Contagion

by Robin Cook

  “I really should be getting back to work,” Beth said. “And I shouldn’t be talking with you. Dr. Cheveau told us specifically.”

  “Don’t you find that strange?” Jack said. “After all, I am a medical examiner in this city. Legally I have a right to investigate the deaths of the patients assigned to us.”

  “I guess I do,” Beth admitted. “But what can I say? I just work here.” She stepped around Jack and went back to her workstation.

  Jack followed her. “I don’t mean to be a pest,” he said. “But my intuition tells me something weird is going on here; that’s why I keep coming back. A number of people have been acting defensive, including your boss. Now there could be an explanation. AmeriCare and this hospital are a business, and these outbreaks have been tremendously disruptive economically. That’s reason enough for people to be acting strangely. But from my point of view it’s more than that.”

  “So what do you want from me?” Beth asked. She’d taken her seat and gone back to transferring the throat cultures to the agar plates.

  “I’d like to ask you to look around,” Jack said. “If pathological bacteria are being deliberately spread they have to come from somewhere, and the microbiology lab would be a good place to start looking. I mean, the equipment is here to store and handle the stuff. It’s not as if plague bacteria is something you’d find anywhere.”

  “It wouldn’t be so strange to find it on occasion in any standard lab,” Beth said.

  “Really?” Jack questioned. He’d assumed that outside of the CDC and maybe a few academic centers, plague bacteria would be a rarity.

  “Intermittently labs have to get cultures of all different bacteria to test the efficacy of their reagents,” Beth said as she continued to work. “Antibodies, which are often the main ingredient in many modern reagents, can deteriorate, and if they do the tests would give false negatives.”

  “Oh, of course,” Jack said. He felt stupid. He should have remembered all this. All laboratory tests had to be constantly checked.

  “Where do you get something like plague bacteria?”

  “From National Biologicals in Virginia,” Beth said.

  “What’s the process for getting it?” Jack asked.

  “Just call up and order it,” Beth said.

  “Who can do that?” Jack asked.

  “Anybody,” Beth said.

  “You’re joking,” Jack said. Somehow he’d thought the security at a minimum would be comparable to that involved in getting a controlled drug like morphine.

  “I’m not joking,” Beth said. “I’ve done it many times.”

  “You don’t need some special permit?” Jack asked.

  “I have to get the signature of the director of the lab on the purchase order,” Beth said. “But that’s just to guarantee that the hospital will pay for it.”

  “So let me get this straight,” Jack said. “Anyone can call these people up and have plague sent to them?”

  “As long as their credit is okay,” Beth said.

  “How do the cultures come?” Jack said.

  “Usually by mail,” Beth said. “But if you pay extra and need it faster you can get overnight service.”

  Jack was appalled, but he tried to hide his reaction. He was embarrassed at his own naïveté. “Do you have this organization’s phone number?” he asked.

  Beth pulled open a file drawer to her immediate right, leafed through some files, and pulled out a folder. Opening it up, she took out a sheet and indicated the letterhead.

  Jack wrote the number down. Then he pointed to the phone. “Do you mind?” he asked.

  Beth pushed the phone in his direction but glanced up at the clock as she did so.

  “I’ll just be a second,” Jack said. He still couldn’t believe what he’d just been told.

  Jack dialed the number. The phone was answered and a recording gave him the name of the company and asked him to make a selection. Jack pressed two for sales. Presently a charmingly friendly voice came on the line and asked if she could be of assistance.

  “Yes,” Jack said. “This is Dr. Billy Rubin and I’d like to place an order.”

  “Do you have an account with National Biologicals?” the woman asked.

  “Not yet,” Jack said. “In fact, for this order I’d just like to use my American Express card.”

  “I’m sorry, but we only accept Visa or MasterCard,” the woman said.

  “No problem,” Jack said. “Visa will be fine.”

  “Okay,” the woman said cheerfully. “Could I have your first order?”

