by Ross Pennie
“Not as far as I can tell. The toxicology results only came in this week.”
“Yeah,” said Zol, “the provincial lab always runs a backlog, sometimes several months. Autopsy specimens aren’t exactly their priority.” The belated results probably held the key to Joanna Vanderven’s death: the alcohol she ingested could have acted in combination with the three powerful drugs to tip her into respiratory arrest — a final sigh through blue lips, the heartbeat ceasing a few minutes later. The autopsy could have missed that scenario.
“Anyway,” Hamish continued, “no embarrassing questions were asked. The coroner agreed with the duty pathologist’s arrhythmia diagnosis and signed the death certificate. Case closed.”
“Until a few months later, Julian Banbury discovers that her brain is riddled with variant CJD.”
“Not exactly riddled,” said Hamish. “Not enough to kill her, but you’ve got the picture.”
Zol checked the dining-room door for little ears listening on the other side of the glass. Max and Ermalinda were sharing a giggle at the kitchen table, their world still untouched by CJD. “A trophy wife in the early stages of CJD starts acting weird, becomes forgetful and moody. She’s no longer the glamorous asset her billionaire husband had invested in.” The Vandervens had been headlined frequently in the society columns, and it was no secret that Joanna was his much younger third or fourth wife. Zol gazed into the unseen distance and lowered his voice. “Maybe she was overdosed — on purpose.”
CHAPTER 2
About seven that evening, at the sound of the knocker, Max raced to the front door. Zol felt the blast of cold air that followed Hamish in. There was more than icy wind in the scowl that gripped the man’s face. Zol had shared that dread all day, and boning up on CJD hadn’t made him feel any better.
Hamish swept the snow off his flat-top and stamped the slush from his shoes. “Hell’s bells, I wish they’d do a proper job of plowing the streets. It’s costing me a fortune at the car wash to keep the Saab halfway clean.” He set his shoes against the wall beside his briefcase — everything in line, perfectly straight. It occurred to Zol that his friend’s straightness went no farther than his shoes.
Hamish followed Max and Zol into the kitchen and set a shopping bag on the counter. “I just had time to grab one of each,” he said, his face still pinched. “Are they okay?”
“Not too shabby,” said Zol, scanning the labels of the wine bottles. The white was a nasty plonk, but the red was fine — a decent Aussie shiraz. He grabbed the corkscrew and steadied the shiraz. Then he paused. Red wine with chicken? Hell, this was no day for fretting over the niceties of food and wine pairings. “This red will go great with the hens.” He turned to Hamish. “The glasses are in that cupboard behind you. Get out three of them, will you?”
A quizzical frown flashed across Hamish’s brow.
“Max likes his apple juice in a wineglass,” Zol explained, “particularly when we have company.”
Hamish turned to the sink. He pumped a measure of liquid soap into his palm, lathered his hands, and rinsed them under the tap. He turned the faucet off with his elbow and dried his hands. Only then did he open the cupboard and lift out the glasses.
After they’d made quick work of the Cornish hens, Zol dispatched Max to the TV room with a large bowl of chocolate ice cream. And while Hamish went to retrieve his briefcase from the front hall, Zol poured two measures of Glenfarclas. The shiraz had loosened neither Hamish’s collar nor his tongue over dinner. Maybe a Scotch would help.
Hamish returned and placed three dossiers on the table. “Well, here they are,” he said. “Our cases.” He was smiling for the first time since he’d arrived.
Zol handed him a glass of the Glenfarclas and lifted his own. “Cheers,” he said. “And here’s to a speedy investigation.”
Hamish, still smiling, saluted with his glass. “Yes — to an efficient investigation.” He squinted at the amber whisky, then set his glass on the table without taking a sip. The smile left his face as suddenly as it had appeared. “Let me ask you, Zol. Is it ghoulish to love doing this outbreak stuff ?”
“There’s nothing wrong with feeling a passion for our work.”
“Well . . . there’s not much else in my life.”
