerman at her side, she headed for the seventh floor ICU.

“Your patient Bart Kelly is already dead,” he told her. “Others are seriously ill with a virulent, contagious infection. Not responsive to antibiotics.”

Laura willed Kellerman to shut up. She needed to focus on her daughter. She should not have left her, scared in the E.R., trying to share some secret. From the very beginning of her medical career, Laura had been faithful to her mantra: My first responsibility is my family. In any conflicting circumstance, I always will choose family over career. Including medical school, eighteen years and counting into her career, she'd never faced such a defining choice. Until just now.

On the elevator, Kellerman saw fit to lecture her. “The surgical ICU is your responsibility, and we waited for you to make major decisions that must be made.”

The first thing Laura noticed was an
ISOLATION
sign posted near the ICU door. Beside it, another:
HOSPITAL STAFF ONLY. ABSOLUTELY NO VISITORS
. Okay. Good to take precautions. But no visitors was a bit drastic.

T
HURSDAY
, N
OVEMBER
28
T
HANKSGIVING
D
AY

Charles had saved room for pecan pie and that special caramel cake that his mother always served on holidays. Only this year, he was disappointed. Mom's new diet, Dad's cholesterol. All the maid offered him with the coffee was some low-fat custardlike pudding that tasted like, well, the stuff didn't even have a taste. As soon as the servants cleared the table, Charles got up and left his parents' home. He'd overindulged on turkey, cranberry-walnut stuffing, potatoes, you name it.

Letting himself into the mansion, he went straight for the kitchen, took out a spoon from the drawer, and pulled a half gallon of Haagen-Dazs butter pecan out of the freezer. He ate right out of the carton. Nobody here to scold him. Then he heard steps coming from the basement.

“That you, Will?” he called. He hadn't expected Banks back until tomorrow. Had The Order already chosen the target?

“Yeah, Chuckie, where the fuck were you?” Banks stepped into the kitchen. “You got an important mission, you gotta stay on call. We're in combat mode, you can't go runnin' to Mama and Daddy's. Don't fuckin' care if it is Thanksgiving. That where you were?” He held out his hand for the carton of ice cream. “Give me that.”

“What did The Order decide?” Charles asked. Just the question made him queasy, and he gladly surrendered the carton.

Banks grinned, dipped in with the same spoon, and swallowed a lump of the butter pecan ice cream. “Creamy. Only the best for
Chuckie. What, you didn't get enough to eat over there at the ancestral mansion?”

“Did The Order decide?” Charles repeated.

Will took another mouthful and grinned. “Indeed they did, Chuckie. Indeed they did, and you're the star player, my man.”

Charles backed into the nearest kitchen chair and sat down. He had overeaten; his stomach felt uneasy.

“We're on, my man. You're gonna do the deed. I got all the details.” Banks patted the right front pocket of his tattered jeans. “You're gonna release those bad ass germs and all we gotta do is stay out of the way and enjoy the show. I can hear the moans and groans and gnashing of teeth already. Those people are gonna die, my man. And it's not going to be pretty, is it?” Banks stooped and leaned over Charles so they were face to face. “That right, Chuckie? Not pretty?”

The Order had chosen Charles.

“Not pretty,” the star player managed to reply.

T
HURSDAY
, N
OVEMBER
28
T
HANKSGIVING
D
AY

During her training at Detroit City Hospital, Laura thought she'd seen every variety of pain and suffering, but never anything like this. When the door to the ICU swung open, she heard herself gasp. Yesterday, the unit's seven occupants were doing reasonably well, most drifting in a sedated state close to sleep, their monitors steadily blinking and beeping. Now, she faced sweat-soaked patients writhing on damp sheets, some shaking violently. Patients who'd been recovering twenty-four hours ago, should be getting better now, not worse.

The plague came to mind. The bubonic plague; scourge of the Middle Ages. Pulmonary failure followed by organ shutdown. Signs and symptoms: shortness of breath, shaking chills, raging fever that melted organs. Back then, antibiotics had not existed; they did now, thank God. She scanned the patients, their beds arranged in a semicircle facing a central nursing station. What she saw in the last bed made her steady herself against the closest supply cabinet. Bart Kelly, her carefully selected lung reduction patient, so chipper yesterday, lifeless, covered with a white sheet.