  “How about some meningococcus,” Jack said.

  The woman laughed. “You’ll have to be more specific,” she said. “I need the serologic group, the serotype, and the subtype. We have hundreds of meningococcus subspecies.”

  “Uh-oh!” Jack said, pretending to have been suddenly paged. “An emergency has just come up! I’m afraid I’ll have to call back.”

  “No problem,” the woman said. “Call anytime. As you know, we’re here twenty-four hours a day to serve your culture needs.”

  Jack hung up the phone. He was stunned.

  “I have the feeling you didn’t believe me,” Beth said.

  “I didn’t,” Jack admitted. “I didn’t realize the availability of these pathogens. But I’d still like you to look around here and see if these offending bugs might somehow be stashed here now. Could you do that?”

  “I suppose,” Beth said without her usual enthusiasm.

  “But I want you to be discreet,” Jack said. “And careful. I want this just between you and me.”

  Jack took out one of his cards and wrote his home number on the back. He handed it to her. “You can call me anytime, day or night, if you find anything or if you get into any trouble because of me. Okay?”

  Beth took the card, examined it briefly, and then stuck it into her lab coat pocket. “Okay,” she said.

  “Would you mind if I asked for your number?” Jack said. “I might have some more questions myself. Obviously microbiology isn’t my forte.”

  Beth thought for a moment, then relented. She got out a piece of paper and wrote her phone number down. She handed it to Jack, who put it into his wallet.

  “I think you’d better go now,” she said.

  “I’m on my way,” Jack said. “Thanks for your help.”

  “You’re welcome,” Beth said. She was her old self again.

  Preoccupied, Jack walked out of the microbiology section and headed across the main portion of the lab. He still couldn’t believe how easy it was to order pathological cultures.

  About twenty feet from the double swinging doors that connected the lab to the reception area, Jack stopped dead in his tracks. Backing through the doors was a figure that looked alarmingly like Martin. The individual was carrying a tray loaded with prepared throat swabs ready for plating.

  Jack felt like a criminal caught in the act. For a fraction of a second he contemplated fleeing or trying to hide. But there was no time. Besides, irritation at the absurdity of his fear of being recognized inspired him to stand his ground.

  Martin held the door open for a second figure Jack recognized as Richard. He, too, was carrying a tray of throat swabs. It was Richard who saw Jack first.

  Martin was a quick second. He recognized Jack immediately, despite the mask.

  “Hi, folks,” Jack said.

  “You…!” Martin cried.

  “It is I,” Jack said cheerfully. He grabbed the end of his face mask with his thumb and forefinger and pulled it away from his face to give Martin an unobstructed look.

  “You’ve been warned about sneaking around in here,” Martin snapped. “You’re trespassing.”

  “Not so,” Jack said. He produced his medical examiner’s badge and pointed it toward Martin’s face. “Just making an official site visit. There’ve been a few more regrettable infectious deaths over here at the General. At least this time you were able to make the diagnosis on your own.”


  “We’ll see whether this is a legitimate site visit,” Martin said. He heaved the tray of throat swabs onto the countertop and snatched up the nearest phone. He told the operator to put him through to Charles Kelley.

  “Couldn’t we just discuss this like grown-ups?” Jack asked.

  Martin ignored the question as he waited for Kelley.

  “Out of curiosity, maybe you could just tell me why you were so accommodating on my first visit and so nasty on my next,” Jack said.

  “In the interim Mr. Kelley informed me what your attitude had been on that first day,” Martin said. “And he told me he had learned that you were here without authorization.”

  Jack was about to respond when it became clear that Kelley had come on the line. Martin informed the administrator that he’d again found Dr. Stapleton lurking in the lab.

  While Martin listened to an apparent monologue from Kelley, Jack moved over and leaned casually against the nearest countertop. Richard, on the other hand, stood rooted in place, still supporting his tray of throat swabs.

