Isolation Ward

by Joshua Spanogle

  John Myers pivoted and made his way up the dirt slope. “I gotta breathe,” he said. I looked back to the body.

  A jagged cut ran in a large Y from each of Douglas’s shoulders to his sternum and down to his pubis. It was the same type of cut pathologists use when conducting autopsies. The left side of his rib cage was pulled back and lay over the lip of the body bag like an open door revealing his chest and abdominal cavities. The scene reminded me of the work of the great Renaissance anatomist Vesalius. Figures in his etchings were often placed in pastoral settings, reclining peacefully as they retracted their chest walls to give the viewer an eyeful of viscera. They were beautiful pieces, really. A world apart from what was below me now.

  And there was another difference between the anatomist’s drawing and Douglas Buchanan: Vesalius’s figures had their organs.

  Without disturbing the body, I could see that Douglas Buchanan’s heart and lungs were gone. He was also missing his pancreas, his liver and gallbladder, and his spleen. The neck was flayed and the thyroid removed. The Broken Man? O’Leary took too much literary license with his moniker. This body wasn’t broken, it was stripped.

  “You ever seen anything like this, Doc?” O’Leary asked.

  I ignored the comment. “Can I open the other side of the body?”

  “Sure.” O’Leary threw up his hands. “What the hell? You seem hell-bent on scaring everyone else away from the investigation. You the boss now.”

  “Cool it, O,” Myers said quietly.

  I climbed out of the crater, went to the coroner’s van, and got a paper gown and some goggles, two pairs of gloves to double-glove, then returned to Douglas Buchanan’s body. O’Leary and Myers weren’t talking. Nobody was talking, in fact, and the silence made the awful scene even more awful.

  Squatting at the edge of the body, I reached to Douglas’s right side and used my hand to retract his chest and abdominal walls. The ribs had already been broken from a previous, violent retraction, so the flap fell open easily. No kidneys, it looked like. The stomach was gone. So were sections of small bowel. There were, I noticed, no flies. Nothing could live here.

  I dropped the flaps of muscle, rib, and skin back into place.

  I noticed the penis and scrotum had been pulled up so they rested on top of the dead man’s closed thighs. The flesh of the scrotum had been sliced open and the testicles removed.

  “My God,” I said.

  The head. It rested on a small pillow of soil, so that Douglas seemed to be looking down the length of his body. The top of the skull had been sawed through, and it had shifted from the rest of the cranium. The brain was missing.

  I stood, climbed up the dirt slope, stripped off my gloves and mask, and breathed deeply. Bile rose in my throat, but I forced it down. I’d be goddamned if I was going to let these guys see me puke.

  I turned to O’Leary. “Is the medical examiner in Carroll going to handle this?”

  He looked at Detective Myers, then back to me. He sighed. “That’s the plan.”

  “All right,” I said, “I’m going to suggest that the body be moved to St. Raphael’s Hospital in Baltimore. That’s where we’ve quarantined the people who are sick already. Your forensics team can work there if they need to.”

  O’Leary looked at Myers, then back to me. He nodded.

  I asked, “Will there be any jurisdictional trouble?”

  “There won’t be. I’ll make the calls.”

  “John,” I asked Myers, “any problem on the part of Baltimore City?”

  “Shouldn’t be.”

  O’Leary spoke up. “It’s still our investigation, though—”

  “Of course,” I said.

  “—the body was found here. Looks like he was killed here, too.”

  “How do you know he was killed here?”

  “Not here here, here over there.” O’Leary pointed to another cordoned area, about ten yards away. “We found some disturbed leaves. We got a positive for blood.”

  “Blood?”

  “Just a trace.”

  “A trace . . .” I looked around. “How the hell did the farmer find this? I mean, I’m no expert on dogs, but . . . there was concrete all over it. And the body bag was filled with bleach.”

  O’Leary shrugged. “We got real lucky. The guy who found it has hounds, which was a break. We got a light trail of blood from over there to this. The dogs must have got the scent from the blood, then started digging at the grave site.” He looked around. “Yeah, we got real lucky. Another day or two, a good rain maybe, and even hounds wouldn’t find anything.”

