The Arms of Death

by Maggie Foster

  “But what does it all mean?” Ginny asked.

  Gloria shrugged. “It means, according to the tests, that man’s brain is dead. His heart’s still beating so we can’t turn off the ventilator.” She made a face. “Mustn’t let it be suggested we didn’t do everything in our power. In the meantime, we treat him just as if he were going to get well.”

  “Transplant coordinator?”

  Gloria shook her head. “It was discussed, but we haven’t been able to rule out an infection so they don’t want anything to do with him.”

  “Is his family here?”

  “Yes, a nephew and niece-in-law. They are distressed, of course, but seem to understand what’s been said to them. Any other questions?”

  “No. I’ll take it from here, thanks.”

  Ginny looked Professor Craig and the equipment over, jotted down a few notes, then hurried out to meet her other patient. Initial assessments complete, she turned her attention back to Craig, swinging past the monitors to pick up EKG strips.

  “When did this start?”

  Ann, the charge nurse for this shift, looked at the strips in Ginny’s hand. They showed intermittent irregular heartbeats. “Looks like four p.m.”

  “Gloria didn’t say a thing about ectopy.”

  “I guess she missed it.”

  Ginny groaned at the thought of having to fill out an incident report. She studied the waveforms, comparing them to the strips in her hand.

  “His heart is dying, sooner even than we could have expected.” She glanced at the clock. There was no way to squeeze what she knew was coming into her usual routine. She gritted her teeth and prepared for a bad night.

  “We’d better call Respiratory and let them know what’s in the wind,” Ann said.

  “Yes, and I’ve got to call both of his doctors. Can you get them on the phone for me?”

  “What’s the code status?”

  “Full code. Not that it will do any good, but we have to try.”

  Fifteen minutes later, Professor Craig went into full cardiac arrest.

  There was no hope. There had never been any hope. Whatever had destroyed Professor Craig’s brain was now destroying his heart. They worked in calm haste, trying everything, accomplishing nothing.

  Dr. Littleton shook his head at last. “Call it.”

  Ginny glanced at the clock, three minutes past eight p.m. She jotted down the time and watched as the rest of the crew backed away from the bed, reluctant to give up even now.

  “That makes him an M.E. case,” she murmured to Ann. “It’s been less than twenty-four hours since admission.”

  “And you get to do another incident report. Let me know when you’re ready for the family to come see him.” Ann followed the others out.

  Ginny shut the door behind her, closing herself in with the dead man. There was very little for her to do to prepare the body. Nothing could be removed until after the Medical Examiner had finished with him. She turned off the machines and disconnected the apparatus, covering the bloody spots and wiping away some of the more unpleasant aspects of death, then tucked the sheet around him and stepped back.

  She stood quite still, looking down at the shell of a man she had known. “In the midst of life, we are in death.” The phrase floated unbidden into her mind. Ginny knew, better than most, how fragile is the human condition, and how easily destroyed. “In nomine Patris…” Except, she reminded herself, frowning, that he shouldn’t be dead. “…et Filii…” I’ve taken care of lots of Guillain-Barré patients and so has Armstrong. “...et Spiritus Sancti…” and they don’t do this. They don’t die.

  Instinctively, her hand went to the talisman at her neck. The Scots believe that the rowan is a portal tree, a guardian at thresholds such as the one between life and death. They carry small items made from its wood on journeys, to prevent losing their way.

  This death had all the earmarks of a man who had taken a wrong turn and found himself in an unfamiliar land. Ginny asked the rowan to guide the soul of Donald Craig to his final destination, then turned her back on the body and went out to get the family.

  * * *

  Chapter 4

  Friday

  Ginny drove home the next morning still fretting about Professor Craig’s death. She had packed him off to the morgue, then gotten a difficult admission, which helped to distract her, but didn’t answer any of her questions.

  She tossed her bag into the closet and glanced at the clock; eight a.m. It was a bit early, but if she didn’t call now, she’d have to wait until she woke up this afternoon, and that would be far too late.

  She called the head of the Genealogy Society first, explaining what had happened, then picked up the phone and dialed Hal’s number.

  “Hal? Ginny. Sorry to get you out of bed.”

  “You didn’t. The caterers started calling at six. I didn’t realize how much time and effort it took to throw this kind of a party.”

  “That’s what I called about. I think we should postpone the dinner.” She could hear the sharp intake of breath on the other end of the line.

  “What? Why?”

  “Professor Craig died last night.”

  There was a short silence, then, “It’s too late to cancel. The caterer is already here with tons of raw food. Everything’s been paid for in advance and we’ll never be able to get refunds. Besides, most of the guests don’t even know him.”

  “That’s not the point. It isn’t right.”

  “Suppose we call it a wake?”

  “It’s a fund raiser.”

  “I know that, and the appeals went out a long time ago, so everyone else does too. How about if I stand up and make an announcement, moment of silence, that sort of thing?”

  “Well–”

  “He’d want us to go on with it, wouldn’t he? The genealogy section was his baby. He’d want to see it live on after his death and there’s an awful lot of money at stake.”

  Ginny sighed. “I suppose you’re right.”

