Viral

by Robin Cook

  “He did. He said he’d gotten the number from Deputy Chief Michael Comstock.”

  “Really? Terrific! That’s encouraging,” he exclaimed. Deputy Chief Michael Comstock was the commanding officer of the Emergency Service Unit of the NYPD. Brian had served under him for the six years he’d been with the unit and Emma for four. When Brian and Emma had resigned from the NYPD, they had been mildly concerned the CO was resentful, since he skipped their departure party without any explanation. The fact that he was now recommending Personal Protection was a very good sign.

  After dinner, while Brian cleaned up the kitchen, Camila went back to the office to work on their accounts receivable in hopes of scaring up some receipts. A bit later he joined her to do some research on eastern equine encephalitis. After he spent some time reading about it, he wished he hadn’t, especially given the paranoia about viruses engendered by the Covid-19 pandemic. EEE was a very alarming illness with a variety of possible consequences, and now that his beloved wife had possibly contracted it, he had a nagging fear that they would be facing a long road to recovery.

  CHAPTER 5

  August 20

  It was one of the worst night’s sleep Brian could remember having. He kept waking up, tossing and turning, wondering how Emma was faring in the ICU. He hoped that the heavy medication they had given her to stop her second seizure kept her asleep, so she wouldn’t be tormented by the stressful environment. At just after four a.m. he was wandering around the house for the second time, arguing with himself about whether to call the hospital and check on Emma’s status. Ultimately, he didn’t call, not because he didn’t want to but because he doubted he’d get through, and the effort might make him feel even more frustrated and nervous than he already was.

  By eight o’clock both Juliette and Camila were up, and while Juliette watched cartoons, Brian and Camila had coffee in the breakfast nook. He told her what a bad night he had had, and she wasn’t surprised.

  “I think it would be best if you try to keep yourself as occupied today as possible,” Camila said in response. “Make that call to Calvin Foster. It would be terrific for multiple reasons if you could secure us a major security engagement. It would keep Personal Protection moving in the right direction.”

  “That’s the understatement of the year,” Brian said. “Good suggestion. I’ll make the call for sure. How about you?”

  “I think I’ll concentrate on keeping Juliette happy and calm,” Camila said. “She is going to miss Emma terribly. I know because my mother was hospitalized with pneumonia when I was about Juliette’s age, and I still remember how devastated and abandoned I felt.”

  “She is suffering,” he agreed, glancing over at Juliette. “I can tell. I didn’t know four-year-olds could get depressed, but she’s acting that way. Usually she wakes up a ball of energy. This morning I found her in her bed awake, just lying there and staring into the distance. Let’s be more lenient than usual with the cartoons.” Under normal circumstances Juliette’s screen time was sharply limited, but they needed something to keep her distracted.

  “I agree,” Camila said. “Since there’s nothing for me to do in the office and since it’s a nice summer day, I’ll take her out to Isham Park this morning to let her get some exercise. She loves climbing on the rocks.”

  “Great idea to get her out and active,” Brian agreed. “I’ll make an effort to take her to the Emerson Playground after lunch, which she also likes, particularly the swings.”

  By nine o’clock, with Camila and Juliette out of the house, he parked himself at his desk in the home office. The first thing he did was google Calvin Foster and Priority Capital. He was duly impressed. It was one of the larger New York private equity firms and had a stellar record, and Calvin Foster was considered a particularly sharp financier and shrewd investor. Just when he was about to try to call him, Brian’s phone rang. It was Dr. Gail Garner, one of the MMH intensivist physicians.

  “Mrs. Murphy is doing well. Although she has a low-grade fever, her other vital signs are normal and stable. The problem is that she is still not entirely oriented to time, place, or person, although that seems to be slowly improving. We are pleased that her respiratory status is entirely normal without the need for ventilatory support and, as I believe you already know, her coronavirus test was negative.”

  “Has a diagnosis been confirmed?” he prodded.

