When no one said anything more, Susan regarded Grant with curiosity and worry. “Can you leave the zipper alone?” she asked, though she got no response and expected none.
—Sylvia Kostermeyer—
ONCE IN a while San Diego was visited by a major storm, a grey, vicious beating from wind and water that drove everyone indoors and made the streets unsafe, that drove the camp-dwelling Latin American detainees into the crowded Immigration Service Holding Station where frustration and despair often led to violence.
“How many of them are sick?” asked Sylvia, making sure that her California Board of Public Health and Environmental Services badge was clearly visible on her lapel.
“Old sick or new sick?” asked Clifford Gross, who had been working for the Immigration Service for thirty years, his medical oath long since abrogated in favor of bureaucratic survival.
“I mean sick, period. Public health sick,” Sylvia declared, her patience already running thin.
“Well, you can figure that eighty percent of them are undernourished in some way, that seventy percent have some kind of parasites on them, that another seventy percent have some other chronic health problem, such as low-level allergies. Not long ago we ended up with a genuine, full-blown case of rabies. Tell me what you’re looking for and we’ll see if we’ve got any.”
“I’ve been looking over your reports,” Sylvia said, deliberately taking an indirect approach. “I’ve noticed that you have had an increase in toxic waste syndrome, at least that is what the printouts indicate. Obviously a machine can’t tell us anything more than the information we give it, but if there is a contamination site we know nothing about, we must take action at once to protect—”
“I haven’t noticed that there’s been any real increase in toxic waste reactions,” said Gross. “Not that I’ve done much asking. Maybe there’s more sickness around, Doctor.”
“Why not?” Sylvia asked, doing her best to keep from challenging the man. “Why haven’t you checked for toxic—”
“Because there isn’t much of it around. Tetanus, TB, typhoid, you name it. Parasite infestations. Sure, those we find every day. It’s because the country’s so damned poor and most of the people are not educated, and those who are aren’t doing much to help those who aren’t. It doesn’t matter whether we’re talking about Mexico or Central America or South America, the problems are still pretty much the same.” He opened his hands to show how futile it was. “Most of them have been slightly sick for so long that they think they’re okay. They don’t know what it means to be healthy, to have a body that really works properly. It’s nothing we can change, not in a detention center like this one. Besides, what good would it do? Most of them are illegals, not refugees, and they’re simply going home to more of the same.”
Sylvia tapped the file of printouts she had on the edge of Gross’ desk. “Make a few allowances, Doctor Gross. If you find anything that you suspect might be related to toxic wastes, I would appreciate it if you would flag it and send it directly to me. At once. Mark it urgent.”
“It’s not going to make a difference,” warned Gross.
“It certainly won’t if you aren’t willing to make the effort.” She made no apology for the pointedness of the remark.
“But a couple of aliens with suspect symptoms, come on, Doctor . . . uh . . .”
“Kostermeyer,” she supplied.
“Yeah,” he said. “You’re asking a lot. Think about what the trouble is here, what we’re up against.” He waved in the direction of the door. “I’ve got over fifty more patients to see and that means I won’t get out of here until seven-thirty at the earliest, assuming that nothing is seriously wrong with any of them and that no more fights break out.” He folded his arms. “They said in Ninety-one that this new border policy would make things better, but you couldn’t prove it by me.”
“I realize you have difficulties here,” said Sylvia with a patience she did not feel. “And I know that I’m asking a lot, but since December tenth, we have had seven deaths in the greater San Diego area from a condition that appears to be related to toxic contamination. There is debilitation, enervation, anemia, lethargy, a . . . an alteration of blood chemistry, followed by pulmonary distress and vascular collapse. We now have two more cases we’re checking for the . . . blood condition.” She was not anxious to go into the baffling and complex breakdown of connective tissue that was characteristic of the course of the syndrome.
“What if it’s just another disease, a new version of, oh, say something like leukemia.” Gross made an indulgent grimace. “Surely you’ve considered that, Doctor Kosterm—”
“It has some leukemia similarities,” she allowed. “And it has others, like pernicious anemia and amoebic dysentery, for obvious examples. And death doesn’t come from any specific agency of the condition, but from subsidiary breakdowns.” She held out the printout file once more. “You might think that there are too few cases to worry about, but the thing that makes this so . . . upsetting is that so far we have yet to diagnose a patient with this condition and have them live. That’s why we’re looking for new cases, possibly early cases, and why we want to find out what toxic wastes are involved.”
“But suppose it’s not that?” Gross suggested. “Who says that it has to be toxic wastes, anyway?”
“What else fits the ticket so well?” she asked. “The only thing we haven’t found so far—thank God—are incidents in infants and young children. Four of the victims so far have been teenagers.”
“Have you thought about drugs? Especially the designer drugs?” He asked this with a faint, deprecatory smile, since the pervasive drug problem seemed to him far more obvious than toxic wastes.
“No trace of them in the blood.”
“How can you know, if the blood chemistry changes?”
Gross pursued. “If you haven’t any gauge other than that?”