  Martin punctuated Kelley’s apparent tirade with a few strategically placed yeses and a final “Yes sir!” at the end of the conversation. As he hung up the phone he treated Jack to a supercilious smile.

  “Mr. Kelley told me to inform you,” Martin said haughtily, “that he will be personally calling the mayor’s office, the Commissioner of Health, and your chief. He’ll be lodging a formal complaint concerning your harassment of this hospital while we’ve been making every effort to deal with a state of emergency. He also told me to inform you that our security will be up here in a few moments to escort you off the premises.”

  “That’s terribly considerate of him,” Jack said. “But I really don’t need to be shown the way out. In fact, I was on my way when we happened to bump into each other. Good day, gentlemen.”

  25

  MONDAY, 3:15 P.M., MARCH 25, 1996

  “So there you have it,” Terese said as she looked out on the expanded team of creatives for the National Health account. In the present emergency she and Colleen had pulled key people away from other projects. Right now they needed all the man- and womanpower they could muster to concentrate on the new campaign.

  “Any questions?” Terese asked. The entire group was squeezed into Colleen’s office. With no room to sit they were wedged in like sardines, cheek by jowl. Terese had outlined the “no wait” idea in an expanded form that she and Colleen had devised based on Jack’s initial suggestion.

  “We only have two days for this?” Alice questioned.

  “I’m afraid so,” Terese said. “I might be able to squeeze out another day, but we can’t count on it. We’ve got to go for broke.”

  There was a murmur of incredulity.

  “I know I’m asking a lot,” Terese said. “But the fact of the matter is, as I’ve told you, we were sabotaged by the accounts department. We’ve even got confirmation that they are expecting to present a ‘talking heads’ spot with one of the ER stars. They are counting on us to self-destruct with the old idea.”

  “Actually I think the ‘no wait’ concept is better than the ‘cleanliness’ concept,” Alice said. “The ‘cleanliness’ idea was getting too technical with that asepsis malarkey. People are going to understand ‘no waiting’ much better.”

  “There’s also a lot more opportunity for humor,” another voice commented.

  “I like it too,” someone else said. “I hate waiting for the gynecologist. By the time I get in there I’m as tense as a banjo wire.”

  A wave of tension-relieving laughter rippled through the group.

  “That’s the spirit,” Terese said. “Let’s get to work. Let’s show them what we can do when our backs are against the wall.”

  People started to leave, eager to get to their drawing boards.

  “Hold up!” Terese shouted over the buzz of voices that had erupted. “One other thing. This has to stay quiet. Don’t even tell other creatives unless absolutely necessary. I don’t want accounts to have any inkling of what’s going on. Okay?”

  A murmur of agreement arose.

  “All right!” Terese yelled. “Get to it!”

  The room emptied as if there had been a fire. Terese flopped back into Colleen’s chair, exhausted from the emotional effort of the day. Typical of her life in advertising, she’d started out that morning on a high, then sank to a new low, and was now somewhere in between.

  “They’re enthusiastic,” Colleen said. “You made a great presentation. I kind of wish someone from National Health were here.”

  “At least it’s a good idea for a campaign,” Terese said. “The question is whether they can put it together enough for a real presentation.”

  “They’ll certainly give it their best shot,” Colleen said. “You really motivated them.”

  “God, I hope so,” Terese said. “I can’t let Barker have a free field with his stupid ‘talking heads’ junk. That’s like taking advertising back to pre-Bernbach days. It would be an embarrassment for the agency if the client liked it, and we had to actually do it.”

  “God forbid,” Colleen said.

  “We’ll be out of a job if that happens,” Terese said.

  “Let’s not get too pessimistic,” Colleen warned.

  “Ah, what a day,” Terese complained. “On top of everything else I’ve got to worry about Jack.”

  “How so?” Colleen asked.

  “When I met with him and he gave me the ‘no wait’ idea he told me he was going back to the General.”

  “Uh-oh,” Colleen said. “Isn’t that where those gang members warned him against going?”

