Doctored Death

by P. D. Workman

  “Yes. But I walked through a part of the lab... and they had no containment protocols. Gloves and mask. Maybe a sealed ventilation system. That’s it.”

  Dr. Savage snorted. “Unbelievable. And where exactly does their air system vent? Into the alley outside the building, I’ll wager.”

  Kenzie hadn’t thought about that. Even if there was no shared ventilation between the apartments and the lab, what were they doing with the exhaust air? Were they scrubbing it? Was it even possible to make sure that it was virus-free before venting it outside?

  “Dr. Ducros remembered the dog. Volunteered it when I asked him who he would recognize from the neighborhood. He said she was very friendly, liked people. They would see her when she was out for walks or around the neighborhood.”

  “And all it takes is a small transfer of saliva...”

  “Yeah.”

  “Do you have access to this dog?”

  “Yes, I’m just going to go talk to the nurse at Champlain House. I didn’t know whether to tell her to take the dog to you, or some facility where she can be isolated...?”

  “We do have animals in isolation cubes here, so if you can get her here or we can pick her up, we can make sure that she’s safe. Or that everyone else is safe. And we have decontamination here for you if you need it. Best to handle her with as much protective gear as you can, just to be safe, and we can help ensure that you’re clean of the virus once you get here. Start you on an antiviral protocol as well. You’ve already been in contact with the virus in your morgue, so you should consider the antiviral protocol even if you aren’t in contact with the dog.”

  “Yeah. So this Virutek place, you agree that they are probably the contamination point?”

  “Yes, you’re probably right, but we’ll need to test to be sure. I was actually expecting it to be a place that does live animal trials, not just in vitro.”

  “But if it came from a dog, does that explain any anomalies?”

  “One of the large viral segments that the virus gained from recombining with another virus is porcine. So I was expecting pigs to be involved.”

  “Pigs?” Kenzie echoed. She tried to think of any way that pigs entered into the equation. She hadn’t seen anyone walking a potbellied pig around the lab. There hadn’t been any meat-packers close by. If there had been any kind of live pig farm nearby, they would have been able to smell them. Kenzie had only been around pigs a few times, but they always had that distinctive smell. Maybe one of the scientists in the lab had a pet pig? “What kind of sources would you look for?”

  “Like I said, I expected a live animal trial to be involved somehow. That’s why Virutek is way down my list. I know that they got an early version of the engineered virus for use in their studies, but they are not supposed to be doing any live trials. So I didn’t think the source would be them.”

  “Anywhere else?”

  “One of the people who was in contact with the dog might have already been in poor health. While humans do not generally get porcine viruses, it is still possible, especially if their immune system is compromised. In that case, someone in your dog’s circle might have picked up a porcine virus... somewhere.”

  “But the victims at the nursing home all live there. There wouldn’t be a lot of opportunities for transmission of a porcine virus.”

  “Maybe from a visitor or a nurse. It’s impossible to say. We see strange things happening with viruses. They are rather unpredictable.”

  Kenzie thought through what she knew about Lola and her history. Where had she picked up a pig virus? “Could she have picked it up from food? Being fed pig scraps?”

  “They would have to be uncooked, of course, and most people know that pork carries nasty parasites and would not give it to their pets raw. I wouldn’t say it is impossible. But it seems unlikely. Viruses don’t generally live long without a live host.”

  What other way could Lola have been exposed to someone or some creature with a porcine virus? Maybe one of her doggy friends at a dog park? Another animal that had been sick, like a squirrel?

  What about...?

  Kenzie’s heart dropped to her stomach. She didn’t even want to think of other possibilities. That was one area of medicine she wanted nothing to do with.

  “Dr. Savage... what about a xenotransplant?”

  65

  “A transplant of another species?” Kenzie could hear the surprise in Savage’s tone as he considered the possibility. “There are very few cases where xenotransplants are successful. Pigs are certainly high on the list for xenotransplants since their organs are largely compatible with humans and develop to full size within months rather than years. Pig hearts, lungs, kidneys... but they don’t generally last for more than a few weeks.”

