You are safe now. The fire is over. Where are you? What do you see?
“I see the Indian lady. She is coloring.”
Coloring? Is she using crayons or pencils? What is she writing?
“She is coloring with salt, I think. Different colors of salt. She is coloring on the ground without paper.”
Could the Indian lady be coloring with sand?
“Yes, it’s sand. She moves her hand, and the colors appear. I see a bird in a circle and arrows and lines. So pretty. Now she sits back and looks at the picture. She takes some of the sand out of a bowl and throws it into the air. The sand makes little fireworks in the air.”
It is later. The sand picture is finished. Where are you now?
“In the little house. The Indian lady is giving me a drink. She washes my face and my hands. She sees a little cut on my finger. I’m not even crying; it’s such a tiny cut. The lady is singing, but I don’t understand the song. The lady cuts her own hand with a knife. She holds her hand over my cut. There is blood on my finger, now. There is blood, but I’m not crying. Now the Indian lady is washing my finger.”
What is the Indian lady doing now?
“She is rocking me in her lap. ‘Poor little girl,’ she says. She knows my name. She says her name is Eva, and I am her little sister, now. Someday, we will find each other.”
It is morning, now. Where are you?
“I am in the plane. The Indian lady carried me back to the plane. I can’t see mommy. I can’t see daddy. She puts me in a little space high up in the back of the plane. I hear a big wind. No, it’s a bird. No, it’s a helicopter. It’s coming down to the plane. Men are running out of the helicopter. Mommy, daddy, please come out of the plane! Mommy, daddy!”
You are safe now. The helicopter men are policemen, aren’t they?
“Yes, policemen. They said they will take me home. They will take me to see Aunt Pansy and Uncle Henry.”
Where is the Indian lady now?
“She ran away. She put me back in the plane and ran away.”
Rachel, you are not a little girl. You are a grown woman. You survived the plane crash. Aunt Pansy took care of you. Where are you, now?
“In a house, in a garden, in Virginia.”
You can keep your eyes closed. You will remember everything you saw and heard and felt, but it will not frighten you. They are only memories. You can do with them what you choose. Just breathe, and relax, and begin to feel your body. You are back in the present. When you are ready, open your eyes.
Chapter Twenty-Three
Ted Fuller’s apartment looked like an ad from an upscale furniture store. The rooms were furnished in matching suites. There were no sentimental hand-me-downs from parents, no keepsakes from simpler, student days. All the furniture looked as if it was bought on the same day. There were no tchotchkes, no framed photographs, and no plants. Magazines and books were neatly book-marked and shelved. Coasters were stacked. There was not a pen or piece of paper in sight.
Rachel entered the showroom-pristine apartment and wondered if Ted had rented the place for the evening. His office at Socoro was organized but slightly cluttered. There was at least evidence of human occupation. Here, the only person one might believe ever entered the apartment was the person who cleaned it, regularly.
“I don’t spend much time here,” Ted explained. He was used to seeing the expression on his guests’ faces, as if they suspected they were in the wrong place. “The bedroom and my office are much messier,” he added apologetically. “Would you like a drink?”
“Is it allowed?” asked Rachel.
“Oh, sure. Just take off your shoes, and I’ll get you a guest smock,” Ted laughed. He gave Rachel a gentle hug, which she did not resist.
Rachel crossed to the large leather sofa and sat down, pulling her bare feet beneath her. Ted brought two glasses of wine from an upstate New York vineyard.
“How was the trip to Virginia?” Ted asked.
“Fine. That’s what I called to talk to you about. I know now that my parents were murdered. I want you to talk to your contacts at the FBI and get an investigation started.”
“Based on what? I don’t have contacts at the FBI.”
“What about those agents that came to Socoro?”
“They are investigating the company and you. They are hardly, ‘my guys.’ By the way, I promised them that you would give an interview, as soon as you returned from your trip.”