Zol looked away, toward the TV room door, and felt a little guilty at being blessed. He had Max to put the punch in his job, transform the work of public-health medicine into a vital calling where every aspect mattered more with each passing year. Yet he shared with Hamish that lonely kinship, the yearning of the single man. He downed another mouthful of Scotch and pointed to the neat stacks of paper tethered with long staples. “Hey! I thought you weren’t allowed to take charts out of the hospital.”
Hamish’s cheeks flared. “I’ll be sure to return them tomorrow before anyone notices.” He picked up a chart and ran his finger along the top of the front page. “Joanna Vanderven, age forty-three. We already talked about her — apparent cardiac death on June twenty-second. Positive toxicology for drugs and alcohol.” He pointed to the next chart. “Danesh Patel, age forty-nine. Immigrant from India. Hit by a car while crossing Upper James in front of Platinum Honda — he was a salesman there. Killed instantly. That was June twenty-eighth.”
“I think I remember that from the news,” Zol said. “Wasn’t it a hit and run? Did they ever find the guy?”
“I don’t know. No details of the accident made it into the chart. All we’ve got is the death certificate and the report of the preliminary autopsy, performed before Julian Banbury came back from his sabbatical.” Hamish opened the chart and read from the pathologist’s post-mortem summary: “Multiple contusions, lacerated liver, ruptured abdominal aorta, intracerebral hemorrhage.”
Zol pictured Patel’s brain in his mind’s eye: the large hemorrhage like a blood-red egg, produced by the blow from the fast-moving car; such bleeding, obvious even to the naked eye, had been documented long before Banbury examined paper-thin slices of the brain under his microscope.
Hamish took a mouthful of Scotch and was struck by a string of explosive coughs. He dropped the chart and spluttered into his fist. “Sorry — I’m not — used to — this stuff.”
“Here,” said Zol, lifting a jug. “I’ll add a little water. Easier on the throat.”
Hamish wiped his eyes and lips with a tissue, then pointed to the name on the third chart. “Hugh McEwen, age thirty-six. A dentist. We did our degrees in biochem together at U of T. Nice guy, but we lost touch.” Hamish paused and dipped his head. “Committed suicide. In his office. Saturday, September fifteenth. Pronounced dead at the scene by the coroner.” Hamish swallowed hard, then lifted the chart and riffled its pages. “There’s not much here. A brief hospital admission two years ago for an appendectomy, a trip to Emerg with a sprained knee last year, and the preliminary autopsy report — again, minus the latest brain findings.”
“Not much to go on, eh?” Zol said. “The three of them died fairly close together — June twenty-second, June twenty-eighth, and September fifteenth.”
“But did they get infected at the same time?” asked Hamish. “And when did they start showing the first signs of their disease?”
“It all hangs on how long ago they ate the tainted beef. And where. Our best hope is that they’ve all got ties to Britain and dined on mad cows in England.”
“Good point — the English connection. That would be the perfect solution.”
“But only if it were true,” Zol said. “And we’d have to prove it beyond a reasonable doubt.”
Hamish lifted his well-diluted Scotch, pursed his lips, and sipped carefully. “You make it sound like a court case.”
“It’s the court of public opinion,” Zol said. “As soon as the news of these cases gets out, the press will be watching every move we make.” With his emotions lubricated by the wine and the Scotch, anger rose into his throat. “And they’ll fall all over themselves trying to run ten steps ahead of us.” He thumped his fist on the table. “The stup
ider we look, the bigger the headlines.”
Zol’s heartbeat quickened as he pictured Health Canada, the Ontario government, the Canadian Food Inspection Agency, and the Canadian Cattlemen’s Association all thrown into a maelstrom of panic. Pandemonium far worse than a few soon-forgotten headlines. The Americans, the Europeans, the Japanese shutting their borders to almost everything edible produced in Canada. And years of negotiations to reopen them. He wiped his palms on his trousers and took up his pen. “Let’s make a list of questions we need to answer.”
“For a start,” said Hamish, “did all three actually eat beef?”
“And did they live in the United Kingdom during the mad cow epidemic?”
“That’s the key point.”
“And our best hope for a quick solution that’s politically painless,” said Zol.