  “Except in a case where it is a tissue transplant rather than an organ transplant,” Kenzie amended. “People sometimes get porcine heart valves instead of artificial valves. Particularly if they are old, so the heart valves may outlast them and not need to be replaced.”

  As much as Kenzie disliked the field of transplantation, she knew her stuff.

  “Yes. It’s possible that someone at the nursing home has porcine valves,” Savage agreed. “They are supposed to be disinfected in an antiviral solution before transplant to avoid just that problem. And as you can imagine... not everyone remembers, or there could be confusion over who on the team is supposed to do that step. Or just plain sloppiness. Third world transplants are notorious for transferring diseases along with the transplanted tissue or organ.”

  “So I’ve heard,” Kenzie agreed tonelessly. Zachary gave her a sympathetic look and squeezed her knee gently. “My point is, the dog’s previous previous owner, before she lived above the Virutek lab, died of heart issues. The woman who got Lola from him said that he’d had surgery a few years earlier to replace his valves.”

  “Indeed.” Savage’s voice was impressed. “Dr. Kirsch... I think you’ve nailed the source. That explains both the genetic tag of the lab-manipulated HHV-4 and the large porcine segment.”

  “Virutek was designing a virus that they hoped to use to cure brain degeneration like Parkinson’s,” Kenzie told him. “It has been designed to go through the blood-brain barrier. What effect would the pig virus have on the brain of a human?”

  “We have no way of knowing. Except to say... you have already seen some symptoms repeated across several victims. Those symptoms are probably not just coincidental.”

  “You mean the protein deposits and dementia?”

  “That is what I fear.”

  “Yeah. Me too.”

  They were both silent for a moment. It was Savage who broke it.

  “If you will get me the dog, I will see if I can do some magic and talk Virutek into giving me a sample of their re-engineered HHV-4.”

  “Do you think they will agree? They seem pretty possessive about it.”

  “That’s why I said it will take some magic. We will see.”

  Kenzie sat in the car after hanging up with Dr. Savage, thinking it all through. The pieces were gradually coming together and, while she didn’t like the picture, she was happy to be making progress. If they figured out enough details, maybe they could stop the virus’s spread before it became an epidemic. She hated to think of all the people whose lives could be lost if they didn’t manage to stop the novel virus.

  “Are you okay?” Zachary asked.

  “Yes. Just... it’s a little overwhelming. Finding out these details while everyone else in the world still has no idea of what’s going on. Even though we can see the virus spreading, causing deaths, the situation potentially getting worse and worse... but no one else knows.”

  Zachary nodded. “Imagine what the world looks like to a paranoid schizophrenic.”

  Kenzie raised her eyebrows, thinking about it. Seeing conspiracies and connections everywhere and having no one believe them. Even if they weren’t yet satisfied that there was enough evidence, Dr. Wiltshire and Dr. Savage at least didn’t think s
he was crazy. Just that they needed to gather more information before they could take any action. “Sheesh. Can you imagine? What a horrible world it would be for them.”

  “Very scary.”

  “Very,” Kenzie agreed.

  She dug around in her purse again. She really needed to organize it a bit better so that she could lay her hands on what she wanted to quickly. Zachary was quiet this time, not asking her what she wanted. Kenzie pulled out a plastic zip bag with gloves and a mask inside it.

  “You keep those in your purse?” Zachary asked.

  “You never know what you’re going to run into. Stopping to give someone first aid beside the road... best to be prepared. I should have put them on before going into Virutek. I had no idea what we were walking into over there.”

  “I’m sure we will be fine.”

  “Probably. I hope so.” Kenzie put on the mask and gloves. She touched the door handle. “Do you mind staying in the car? I probably should try to maintain some level of confidentiality here. I should be pretty quick in and out.” She looked into the back seat. “Do you think we have enough room for a large dog kennel back there?”

  Zachary looked. “Well... I can lay down the seats. That gives a bit more cargo space. But it really depends on the size of the kennel.”