Ted let his last phrase hang in the air. Rachel gave him no reason for the trip to Virginia. Socoro was waiting for her answer about accepting the knowledge opinion leader position, and the FBI was waiting to interview her. The prudent move was to provide full cooperation, but Rachel begged off to go to Virginia on a personal trip. If Ted were not so attracted to Rachel, he might have insisted, as a representative of her boss, that she meet with the Feds first, but at this point, his loyalties were definitely confused.
“What makes you believe your parents were killed?”
“I’ve remembered things about the plane crash. Things that can only be explained by the intervention of someone.” Rachel jumped up to sit on her legs. In the process, a few drops of wine sloshed over the lip of her glass. She watched Ted’s face for a reaction. He ignored the spill, so she ignored it, too.
“You have to get the FAA report on the crash. Use the Freedom of Information Act or something. Wait, there’s no statute of limitations on murder. Definitely call the FBI, or I’ll tell them myself at my interview.”
“Don’t do that,” Ted said. He moved to the kitchen and returned with a dish towel. He mopped up the spill and even wiped the bottom of Rachel’s wine glass. She thought he was overdoing the neatness, but it was his place.
“Why not?” she asked, finishing her wine in two gulps.
“You want to appear, shall we say, like the opposite of a conspiracy nut.”
Rachel leaned back abruptly. She knocked a throw pillow onto the floor. “Is that what you think I am? A kook, a crazy? A crazy kook?”
“I do not, but the FBI thinks that about everyone already. Don’t encourage them.”
“Just let my parents’ murderers get off?”
“Of course not,” said Ted. “Tell me what evidence you have that suggests they were murdered.”
“I told you. I’ve remembered things about the crash. Another plane was very close to us just before the crash. Someone put me back into the plane.”
“What?”
“Someone, an Indian woman, rescued me from the fire and then put me back in the plane after the black helicopter circled over the crash.”
Ted pulled Rachel down onto the sofa. He held her in front of him, liking the sensation of her body against his. He could feel the tenseness of her back and shoulders.
“Promise me one thing,” he said.
“What’s that?”
“You won’t use the term ‘black helicopters’ when you talk to the FBI.”
Rachel pretended to struggle to escape his embrace. In truth, she liked feeling his arms around her. Ted’s chest against her back was like a familiar comfort. She relaxed and let him hold her tightly against his body. The gulped wine had hit its mark, and Rachel was relaxing. She knew she would stay with Ted late that night, tell him about her new memories, and, maybe, some old fears.
Part II
Chapter Twenty-Four
Sofia Soto opened four folders on her desk. Each one contained medical records from a hospital and an autopsy report with photographs. Two of the folders contained reports of children: Daniel Martinez and Molly Crane. The other two reports were for a woman named A. Marco and a man named Rick Foote. All the patients died within the past two months of what looked like a hemorrhagic influenza. Sofia was a nurse and senior investigator in the Scientific Lab Division, Virology/Serology Section, of the Colorado Department of Public Heal
th.
Only one of the patients was from Colorado, Patient Zero, the first victim of this new epidemic. Right now, there were four victims in three different states, but Sofia felt a hollowness in her stomach. There was something ominous in these cases. This virus was something she had not seen before, and it was deadly. Assuming the four deaths were from the same virus, the mortality rate was 100%. Even the bubonic plague did not have that kind of kill rate. There had to be survivors out there. Sofia needed to find them, if any defense could be mounted against the virus. She requested the files of the victim in Tucson and the two in New Mexico, and the CDC smoothed the way for her. Since the declaration of the war on terror, the threat of bioweapons was taken more seriously. If this was a mutated virus, as she suspected, with a 100% or even 50% mortality rate, it might not stop until the whole country was shut down, but Sofia was getting ahead of herself.
It did not take Sofia long to come to an opinion that the same hantavirus killed all four of the patients, even though not geographically close or demographically related. Solving the mystery of these seeming unrelated cases was just the work Sofia Soto was passionate about. Five years earlier, she would have been in her car, headed to the homes, work places and schools of the patients to investigate the source of the virus. It was classic cops and robbers, in Sofia’s mind. She was the cop and the bad guy was the virus.
