Contagion

by Robin Cook

  A half hour later they had the full picture. Four people had symptoms of a bad case of the flu. Besides the two nurses, one of the evening microbiology techs had abruptly experienced sore throat, headache, shaking chill, muscle pain, cough, and substernal discomfort. His contact with Kevin Carpenter had occurred about ten o’clock in the evening, when he’d visited the patient to obtain a sputum culture.

  The final person from the evening shift who was similarly ill was Gloria Hernandez. To Kathy’s surprise but not Jack’s, she worked in central supply and had had no contact with Kevin Carpenter.

  “She can’t be related to the others,” Kathy said.

  “I wouldn’t be too sure,” Jack said. He then reminded her that someone from central supply had perished with each of the other recent infectious cases. “I’m surprised this hasn’t been a topic of debate with the Infection Control Committee. I know for a fact that both Dr. Zimmerman and Dr. Abelard are aware of the connection, because they have been to central supply to talk to the supervisor, Mrs. Zarelli.”

  “We haven’t had a formal committee meeting since all this started,” Kathy said. “We meet on the first Monday of each month.”

  “Then Dr. Zimmerman is not keeping you informed,” Jack said.

  “It wouldn’t be the first time,” Kathy said. “We’ve never been on the best of terms.”

  “Speaking of Mrs. Zarelli,” Jack said. “She’d promised me printouts of everything central supply had sent to each of the index cases. Could we see if she has them and, if so, have her bring them down?”

  Having absorbed some of Jack’s anxiety about the influenza, Kathy was eager to help. After talking briefly to Mrs. Zarelli and ascertaining that the printouts were available, Kathy had one of the administrative secretaries run up to get them.

  “Let me have Gloria Hernandez’s phone number,” Jack said. “In fact, give me her address as well. This central supply connection is a mystery that for the life of me, I can’t understand. It can’t be coincidence and could be key to understanding what is going on.”

  Kathy got the information from the computer, wrote it down, and handed it to Jack.

  “What do you think we should do here at the hospital?” she asked.

  Jack sighed. “I don’t know,” he admitted. “I guess you’ll have to discuss that with friendly Dr. Zimmerman. She’s the local expert. In general, quarantine is not very effective for influenza since it spreads so quickly. But if this is some special strain, perhaps it would be worth a try. I think I’d get those hospital personnel who are sick in here and isolate them: worst case, it’s an inconvenience; best case, it could help avert a disaster.”

  “What about rimantadine?” Kathy asked.

  “I’m all for it,” Jack said. “I’ll probably get some myself. It has been used to control some nosocomial influenza in the past. But again that should be up to Dr. Zimmerman.”

  “I think I’ll give her a call,” Kathy said.

  Jack waited while Kathy spoke to Dr. Zimmerman. Kathy was deferential but firm in explaining the apparent connection between the sick personnel and the deceased, Kevin Carpenter. Once she had spoken, she was reduced to silence punctuated only by repetitions of “yes” at certain intervals.

  Eventually, Kathy hung up. She rolled her eyes. “That woman is impossible,” she said. “At any rate, she’s reluctant to do anything extraordinary, as she puts it, with just one confirmed case. She’s afraid Mr. Kelley and the AmeriCare executives would be against it for PR reasons until it was undeniably indicated.”

  “What about the rimantadine?” Jack asked.

  “On that she was a little more receptive,” Kathy said. “She said she’d authorize the pharmacy to order in enough for the staff, but she wasn’t going to prescribe it just yet. At any rate, I got her attention.”

  “At least that’s something,” Jack agreed.

  The secretary knocked and came in with the printouts Jack had wanted from central supply. He thanked the woman, and immediately began scanning them. He was impressed; it was rather extraordinary what each patient utilized. The lists were long and included everything short of medications, food, and linen.

  “Anything interesting?” Kathy asked.

  “Nothing that jumps out at me,” Jack admitted. “Except how similar they are. But I realize I should have asked for a control. I should have asked for a similar list from a random patient.”

