“I agree,” said Dr. Wu. “This is something entirely different. Something nobody’s seen.”
“Have we sent any of the patients to radiology? An MRI would show swelling,” said Dr. Cabrera.
“A polymerase chain reaction test of cerebrospinal fluid would be conclusive,” said Hale.
“I thought you were studying emergency medicine?” said Cabrera.
“I’m interested in a pediatric emergency medicine fellowship,” she said, suddenly very aware that the entire room was focused on her.
“We’re not doing spinal taps,” said Dr. Wu.
“Damn right we’re not,” said Dr. Owen. “We can send some patients on to radiology. Bring an anesthesiologist down for the spinal taps.”
“All of the attending physicians can do a spinal tap,” said Cabrera.
“Not anymore. This group is shot,” said Dr. Owen. “How much sleep have you logged in the past forty-eight hours?”
Dr. Cabrera started to calculate the number.
“The answer to that question is not even fucking close to enough to mess with the spine,” stated Dr. Owens. “And I don’t anticipate any of us getting any sleep soon. We’ve lost three doctors and six nurses from the overall rotation already.”
“Lost?” said Dr. Hale.
Dr. Wu grimaced and shook his head. “Some just disappeared. Slipped away when nobody was looking. The others are sick. Same symptoms. Dr. Edwards is strapped to a bed in the psych wing. We didn’t want to keep him here.”
“That’s where half of these patients should be right now,” stated Dr. Owens.
“Jesus,” said Dr. Hale. “Is anyone else…sick?”
“Good question,” said Dr. Owens. “Dr. Edwards didn’t give us much warning.”
“Let’s get back to the question of police protection,” said a young-looking doctor toward the back of the conference room. “If the patients are getting worse and the police are disappearing, where does that leave us? I have to be honest. I’m one patient rampage from slipping away myself. Sorry, but I have a four-month-old baby and a pissed-off wife at home. If we’ve moved into the patient warehousing business, I can’t imagine sticking around very long.”
The room broke into a discordance of yelling, most of the room angry with the young doctor, a few joining his cause. Dr. Hale wanted to pursue Dr. Owens’s statement about Edwards. What had he done so suddenly?
“Dr. Blake, we all have lives outside of the ER, and it’s not like we’re sitting around useless,” said Dr. Wu. “We’ll implement a new triage protocol after I can meet with some of the administrators. I can’t effectively shut down the ER without their input. If you choose to leave, nobody will stand in your way—but that’s the end of your career here, as far as I’m concerned. We’re obligated by contract to be here in the event of a disaster.”
“We don’t even know what we’re dealing with,” said the young physician.
“Doesn’t matter. We’re on the front lines of something big. That’s all—”
Dr. Wu winced, bringing a hand to his head before continuing the sentence. “That’s all we need to know.”
Dr. Hale looked at Dr. Owens, who met her glance with an almost imperceptibly raised eyebrow. She scanned the rest of the faces, finding a few concerned looks, but nothing that raised any serious alarms.
“You okay?” said Dr. Cabrera.
“I’m fine. Just exhausted like everyone else…and dehydrated. Make sure everyone remembers to keep the fluids going,” said Dr. Wu, still looking a little shaken by what she assumed was a sudden headache. “Are we good?”
The younger doctor raised a finger, garnering an impatient nod from Dr. Wu.
“It’s going to be a long night. I suggest we restrain any of the patients that have exhibited symptoms beyond headache and fever,” said Dr. Blake.
“That’s more than a third of the patients,” said Dr. Cabrera. “We have four sets of restraints.”
“I’m sure the psych floor can lend us a hand,” said Dr. Blake. “Hell, we can use duct tape. Plenty of that in the storage closet.”
“We’ll get sued off our asses if we start preemptively lashing patients to their beds,” said another doctor. “Duct tape? What the fuck? Imagine that photo getting around the Internet.”
“Exactly,” said Dr. Wu. “That’s why I need to talk to someone above my pay grade before we take any drastic steps.”
“Fuck. Then call them up right now!” said Dr. Owens. “Duct tape is sounding pretty good right now.”
