Viral

by Robin Cook

  “Please try to discourage her. I’ll let you know the moment I learn anything, and you can let her know.”

  After speaking with his mother, he debated whether to call his two older brothers or his younger sister, more as a way of keeping his mind occupied than anything else. While he was still debating, he heard his name called out by a tall, slim, relatively young doctor who’d stepped into the waiting room from the depths of the ED. Dressed in rumpled scrubs, a surgical hat, and face mask, he looked the part of a harried emergency physician with a raft of pens jammed into his breast pocket and a stethoscope slung around his neck.

  Brian stood up and waved to get the doctor’s attention.

  “Mr. Brian Murphy?” the doctor questioned yet again as he neared. He had lowered his voice considerably. “You are Emma Murphy’s husband?” He had a lilting accent Brian associated with people from the Indian subcontinent.

  “I am,” Brian responded. He felt himself stiffen, sensing from the doctor’s tone that all was not well.

  “My name is Dr. Darsh Kumar. I have important news about your wife.”

  “Okay,” Brian said slowly, bracing himself for what he was about to hear.

  “She’s going to be admitted to the hospital. In fact, she has to be taken to the Intensive Care Unit.”

  “Okay,” he repeated, feeling increasingly panicked but trying to calm himself. “Why the ICU?”

  “She had another seizure while she was being examined,” Dr. Kumar explained. “However, we were able to control it rapidly since we already had an IV running. She’s resting comfortably now, but is disoriented. We want her to be closely monitored.”

  Brian nodded. His mind was racing around at warp speed. “More disoriented than when she arrived?”

  “Probably, but not necessarily. I can’t say for sure.”

  “Is there a diagnosis? Could this be coronavirus?”

  “It’s possible, but not probable with these symptoms,” Dr. Kumar said. “What we are certain of is that she has some sort of encephalitis, meaning an inflammation of the brain.”

  “I’ve heard of encephalitis. I’ve had EMT training,” Brian explained.

  “What we don’t yet know is the specific etiology,” Dr. Kumar continued. “We suspect viral. We did a spinal tap and have sent the specimens to the lab. They will soon let us know what we are dealing with. If I had to guess, I’d say possibly something like West Nile virus or possibly even Lyme disease. Did you have much contact with mosquitoes or ticks while you were on Cape Cod?”

  “No ticks, but we did have some mosquitoes during a beach barbecue four or five days ago.”

  “That could be it, which would favor a viral disease. But there is no reason to speculate at this point. It won’t change our treatment.”

  “What’s the treatment?”

  “Essentially just supportive. She’s on supplemental oxygen. Even though we were able to stop her seizure quickly, her oxygen level fell considerably.”

  “Can I see her?” Brian asked desperately.

  “Not at the moment,” Dr. Kumar said. “She’s getting an MRI and a CT scan.”

  “Both? Why both?”

  “I leave that up to our radiology colleagues. Meanwhile the business office needs to speak to you about your wife’s admission.” He pointed across the room to a door that had admitting stenciled on it, and then turned and started to leave.

  “Excuse me,” Brian called after him. “I would like to see my wife when I can.”

  “I’ll let the nurses know,” Dr. Kumar said over his shoulder before quickly disappearing whence he came.

  After taking a deep breath to fortify himself, Brian picked up the few things he had brought in with him and walked over to the Admitting office. He had no idea what they wanted from him since he’d already given their information to the ED clerk.

  It was a reasonably sized room with several rows of chairs facing two desks. On the cream-colored walls were multiple framed photographs of mostly serious-looking men in business suits although there were several women. He assumed they were hospital administrators. Only one of the desks was occupied, by a middle-aged woman with dark hair and eyes. She was wearing a colorful flower-print dress under a white lab coat.

  “Mr. Murphy?” the woman called out as soon as Brian entered. She and Brian were the only people in the room.