  “That shouldn’t be hard to get,” Kathy said. She called Mrs. Zarelli back and asked her to print one out.

  “Want to wait?” Kathy said.

  Jack got to his feet. “I think I’ve overstretched my luck as it is,” he said. “If you could get it and have it sent over to the medical examiner’s office, I’d be appreciative. As I mentioned, this central supply connection could be important.”

  “I’d be happy to do it,” Kathy said.

  Jack went to the door and furtively glanced out into the hall. Turning back to Kathy, he said, “It’s hard to get used to acting like a criminal.”

  “I think we’re in your debt for your perseverance,” Kathy said. “I apologize for those who have misinterpreted your intentions.”

  “Thank you,” Jack said sincerely.

  “Can I ask you a personal question?” Kathy asked.

  “How personal?” Jack asked.

  “Just about your face,” Kathy asked. “What happened? Whatever it was, it looks like it must have been painful.”

  “It looks worse than it is,” Jack said. “It’s merely a reflection of the rigors of jogging in the park at night.”

  Jack walked quickly through administration and across the lobby. As he stepped out into the early-spring sunshine, he felt relief. It had been the first time he’d been able to visit the General without stirring up a hornet’s nest of protest.

  Jack turned right and headed east. On one of his prior visits he’d noticed a chain drugstore two blocks from the hospital. He went directly there. Kathy’s suggestion of rimantadine was a good one, and he wanted to get some for himself, especially given his intention of visiting Gloria Hernandez.

  Thinking of the Hernandez woman made Jack reach into his pocket to be sure he’d not misplaced her address. He hadn’t. Unfolding the paper, he looked at it. She lived on West 144th Street, almost forty blocks north of Jack.

  Arriving at the drugstore, Jack pulled open the door and entered. It was a large store with a bewildering display of merchandise. Everything, including cosmetics, school supplies, cleaning agents, stationery, greeting cards, and even automotive products, was crammed onto metal shelving. The store had as many aisles as a supermarket.

  It took Jack a few minutes to find the pharmacy section, which occupied a few square feet in the back corner of the store. With as little respect as pharmacy was given, Jack felt there was a certain irony they even called the establishment a drugstore.

  Jack waited in line to speak to the pharmacist. When he finally did he asked for a prescription blank, which he quickly filled out for rimantadine.

  The pharmacist was dressed in an old-fashioned white, collarless pharmacist jacket with the top button undone. He squinted at the prescription and then told Jack it would take about twenty minutes.

  “Twenty minutes!” Jack questioned. “Why so long? I mean, all you have to do is count out the tablets.”

  “Do you want this or don’t you?” the pharmacist asked acidly.

  “I want it,” Jack muttered. The medical establishment had a way of bullying people; doctors were no longer immune.

  Jack turned back to the main part of the store. He had to entertain himself for twenty minutes. With no goal in mind, he wandered down aisle seven and found himself before a staggering variety of condoms.

  BJ liked the idea of the drugstore from the moment he saw Jack enter. He knew it would be close quarters, and as an added attraction, there was a subway entrance right out the door. The subway was a great place to disappear.

  After a quick glance up and down the street, BJ
pulled open the door and stepped inside. He eyed the glass-enclosed manager’s office near the entrance, but experience told him it wouldn’t be a problem. It might take a short burst from his machine pistol just to keep everybody’s head down when he was on his way out, but that would be about it.

  BJ advanced beyond the checkout registers and started glancing down the aisles, looking for either Jack or Slam. He knew if he found one, he’d quickly find the other. He hit pay dirt in aisle seven. Jack was at the very end, with Slam loitering less than ten feet away.

  As BJ moved quickly down aisle six, he reached under his sweatshirt and let his hand wrap around the butt of his Tec pistol. He snapped off the safety with his thumb. When he arrived at the cross-aisle in the middle of the store, he slowed, stepped laterally, and stopped. Carefully he leaned around a display of Bounty paper towels and glanced down the remainder of aisle seven.

  BJ felt his pulse quicken in anticipation. Jack was standing in the same spot, and Slam had moved over next to him. It was perfect.