“I’ve tried,” said Dr. Wu. “Nobody is answering my calls.”
The room went dead silent.
“Seriously?” said Dr. Owens.
“Yes. We’re on our own until morning, with whatever police support we can wrangle,” said Dr. Wu. “Dr. Hale, I’d like you to liaison with the Indianapolis PD sergeant in the parking lot. Let him see your bruised face, and make the case for a stronger police presence inside the ER tonight.”
“Are the other hospitals dealing with the same thing?” said Dr. Lundy, a normally soft-spoken, easygoing member of the ER team.
“They are. Every hospital in Indianapolis is slammed. This is widespread,” said Dr. Wu.
“How widespread?” said Dr. Blake.
“Citywide for sure. I don’t know about the suburbs.”
“Have we contacted the CDC?” said Dr. Cabrera, looking surprised by Wu’s answer. “If this is widespread, it could be a pandemic outbreak or some kind of biological attack.”
A few of the doctors and nurses laughed condescendingly at the doctor’s comment, but most of the room remained ominously silent.
“Damn it, Larry,” said Dr. Wu, grinning. “I hadn’t thought of it. I’ll get on the line with them right after this meeting. Maybe they can send one of their outbreak response teams or something.”
Dr. Cabrera began to respond. “If this is citywide, I’d be surprised if they—”
The sound of staccato gunfire stopped him in mid-sentence. Screams from the direction of the ER waiting room catalyzed the doctors, scrambling most of them into the hallway. Dr. Wu took off for the waiting room, trailed by most of the staff.
Dr. Hale started to follow the group, but stopped when she noticed that Dr. Cabrera and Dr. Owens had paused just inside the conference room. She backed up a few steps, catching Cabrera’s attention.
“In here for a second?” he said, motioning for her to join them.
She glanced furtively at the swarm of white coats and blue scrubs surging through the waiting room’s doors before joining them inside the conference room.
“What’s up?” she said.
“First, how are you feeling?” said Cabrera.
“Tired. Head hurts,” she said. “Otherwise I’m fine.”
Owens gave her a concerned look.
“Seriously. I’m fine,” she said.
“Mind if I check something?” said Cabrera, producing a forehead thermometer from his lab coat pocket.
“Really?”
“Really,” he said, and she immediately understood why.
Dr. Owens kept a neutral face while Cabrera pressed the thermometer to her temple for a few seconds, followed by her forehead. Moments later, the device beeped. He showed her the temperature on the LED readout before turning the screen toward Dr. Owens.
“Ninety-eight point eight. Normal,” said Owens, clearly relieved.
“I figured her headache was concussion related,” said Cabrera.
“That’s reason enough to send you home, Dr. Hale,” said Owens.
“I can manage for now,” said Hale. “How many of the staff are running a temperature?”
“We don’t know,” said Cabrera. “Dr. Owens and I haven’t found the right moment to suggest staff-wide temperature checks.”
“It would be the beginning of the end for the ER,” said Owens. “Not that we’re moving in any other direction.”
“Dr. Wu didn’t look good,” said Hale.
“No. He didn’
t. And if Wu goes, the ER will follow,” said Owens. “Based on patient observation and history, I say he’ll be out of commission by noon tomorrow. Maybe sooner, depending on how long he’s been hiding the headaches.”
“Jesus. Out of commission?” she said.
“Fever and headache will put him in a hospital bed,” said Cabrera.
“If he’s lucky,” said Owens.
“Jesus,” said Hale. “Is there anything we can do?”
“Watch your back, for one,” said Cabrera. “Any of these patients can go haywire at any moment. We usually get some warning. Abusive language is a dead giveaway.”
“What happened with Dr. Edwards?” said Hale.
“He fell into the no warning category. Probably been nursing a headache and fever for a while, but he didn’t exhibit any neurological symptoms until he started beating a patient. Fortunately, he lost his shit right in front of a police officer, who stopped him cold with his Taser. We had him strapped to a gurney and out of there pretty fast.”
