Jim’s expert knowledge of viruses cut both ways. He knew, understood thoroughly, what the medications could and could not do for him. He knew they had never been tried on this engineered virus. He also knew the risks the medications themselves posed Whatever happened, Dr. Armstrong was going to get a hell of a journal article out of it.
Jim prowled his assigned room, scratching irritably at the cardiac sensors attached to his chest. He did not want to be here. He wanted to be up in the Neuro ICU. Was there any reason why he shouldn’t visit Ginny? As long as he didn’t touch her, he couldn’t think of any. The virus had a rabies base (supplying the neurotoxicity) and rabies required only standard precautions. The norovirus (the rapid turnover part of the design) usually required contact precautions, but it had been deactivated.
He could not give the virus to her by breathing on her, or coughing and sneezing in her direction (which was a possibility with his hair still wet). All four of the known victims had been treated in healthcare facilities with lots of droplet splatter and no one had contracted the disease from them. It should be safe, if he didn’t touch her.
He left a message with the charge nurse telling her where to find him and made his way up to the unit. He got some curious looks from the staff and at least one whispered comment as he walked down the hall and into Ginny’s room. It didn’t surprise him. The whole hospital probably knew what was going on by now.
He pushed the door open and slipped in, pausing just inside, looking around and trying to see everything at once. She lay in the bed, her eyes closed, breathing easily. Oxygen via nasal cannula. No ventilator. Good. The monitor above her head showed normal vital signs and EKG rhythm. Good. Her left foot was wrapped and elevated, an ice pack in place, but Jim could see from where he stood that the toes were pink. Good.
The door opened behind him and Jim stepped aside to let Dr. Armstrong into the room. He looked at Jim, a small smile playing at the corner of his mouth.
“They told me I would find you here.”
Jim nodded, then looked over at the bed. “How is she?”
“She should do well enough. The fall rattled her brain a bit. We’ll keep a close eye on her for another day or so, then reevaluate.”
Jim nodded. “I was meaning to ask you about the cracked ribs. She had some fluid in her lungs yesterday.”
Dr. Armstrong nodded. “Yes. We’re going to have to address that.” He turned and looked at Jim. “How about you? How are you doing?”
Jim shrugged. “I’m waiting to either die or live. It’s a very odd feeling.”
“I can only imagine.” He gave Jim a hard look. “Are you going to let the nurses keep an eye on you for me?”
“Do I have a choice?”
Armstrong lifted one eyebrow, then let it fall. “The medications need to stay on schedule. I’d like good documentation for all the obvious reasons. And you may not notice subtle changes which one of them could pick up on.”
Jim sighed, running his gloved hand through his hair. “Can they do it here?”
“Yes. As long as they can find you.”
Jim nodded. “I’ll cooperate.” He laughed. “This may be my only chance to go down in the history books.”
“I hope not.” Dr. Armstrong pulled on a pair of gloves, had Jim sit down in the empty chair and put him through reflex and muscle strength testing, then gait, then coordination, then memory and cognition. “No deficits I can see,” he said at last. “Let’s keep it that way.”
“I’ll do my best,” Jim said. He glanced over at the bed and found Ginny looking at him, a smile on her lips.
“That was very entertaining,” she said.
“Your turn,” Dr. Armstrong said.
When he was finished, he pulled out the computer access point and charted on the pair of them, then spoke to the nurses. During all this time Jim stood and looked at Ginny, not speaking, just waiting.
“Let me know if there are any changes in either of them,” he heard Armstrong say, and heard the nurse respond; then Dr. Armstrong took his leave and the two of them were alone.
* * *
“What was that about?” Ginny asked.
“I’ve been exposed.” He outlined what had happened while she lay unconscious at the bottom of the stair.
“Hal had the virus in his pocket?”
“Yes.”
Jim watched as Ginny struggled to make sense of what she was hearing.
“How did he get it?”
“He took it from the GeneTech lab after the first death.”
He watched her eyes get wider. “He was there.”
“Yes.”
She nodded. “Alex told me.”
Jim was glad to have a trustworthy source corroborating his story.
“If he’s the one who took it, that means he’s the—”
“Yes.”
Her face, already pale, went dead white and Jim wondered if she was going to be sick.
Her hands came up, first one, then the other, and settled on her chest.
“He had the virus in his pocket when he came to see me?”
“Apparently so.”
Jim didn’t think she could get any whiter, but she did.
She took a shuddering breath, her eyes focusing on him.
“You said you’d been exposed.”
Jim nodded.
“He threw it at you?”
“He threw it to me and I caught it.” Jim spread his gloved hands. “I have scrapes and punctures on my hands and arms, from the holly bushes and from smashing the window to get to the door lock. I have to assume the virus got into the cuts.”
“Oh, Jim! This is my fault. I shouldn’t have involved you.”
He shook his head at her. “This is Hal’s fault. When he saw what he’d done to himself, he tried to make sure I would die, too.”
Jim watched as a tear welled up and spilled down her cheek, followed by another, then a whole stream of tears. He took a step toward her. “Ginny! Please don’t cry. It’s going to be all right. I promise.”