It was the Sin Nombre outbreak of 1993 that earned Sofia her reputation as a guerrera, a warrior. The unnamed (Sin Nombre) virus was a hantavirus, an enveloped, negative-sense, single-stranded RNA virus. It was first isolated in the Four Corners region of the United States, and it was endemic to rodents. It lives in deer mice that inhabit the Southwest without making them sick. When humans come into contact with droppings or dried urine of the mice, the virus can move to humans. When people sweep out rodent-infested sheds or homes, they can touch excreta or breathe aerosolized urine in the dust kicked up into the air by sweeping. It can even be passed by contact with contaminated rags, blankets, and food stored where mice have nested. Sin Nombre is a disease of the poor, and those living in the country.
The patients before Sofia were from all over the map, literally and demographically. Daniel Martinez, Patient Zero, lived in an income-restricted apartment complex in Greeley, Colorado. Sofia read Daniel’s autopsy report so many times that she could almost recite it from memory:
* * *
Upon initial examination, the patient had cyanotic lips and nail beds, with cold extremities. His temperature was 101° F. Patient’s grandfather reports that he began having diarrhea and shortness of breath on the Tuesday night previous, less than 48 hours before coming to the hospital. Soon after he was admitted, the patient became apneic, with no palpable pulse. Chest compressions were initiated, and the patient was intubated and ventilated. Radiology revealed bilateral infiltrates of the lungs. Blood analysis showed an elevated hematocrit and WBC count. Within four hours of admission, the patient expired from cardiac failure secondary to shock. The Colorado Department of Public Health conducted an enzyme-linked immunosorbant assay (ELISA) and reported the presence of Sin Nombre hantavirus. An environmental assessment of the patient’s apartment found no evidence of rodent infestation. Rodent droppings and nesting materials were found at the playground frequented by children living in the apartments, but interviews with neighbors confirmed the patient had not been to the playground for several weeks prior.
* * *
Sofia knew that Hantavirus Pulmonary Syndrome (HPS) among children under ten years of age was extremely rare. There were only five pediatric cases reported to the CDC in the second half of 2009.
Daniel’s family worked in meat packing, so they were in a controlled, clean environment during the day. Just because the public health investigators found no evidence of rodents when they looked at the apartment did not mean there had never been rodents present. Daniel lived in government subsidized housing, which meant they were supposed to be exterminated regularly. The first call Sofia made would be to find out the name of the exterminator used by the city and get the company’s records of work done in little Daniel’s apartment. If they were skipping their appointments to exterminate the apartments, the company would hear directly from Sofia Soto. She would threaten them with personal liability for Daniel’s death, including the medical costs paid by the State of Colorado. If the exterminator was too cocky or profited from this neglect, she would call the county attorney to rattle handcuffs in front of his face. Greeley, Colorado was out of her jurisdiction, but Sofia always relied on the ignorance of scofflaws to scare them onto the straight and narrow.
Sofia was a formidable investigator. She loved confrontation. She learned the art of tongue lashing from a mother who wore out three husbands from her merciless scolding and her ceaseless recitation of the men’s inadequacies. Sofia was tall, and she had squared off against men larger and stronger without losing eye contact for an instant. She was called jefa, the boss.
* * *
Molly Crane, a 12-year-old female, presented at the St. Joseph’s Hospital in Tucson, admitted by her father Dr. James Crane, with a 24-hour history of shortness of breath, chest pain, cough, and fever. Upon admission, the patient’s temperature was 103°F (39.4°C), pulse of 100 and a respiratory rate between 40 and 60. She was thrombocytopenic and had elevated WBC. Chest x-ray revealed bilateral interstitial infiltrates. During the next 2 hours, the patient’s respiratory distress and hypoxia exacerbated. She was intubated and ventilated for approximately 24 hours, when the patient suffered cardiac failure. The patient’s family continued ventilation so that organs could be harvested and ceased mechanical ventilation after signing the appropriate informed consents. Arizona Department of Public Health conducted environmental studies of the patient’s home and school. Two days before the first symptoms appeared, the patient spent several hours at the Tucson Convention Center. An assessment was conducted of the areas the patient occupied in the convention center, and no evidence of rodent infestation was found.