  I followed O’Leary to the second cordoned spot. The tangle of police tape actually formed a lane, of sorts, between the two boxed areas. He said, “We have three sets of footprints headed toward this site, two headed from this site toward the grave, two headed away from the grave. All of it’s pretty incomplete, though.” He lifted up the police tape and stepped into an area where a man on his hands and knees was pawing through the downed foliage. “The best we figure it is that whoever did this cut your guy up here, then transported the body to the grave, which was already dug.”

  “Why do you say that?” I asked stupidly.

  “’Cause you don’t mutilate someone in a six-foot grave. Plus we got the blood traces. Maybe they punctured the body bag when they cut him.”

  I took a deep breath, finally felt my head begin to clear. “These people were thorough.”

  “Yeah.” He looked blankly at the crime scene tech moving through the leaves. “Goddamned lucky,” he repeated.

  CHAPTER 28

  Il Duce was not pleased.

  “Was I that vague?” Tim Lancaster asked. “Was I unclear when I said I wanted you to be working here, in this office? Was it that unclear that I wanted you on a short leash?”

  We were sitting in a conference room at the Department of Health, Herr Lancaster, Herb Verlach, and I. The doors were closed. I hoped they were thick.

  “It was clear,” I said. “But the service gives EIS officers the freedom to follow hunches and—”

  “But not for something like this. Not when we have the press crawling up our butts, lawyers rumbling about civil suits, assault charges against you—”

  “The charges were dropped—”

  “Quiet. And I specifically told you to stay put. I don’t have to tell you, Nate, that this kind of behavior could put you back in Atlanta, doing literature searches on every outbreak of flu for the past five hundred years.”

  Which was true and it wasn’t. EIS isn’t so well staffed that they could afford to relegate me to weeks of busywork. Besides, because my infraction had been relatively slight, Tim would have had to answer questions about my banishment. Notwithstanding the previous few days, my evaluations had been generally stellar. Add to that, despite what Dr. Lancaster said now, the guy liked me. Don’t ask me why.

  He said, “We can’t go gallivanting to murder scenes.”

  “It was a damn good thing I was gallivanting. They were mucking around with only gloves and masks.”

  “So you run in, screaming and yelling, telling them they’re going to die?”

  “I didn’t say they would die.”

  “That’s how they heard it.”

  “That’s not my responsibility.”

  “Don’t be obtuse. Of course it’s your responsibility.”

  Verlach chimed in. “My people are fielding calls from half the municipal staff in Carroll County. You scared them good, Nate.”

  Thanks, Herb. “I wanted to.”

  “Dr. McCormick,” Tim said, “most of your instincts are good. Most of them. But you are out of control here. Are you so fucking concerned—yes, fucking concerned—with solving this case that you don’t care what kind of problems you’re creating for the rest of us? For CDC? For the health departments here? For the goddamned city itself? Are you so damned blind that you can’t see the bigger picture? Come on.”

  My face flushed and I could feel the sweat pricking through
my scalp. Under the table, my hands were knotted together.

  “And this call from Douglas Buchanan’s phone. How long were you planning to keep that to yourself? I have to find out about that from Dr. Verlach, who finds out about it only because he happened to talk to the detective on the case?”

  Tim was up and about, pacing and scratching like a chimpanzee. Though I’d seen him annoyed, I’d never seen him this annoyed. “You piss off everyone you come in contact with. The state police up in Carroll said you marched in like a freaking general and screwed up their crime scene—”

  “They said they were finished—”

  “I don’t care. What they’re saying now is that you screwed things up royally. They’re saying you took the body from them and sent it to Baltimore. Think about that for a second, will you, Doctor? They’re not bitching about these things because what you did was wrong, they’re bitching because they don’t like you. Even your contact in the Baltimore PD is hightailing it from you. Because he knows he has to work with all his friends up north again.”

  Tim’s fingernails dug into his scalp. “And what are you doing spending so much time on one person?”

  “He’s the vector, Tim.” I was whining.

  “Is he, now?”

  “Look at the spot map. Look at the graph of contacts. He’s at the center—”

  “I can’t look at them because they’re not finished. And they’re not finished because you were running around with the cops.”

  Touché.