  “No one will think a thing about it, I promise you. See you at six?”

  “Closer to seven, I expect.”

  “Okay. Bye.”

  Ginny set the phone down and sighed. Hal was right. The gap created by Professor Craig’s death would close. The library and family history section would go on as before. The community would pay their respects, bury him in the Auld Kirk yard, and forget about him. The way of the world.

  * * *

  The phone woke her.

  “Ginny? It’s Ethel Barton.”

  Ginny frowned. What was the Director of Nurses doing calling her at — she peered at her bedside clock — three in the afternoon?

  “Yes, Mrs. Barton? What can I do for you?”

  “I’m sorry to call you. I know you worked last night, but something has come up. Are you awake?”

  Ginny pulled herself to a sitting position. “I am now.”

  “There’s a CDC investigator here and he wants to talk to you, today, as soon as possible.”

  “What on earth for?”

  “It’s about the man you took care of in the ICU last night, Professor Craig.”

  “The one we thought had Guillain-Barré?”

  “Yes. They’re worried it may be something else.”

  “Are they suggesting we’re in danger?”

  “They’re not saying just yet, but they’ve been talking to everyone who came in contact with him since admission. How soon can you get here?”

  Ginny looked at the clock again. “Half an hour.”

  “Come by my office first. I want to go over the records with you, then I’ll take you to him. Oh, and clock in.”

  “Clock in?”

  “Yes. We’re paying all the off-duty staff to come in for these interviews so don’t forget.”

  “All right. I’ll be there as soon as I can.”

  Ginny stared at the instrument in her hand then set it down. Lord. If they were willing to pay the staff to cooperate, it must be important. She threw th
e covers off, hurried into sweats, grabbed her purse, and headed for the door.

  * * *

  Ginny swung past the time clock and headed for the elevator. The Director of Nurse’s office was on the second floor.

  “Ginny. Good.” The Director rose and came towards her, holding out her hand. Ginny took it, astonished to find the D.O.N. knew her by sight.

  “I’m sorry to bring you in like this, but the investigator was very insistent.” Mrs. Barton was a trim forty-five with coal black hair worn swept up in a French twist. Her reading glasses hung from a chain around her neck, nestled against the white silk blouse under the dark blue suit. She looked like what she was, an efficient, reliable executive.

  “I just hope it’s a false alarm,” Ginny said.

  “You and everyone else, but first, would you please explain this incident report?” It was the overlooked ectopy.

  “I caught it, but I wasn’t there when it happened, so I don’t know any more than I put in the report. Have you spoken to the day shift?”

  The D.O.N. nodded. “What I want from you is a detailed description of Professor Craig’s condition at the moment you discovered the error.”

  Ginny spent the next ten minutes telling everything she could remember. The D.O.N. then spent another twenty minutes going over the rest of the chart making notes and asking terrifying questions. It was clear she anticipated a lawsuit.

  Ginny protested. “I don’t think it contributed in any way. How could it? It wasn’t a lethal arrhythmia that got him. It was no brain cells.”

  “I know, but a jury might not see it that way.”

  “That would not be fair.”

  The Director of Nurses frowned. “Let’s hope this is the worst of it. A high profile malpractice case can be handled in the courts, but an outbreak of something this lethal in Dallas would be a disaster.”

  Ginny bit her lip. “I’d forgotten about the CDC.”

  “I hadn’t.” The D.O.N. rose from her chair. “Come on. I’ll introduce you.”

  Ginny followed her down the hall and found herself ushered into a small conference room.

  “This is Mr. Galloway.” The D.O.N. retreated, leaving them alone.

  “Thank you for coming in to talk to me,” he said.

  Ginny looked at the stranger as she sat down. Somewhere between twenty-five and thirty, she guessed, but the fatigue in his face made him appear older. He was dressed in a standard business suit with a lab coat over it, his name and credentials embroidered over the left breast pocket.

  “Am I allowed to ask what’s going on?”

  “I’m sorry. I’m not at liberty to say. What I want to do is explore what happened to the patient. Everyone he came in contact with. You never know when a tiny detail might be significant. So just tell me everything you can remember, from start to finish.” He tapped the screen on the recording device, then set it down on the table between them.

  Ginny nodded and started talking. It wasn’t hard to remember. She’d been thinking about nothing else since this incident began. He interrupted from time to time with questions.

  “Did you draw blood from him?”

  “Yes and no. The lab collected the specimens, but I started IVs and helped with the other line insertions.”

  “Did you wear gloves?”

  “Of course.”

  “Did you stick yourself at any time?”

  “No.”

  “Have you ever seen a case of Disseminated Intravascular Coagulopathy?”

  Ginny nodded. DIC was a condition in which the blood clotting system went haywire, plugging up arteries and preventing blood flow. Paradoxically, these patients often bled to death.

  “Did he look like that?”

  Ginny shook her head. “All his symptoms were neuro. So it doesn’t look like one of the hemorrhagic fevers.”

  The investigator paused. “What do you know about hemorrhagic fevers?”

  Ginny shrugged. “After the first Ebola case, we all got a crash course. Very contagious, very fast, very deadly, and the CDC moves very swiftly when an outbreak is suspected.”