  “Okay. Put them down. I will try to be quick.”

  “Take the time you need to. We don’t want to mess anything up because we are rushing.”

  “True. Thanks.”

  Kenzie left him there and went into the nursing home. The receptionist didn’t seem to remember or recognize her, so Kenzie showed her identification and gave her name. “I’m going in,” she said, without asking for permission. Act as if being the Medical Examiner’s assistant gave her the right to just march in there, and no one would stop her.

  And she was right. The receptionist looked flustered but didn’t try to stop her or run after her or call security. Kenzie went to the nursing station in the independent living unit. She took a quick glance around.

  “Where would I find Nurse Ellie?” she asked briskly.

  It was not Nurse Summers at the desk, and Kenzie hoped that if she again confidently demonstrated her authority, it would not be questioned. It was a break, Nurse Summers not being there, because Kenzie had a feeling she would have objected to what was about to happen.

  “Nurse Ellie? She’s not here.”

  “Where is she? And where is Lola?”

  “They’re not here.”

  Kenzie focused on the nurse’s name badge. Camille Jackson. “Nurse Jackson. Please tell me where she is. I understand she wasn’t able to keep Lola at her apartment, so are they out for a walk? Visiting one of the other units? Where would they have gone?”

  Nurse Jackson’s face folded into a scowl. “Just who do you think you are? You can’t come marching in here and demand to know details of where everyone is. How is it any of your business?”

  “I am with the Medical Examiner’s Office, and that dog was supposed to be under quarantine. Where has Nurse Ellie taken her?”

  “Oh, you’re the one who’s been making all of the trouble? The one everyone keeps talking about? You don’t have the right to know where Nurse Ellie and her dog are. You can’t interfere in their freedoms as citizens.”

  Lola was a citizen? Kenzie suppressed the urge to laugh at the statement.

  “Nurse Jackson, please. I’m not here to make trouble. I’m here to help to protect your patients. That dog is carrying a dangerous virus and needs to be examined. You don’t want her killing off any other patients, do you?”

  “The dog doesn’t kill patients. She helps them. She can sense when they are sick and dying, and she helps to make their last moments more peaceful.”

  “I’m sure she does.”

  “You and your kind can’t come around here and do whatever you like. That dog is not yours! She is smarter than you will ever be. She knows what’s going on, and she wouldn’t let you near her. Neither will I!”

  Kenzie shifted uncomfortably. The conversation had rapidly gone to a bad place. Nurse Jackson was not just being obstructive and provoking, but she sounded paranoid. Kenzie tried to remember what she and Zachary had just talked about. How scary the world would be to a person who had paranoia.

  “I’m sorry if I scared you,” Kenzie said soothingly. “I didn’t mean to do that. I’m not here to do anything to hurt Ellie or Lola. They will both be very safe with me. I’m a doctor, you know, and we promise to do no harm.”

  “You’re not a doctor. You’re with the coroner’s office.”

  “Yes. I am an assistant to the medical examiner. I am a doctor. Do you want me to show you my credentials?”

  Nurse Jackson drew back suddenly when Kenzie reached into her purse for her wallet, cringing as if Kenzie had pointed a loaded gun at her. “Stop! No!”

  Kenzie glanced around herself. Others were watching, puzzled and concerned. Kenzie looked at Nurse Jackson, cowering back as if Kenzie had threatened her. When Kenzie saw Nurse Summers coming down the hall at a quick clip, she was actually glad.

  “What is going on here?” Summers demanded, looking at Nurse Camille Jackson and Kenzie with a scowl.

  “I was just asking Nurse Jackson about where Lola and Ellie are,” Kenzie said. “I’m sorry, I think she has misunderstood me...”

  Nurse Summers looked at Nurse Jackson. “What’s the matter?”

  Nurse Jackson slapped her hand down on the counter with a loud crack. “That’s enough! No one is going to touch me!”

  Summers’s eyes were wide. She glanced uncertainly at Kenzie as if she might have the explanation for Nurse Jackson’s behavior.