“And nobody has any idea what’s causing this?” said Hale. “It sounds like encephalitis, but I agree that it’s too widespread. Rabies? Violent outbursts have been recorded with rabies.”
“Rabies is a hundred times rarer than encephalitis, especially in the United States,” said Owens.
“It has to be something that affects the frontal lobe,” said Hale.
Owens frowned. “If we can schedule a spinal tap with anesthesiology—sooner than later—I have a friend at NevoTech that could very likely make sense of this. He specializes in this field.”
“Could you do the spinal tap yourself?” said Hale.
Owens rubbed his face and squinted before slowly nodding. “I don’t see why not, but I think I more or less convinced Dr. Wu that we need someone from anesthesiology to do it.”
“Fuck anesthesiology. Wu’s crossing his t’s and dotting his i’s on this one. No way he’ll let you walk out of here with an official hospital sample,” said Hale. “We have no idea what we’re dealing with and may need to rethink our biosafety posture. All the sterile gloves and masks in the world won’t make a difference against BSL 3 or 4 pathogens. The sooner you get a sample into your friend’s hands, the better. If the CDC isn’t responding, this might be our only way to get some answers. We’ll figure out a way to get you a patient. What are the collection protocols?”
“Where did you find her?” said Owens.
“Random residency assignment,” said Cabrera. “Lucky. Right?”
“Very,” said Owens. “To answer your question, we’ll need to time this right, especially if we don’t run it through the hospital lab. Cerebrospinal fluid needs to be processed within an hour of collection, or mixed with a Trans-Isolate medium if the wait time will be longer. We don’t carry the T-I medium in the ER. Ideally, my friend would be set up and waiting for the sample by the time I do the spinal tap. One of us would have to run it over to him.”
“Maybe we should explore the hospital option. Sounds like a lot of moving parts,” said Cabrera.
“We may have to go that route anyway. There’s no guarantee my friend is in town. He travels a lot for his research. If he’s here, I’m almost certain he’ll want to take a look. Even if it means waiting until morning, I think it’ll be worth it. He studies potential biological threats, manmade and naturally occurring. If he can’t determine what we’re dealing with, this might be a brand-new virus strain.”
Angry voices rose from the waiting room, drawing them into the hallway.
“Shit,” said Cabrera, moving hesitantly toward the double doors.
She swore to herself that she’d run in the opposite direction if she heard gunfire. They might be under obligation to stay here and treat injured patients, but nothing in her residency agreement stipulated she had to work in a war zone. Gunfire in the ER equaled cancellation of that contract. She highly doubted anyone would argue differently. As they edged toward the waiting room, Dr. Wu and two of the ER nurses burst through the double doors, followed closely by a blood-splattered police officer carrying another officer in a fireman’s carry.
“Multiple gunshots!” yelled Wu. “Get trauma down here immediately!”
“On it!” yelled Cabrera, disappearing into the office next to the doors.
“Owens, emergency room one!” said Wu.
“Meet you there,” said Owens, sprinting ahead and yelling over his shoulder, “What the fuck happened?”
“Guy just walked up to us, screaming his head off!” yelled the cop. “As soon as we started to walk over, he unloaded. Hit some civilians behind us, too.”
Hale hated to ask this question right now, but she felt it was important. Possibly a chance to force a decision that should have been made hours ago.
“Where’s the officer in charge of the police detail?” she yelled. “We need to secure the ER.”
“We’re about to save her life!” said Wu, stopping momentarily.
The police officer plowed past him, following Dr. Owens and the nurses.
“It’s only a matter of time before this spills into the ER,” she said.
He muttered a few curses before looking up at her. “Help the ER staff move the drive-by victims into treatment rooms—then lock the fucking doors. We’re closed until further notice.”
“Right,” she said.
She took off for the waiting room to assess the situation, slipping on the floor. Nearly falling, she steadied herself and looked down at the blood-covered black and white checkered tiles. That’s a lot of blood.
Cabrera poked his head out the office door, a phone in his hand. “Did he just close the ER?”
She took a moment to respond. “Yeah. I need to figure out how to do that.”
