Silent Fear, a Medical Mystery

by Barbara Ebel

  As she applied a rosy-colored gloss to her lips in the bathroom, the sunshine danced along the sink top, broken by the fluttering leaves outside. She slid a belt through light gray capris and after deliberation, opened the top button of her white sporty blouse. School would start next Monday and she was headed in this Wednesday morning to sign a document needed for health care insurance and put the finishing touches on her classroom.

  Sara stopped in the kitchen and gathered her things.

  “Where ‘ya going, Mom?” Annabel asked.

  “To our school to do last minute work before the big day. I hope you two are ready, I haven’t been quizzing you over your preparations.”

  “That’s because we’re not kids anymore,” Annabel said.

  Nancy turned around from buttering toast. “I’m not a child, but that doesn’t apply to you.”

  Annabel gave her a piercing stare without her mother’s knowledge. “Bye, Mom, we’ll see you later.”

  “You girls are on your own for dinner. I’m meeting your Father.”

  Annabel kept a smile from creeping over her braces. “How come?”

  “Just to discuss things.” Both girls stood shoulder to shoulder staring at her. “And simply to eat dinner,” she added.

  “Where?” Annabel asked.

  “Downtown Italy.”

  “Sounds interesting,” Annabel said.

  “Interesting enough for you to bring us home some Italian pastries,” Nancy said.

  ----------

  Fond memories stirred for Sara as she walked under the front entrance canopy of the two-story brick building and made her way inside. She’d had enough big changes in her life the last two years, so she counted her blessings that she would again work in familiar surroundings. She made a right turn into the front office. “Good morning, Mary Ann,” she said to the first woman at a desk. “Who should I see about my health insurance form?”

  Mary Ann fumbled through papers in front of her. “You know, Mrs. Tilson, I think Mr. Robinson has it.” She checked the light on his phone extension. “He’s free, you can go back there.”

  Sara passed the two desks and rapped on the principal’s door. She saw him wave to come in through the open-blinded window. Ross Robinson stood, walked around his desk, and extended his hand. “A formal on-board greeting to our new teacher,” he said, giving her a warm handshake. Her impression after meeting him the first time had stuck – he seemed the rugged, outdoorsy type - like his office only substituted for a campground.

  Ross pointed to the leather chair in front of his desk. As she sat, Sara noticed the pictures on the back wall of an American eagle and a black bear, prints similar to National Geographic pictures. He massaged his sparse beard and mustache and also sat, narrowing his eyes to take a better look at her.

  “Thank you, Mr. Robinson, I’m on the way to my classroom and Mary Ann said you have my insurance form for signature.” Suddenly she realized it strange that he had that paperwork. She could swear she blushed. He was good-looking and seemed pleasant enough. His pitch black hair twisted in curls like rope and he had pencil thin eyebrows. He wasn’t skinny, but wiry, like a thin yoga master.

  “Ahh, yes, it’s here somewhere.” His eyes darted downward but he leaned back in his chair. “I don’t know if I mentioned it. I’ve been the principal here for five years. I contacted the former principal, Mr. Baldwin, for a recommendation and he had only good things to say about you.”

  Sara crossed her legs and raised her hand in acknowledgement. “His tenure was much appreciated by everyone here. How is he doing?”

  “Bored from retirement, so he wishes he hadn’t left. I guess you missed it being away, too.”

  “Circumstances change. I think I’m going to love it, especially if I get a group of great kids.” A pause settled, allowing Sara to wonder about him searching for the form.

  “Sara, I thought about letting you get settled into the job, but upon reconsideration, I would like to ask you out now. A casual date. In other words, I’d like to ask you out the first time while you’re not a school employee. I’d feel more comfortable this way.”

  He smiled tentatively at her. “I’ve probably said too much already. However, just in case you aren’t aware of it, I’m a widower, not a married man hitting on you.”

  Sara’s hand encircled the end of the arm rest. The surprise request and flattery registered with her pulse picking up all the way to her fingertips. “Oh, I’m so sorry. May I ask what happened to your wife?”