“The victims might have travelled to other countries,” Hamish suggested. “Patel was from India. Does that ring any bells?”
“Not that I know of. Lots of malaria and tuberculosis, and more HIV than they’ll admit.”
“You’re right, this isn’t tropical.”
“Focusing locally,” Zol continued, “we need to know where they bought their groceries.”
“And did they ever go to butcher shops?” said Hamish.
“Probably not,” Zol replied. “Most people don’t these days.”
Hamish leaned on the table and scanned the growing list. “We’ll want to know which restaurants they ate at.” He rubbed at an apparent stiffness at the back of his neck. “And we can’t forget the iatrogenic causes of CJD.”
“Good point,” said Zol. The alcohol, though great for loosening the mind and promoting creative connections, had begun to take the edge off his memory. “Let’s see. . . .” He paused, his hand hovering above his notepad. “There’ve been concerns about transmission as a result of neurosurgery performed with contaminated instruments. And reports of cases acquired through corneal transplantation. And from injections of growth hormone extracted from pituitary glands. But recipients of corneas and growth hormone harvested from infected donors developed regular CJD, not the variant type, didn’t they? What a tragedy — regain your sight or grow a few extra inches, then die prematurely because your brain is riddled with infectious prions.”
As Zol continued writing, Hamish tipped back another mouthful of Scotch and dabbed his lips with his serviette. “We’ll need to ask about any recent deaths among family members.”
Zol looked up from his list and held Hamish’s gaze. “What are you suggesting?”
“Maybe there’ve been more of these cases than anyone realizes.”
“What do you mean?” Zol said, his mind jolted to sharpness.
“Families eat together — they get exposed to BSE prions together. None of these three had obvious CJD when they died.”
“And if Vanderven, Patel, and McEwen hadn’t had autopsies, we’d never have found out about their variant CJD, which means . . .”
“There might have been others infected among their families,” said Hamish, raising his index finger. “And their friends and neighbours.”
Zol poured himself another Scotch and let a mouthful warm the back of his throat. The workload of hunting down more cases, the ramifications of finding them, were almost too much to contemplate. “You realize,” he said to Hamish, “we can’t openly investigate these deaths by asking questions about variant CJD.”
“And why not?”
“As soon as there’s a hint of Julian Banbury’s revelation, the press will get wind of our investigation and they’ll throw the entire country into a panic. I can see it now — economic chaos.” But what excuse could they give the grieving families for asking so many penetrating questions about their lives and their habits? “How about this?” he suggested. “We’ll tell them that their loved ones showed features of an encephalitis. We’ll explain that the health unit is conducting a routine set of interviews, just like we do for other infections like food poisoning, diarrhea, and meningitis.”
“It might buy us a little time,” Hamish said, his tone hesitant. After a moment his face brightened slightly. “I suppose we wouldn’t actually be lying. CJD is one of the transmissible spongiform encephalopathies. It can rightly be called a form of encephalitis.”
“We can even hope that people might jump to the conclusion that we’re investigating West Nile.”
In the summer and early fall the newspapers had been full of alarming stories about mosquitoes and West Nile virus encephalitis. The exaggerated headlines had been a headache at the health unit, but perhaps they could be used as a smokescreen.
Hamish pressed his hands together, as if in prayer. “But what if we’re asked point-blank what sort of encephalitis the victims had, and was it really West Nile virus?” His face looked grave as he shook his head. “We can’t lie.”
“At first, we might have to,” Zol said.
The colour drained from Hamish’s cheeks. “But we’re professionals. We can’t lie.” He scowled and pointed his finger at Zol’s chest. “And you’re — you’re a public figure. You can’t breach that trust.”
“Look, Hamish,” Zol replied, his tone flat and firm, “for a little while, we might have to play with the truth. For a greater good.”
“But . . .”
“We’ll say we’re not sure what we’re dealing with, that we’re still gathering our facts.”
“But we’re . . .”
“It’s true. We are still gathering our facts. Surely you can live with that?”
“Hell’s bells, Zol. I’m a diagnostician, not a detective. Supposed to be a disciple of Hippocrates, not Sherlock Holmes.”