  “How long has she been like this?” Kenzie asked.

  “Like this?”

  “Confused, paranoid, emotionally labile.”

  “I... don’t know.” Summers shook her head. “There’s got to be something wrong. This is not... she’s never behaved this way before.”

  “I think... she’s got it.”

  “Got what?”

  “The virus that Lola is carrying.”

  Kenzie wanted to say, “The virus that killed Mr. Cartwright,” but she didn’t want to cause panic. That would probably be enough to send Nurse Jackson right over the edge if she hadn’t already crossed it.

  “The virus?” Summers repeated.

  “Yes. That’s why we called and gave instructions that the dog was to be isolated and anybody who had anything to do with her should be gloved and masked.” Kenzie motioned to her own face. “Because we don’t want anyone else catching this.”

  “What virus are you talking about?”

  Kenzie didn’t have the time to walk Nurse Summers through it. “A novel variant HHV-4 virus that causes dementia.” She looked at Nurse Jackson. “Dementia that appears to develop very, very quickly.”

  Nurse Summers swore. She looked at Nurse Jackson as if trying to convince herself that it was true. Then she looked at her watch. She looked back at Kenzie, her mouth opening wide.

  “What?” Kenzie demanded.

  “The dog... there was a big write-up about her in the news. She was a celebrity.”

  “Yes.”

  “Well... she was invited to the Halloween Masquerade Ball.”

  Kenzie remembered the article that Zachary had sent her.

  It took a few more seconds for everything to click into place. The ball. The one her mother and father were going to. That they had begged her to go to. All the people who would be there. Politicians, celebrities, the wealthiest and most influential people in the state. All jammed together in one room, with a friendly, hero dog carrying a deadly virus.

  Kenzie swore. It wasn’t under her breath and she didn’t stop swearing. She just kept swearing over and over, like a mantra, as she hurried away, leaving Summers to deal somehow with Nurse Jackson. Kenzie swore all the way back to the car, one final time as she sat down in the passenger seat and pulled her door closed.

  Zachary looked at her
. “She... wasn’t there?” he guessed.

  Kenzie swore again. “Okay. I’m stopping now.”

  And then she swore again.

  66

  “She’s gone to the ball.”

  Zachary’s head tipped slightly to the side as he tried to understand what she was saying. “Who has gone to what ball?”

  “Lola. The dog. And her owner. You remember you saw the article...? They have gone to the masquerade ball. The big fundraiser that my dad and mom were trying to get me to go to. That place is going to be packed, and Lola will be the star of the show. Do you know how many people are going to want to pet her or shake a paw? Or how many will let her lick their faces? Especially for a well-placed photo in the big magazines?”

  “Oh.” Zachary repeated Kenzie’s swear.

  “Exactly,” Kenzie agreed.

  “What do you want to do?”

  “Go to my office.”

  “Your office?”

  He had clearly been expecting other directions from her. Such as to go to the ball so they could get Lola before she infected everybody of importance in Vermont.

  “Yes. As quickly as we can safely get there. And not get pulled over for speeding.”

  Zachary was happy to comply. He pressed the gas pedal down and focused on the road ahead.

  Kenzie called Dr. Wiltshire again. “We have a problem.”

  “Kenzie.” The sigh that carried down the line let Kenzie know that her call was not cause for celebration. “What problem? What do you mean?”

  “I went to Champlain House to get Lola.”

  “To get Lola?”

  “Dr. Savage said that they could properly isolate her while they ran tests to find out if she carries the virus. So I went to pick her up.”

  “Okay.”

  “She’s not there. They did not isolate her as we instructed them. Instead, they have sent her to the big masquerade ball to meet all the celebrities.”

  There was silence from Dr. Wiltshire. He didn’t swear. But Kenzie knew he wanted to.

  “Not only that, but when I got there, one of the nurses freaked out. She wasn’t making any sense. She was making accusations, acting paranoid. Inappropriate emotions. Confusion.”