  “Yes, it has. As predicted, she’s positive for eastern equine encephalitis, or EEE.”

  Brian swallowed as his throat had suddenly gone dry. After what he’d read on Wikipedia the night before, he’d hoped for a different diagnosis, and the terrifying feeling of serious impending consequences came back in a rush. The fact that she was having neurological symptoms was not a good sign. It seemed unbelievable to him that apparently due to climate change his wife had come down with a serious viral illness he’d never even heard of.

  “As required, we have reported this case to the New York State Health Department,” Dr. Garner continued. “You might hear from them for more information, although we were able to tell them that the patient had recently been on Cape Cod, Massachusetts, and had reportedly been exposed to mosquitoes. Do you have any questions for me?”

  “Can I visit her?”

  “I’m afraid that with the Covid-19 situation, visitation in the ICU has been restricted.”

  “I assumed as much,” Brian said. “How long do you think she will be kept in the ICU?”

  “Perhaps another twenty-four hours. If she stays stable, we will send her to a normal hospital room. She’ll be having a neurology consult today, which might influence timing depending on what they find.”

  “Will I be kept up to date on her progress?”

  “If there are any changes, absolutely,” Dr. Garner said. “And I can call again in the morning if you would like.”

  “I’d appreciate it,” Brian said.

  After hanging up, he found himself literally shaking at what he’d just found out. He didn’t even want to contemplate what could be in store for Emma.

  Feeling obligated and with trembling fingers, Brian put in calls to his mother, Aimée, and Emma’s mother, Hannah, to tell them what the hospitalist had told him. Both had more questions than he could answer, and he promised he’d let them know as soon as he heard any updates.

  After taking a deep breath to try to calm himself, he placed a call to Calvin Foster, desperate to think about something else besides Emma’s situation. Luckily it turned out that not only was Calvin Foster seemingly a first-class financier, he was also personable, easy to talk to, and informed. What was particularly helpful was that Brian didn’t have to sell himself. After only a few minutes of conversation it was apparent that Calvin knew a great deal about Brian’s NYPD background, including his time in the Emergency Service Unit’s elite A team.

  “How do you know Deputy Chief Comstock?” Brian asked. As the conversation progressed, it became apparent he and Calvin were more than acquaintances.

  “I’ve known Michael since high school,” Calvin said jovially. “He’s the one who recommended your security firm. I must say, he was full of praise. He said you’d gotten a few awards for exemplary service as a policeman.”

  “A lot of officers get awards,” Brian replied. He was never one to brag or boast, mainly because he always thought he could do better no matter what others thought of him.

  “I even heard you won a sniper award when you were an ESU cadet,” Calvin commented.

  “Luckily that’s a skill that doesn’t have a high demand.”

  Calvin laughed. “No, I suppose that’s true. Nonetheless, I’m impressed.”

  “So, how can I help you?” Brian asked, eager to get down to business.

  “I’d like to know if your company could cover my daughter’s wedding that we’ve scheduled for the middle of October despite the pandemic. It’s kind of a ‘hurry-up’ affair th
at we’re throwing together but still trying to keep safe. It’s going to be outside under an open tent. Kids today live in a different universe than you and I occupied, if you know what I’m saying.”

  “And it’s only getting more different every day. I understand the affair will be at your Southampton summer home?”

  “That’s the plan. I’ve been told there will be about fifty guests with about half flying in private, some with their own security. Do you have adequate personnel to handle a job like this?”

  “Our business plan is to utilize off-duty NYPD Emergency Service Unit officers, of which there are always a sizable and eager number. I’m certain we could provide the required security.”

  “Wonderful. What I would like beforehand is a security evaluation and an estimated budget. How soon might you be able to provide that?”

  “First, I’d need a guest list with contact information, and I’d have to make a site visit to your Southampton home to view the venue. I can do that in the next few days.” Brian welcomed the idea of the diversion, yet he wasn’t entirely sure he’d feel comfortable leaving town with Emma in the hospital, even though Southampton was only two hours from the city.