“Come on — right now, I need you to be a bit of both. You have to admit there’s a tremendous amount at stake. And you did say you loved this outbreak stuff.”
“Well, yes.”
“And you’re the guy with the best brain for this job.”
Hamish flushed. “Stop buttering me up.” He picked up his Scotch, sighed, and returned it to the table. “Look — I’ll do my best. If anyone jumps to the wrong conclusions, thinks we’re investigating West Nile or something else, I won’t correct them. But you’ll have to do the lying and the politicking. I don’t have the stomach for the backroom intrigue you put up with at your health unit.”
“Okay then,” Zol said with relief. “We won’t actually lie. We’ll just keep the facts to ourselves until we’re set to divulge them.” He gripped Hamish’s arm. “And when we’re asking all our picky questions, we’ll use the ‘better safe than sorry’ line. At our office, we’re good at that.”
Zol found himself wondering, and not for the first time, how much time and money had been wasted over the years by that four-word catchphrase. How many unexpected consequences had it triggered? Antibiotics rendered useless after decades of frivolous prescriptions for minor colds. Classrooms demolished after the discovery of harmless mould inside their walls. Teddy bears banished from bedrooms after someone said they could make kids wheezy. But now they had hold of a real problem. And it felt great to grapple with it.
“What about Julian Banbury?” Zol said. “Can we get him to keep a lid on his findings until we’ve completed our investigation?”
“He might keep this quiet for a week, not much longer.”
“Can you . . .”
“Yes, I’ll talk to him.”
The phone started ringing. Zol looked at his watch: ten thirty. He knew who it must be. Call Display confirmed it: P. Trinnock.
“Hell,” said Zol. “I’m not talking to him tonight.”
CHAPTER 3
At seven thirty the next morning, Zol backed the minivan out of the driveway and headed along Scenic Drive toward the health unit, on the Escarpment at the western end of Concession Street. He’d walked to work a couple of times the previous summer, but forty minutes twice a day was time away from Max he wasn’t prepared to spare, no matter how good it might be for his heart. Maybe he should get a bike in the sp
ring. It would be a beautiful ride along Scenic Drive, through the grounds of the psychiatric hospital, then along the dizzying edge of the Niagara Escarpment, a corridor of limestone terraces and old-growth forest that snaked all the way from Niagara Falls to Georgian Bay. The United Nations had deemed the eight hundred kilometres of cliff face a World Biosphere Reserve; as a public-health official he felt vaguely guilty about soiling it with noxious fumes twice a day from the tailpipe of his minivan.
In the distance to his left, beyond the city’s gritty port, Lake Ontario’s western bow shimmered in the low-flying sun. The dazzle of the watery horizon always lifted his spirits no matter how daunting the current office crisis. Even the motley smokestacks, bristling and flaring from Hamilton’s lakeside steelworks, offered no more than a dubious threat to life up here on the Escarpment. Hamilton natives referred to this lofty part of the city as the Mountain, but in the seven years since Zol had moved here, he’d never been able to see anything remotely hilly about this dead-flat plateau.
He parked, then climbed the stairs to his fourth-floor office, taking the steps two at a time but pulling heavily on the banister. His breakfast coffee had yet to dissolve the stubborn grains of sleepiness that lingered in his head. Last night at lights out, a fringe festival of images had disturbed his sleep — drooling cows, disintegrating brains, jeering reporters. He awakened twice with a start, breathless, his heart pounding, his T-shirt soaked in sweat. As he strode past the dark reception desk and headed for his office, he felt the excitement of the impending investigation, then shuddered at the hornets’ nest he might soon be splitting open.
He logged on to his computer and answered the three emails that demanded immediate responses. Then he emailed Anne, the secretary he shared with his boss, and asked her to cancel all his meetings for today. He clicked Send, then scanned the potholed parking lot outside his window. No postcard view over the Escarpment for the associate MOH. Just cardboard cartons and paper coffee cups spilling from the dented garbage bins huddled at the edge of the tarmac. A red Honda was parked in the lot not far from his minivan. He dialled Natasha’s extension and got a busy signal. Good. She was at her desk.