Sylvia stared at Gross before she answered. “It’s what we have to go on, and right now . . . Look, one of the patients did test positive for drugs, but that doesn’t mean that drugs are the only explanation. We would have found traces in the others. They aren’t that hard to identify.”
“Unless one of the designer drugs is at fault. Have you considered that?” Gross rocked back on his heels.
“It’s being checked out, but so far there’s no indication that they’re a factor.” She sighed. “Will you help me out? I don’t want to have more deaths if I can help it.”
“Everyone dies,” said Gross, more cynically than philosophically.
“Agreed, but—”
“Sure, why not? If I see anything suspicious, or if there are indications of toxic contamination of some kind I’ll let you know. How’s that?” He looked at the door. “And I have to get back to work.”
“Of course. Thank you for giving me so much of your time,” Sylvia said with automatic courtesy.
“Pleasure,” said Gross, shaking her hand.
As she drove back through the rain, cursing the flooded streets and trying to keep from skidding in turns, Sylvia fought down her irrational desire to go back to the Immigration Station and remonstrate with Gross—his inadequacy as a physician, his conduct as a person, his total lack of manners—though she knew it would be useless. Instead she went over the cases of the puzzling condition she was investigating. Dead so far: Marilee Grey, aged sixteen; Jeanine Hatley, aged fourteen; Benton Smith, aged thirty-one; Paul Clancy, aged fourteen; Samuel Lincoln, aged fifteen; Elaine Bradley, aged twenty-seven; and Dwight Tracy, aged sixty-two. Ill so far: Isabeau Cuante, aged (about) forty-six or -seven; Lorraine Gomez, aged sixteen.
It was so disheartening that Sylvia almost missed her turn to the Public Health and Environmental Services building on Escondido, in the new complex built after the ’93 quake.
“How’d it go?” asked her superior, Doctor Michael
Wren, as Sylvia pulled off her coat and shook it.
“Don’t ask.” She ran her hand through her hair and shook out the drops from it.
“Problems?” Mike sat down, pulling up one of the two chairs so that he could face her over the corner of her desk.
“That man ought to be taken out and . . . and . . .”—she gave an unexpected smile—“and subjected to a lecture on manners from my Great-Aunt Lucy!”
Mike grinned, his large, white teeth appearing to be even larger against the blackness of his skin. “Sounds like a fate I wouldn’t wish on anyone.”
“Well, I sure as hell wouldn’t,” said Sylvia, settling down a bit. “I told him what we were looking for. That was after Rosenblum had his secretary ask me to leave a copy of the printouts so that he could look at them when he had time.”
“Sounds like you’ve had a great afternoon,” said Mike. “I don’t blame you for being testy.”
“Thanks. Oh, I think Steinmetz might get a fire lit under him if you’d give him a call and warn him that Environmental Services might have a mess on their hands. You know how good he is at covering his ass.” She looked at the primrose message memos stacked in the center of her desk. “Three from hospitals?”
“It looks like we’ve got another two cases at least. All in the same general area with the exception of one man who works at a restaurant across from Coronado, a place called The Galley.” He shook his head slowly. “I’ve put in a call to L.A. and another to Sacramento. One more case and we have to alert Environmental Diseases in Atlanta.” This time he spoke with real concern. “God, I hope it doesn’t come to that.”
“Me, too,” Sylvia admitted. “Timmons will have a fit.”
“Humanity has always been his long suit,” Mike said sarcastically.
Sylvia put the stack aside. “I’ll take care of them in a bit. By the way, take care driving home. It’s a mess out there and once the rush hour starts, it’s going to snarl all the way to Mexico.”
“Great.” She glanced at her wall map, at the day-glo green labels indicating addresses of those with the new syndrome. “Most of them are within a two-mile radius still; that’s something.”
“And with the exception of the guy at the restaurant, they all work in the same general area, or go to school there.” Mike stood up and went to the map. “Now, we have found toxic sites here”—he indicated an area ten miles north of the city—“and here”—this time his finger was east of San Diego near Spring Valley—“but nothing where these guys live.”
“So that’s no help, unless they all go out there for picnics.” She stared at the map as if it was deliberately withholding information. “We’re overlooking something. There’s got to be a commonality somewhere.”
“Well, Jeanine Hatley took ballet from Isabeau Cuante,” said Mike.
“And the rest? Did they take ballet?” As soon as she spoke, she was sorry. “That was a bitchy thing to say. I beg your pardon.”
“What would Great-Aunt Lucy think?” said Mike, rolling his eyes heavenward in simulated horror. “I don’t blame you for snapping. It’s shitty to be stymied this way.”
“Agreed.” She pursed her lips. “Do we have histories on the families of the victims? Have they been tested for signs of the syndrome?”
“A little hard to do when we’re not sure what we’re looking for,” Mike reminded her gently.
“Well, have they been checked, period, just in case? Look for hangnails and dandruff if nothing else turns up.” She folded her arms. “Complete histories, and neighborhood reviews, to find out if anyone else has had something like this that we might not have seen yet, and then . . . oh, hell.” To her chagrin she had to stop because her mouth was quivering and her eyes were moist.
“Hey, Sylvia,” Mike said, putting his hand on her arm. “We’ll find out what it is and we’ll stop it, right?”