“You need to clear the waiting room. We don’t have the resources to monitor a room full of loose cannons. Then lock the doors.”
Hale nodded before turning her attention toward the waiting room. How the hell was she going to shut down the ER and eject close to a hundred patients. Hale took a deep breath, the answer coming to her moments later.
“That’ll work,” muttered Hale, pushing the door open to the chaotic waiting room.
The only police officer visible had a patient face-planted against the wall next to the ER’s wide sliding door. He was the only authority figure among a sea of desperate, deteriorating patients. She briefly considered the options, settling on the one that would solve their problem the quickest. Trying to drag the rest of the wounded through this gaggle could prove disastrous. This is the only way.
“Officer! We need to evacuate the ER. There’s been a bomb threat,” said Hale. “Everyone. Move to the exit. We’ve had a bomb threat.”
All hell broke loose in the waiting room as patients stormed the sliding door, which opened just in time to accommodate the panicked mob. The officer released the woman he’d detained and moved out of the way, the stream of patients dragging her away. He spoke into his radio and barged through the storm of people. When he reached her, he took her aside.
“There’s no bomb threat, is there?” said the officer.
“No. We needed to defuse this situation before it spiraled completely out of control,” she said.
“A little late for that.”
“I agree,” she said, making direct eye contact with him. “The officer that was shot is with our best people right now. Trauma is on the way. She’s going to make it. I need you to clear the remaining patients when this dies down, and barricade the door after we move the drive-by victims inside. The ER is closed.”
Chapter 7
Eugene Chang rolled over in bed and swiped his persistently vibrating phone from the nightstand. He’d ignored the first call, thinking the early morning caller would leave a message. It didn’t happen often, but occasionally one of his colleagues around the world would get excited about a research-related breakthrough or discovery, and momentarily forget about the time difference. But two separate calls in a matter of minutes warranted his attentio
n, however groggy that attention might be. He could count the number of times his phone had rung back-to-back on one hand; all of them had been emergencies.
When his blurry eyes came into focus on the smart phone screen, he hesitated for a moment. The caller ID read Jeff Owens, MD. It took his still-foggy brain another second to make the connection. Of course. Dr. Owens was a senior ER doctor at Indiana University Methodist Hospital. They’d met at a state disaster planning conference a few years back. Owens had kept in touch, occasionally asking for advice regarding ER policy and training related to pandemic and biological disasters. He didn’t strike Chang as the type that would call at three in the morning with something that could wait, so he accepted the call.
“Dr. Chang,” he said in a scratchy voice.
“Gene, it’s Jeff Owens over at Methodist. Very sorry to call you in the middle of the night, but I didn’t think this could wait.”
“It’s not a problem, Jeff. Just bear with me if I don’t sound one hundred percent lucid,” said Chang.
“I’m running on fumes, so I probably won’t notice. I’ve been at the ER for thirty-seven hours straight,” said Owens. “The ER has been in a maximum-overflow situation for longer than that.”
Chang hadn’t watched the news since he’d returned earlier in the afternoon, but he had noticed more police and ambulance sirens than usual. He could hear one in the distance right now, which was unusual for Indianapolis.
“Has there been an accident?”
Before Owens could answer, he realized that his line of thinking didn’t make much sense. The sirens wouldn’t still be going almost two days after an accident. His mind was still sluggish.
“Not that I know of. Why?” said Owens.
“The sirens. Seems like they’ve been going nonstop since I got back this afternoon. There’s one going right now.”
“The sirens are related to what’s going on,” said Owens. “Here’s the bottom line. The ER is full of patients with fever, severe headaches, general fatigue, speech abnormalities, erratic behavior, catatonia or worse.”
His mind raced to keep up with the list of symptoms, hoping that they were spread widely among the patients. If seen as a cluster of symptoms in a single patient, a disturbing diagnosis emerged. Impossible on this wide of a scale—unless the unthinkable had occurred. The thought of such a catastrophe cleared his mind, snapping him fully awake.
The Zulu Virus Chronicles Boxset (Books 1-3) Page 4