She was shivering, reaching for a tissue, having trouble finding it, and making him ache to hold her, to brush the tears away. He picked up one of the blankets, being careful to touch it only through the gloves, and brought it over, tucked it around her, then stepped back. He was shaking, too.
“We know what we’re dealing with this time,” he said. “I’ve been talking to the CDC and we have a plan. That virus is not going to be allowed to flourish unchecked. We’re going to fight it and I have to believe we’ll win.”
“It’s still my fault. If I hadn’t let Hal in, you wouldn’t have had to break the glass.”
Jim took a ragged breath. “Why did you?”
Her face twisted. “I wanted to believe it wasn’t true, to give him a chance to explain.” She swallowed. “He came to propose.”
Jim felt his mouth go dry. “What did you tell him?”
“I hadn’t answered him when you got there. I didn’t know what to say.”
Jim’s stomach did a flip-flop and he wondered if it was the drugs kicking in.
“How did you come to fall down the staircase?”
“I was trying to get past him, to answer the doorbell. He saw your car and he didn’t want me to let you in.”
Jim nodded. He could understand that.
“So what happened?”
“I’m not sure. He had my arm and I think I tried to pull free. Then I lost my balance and grabbed for him, but it was too late.” She put her hands on her cheeks and closed her eyes.
“He had that virus in his pocket when he proposed to me.”
Jim felt his heart constrict. “Ginny?”
She was crying again and brought her hands up to cover her face.
“Ginny! Please, please don’t cry.”
“I’m sorry. Dear God, I’m so sorry!”
Jim grabbed one of his hands in the other and held on tightly. If she kept this up, he was going to have to leave. To stand here and watch her weep wa
s more than he could bear.
She suddenly pulled her hands away from her face, her eyes blazing. “And God damn you, Jim Mackenzie!” She looked at him in fury.
“What?” Jim was so startled he took a step back.
“You promised me you’d duck!”
It took Jim a minute to remember the dueling pistols. When he did, he started laughing. Just a little at first, then harder, then hard enough to force him to sit down, tears rolling down his face and a stitch in his side. When he could see again, he looked over and found her smiling, crookedly, but still smiling.
He swallowed his heart, then took a deep breath and smiled back.
“It’s going to be all right, Ginny. Wait and see.”
* * *
Chapter 47
Saturday / Sunday
At change of shift, Jim found himself hustled back to his own room and tucked in for the night. He ached from the tension of the afternoon and his arms hurt where they had given him the rabies shots and he felt a little sick from the antivirals, but he wasn’t planning to sleep. It might be his last night on earth and he didn’t want to miss any of it. He tucked his hands behind his head and stared at the ceiling.
Jim hadn’t really thought about their third patient, yet. He did so now.
Hal Williams was also in the Neuro ICU, also on injections and antivirals. But, unlike Jim, Hal had symptoms.
Dr. Armstrong had come quietly into Jim’s room and sat down and reported to him. The virus wasn’t moving as fast as it had with Professor Craig. The medications were helping, but the damage was being done. Neural cells were dying and there didn’t seem to be any way to stop the process, just delay it.
Dr. Armstrong had risen and stretched. He was going home to get a few hours of sleep, but would be back to check on Jim before the night was over. Jim should sleep, let his body concentrate on fighting the invader. Jim had nodded.
He found himself considering the situation in a purely clinical light, with no emotional component. They were not dealing with pure rabies. This virus didn’t exist in nature. Nor did it behave like rabies. For one thing, it targeted the peripheral nerves first, rather than going straight for the brain. It also seemed to be exclusively paralytic; no foaming at the mouth with this one, and it was much, much faster than normal rabies.
There were no studies, no drug trials, no literature he could rely on. It was all guesswork. The drugs recommended by the CDC were slowing the virus down. That had implications for other drugs or a new combination of drugs. He went through his arsenal in his head.
There were some similarities between HIV and rabies. Both were neurophilic, both encapsulated, both RNA viruses, and both took advantage of the ability to hide inside a nerve to escape the human immune system.
But there was no way to know if the HIV medications would work. They had been developed for specific proteins on the immune system cells, not the peripheral nerve cells targeted by this virus, and all of those drugs came with serious side effects.
With Hal, it might be worth it; allowing the HIV drugs to destroy some tissues in exchange for halting the spread of the virus and preserving the remaining neurons. For Jim, that was an unacceptable risk.
Hal would have to be offered the choice, though. Jim had the authority to change Hal’s medications, but had let everything he suggested be funneled through Dr. Armstrong, to make sure there was no conflict of interest. He glanced at the clock. Two a.m. How long did they have, realistically, before there were too few neurons left for it to matter?
Jim climbed out of bed and pulled on the extra shoes he kept in his locker in the E.R., then grabbed his lab coat, opened the door, and came face to face with one of the ICU nurses.
“Dr. Mackenzie. I was just coming to get you. It’s Mr. Williams. He is asking for you.”
Jim nodded. “I’ll come.”
The two of them made their way back to the Neuro ICU, Jim wondering what he would find when he got there. He went first to Ginny’s room and assured himself she was asleep, then walked down to the other end of the unit and looked in at Hal’s door.
The room was full of people.