  “She died from malignant melanoma.”

  Sara bowed her head for a moment. “Okay,” she said. “A casual date would be nice.”

  Ross shook his head as his eyes twinkled. He picked up the form smack in front of him and handed it to her across his desk.

  ----------

  After the reporters and news camera people left the auditorium, the docs peeled out. Danny got in his Lexus and drove to the office a few minutes away. The schedule would be jammed, and they had to finish by 5 p.m. in order to make Harold’s family memorial in time.

  Danny put his cell phone and brief case in his office as Cheryl tagged after him. “I’ve got two patients in rooms waiting on you,” she said, “and Bruce wants a quick word after he finishes dictating for a patient’s chart.”

  As Danny slipped into his white coat he entered Bruce’s office. Bruce looked over his bifocals while finishing his microphone entry and handed Danny a file folder. The inside didn’t hold a patient’s history, but a resume on a Dr. Jeffrey Foord. Danny scanned the C.V. – a Knoxville trained doc who just finished his residency.

  Bruce stopped, pushed back, and draped one long leg over the other. “What do you think?” he asked.

  “Most programs finish this time of year and residents have jobs lined up. This would be too good to be true and timely. But why didn’t he have a job already?”

  “He had a position in Indiana all ready to go, but there was a snag and that state license didn’t come through in time. They gave his spot away to someone else. He’s coming in shortly for me, or us, to interview him.”

  Danny nodded and smiled as he put the folder back on Bruce’s desk. “He’ll be green around the gills getting out in the real world but there are advantages. He may be someone who stays with us a long time, he’s younger with perhaps new ideas and concepts, and the timing is perfect.”

  “My sentiments exactly. So, how did the press interview go?”

  Danny gave Bruce the highlights as well as an update. Bruce opened his top drawer and took out his notepad. He wrote under his previous notes, putting the day and date, number of cases and where, and the new antibiotic. “This is just so I keep abreast of the current facts, not what I hear from the rumor mill. Speaking of which, patients are asking intelligent questions and I’m hearing concern about being seen in this office.” Bruce’s voice turned somber, but he shot the next statement to Danny in one breath. “So try to assure patients today we’re not spreading infectious diseases.”

  “I’ll do my best.”

  Bruce pushed his glasses back up the bridge of his nose. “Actually, I’m worried about you. Based on what you say, this is deadly and won’t go away with an aspirin. One person can do major damage to others. Are you harboring even a trace of a symptom that tells me you shouldn’t be here?”

  Danny leaned forward, running his hand over his temple. “Not even an infinitesimal grain. I feel fine, maybe more healthy these days than usual.”

  “But you were proactively treating the pod of people catching it from each other.”

  Danny had nothing more to add as they both rose with quizzical expressions and went to see patients.

  ----------

  After Danny saw two patients for follow up visits post cancer surgery, he stepped into an examining room for a young man who’d been in the ICU two weeks after a motorcycle accident. His mother sat across from the twenty-year old. She still wore a grateful look that her son
had escaped near death.

  “It pleases me to see you both under different circumstances,” Danny said, “and I’m happy to report your last MRI is totally normal.”

  “Thanks, Dr. Tilson,” the man replied, holding his cell phone on his lap.

  “It’s not my business to police patients in their private lives,” Danny said, “but please reconsider wearing a helmet if you get back on a motorcycle.”

  The boy’s mother nodded. “He’s lucky to be alive,” she interjected. “That’s what I told him from the beginning.”

  The boy twisted his mouth. “Dr. Tilson, I don’t want to go through this again. You’ve got a deal.”

  Danny shook his hand as Cheryl rapped on the door and stuck her head in. “Dr. Tilson, in case I miss you between patients, please see Bruce again in his office.”

  After completing the patient’s visit, Danny returned to Bruce’s office to find Jeffrey Foord, a short man alongside Bruce at his window. Bruce pointed to the various medical buildings nearby. When he turned, Danny noted him to be a baby-faced thirty-one year old with dark red hair, fluffy around the ears and neck, with a few matching freckles.