She felt a hand grip her shoulder. “Laura, thanks,” Ed Plant said, “for coming back—glad you're here. I don't know what to make of this. They're deteriorating right before my eyes.”

Her colleague's disarray stunned her. His red hair had lost its styled perfection; blood and body fluids stained his pressed white
pants and starched lab coat. But his expression scared her the most. Amber eyes widened in terror, his face so white you could count each freckle.

She felt a tremor in his hand on her shoulder. “Let's take a moment,” Laura said, indicating two vacant chairs behind the nursing station.

“I can't. I've got to get a chest tube into bed seven. He's a young kid. Take out the fluid. Radiology is shorthanded for the holiday and they can't get the on-call staff to answer their phones. So no portable x-rays. And he's too critical to take downstairs.”

Laura looked to bed seven before something struck her as strange. Despite so many patients taking a turn for the worse, she saw only two nurses in the room. ICU standards called for a one-on-two ratio. Where were the other two? And where were the aides? The only other personnel on the floor was chief resident Michelle Wallace and she was inserting a central line into Mr. Mancini in bed five with no one even assisting her.

“Where is everybody?” Laura asked. “Not a good time for a coffee break.”

“The staff is worried, Laura,” Ed said. “Something frightening is happening, a virulent infection of some type. The AIDS patient we had here spooked everybody in the first place, and now they think we've got the next plague.”

So she hadn't been the only one to invoke the specter of plague. And why wasn't Ed wearing protective clothing?

The remark about the AIDS patient made her ask about Matthew Mercer. “Didn't he leave, transfer up north?” Could this possibly have anything to do with him? Not much was known about the HIV virus. But he had improved enough to transfer via Medjet.

Ed lowered his body onto the hard-backed chair, never taking his eyes off bed seven. “Yeah, he left all right. This afternoon. The father raised hell. The staff's attention was diverted from other patients, trying to keep him placated. Sorry I let him call you, but we all wanted him out of here. Not the patient, so much, but
Doctor
Worth. Good riddance.”

Laura noted the tremor in both of Ed's hands. She reached out casually for one, held it. Warm to the touch.
Good lord, what was happening here?

“Are you all right?” She wanted to say, but didn't. Until she was sure that her daughter was okay, she'd have to leave the ICU in Ed's hands. Even if Ed was sick, she couldn't bring herself to suggest he go home. She needed him. She just wanted to get back to her daughter.
But what was going on here?
Something she couldn't fathom.

“Tell me what's happening, Ed. From the beginning. Since I signed out to you about five yesterday afternoon.”

“Nothing in the evening. Matter of fact the whole night was calm. Unusually so. Not a single call from the nurses. I came in this morning, later than usual since it's a holiday. I planned to round about ten. The patients seemed okay, but I did note that Mr. Kelly had a low-grade temp. A hundred and one. I thought about calling in Kellerman but didn't want to upset his holiday so I decided to wait. I left orders for our ICU patients. Then I rounded on my other patients on the surgical floor. And those of my partners, as I'm covering the entire practice.” He coughed, raspy, but superficial. “I could use a drink of water.”

“Sure.” Laura got up, went to the watercooler at the nursing station, returning with water in a paper cup.

“Thanks. Then I decided to come back to the ICU and check on your patient, Mr. Kelly.” He nodded to the inert figure in Bed 1, then looked over at the chief resident. “Michelle's doing a great job, Laura. I told her to go home, but as you see, she's still here.”

For the first time, Laura noted that Michelle and the nurses were gloved and gowned. Good. This whole unit was under strict isolation protocol. Shouldn't the entire hospital be?

“The minute I came through the door, the charge nurse hit me with it. Five of the seven patients in the ICU were spiking fevers.” Ed's eyes moved across the room. “That kid in Bed 7 was a 105.”

Laura looked around. “Where is the charge nurse?” she asked.