  BJ’s heart skipped a beat when he felt a finger tap his shoulder. He swung around. His hand was still under his sweatshirt, holding on to the holstered Tec.

  “May I help you?” a bald-headed man asked.

  Anger seared through BJ at having been interrupted at precisely the wrong moment. He glared at the jowled clerk and felt like busting him in the chops, but instead he decided to ignore him for the moment. He couldn’t pass up the opportunity with Jack and Slam standing nose to nose.

  BJ spun back around, and as he did so he drew out the machine pistol. He started forward. He knew a single step would bring the aisle into full view.

  The clerk was shocked by BJ’s sudden movement, and he didn’t see the gun. If he had, he never would have shouted “Hey” the way he did.

  Jack felt on edge and jittery. He disliked the store, especially after his run-in with the pharmacist. The background elevator music and the smell of cheap cosmetics added to his discomfort. He didn’t want to be there.

  As wired as he was, when he heard the clerk yell, his head shot up, and he looked in the direction of the commotion. He was just in time to see a stocky African-American leaping into the center of the aisle brandishing a machine pistol.

  Jack’s reaction was pure reflex. He threw himself into the condom display. As his body made contact with the shelving an entire unit tipped over with a clatter. Jack found himself in the center of aisle eight on top of a mountain of disarranged merchandise and collapsed shelves.

  While Jack leaped forward, Slam hit the floor, extracting his own machine pistol in the process. It was a skillful maneuver, suggesting the poise and expertise of a Green Beret.

  BJ was the first to fire. Since he held his pistol in only one hand, the burst of shots went all over the store, ripping divots in the vinyl flooring and poking holes in the tin ceiling. But most of the shots screamed past the area where Jack and Slam had been standing seconds before, and pounded into the vitamin section below the pharmacy counter.

  Slam let out a burst as well. Most of his bullets traveled the length of aisle seven, shattering one of the huge plate-glass windows facing the street.

  BJ had pulled himself back the moment he’d seen the element of surprise had been lost. Now he stood, crouched over behind the Bounty paper towels, trying to decide what to do next.

  Everyone else in the store was screaming, including the clerk who’d tapped BJ on the shoulder. They began rushing to the exits, fleeing for their lives.

  Jack scrambled to his feet. He’d heard Slam’s burst of gunfire, and now he was hearing another burst from BJ. Jack wanted out of the store.

  Keeping his head down, he dashed back into the pharmacy area. There was a door that said “Employees Only,” and Jack rushed through. He found himself in a lunchroom. A handful of open soft drinks and half-eaten packaged pastries on the table told him that people had just been there.

  Convinced that there was a way out through the back, Jack began opening doors. The first was a bathroom, the second a storeroom.

  He heard more sustained gunfire and more screams out in the main part of the store.

  Panicked, Jack tried a third door. To his relief it led out into an alley lined with trash cans. In the distance he could see people running. Among those fleeing, he recognized the pharmacist’s white coat. Jack took off after them.

  29

  TUESDAY, 1:30 P.M., MARCH 26, 1996

  Detective Lieutenant Lou Soldano pulled his unmarked Chevy Caprice into the parking area at the loading bay of the medical examiner’s office. He parked behind Dr. Harold Bingham’s official car and took the keys out of the ignition. He gave them to the security man in case the car had to be moved. Lou was a frequent visitor to the morgue, although he hadn’t been there for over a month.

  He got on the elevator and pushed five. He was on his way to Laurie’s office. He’d gotten her message earlier but hadn’t been able to call until a few minutes ago as he was on his way across the Queensboro Bridge. He’d been over in Queens supervising the investigation on a homicide of a prominent banker.

  Laurie had been telling him about one of the medical examiners when Lou had interrupted to tell her he was in the neighborhood and could stop by. She’d immediately agreed, telling him she’d be waiting in her office.

  Lou got off the elevator and walked down the hall. It brought back memories. There had been a time when he’d thought that he and Laurie could have had a future together. But it hadn’t worked out. Too many differences in their backgrounds, Lou thought.