“Sure,” she said miserably. “Next week at the latest.”
“That’s my pal,” Mike said, patting her arm. “Remember that and it’ll be easier to get the job done.” He touched the map, covering the area where the cases were. “At least it’s contained, whatever it is.”
“So far,” she reminded him. “I guess since we’ve had teenaged victims we’d better contact the schools as well. I hate causing panic like that.”
“I’m not too crazy about it myself. But you’re right. It’s probably necessary.”
“If Timmons decides that we’re being alarmist,” Sylvia wondered aloud, “do you think he’ll interfere?”
“Only if the sun rises,” said Mike in a resigned tone. “I’m going to get back to my office, and I’ll stop by before I head for home.”
“Okay,” she said, already reaching for the phone memos, her mind on the next stage of her investigation.
“If you need a hand . . .”
“Thanks,” she said, waving vaguely as she punched in the number on the first memo.
—Elihu Dover—
“I wish I knew what to tell you.” Dover shoved his hands more deeply into the pockets of his tweed jacket. “Your sister is in failing health, and I don’t know yet what the cause is.”
Sven Barenssen swallowed hard. “Will she have to go to the hospital? We don’t have insurance, you know.”
Dover frowned ponderously. “I’m aware that hospitalization would be a hardship. There are funds for cases like yours, particularly where there is some question as to the cause.” He added the last as delicately as he could, trying to diminish the worry Kirsten Barenssen’s brother was feeling. “And her church has some money available for . . . special cases. With all she’s done for them, I’m certain that if you speak to Will Colney, he would be more than willing to—”
“No. Kirsten wouldn’t accept that.” He stared up at the ceiling. “She’s not one to take charity. Not even now.”
“Well, you might have to make some arrangements, Mister Barenssen. I’m afraid that she may need quite a lot of care, and under the circumstances—”
“Under the circumstances, I can’t afford it,” Sven said flatly, “I know that. We both do.” He took a deep breath. “How serious is it? I mean, is she going to get well?”
“I hope so,” Dover hedged. “But since her condition is unfamiliar, I have no way of telling what might happen or what the . . . outcome might be. I suppose I ought to say that she is seriously ill now. Her blood . . .”—he lowered his head and tried to figure out how much he could tell Barenssen that he would understand—“is damaged in some way. She is anemic and there is a general breakdown of her bodily tissues. For some reason, she is having trouble keeping everything . . . connected.” He laced his fingers together in futile illustration. Little as he wanted to admit it to Kirsten’s brother, Dover knew he was out of his depth, and it troubled him.
“But why?”
The question was enormous, Elihu Dover knew, but he gave the simplest answer he could. “I wish I knew, Mister Barenssen.”
“What if we took her home? Could we arrange for care? Isn’t there someone who could come in and take care of her? Why does she have to go to the hospital? Is there a way you could arrange for a . . . nurse?” He looked at the doctor with desperate hope in his eyes.
“She needs more than that, Mister Barenssen,” said Dover heavily, wishing now that he had had this conversation at the hospital rather than in his own offices: at the hospital there would be any number of excuses to end this uncomfortable discussion—here he was stuck with Sven Barenssen for at least another ten minutes. “You’re fortunate that she’s the only one in your family who has shown symptoms of this condition.”
“What?” Sven asked, more dazed than before.
“The Standard Public School Blood Screen didn’t turn up anything in your sons, and that’s good news.” He watched Sven, trying to see how much if any of what he was saying
was getting through to the man.
“They’re in a private school,” Sven said, sounding more puzzled than anything.
“Oregon made it mandatory for all kids during the Tunis Flus Two and Three.” He had thought at the time that it was a good idea—it had cut down not only on the Tunis Flu but venereal disease as well—but he agreed that it was probably on the borderline of constitutionality.
“Oh. That thing in September,” said Sven. “Reverend Colney told the congregation not to protest. He said that it would only bring further problems.” His large eyes, the color of faded denim, appeared not quite in focus. “The whole school did it, didn’t they?”
“Yes,” said Elihu, thinking that he might want to see the records from the district, just in case.
“Kirsten said that it wasn’t godly to do that. It questioned Providence.” He stood up and walked about the room. “She’s real sick, isn’t she?”
“Yes,” Elihu said.
“How sick?” Sven was still baffled. “What kind of care does she have to have?”
“More than we can give in the hospital here. I want your permission to transfer her to the research hospital in Portland.” He had already made a few phone calls and had been assured that there would be a place for Kirsten once the proper forms had been signed.
“Portland?” Sven repeated. “Why? Why so far?”
This was growing increasingly difficult, thought Dover. “You see, Mister Barenssen, your sister has . . . she has a number of things wrong with her. Anyone of them alone and the local hospital would be able to treat her.” This was a bit of a white lie, but one that Dover felt acceptable. “But because there are so many problems, she needs more monitoring and tests than we can provide here. Given the seriousness of her illness, I think it would be wisest to transfer her at once. Today, in fact.”
“What? Today?” Sven’s eyes had taken on the hard glaze of shock and he spoke mechanically, moving as if his joints were connected by loose wires and string.
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