* * *
Molly Crane’s father was a doctor. They lived in a good neighborhood in Tucson. Molly was unlikely to have come in contact with rodent droppings in her gated neighborhood. She was an active Girl Scout, so maybe she picked up something at a campsite. Sofia made a note to talk to her scout leader.
The last two patients were A. Marco, a rich art gallery owner in Las Cruces, New Mexico and Rick Foote, who worked for a caterer. Rick probably worked at Marco’s house at a party, where everything would have been clean. Sofia needed to check out where he lived. She also wondered if A. Marco, collector of indigenous art, ever dug up any of it on her own. It was possible she went out to dig sites. It was more likely that she had interaction with amateur archeologists who did not know the value of what they found nor the danger of digging in places where deer mice nested.
* * *
A. Marco, age 41, female in excellent health presented in the E.R. with chest pain and shortness of breath. Her temperature was 99.9°F, and her pulse was 163. The patient reported becoming ill early in the morning following a party at her home, which was catered by a local company. [Note added after dictation: Public Health reports an employee of the catering company was also admitted with symptoms of HPS at New Mexico State University Medical Center at approximately the same time. Nothing further is known of this patient.] The patient presented with coarse breath sounds, wheezes and crackles on auscultation. Over the next few hours, the patient’s pulmonary distress worsened so that she was intubated and mechanically ventilated. Upon a presumptive diagnosis of HPS, the patient was treated with intravenous fluids, ceftrixone, and vancomycin. She remained on a ventilator for 48 hours and expired due to apparent sepsis caused by pneumonia.
* * *
Sofia began by reading everything she could find on Sin Nombre. One thing bothered Sofia even more than the distance between the victims and the extraordinary mortality rate. It was how quickly the victims becam
e sick. The usual prodromal period for Sin Nombre was three to five days from the time of infection. The patient experienced myalgia, chills, headache, dizziness, cough, and nausea. Shortness of breath generally manifested by about day seven. The patients’ fluid eventually shifts from their circulation system to the lungs, causing a high white blood count and low platelet count. Once fluid moves into the lungs, the disease progresses quickly. The reports on these four patients all stated they were hospitalized within 24 hours of the first onset of symptoms. If this was Sin Nombre, it may have mutated to something that hit faster and harder. Sofia knew she had to find the common link between these patients soon or more folders would show up on her desk.
Hantavirus Pulmonary Syndrome was first identified in 1993 in the Four Corners area of the Southwest United States. It soon appeared in other states. By 2002, over 300 cases were identified in 31 states. The virus was carried by New World rodents, who do not usually transmit illness to humans. The deer mouse is the host for the Sin Nombre virus, which causes most HPS in the U.S. Still, only a small percentage of deer mice tested carry Sin Nombre.
The virus is transmitted to humans by inhaling infectious, aerosolized saliva or excreta from deer mice. A human might unknowingly disturb dirt or leaves where the rodents have nested. Particles of dried urine or excrement are kicked up into the air and inhaled, or it is introduced into a cut or break in the skin. No human-to-human transmission has been reported in the U.S.
There are many types of hantaviruses, classified into two groups called Old World and New World. The viruses cause different illnesses in humans. Old World hantaviruses cause a hemorrhagic fever with renal syndrome (HFRS). Almost 200,000 people become sick with these viruses each year. New World hantaviruses are associated with HPS. The first strain discovered was Sin Nombre.
New World hantavirus infections usually begin with a mild fever and progress to HPS. Gestation from infection to onset of symptoms is one to two weeks. In HPS, the patients develop a cough and shortness of breath one to six weeks after infection. After that, the disease quickly progresses to respiratory and cardiac failure. The fatality rate from HPS is over fifty percent.
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