  “Yes,” he said. “Brian Murphy.” He could see her name was Maria Hernandez. He approached her desk, where a large plexiglass shield had been added in recent months. Like a cashier’s window at a bank, there was a slot for passing papers to and fro along its base.

  “Brian Murphy,” Maria repeated while tilting her head to the side to give him a good once-over. “Were you related to Deputy Inspector Conor Murphy, the commanding officer of the 34th Precinct, by any chance?”

  “He was my father,” Brian said, surprised that she recognized him with his face mask. Luckily the short time Brian had been assigned to the 34th Precinct was before his father had become the CO.

  “I knew it the moment you walked in here,” Maria said, as if proud of herself. “You’re certainly your father’s son. My husband, Adolpho, who was the sanitation supervisor for Inwood, knew your father very well. In fact, they shared many an after-hour beer.”

  “Unfortunately, my father shared far too many beers,” he responded. He didn’t want to be reminded of that aspect of his father, who ultimately fell victim to the Irish curse of alcoholism and had died a year and a half earlier. At the same time, Maria’s comment reminded him of the benefit as well as the disadvantage of living within one of the many tight-knit New York neighborhoods. Lives were inextricably intertwined.

  “Isn’t that the truth,” Maria said grimly. “Same can be said about my Adolpho, bless his soul. Aren’t you a policeman, too?”

  “I was. In December I left the force to start my own business. One of my brothers is a cop and so was my uncle, grandfather, and great-grandfather.” Brian had loved being a policeman and had longed to become one for as long as he could remember. But part of the reason he left the force was to avoid the trap that had ensnared his father, grandfather, and great-grandfather. The security business had been a way to use his law enforcement background and experience in a new and creative way, without it becoming too routine or depressing.

  “And who is this Emma Murphy?” Maria said, holding up the admission papers.

  “That’s my wife,” Brian said. “Emma O’Brien. You probably know her father and mother. Her father started Inwood Plumbing and Heating.”

  “Yes, I know of her. I’m sorry she’s being admitted, especially to the ICU.”

  “I am, too. What do I need to do here?”

  “Just sign these admission forms for me,” Maria said. She slid the stack of papers through the slot in the plexiglass.

  He leafed through the stack, and he could see it was the usual legalese that he detested and for which he had little patience. It reminded him of income tax forms. “What is all this?” he asked.

  “The customary material. It’s mostly to give the hospital and our fine doctors and nurses the right to take care of your wife. It also means you are agreeing to pay for the necessary services.”

  “Does it have our health insurance information?” Brian asked.

  “Whatever you gave to the ED clerk, I put in there,” Maria said. “Slip it back to me and I’ll make sure.”

  Brian did as he was told. Using her index finger, Maria rapidly flipped through the pages. In a moment she’d found the correct one. “Yes, here it is. Peerless Health Insurance with the policy number. You’re fine.”

  “Okay, good,” he said with relief. “Let me sign it.”

  Maria shoved the pages back through the hole in the plexiglass. While Brian was signing, she asked: “Why do you have Peerless insurance? Why don’t you have your official NYC insurance? I
mean, you were a policeman for years, right? I still have my Adolpho’s plan. It’s really terrific.”

  “When Emma and I left the force to start our company, which was far more expensive an undertaking than we thought, we had to pinch pennies. We couldn’t afford the premiums to keep our NYPD insurance, so we turned to the short-term market. Peerless offered what we needed. We felt obligated to be covered because of our daughter. She’d been a preemie.” He slid the signed document back through the plexiglass.

  “It does seem to be a quite popular company,” Maria agreed. “I’ve seen a lot of it lately. Okay, you are good to go, and I hope Emma gets better quickly.”

  “Thanks, Maria. Nice chatting with you.”