  “I’ll have one of my secretaries email the Southampton address and guest list to you today, and I’ll let my wife know to expect you. She’s been living out there along with one college-aged daughter full-time since March, and I’ve been going back and forth.”

  After setting up plans to reconnect after Brian submitted his security evaluation and budget, they disconnected the call. The second he put the phone down, concern about Emma flooded back.

  “Good God,” he murmured, wondering if he could handle this potentially complicated engagement requiring interfacing with other security people while dealing with the stress of worrying about what Emma’s status might be in mid-October and without her business input. Personal Protection LLC had always been something they were to do together, but Brian would have to find a way to fare on his own.

  CHAPTER 6

  August 20

  It was after one o’clock in the afternoon when Brian and Juliette started walking home from the Emerson Playground. It wasn’t far, only five or six blocks. Try as he might, he had been unable to get Juliette to do anything at the playground. Instead, she sat with Brian on a park bench holding Bunny, content to watch the other children play. To Brian she seemed completely out of character, acting listless and disinterested. Eventually he ran out of things to talk to her about, especially since he had admitted early on that he didn’t know when Emma would be coming home from the hospital.

  “We’re home,” he called out the moment they entered the front door. In response, Camila quickly emerged from the dining-room-cum-office to welcome them as they took off their shoes.

  “How was your time at the playground?” Camila asked Juliette with forced positivity. “Did you have fun?”

  “I want to watch cartoons,” Juliette declared, ignoring the question and heading for the kitchen.

  Brian and Camila exchanged a concerned glance. “She’s not happy,” he mouthed. “She didn’t want to play with the other kids.”

  “It was the same this morning at Isham Park,” Camila said with resignation. “I’ll see if I can interest her in a bite of lunch.”

  “Any communication from Calvin Foster’s people while I was out?”

  “Yes, there’s an email with the venue address and a preliminary guest list. There was also a call from the hospital.”

  “Really? Was it one of the doctors?” Brian asked nervously.

  “No,” Camila said. “It was a Roger Dalton from the hospital business office. He requested a call back as soon as you can. I left his direct-dial number on your desk.”

  “The business office?” he questioned. He felt relieved but curious. “What do they want?”

  “He didn’t say. He just said for you to call. Apparently, it is something important.”

  Brian nodded. He couldn’t imagine what it was about since he’d already spoken with Maria Hernandez and had signed the admission papers. Sitting at his desk and with the number in hand, he took out his cell phone and dialed. The line was answered quickly by a commanding, whiskey-baritone voice with a strong New York accent. Brian identified himself and mentioned that he’d gotten the message to call.

  “Yes, thank you for getting back to me,” Roger said. “I’ve been assigned as the case manager for Emma Murphy. A problem has developed. I think it is best if you come into the hospital, so that we can discuss it in person.”

  “What kind of a problem? Is Emma okay?” Brian asked urgently.

  “It’s a problem with your health insurance coverage.”

  “I gave all the appropriate information to Mrs. Hernandez and signed the admission papers. Have you spoken with her?”

  “This is not about Emma Murphy’s admission to the hospital,” Roger said. “It’s about her visit yesterday to our Emergency Department, and I need to speak to you directly to set up a payment plan.”

  “What are you talking about? What kind of ‘payment plan’?”

  “I can explain it far better in person. I see that you live here in Inwood, so it shouldn’t be too much of an imposition for you to come in? I will be here all afternoon.”

  Suddenly Brian realized the line had been disconnected and that the man had hung up. With a sense of impatience, he put the phone down. He didn’t know whether to feel irritated or concerned, and what tipped the balance was a mild worry about the possible impact on Emma’s treatment if he didn’t comply. He didn’t think that would really happen, but the mere thought of it made him decide not to make an issue of the situation. Instead, he got up, told Camila that he had to return to the hospital to visit the business office, and set off.