  “Exactly,” Terese said. “Talk about a Taurus, he’s the epitome. He’s so damn bullheaded and reckless. He doesn’t have to go over there. They have people at the medical examiner’s office whose job it is to go out to hospitals. It must be some male thing, like he has to be a hero. I don’t understand it.”

  “Are you starting to get attached to him?” Colleen asked gingerly, aware it was a touchy subject with Terese. Colleen knew enough about her boss to know that she eschewed romantic entanglements, though she had no idea why.

  Terese only sighed. “I’m attracted to him and put off by him at the same time,” she said. “He got me to open up a little, and apparently I coaxed him out a little too. I think both of us felt good talking to someone who seemed to care.”

  “That sounds encouraging,” Colleen said.

  Terese shrugged, then smiled. “We’re both carrying around a lot of emotional baggage,” she said. “But enough about me. How about you and Chet?”

  “It’s going great,” Colleen said. “I could really fall for that guy.”

  Jack felt as if he were sitting through the same movie for the third time. Once again he was literally on Bingham’s carpet enduring a protracted tirade about how his chief had been called by every major civil servant in the city to complain bitterly about Jack Stapleton.

  “So what do you have to say for yourself?” Bingham demanded, finally running out of steam with his ranting. He was literally out of breath.

  “I don’t know what to say,” Jack admitted. “But in my defense, I haven’t gone over there with the intention of irritating people. I was just looking for information. There’s a lot about this series of outbreaks that I don’t understand.”

  “You’re a goddamn paradox,” Bingham remarked as he visibly calmed down. “At the same time you’ve been such a pain in the butt you’ve made some commendable diagnoses. I was impressed when Calvin told me about the tularemia and the Rocky Mountain spotted fever. It’s like you’re two different people. What am I to do?”

  “Fire the irritating one and keep the other?” Jack suggested.

  Bingham grunted a reluctant chuckle, but any sign of amusement quickly faded. “The main problem from my perspective,” he grumbled, “is that you are so goddamned contumacious. You’ve specifically disobeyed my orders to stay away from the General, not once but twice.”

/>   “I’m guilty,” Jack said, raising his hands as if to surrender.

  “Is all this motivated by that personal vendetta you have against AmeriCare?” Bingham demanded.

  “No,” Jack said. “That was a minor factor to begin with,but my interest in the matter has gone way beyond that. I told you last time that I thought something strange was going on. I feel even more strongly now, and the people over there are continuing to act defensive.”

  “Defensive?” Bingham questioned querulously. “I was told that you accused the General’s lab director of spreading these illnesses.”

  “That story has been blown way out of proportion,” Jack said. He then explained to Bingham that he’d merely implied as much by reminding the lab director that he, the director, was disgruntled about the budget AmeriCare was giving him.

  “The man was acting like an ass,” Jack added. “I was trying to ask his opinion about the possible intentional spread of these illnesses, but he never gave me a chance, and I got mad at him. I suppose I shouldn’t have said what I did, but sometimes I can’t help myself.”

  “So you’re convinced about this idea yourself?” Bingham asked.

  “I don’t know if I’m convinced,” Jack admitted. “But it is hard to ascribe them all to coincidence. On top of that is the way people at the General have been acting, from the administrator on down.” Jack thought about telling Bingham about his being beaten up and threatened, but he decided against it. He feared it might get him grounded altogether.

  “After Commissioner Markham called me,” Bingham said, “I asked her to have the chief epidemiologist, Dr. Abelard, get in touch with me. When he did, I asked him what he thought of this intentional spread idea. You want to know what he said?”

  “I can’t wait,” Jack said.

  “He said except for the plague case, which he still cannot explain but is working on with the CDC, he feels the others all have very reasonable explanations. The Hard woman had been in contact with wild rabbits, and Mr. Lagenthorpe had been out in the desert in Texas. And as far as meningococcus is concerned, it’s the season for that.”