  Brian returned to the main waiting area. As someone who was a committed “doer,” he found this kind of inactivity a strain. Yet he couldn’t leave without having more information and reassurance about Emma’s condition. To make certain that the powers that be knew he was still there, he went back to the information desk and essentially rechecked in. He told the clerk that Dr. Kumar had informed the nurses that he wanted to see his wife as soon as her MRI and CT scans were done. The clerk assured him that the nurses would surely let him know the moment they could. With a strong suspicion the woman was merely placating him, he nonetheless took a seat as far away from everyone as possible and committed himself to waiting.

  Another hour crept by. Brian watched as an endless cast of characters either walked into the ED or were carried in. Some came with extended family, most of whom were denied entry by the security people because of the coronavirus situation. Under less stressful circumstances he might have found the scene mildly entertaining as a reflection of life in Inwood. He even recognized some of the patients or the accompanying family members, but he didn’t talk to anyone, preferring to hide behind his mask and just observe.

  “Mr. Murphy?” a voice asked.

  Brian turned away from the scene of another ambulance arriving to find himself looking up into the masked and shielded face of Ms. Claire Baxter, RN, as evidenced by her name tag.

  “Yes, I’m Brian Murphy.”

  “Dr. Kumar said you’d like to see your wife before she is transferred upstairs. Come with me.”

  He quickly got to his feet and followed the nurse back into the Emergency Department’s busy hinterland. He was shown into one of the larger treatment rooms, where Emma was seemingly asleep on a gurney with its rails raised. To his great relief she looked entirely normal save for a nasal cannula providing oxygen and a stocking cap covering her red hair. She even had a very slight but healthy-looking tan on her normally porcelain cheeks, which made the IV and an oximeter on one of her index fingers look totally out of place. Dr. Kumar was busy studying MRI images on a flat-screen monitor.

  Brian approached the gurney and closed his fingers around Emma’s forearm, hoping that she’d wake up. She didn’t budge.

  “She’s sleeping off the considerable medication we gave her to control her seizure,” Dr. Kumar explained, speaking rapidly. He quickly moved around to the other side of the bed. “She is still quite disoriented, but I’m happy to say that her oxygen saturation now is entirely normal. That means her lung function is steady, which we feel lessens the chance we are dealing with coronavirus or will be in need of a ventilator. She tested negative for SARS-CoV-2, by the way.”

  “That’s encouraging,” he said. “What did the MRI and the CT scans show?”

  “Both are consistent with viral encephalitis,” Dr. Kumar said. “More importantly I spoke with an infectious disease specialist. She told me that considering the history of you and your wife having just been on Cape Cod and that beach incident you recounted, she’d favor a diagnosis of eastern equine encephalitis rather than West Nile, which we’ll be testing for. She reminded me that Massachusetts has seen an uptick in EEE over the last couple of years.”

  “I’ve never heard of EEE.”

  “You and a lot of other people,” Dr. Kumar said. “But that’s going to alter with climate change. Mark my words.”

  “Is EEE serious?” Brian asked hesitantly, not sure he wanted to hear the answer.

  “Yes, it can be. Particularly when there are neurological symptoms.”

  “Like my wife is experiencing.”

  “Like your wife is experiencing,” Dr. Kumar agreed. “It’s why I want her in the ICU. I want her to be closely observed, particularly for more seizure activity and changes in her orientation and oxygenation level.”

  “How long do you think she will be in the ICU?” Brian asked. “I think it might stress her out even more.”

  “With luck, just a few days,” Dr. Kumar said. “One of the ICU hospitalists will call you in the morning and let you know how she is doing.”

  “I appreciate that,” he said. “Tell me, is EEE contagious?”

  “Not from person to person,” Dr. Kumar assured him.

  “At least there’s that,” Brian said.

  “It’s a mosquito-borne illness, which, simply enough, means it’s becoming more and more important to avoid mosquitoes. Especially during evening barbecues like you mentioned. That’s when those Asian tiger mosquitoes are out in force.”