  As Brian entered through the main entrance, he could see multiple ambulances pulled up to the ED dock. The main lobby was moderately full, and he had to wait for his turn at the information desk. From his time at the hospital when he’d done off-duty patrolman work, he knew where the hospital administration offices were, but he didn’t know if Roger Dalton’s business office would be there as well. He found out quickly enough that it was.

  Moving from the impressively renovated but cold marbled lobby into the admin section of the hospital was a stark transition. Now footsteps were muffled with carpet and the forest-green walls were hung with real art. To him the area looked more like a prosperous international corporation rather than the nerve center of a city hospital. There was even a glass-fronted conference room with a large mahogany library table and captain’s chairs that looked to Brian more like it belonged in a bank. Next to the conference room was what he assumed was the hospital’s CEO’s office, outfitted as impressively as the conference room. As a police officer, he’d met the hospital president at the time, a doctor who had transitioned to administrative work, but Brian knew that had changed when the Inwood Community Hospital was purchased by the Manhattan Memorial Hospital corporation eight years earlier and became MMH Inwood. Under new management, it had undergone a major makeover before officially joining the ranks of the hospital chain.

  Asking directions from one of the many secretaries, he quickly found Roger Dalton’s office, but then he had to wait for a time while Roger finished with someone else. Finally, after nearly twenty minutes, Dalton appeared in his office’s doorway and beckoned for Brian to enter.

  Brian’s first impression was that Roger Dalton didn’t look anything like his imposing baritone voice implied. Instead of a commanding figure, he was a tall, thin man whose sports jacket looked more like it was draped over a metal hanger than over a pair of shoulders. His face behind his mask looked haggard, and he had deeply set eyes behind heavy-rimmed glasses. With slicked-back hair streaked with gray, he looked like a man who was either a heavy smoker and drinker or battling a serious illness.

  “Thanks for coming,” Roger bega
n while taking his seat behind his desk and directing Brian to a chair front and center. “You’re probably wondering why I insisted you come in. I’m afraid I have some bad news for you.”

  Although Brian knew from his call that Roger wasn’t talking about Emma, for a second his heart stopped until Roger added: “. . . your insurance carrier, Peerless Health Insurance, has declined to cover your wife’s $27,432.88 Emergency Department bill.”

  “You have already heard from Peerless?” Brian asked. He was astounded by Roger’s comment on many levels, but for the moment the speed with which it had been discovered that Peerless wasn’t paying took precedence. Emma had only been admitted yesterday, and he assumed the insurance matters took weeks, if not months.

  “Yes, we have,” Roger said. “As you might be aware, hospitals are being financially stressed through this pandemic. Our usual major sources of operating income such as elective surgery have been curtailed, forcing us to be strict in other areas, particularly the ED, whose operating costs are enormous. I was distressed when I saw that your carrier was Peerless. Our experience with them has been difficult at best, so I wanted to file the claim as soon as possible. True to form, they let us know immediately they were declining the claim, which I’m afraid to say is their normal modus operandi. It seems Peerless often finds creative ways of avoiding paying claims.”

  “Why would they decline my wife’s ED visit?” Brian asked, still perplexed. “That doesn’t make any sense.”

  “As I said, Peerless is particularly creative,” Roger said. “But my guess in this particular instance is that the rationale is pretty straightforward. Even some of the big insurers like Anthem and United are getting involved. Here’s the deal. There is a lot of talk of the cost of healthcare needing to be curtailed, and that insurance companies have an obligation to put on the brakes or at least appear to be doing so. One area that stands out is the ‘emergency’ overuse situation. Running emergency departments, particularly Trauma 1 centers like ours, is very, very expensive, and far too many people are abusing them for non-emergency ambulatory care rather than for true emergencies, like heart attacks, strokes, massive trauma and bleeding, and the like. Many insurance carriers feel that they have to put a stop to such abuse by denying claims, especially during normal business hours when patients can see their general practitioners or visit small, independent urgent-care centers.”