  “Hey, Laur,” Lou called out when he caught sight of her working at her desk. Every time he saw her she looked better to him. Her auburn hair fell over her shoulders in a way that reminded him of shampoo commercials. “Laur” was the nickname his son had given her the first time he’d met her. The name had stuck.

  Laurie got up and gave Lou a big hug.

  “You’re looking great,” she said.

  Lou shrugged self-consciously. “I’m feeling okay,” he said. “And the children?” Laurie asked.

  “Children?” Lou commented. “My daughter is sixteen now going on thirty. She’s boy crazy, and it’s driving me crazy.”

  Laurie lifted some journals off the spare chair she and her officemate shared. She gestured for Lou to sit down.

  “It’s good to see you, Laurie,” Lou said.

  “It’s good to see you too,” she agreed. “We shouldn’t let so much time go by without getting together.”

  “So what’s this big problem you wanted to talk to me about?” Lou asked. He wanted to steer the conversation away from potentially painful arenas.

  “I don’t know how big it is,” Laurie said. She got up and closed her office door. “One of the new doctors on staff would like to talk to you off the record. I’d mentioned that you and I were friends. Unfortunately, he’s not around at the moment. I checked when you said you were coming over. In fact, no one knows where he is.”

  “Any idea what it’s about?” Lou asked.

  “Not specifically,” Laurie said. “But I’m worried about him.”

  “Oh?” Lou settled back.

  “He asked me to do two autopsies this morning. One on a twenty-eight-year-old Caucasian woman who’d been a microbiology tech over at the General. She’d been shot in her apartment last night. The second was on a twenty-five-year-old African-American who’d been shot in Central Park.

  Before I did the cases he suggested that I try to see if the two were in any way related: through hair, fiber, blood…”

  “And?” Lou asked.

  “I found some blood on his jacket which preliminarily matches the woman’s,” Laurie said. “Now that’s just by serology. The DNA is pending. But it’s not a common type: B negative.”

  Lou raised his eyebrows. “Did this medical examiner give any explanation for his suspicion?” he asked.

  “He said it was a hunch,” Laurie said. “But there’s more. I know for a fact that he’d been beaten up
recently by some New York gang members—at least once, maybe twice. When he showed up this morning he looked to me like it might have happened again, although he denied it.”

  “Why was he beaten up?” Lou asked.

  “Supposedly as a warning for him not to go to the Manhattan General Hospital,” Laurie said.

  “Whoa!” Lou said. “What are you talking about?”

  “I don’t know the details,” Laurie said. “But I do know he’s been irritating a lot of people over there, and for that matter, over here as well. Dr. Bingham has been ready to fire him on several occasions.”

  “How’s he been irritating everyone?” Lou asked.

  “He has it in his mind that a series of infectious diseases that have appeared over at the General have been spread intentionally.”

  “You mean like by a terrorist or something?” Lou asked.

  “I suppose,” Laurie said.

  “You know this is sounding familiar,” Lou said.

  Laurie nodded. “I remember how I felt about that series of overdoses five years ago and the fact that no one believed me.”

  “What do you think of your friend’s theory?” Lou said. “By the way, what’s his name?”

  “Jack Stapleton,” Laurie said. “As to his theory, I don’t really have all the facts.”

  “Come on, Laurie,” Lou said. “I know you better than that. Tell me your opinion.”

  “I think he’s seeing conspiracy because he wants to see conspiracy,” Laurie said. “His officemate told me he has a long-standing grudge against the health-care giant AmeriCare, which owns the General.”

  “But even so, that doesn’t explain the gang connection or the fact that he might have knowledge of the woman’s murder. What’re the names of the homicide victims?”

  “Elizabeth Holderness and Reginald Winthrope,” Laurie said.

  Lou wrote down the names in the small black notebook he carried.

  “There wasn’t much criminologist work done on either case,” Laurie said.

  “You of all people know how limited our personnel is,” Lou said. “Did they have a preliminary motive for the woman?”