  Bruce introduced them and invited them to sit down at the round mahogany table. Danny enjoyed seeing the originality of his one small ear ring, unusual for a neurosurgeon, but the sneakers along with a coat and tie for an interview took him by surprise. He wondered how Bruce would interpret it.

  “Matthew Jacob is another member of our group,” Bruce said, “We need to get back to four of us instead of three. I contacted your program in Knoxville and they gave you flying colors. Why do you think we should hire you?”

  Jeffrey had already posed his right elbow in the palm of his left hand and had his fist by his chin, like a sturdy listener. “We’re both in the market for what the other has to offer. I work well with colleagues and yet I’m independent with my own cases. I’m born and bred in Tennessee and will slip right in. The only reason I was leaving the state was because nothing turned up here.”

  “You have any areas of interest?” Danny asked.

  “Yes, awake craniotomies and electrophysiologic monitoring.”

  “I’ve done a few myself,” Danny said.

  After ten minutes, Bruce cut the interview short. “We’re on a short time frame,” he said, “and there’s a remembrance at six o’clock for our colleague who passed away. I’ll give you a call by tomorrow night.”

  Jeffrey got up on cue and shook their hands. “I’m sorry to hear about your other partner. It’s all over the news in Knoxville. We also just confirmed two cases in our teaching hospital today after talking with someone at the CDC in Atlanta yesterday. Apparently the other case in Tennessee outside here is in Chattanooga?”

  “That’s correct,” Danny said. “How sick are the patients in Knoxville?”

  “Practically went straight into comas on admission.”

  ----------

  The office closed promptly at five and Danny headed straight home. Casey pulled his Jeep into the driveway ahead of him but drove into the garage. Danny parked in the driveway.

  “You must have been seven to three today,” Danny said, “but I never saw your ambulance as I went back and forth to the hospital.”

  Casey walked toward him with his gym bag. “Mark and I only made one run there at the end of the shift, an elderly lady with a broken hip. And I avoided getting up close and personal with not one, but three ER admissions they just received - hospital staff with probable meningoencephalitis.”

  “Damn,” Danny said, leaning against his car. Anger welled up … how he hated this spreading disease. What else could he do? The situation seemed hopeless. Even the CDC was stumped. Casey stared at him. “We have to get three doses of the new antibiotic into the current diagnosed patients before they can possibly turn around.”

  Casey grabbed Danny’s upper arm and tugged. “Come on, let’s go in. Dakota’s barking at the door.”

  “Joelle Lewis said it’s got an acronym called PAM,” Danny said. “And by the way, I swear you’re getting more ripped.”

  “I only just did an hour, but yeah, I’ve slimmed and am muscling up for the wedding.”

  Danny grinned as they opened the house door. Dakota’s tail waved feverously as he pushed his back end into them, blocking their entrance. Casey dropped his black bag and hoisted the dog into his arms. “How’s this for a view, Dakota? See, you’re not the strongest body in here.” Casey took several steps and then placed him on the floor by the French doors. Dakota put his rump up in a play bow, taunting Casey to try it again.

  Danny savored the show.

  “Leave the milk out,” Casey said as Danny poured a glass. He stepped away from Dakota, pulled out a big container from the closet, and poured powder and milk into a blender. He turned on the machine, poured the contents into a large glass, and downed the protein drink while Danny still had milk to finish.

  “Isn’t tonight the night Howard’s family has an open house?” Casey asked.

  Danny crouched down face to face with Dakota and with both hands massaged the dog’s neck. “Yes, I’ve come home to change my shirt and spruce up. I’m taking Sara out, but I never called to tell her we’re stopping there first.”

  “Really?” Casey said surprised. He put the glass in the sink and smiled. “Tell her hi and have a great time, which should be a no brainer unless you screw it up.” Before he gave Danny a chance to respond, he ran up the stairs to see Mary.