Hal sat in the bed, leaning over the rolling table, a stack of papers in front of him. He seemed to be trying to sign something. Jim watched him struggle with the pen, taking note of the hand position and use of shoulder muscles to move the pen across the paper. From the looks of it, even if they were able to halt the advance of the virus, Hal could end up a quadriplegic. He glanced up and saw Jim.
“Please come in.” He waved at his entourage. “Accountant, lawyer, boss.” Jim noticed there also seemed to be a man of the cloth sitting on the window ledge, waiting. “Detective Tran has come and gone. I’m working on my Last Will and Testament.”
The man designated as boss interrupted. “Was there anything else?”
Hal shook his head. “I can’t think of anything. You have the keys?”
“Yes.”
“Then I turn it over to you. You’ll hear from the lawyers about the disposition of the company.”
“Hal—”
Hal raised a hand to stop him. “Tell your wife goodbye for me.”
The other man nodded wordlessly, then turned and left.
Jim had to step aside to let him through the door. When he looked back, he found Hal’s eyes on him. They looked at one another in silence, neither cordial, neither exactly hostile. Perhaps they were both remembering better times.
Jim spoke first. “I have a proposition for you.” He explained about the additional antivirals. Hal nodded.
“Whatever you think is best.”
“You trust me?”
Hal looked straight at him. “I have always known you were a good physician.”
Jim nodded. “I’ll make the changes.” He turned to go.
“Jim.”
He turned back to find Hal still looking at him, his face troubled.
“I have something I want to do and I need your help.”
“Oh?”
“It’s about Ginny.”
“Oh.” Jim crossed his arms on his chest, waiting.
“I have something of hers and I need to give it to her, but I don’t think she’ll take it from me.”
“Well, that’s her choice, isn’t it?” Jim hadn’t meant his voice to sound so cold.
Hal nodded. “Except it’s not from me. It’s from my mother.”
Jim waited for him to continue.
“Before she died, she set up a trust fund for Ginny. It was intended as a wedding present.” He shrugged apologetically. “Mother always wanted me to marry her.”
Jim said nothing.
“I want to transfer the funds to her directly, for her to use in any way she chooses. Mother would approve, given the circumstances.” He sighed. “She liked Ginny very much.”
“Where do I fit in?” Jim asked.
“It needs a trustee. My name has been on it, but that has to change.”
“Why me? Why not one of these gentlemen?” Jim indicated the accountant and lawyer.
“Because she’ll just say no to them. That is one stubborn woman.” The corner of his mouth twitched.
Jim sighed. That much, at least, was truth.
“I want you to retain control until you can persuade her to accept the gift my mother intended her to have. None of it is my money, never was. It’s always been hers.” Jim saw the accountant nod in corroboration. “Will you do that?”
Jim found himself thinking he wouldn’t want anything that had ever belonged to the Williams family, but Ginny might feel differently.
“I’ll need to think about it.” He turned on his heel and made his way to the nurse’s station.
He pulled up Hal’s chart and got busy writing the new orders, then picked up the phone and called the pharmacy, giving them detailed instructions. When he hung up the phone, he turned to find the chaplain seated nearby. The man introduced himself.
“I’m Joseph Wallace, Pastoral Care.”
Jim ey
ed him. “I didn’t know Hal cared about that sort of thing.”
“I don’t know that he does, but I do. What about you?” The other man had an unexpected mildness about him that made the question seem reasonable.
“I’ve been known to attend church services on occasion.”
The chaplain nodded. “I take it Mr. Williams has treated you and the young lady very badly.”
Jim shrugged. “He was jealous of me, but he rigged a trap for her, to stop her from finding out the truth about him.”
The other man frowned. “That complicates matters.” He looked at Jim, studying him. “Are you going to do as he asks? Protect the young woman from acting too rashly?”
Jim sighed. “I suppose so. She can always get rid of it later.”
Chaplain Wallace nodded. “Will he live?”
“Probably not.”
“But you are trying.”
“Yes.” Jim met the man’s eyes. “Hal Williams is not the only person who might benefit from our efforts. We will do our best to save him, because, even if we can’t, we may learn something that will help us save someone else.” He shrugged. “It’s what doctors do.”
The other man nodded, a ghost of a smile playing at the edge of his mouth. “And I am going to do what chaplains do. If I talk, will you listen?”
Jim frowned, unsure what he was getting himself into. “What is it you want to say?”
“You already know that God sees all that you do, all that you think, all that your heart contemplates. There are no secrets from him.”
Jim nodded.
“The same is true for Hal Williams. It would be good for everyone involved if Mr. Williams was allowed to say he’s sorry.”
“Is he?”
“You were at school together. What do you think?”
“I think he’s sorry he got caught.”
The chaplain laughed. “They all are. But I’m not thinking about him. I’m thinking about you, and the young lady.”
Jim frowned, thinking about the injuries Hal had done to him, to Ginny, to those innocent genealogists and their families.
“Has he told you why he did it?” Jim asked.
“No. You?”
“No.” Jim studied the other man for a moment. “I don’t understand why you aren’t concerned for his immortal soul.”
The Arms of Death Page 30