  At that moment several orderlies appeared. Without a word one went to the head of Emma’s gurney, where he disengaged the brake, while the other went to the foot and began guiding it out of the treatment room. Brian was able to follow and quickly give her arm one more squeeze before watching her disappear from the room. He couldn’t help but wonder when he would be seeing her again, especially since he assumed that ICU visitation was most likely limited these days.

  “I can show you back to the waiting room,” Ms. Baxter offered.

  Brian merely nodded and followed the nurse, passing out through the same door as Emma had just been pushed, but turning in the opposite direction once out in the hallway. He’d hoped to feel more encouraged after seeing Emma for himself, but he didn’t. He also didn’t respond to the nurse’s small talk, too distracted by a wave of anger directed at fate. First it had been the coronavirus that had derailed all their carefully laid plans for their new security business. And now it was this illness he’d never heard of threatening his wife. And to make matters worse, it happened while they were trying to make the best of a difficult situation by having a bit of family fun in the face of the pandemic.

  Five minutes later Brian started the short walk from MMH to his home on West 217th Street. Just getting out of the hospital helped his mindset to a degree. Yet he still felt as if he’d run an emotional marathon. Transitioning from yesterday to today boggled him. He couldn’t imagine two days being so different. Yesterday he’d been capable of feeling relatively happy despite the obstacles they faced, and today he was overwhelmed with worry about Emma.

  When he walked into the house, he was relieved that Juliette was already fast asleep in bed. He’d been concerned about how he would find the patience to deal with her needs. Camila said she hadn’t eaten much dinner but had been eager to go to bed after having a long bath.

  “You are more than a lifesaver, you’re a godsend,” Brian told her after looking in at his peacefully sleeping daughter clutching her beloved Bunny. “You certainly have a way with her that I’m so thankful for. As hard as she was crying at the hospital, I was worried she’d be up all night.”

  He closed Juliette’s door silently to avoid waking her.

  “She’s a joy,” Camila said. “Emma’s seizure and then the hospital frightened her, and she just needed to get home to calm down. How is Emma?”

  “I only got to see her for a few seconds,” Brian said. “She was sleeping off some medication, so I wasn’t able to speak with her.”

  “I’m sure she is going to be just fine. Did they give you any idea when she might be coming home?”

  “No, they didn’t. I guess we’ll just have to see how it goes and keep our fingers crossed
.” He didn’t mention that Emma had had a second seizure. He wasn’t sure why, although he guessed it was because he was trying to forget it.

  “How about we have some dinner?” Camila suggested. “On the way home from MMH I picked up enough take-out from Floridita for the three of us: pulled pork, black beans, and yellow rice. Juliette didn’t do it justice.”

  “That was thoughtful,” Brian said. “The idea of dealing with food hadn’t even occurred to me. What did we do to deserve you?”

  “I think the feeling’s pretty mutual,” she said with one of her characteristic laughs. “It’s been a real win-win situation.”

  Over dinner Camila shared some good news. She said that she’d gotten a serious inquiry that afternoon about security needs for a weekend-long wedding planned for the middle of October out in Southampton. “Apparently it’s going to be a sizable affair with people flying in on their private jets from all over the country. The man’s name is Calvin Foster of Priority Capital. He made the call himself, which impressed me. He asked to speak to you directly and gave me his number. I told him that you would call him back tomorrow.”

  “Wow,” Brian said. “Did he say anything at all about Covid-19 restrictions?”

  “He did,” Camila said. “Everyone will be required to be tested before arrival, and he’s going to have an on-site testing setup.”

  “Whoa! That is good news,” he said. “A big wedding like that will be a significant financial shot in the arm, especially if we will be tasked to take care of some of the guests as well.”

  “The number to call is on your desk in the office,” she said. When Emma and Brian had started Personal Protection LLC, they’d turned the home’s formal dining room into a dedicated office with desks for all three of them.

  “Did he happen to mention how he got word about us?” Brian asked. The conundrum of publicity from day one had only been made worse by the lockdown. Lately they had only been doing online advertising and not even much of that. With people staying at home, there was simply no real need for security.