  The investigator smiled. “Alex told me you were sharp.”

  “You know my brother?”

  “Yes. He’s very good.”

  Ginny smiled. “I’m glad to hear it.”

  “Now, I believe someone mentioned Guillain-Barré.”

  “Yes. It was the characteristic presenting symptoms; weakness in the lower extremities, progressing up the torso to the lungs. Except that it moved really fast.”

  The investigator nodded. “In your opinion, did he get adequate medical support for his condition?”

  “Oh, yes. The floor nurses were right on it when he started having trouble breathing. That’s why I was so surprised when he died. There didn’t seem to be any reason for it, and, of course, I knew the man, so it was doubly distressing.”

  The CDC man blinked. “You knew Donald Craig?”

  “Yes. He was the head librarian in the genealogy department at the local library. Genealogy is one of my hobbies and I’ve had occasion to work with him.”

  The investigator frowned. “Does his job expose him to people who might be infectious?”

  Ginny shrugged. “No more so than anyone who works with the public. Except this week, of course.”

  “What’s special about this week?”

  “We’ve been hosting a big genealogical seminar here in Dallas. He was one of the featured speakers.”

  “Honored guest speaker, something like that?”

  She shook her head. “No. There were ten classes a day, two hours each, every day of the conference, and he was scheduled to teach four of those.”

  “How big a conference?”

  “Somewhere between five and six thousand individuals.”

  Ginny watched the man’s face blanch and felt sorry for him.

  “What were the dates of this conference?”

  “It started Sunday night and the last sessions will be tomorrow. At least, that’s what we planned.”

  “Is there a list somewhere of the people who attended?”

  Ginny half-nodded. “A partial, at least. There’s a list of everyone who registered and paid their fees before they got here, though some of those will be no-shows. There’s another list for the pay-at-the-door group. The vendors are registered and take names for their mailing lists. The convention center will know which of their staff worked the event, and we have a semi-official list of the volunteers, but that’s not going to be either complete or accurate. There are always last minute substitutions. The host hotel may be able to tell you who used the discount we set up, but I doubt if they can tell who came in just for the parties.”

  “How about other places? Anyone he may have come in contact with in the last two weeks?”

  Ginny shrugged. “I’m sorry. I wish I could tell you more.” She pulled her phone out, called up her contacts list, located Fiona Campbell, and handed it over.

  “Here’s the name and number of the person in charge of the conference. She’s the head of the genealogy society. And here’s the number at the genealogy library where he worked. The staff will be able to help you more than I can. He should have an appointment calendar of some sort. They can also get you the sign-in sheets.”

  “Sign-in sheets?”

  “The library asks that patrons sign-in when they visit the genealogy department, so they can track the number of users, but that doesn’t mean they’ve seen anyone in particular.” She shook her head. “I am afraid I haven’t been of much help.”

  “On the contrary,” he said. “You’ve been very useful.”

  “Is there anything else I can tell you right now?”

  “No, but we’ll be in touch if there is.” He got up and came around the end of the table, reaching for gloves, a venipuncture kit and several glass tubes from a box in the middle of the table. It was Ginny’s turn to blanch.

  “Do you always draw your own blood samples?” she asked.

&nb
sp; He smiled, snugged the tourniquet around her arm above the elbow, then snapped open the skin prep kit and scrubbed the area with germ killer. Ginny’s nostrils twitched at the smell.

  “Yes, but don’t worry. We get good training and a great deal of practice.” He slid the needle into her vein without difficulty. It was a neat, professional job and Ginny was impressed. She watched him label the tubes and deposit them in a container already almost full of similar collections, then submitted to the unpleasant sensations accompanying throat and nose swabs.

  “I suppose you’ll let us know if you find anything?” she asked.

  He nodded. “If you don’t hear back, assume there was nothing unusual in the samples. Thank you, again, for your help.”

  * * *

  Ginny headed for the elevators. If she didn’t stay too long, she could sneak up to the unit and see if anyone had news about this investigation. The grapevine at Hillcrest was very efficient.

  She swiped her badge over the access panel and let herself in. The charge nurse looked up as Ginny entered in street clothes.

  “Hi! What brings you back here at this time of day?”

  “The investigation, of course. Tell me everything.”

  Millicent frowned. “Rumor has it they’re worried about a virus.”

  Ginny settled into one of the chairs. “What sort of virus?”

  “No one knows. The biopsy said most of his brain cells had burst.”

  “Burst?” Ginny stared at the other woman.

  She nodded. “You know, the virus gets in, reproduces, then the baby viruses break out of the cell just like a chick hatching from an egg. Anyway, they seem to think we’ve all been exposed. Some more than others.” She looked significantly at Ginny.

  “Yes. Well, if I turn green and curl up, you’ll know why, but if it’s a virus, they’re going to have their hands full. We could be looking at a full-blown epidemic.” Several of the other nurses had drifted over to listen and she told them about the conference and the number of potential casualties.

  “That does not sound like fun,” one of them remarked.

  “So what do we do now? Just wait?” another asked.

  Ginny looked around at the worried faces. It would help if she could get Alex to spy for her on his end.