  ----------

  Hushed conversations lingered inside the Jackowitz’s home. Most of the staff from The Neurosurgery Group of Middle Tennessee made an entrance, giving condolences to close family members and sharing office stories about Harold. Although no one mentioned it, Harold’s remains sat on the fireplace in a keepsake urn surrounded by flowers and sympathy cards. His emotionally wrought mother sat very close in an armchair as if she couldn’t put distance between her and her son.

  After making appropriate rounds, Danny went to Harold’s mother and crouched beside her. “Mrs. Jackowitz, it grieves me every day what happened to Harold. We didn’t see this deadly epidemic coming. I am so sorry.” Her hand rested on the arm rest and Danny clutched over it and squeezed.

  “My son was happy working with all of you. I know you helped take care of him in the end. Thank you.”

  “You have every reason to be proud of him.”

  Sara stood alongside him, grim and weary over the young physician’s demise. There’s nothing worse than a child’s death, she knew. She gave Mrs. Jackowitz a slight hug after Danny got up.

  All of Danny’s co-workers knew Sara. He introduced her to other family members and his friends by simply giving her name and not mentioning her as his ex-wife.

  After fifteen minutes, Danny, Matthew, and Bruce stood in a partial circle near the dining room buffet.

  “Matthew, you didn’t meet him,” Bruce said, “but Danny and I interviewed Jeffrey Foord today. He’s straight out of residency and looking for a neurosurgery position.” Bruce turned to Danny. “What do you think?”

  Danny cracked a smile. “He’s a bit unique for the specialty.”

  “But … that doesn’t matter, does it?”

  “No, not in the least, although he may spice things up a bit.”

  “Hire him?”

  “Hire him.”

  A hand tapped Danny from the side. In a low voice to the three of them, Cheryl said, “This morning’s news conference is on. In there.” She pointed toward the den.

  Danny nodded to Sara to follow as they moved to the next room. A TV sat in a shelf opening, broadcasting the nightly news. A middle aged reporter with an English accent spoke from the street in front of the hospital entrance. “The death count and reported new cases in the unusual meningitis outbreak continues to climb. This epidemic claimed one more life here a short time ago, there are three more cases suspected, and two more confirmed in Knoxville. We go now to the medical news confe
rence highlights, which took place here this morning.”

  The major network aired the meeting while their names appeared at the bottom of the screen. Sara wringed her hands as she found it difficult to take the next breath. What Dr. Lewis seemed to be saying was that the prognosis for patients and their recovery looked dim if the present course of antibiotics failed. The coverage ended with the last statement from the CDC.

  “I assure you,” Dr. Halbrow said, “Dr. Tilson and Dr. Lewis are two of the sharpest knives in the drawer.”

  Chapter 14

  Sitting at a window table in Downtown Italy, Danny broke apart garlic bread and handed Sara the other half. He took a bite and raised his wine glass for a toast. “To a nice dinner together,” he said as he clinked her glass. “I hope you didn’t feel uncomfortable earlier at the Jackowitz’s. Going there wasn’t something I planned on when I asked you out.”

  “I understand. The circumstances are extraordinary. Do you know who died this afternoon?”

  “No, I’ll find out tomorrow. It’s too grim to speculate. Perhaps we can talk about the girls and the upcoming wedding, about nice weather and fishing, and even about us.”

  Sara hid behind her wine glass, then put it down and brushed her hair behind her ear. Her eyes went to the table, but not for long as she leaned in and spoke softly. “Danny, life comes without guarantees. Things don’t always work the way we plan them. I realized that when Melissa died.” On the brink of crying, she buried her forehead under her hand.

  Danny ran his fingertips in the soft hair near her temple. He savored the special moment looking at her and smelling her orange-ginger aroma. The ivory flowered necklace draping her neck - he remembered they’d bought it on a trip - and the peach cotton pullover with a V-neck she wore adorned her complexion. A few intimate seconds seemed like an hour.