  Tim sighed. “Okay. Okay, let’s just assume he’s at the center of this. If that’s so, if he’s the first one, why wasn’t he sick?”

  “Different incubation times.”

  “Wrong. With a disease that seems to be moving this fast—infection to full-blown in two weeks—he is unlikely to be the vector.”

  “He could be resistant. He could just be a carrier.”

  “Unlikely, Nate. What’s the carrier rate in humans for hemorrhagic fever?”

  “Low.”

  “Right. We’re playing an odds game here. And we’re allocating resources. Hours spent on some detective chase is not the best use of your time, is it?”

  I didn’t answer.

  “Is it, Dr. McCormick?” His tone was scathing.

  “No. I guess it’s not.”

  “Learn how to sink time into things that are more likely to matter. Bethany Reginald, for example.” Now he spoke in an incredibly annoying kindergarten-teacher voice. He took a large piece of paper from the top of the table and held it out. “You see this?”

  I looked at the paper, boxes and lines of the contact chart. “Yes.”

  “What do you see?”

  “I thought you said this wasn’t finished.”

  “What do you see here, Doctor?”

  Tim was really being an asshole about this. “I see Bethany Reginald.”

  Indeed, Bethany Reginald—not Douglas Buchanan—seemed to be at the center of this particular graphic. He pulled out the spot map; the two places where Bethany spent most of her time—Open Arms and Miller Grove—had the highest concentration of sick people.

  “Now, Bethany is sick, right?” Tim continued. “There’s obviously something wrong in that young woman. If you had stayed around this morning, you would have found out that she did indeed have intercourse with a man called Roger Epstein, who had intercourse with Deborah Fillmore.”

  On the contact chart, Tim traced a circuitous line from Bethany Reginald to Deborah Fillmore, bypassing Douglas Buchanan and landing on Roger Epstein. Then his fingers went to his neck, raking away.

  “I got the division chief breathing down my neck on this. The director herself is asking questions. This is getting hot, Nathaniel. Really hot. Too hot to have this kind of recklessness. We are here at the invitation of the local authorities, and I’m worried we’re wearing out our welcome.”

  I looked at Verlach, whose eyes were glued to the Formica table. “Herb, am I screwing up that badly?”

  His eyes met mine and the fucking Army officer said, flatly and directly, “It’s a tough environment, Nate. It takes experience to learn how to deal with the politics of everyone involved.”

  “More people will get sick if I’m not in the field, Tim,” I insisted.

  “More people will get sick if you are, Nate.” He scratched at his neck. “That’s why I’m pulling you out. Completely.”

  Tim didn’t actually remove me completely. Instead, he decided to send me to California to follow up on the woman who’d received calls from Douglas Buchanan, since, as he put it, “you like this detective work so much.”

  I, of course, protested, both because I felt I was more needed in the East and because CDC already had EIS presence in Berkeley and a fresh EIS graduate, a woman named Brooke Michaels, in San Jose. I also protested because I thought—we all thought—the woman in San Jose was a dead end.

  After Tim left the room, Verlach and I had a quiet moment in which he couldn’t meet my eyes. I guess my former comrade-in-arms knew he was abandoning me to the political machine. Eventually, he moved toward the door and said simply, “Enjoy sunny California for me.”

  He didn’t know how impossible that would be.

  CHAPTER 29

  It took me less than an hour to pack up my things. I left a message for the landlord that I would be leaving early the next morning and that other people from CDC would be moving in. Two new EIS officers, Andy and Beth, had arrived that day and were camping out at a Holiday Inn or wherever CDC saw fit to put them. Anyway, their early arrival led me to believe that my transfer had been decided long before that afternoon’s meeting.

  While the sheets churned in the washing machine, I pulled out an old address book. I had all my relevant addresses in my PalmPilot, so why I kept this ratty thing—held together by two rubber bands—I didn’t know. Well, actually, I did know.

  I flipped to the Cs and there she was: Alaine Chen. About six numbers and half as many e-mail addresses scratched out and rewritten, although I don’t think I’d ever used half of the numbers or addresses. They were there just to keep track.

  The last number I had for her was in Northern California, for a Redwood City apartment. I was sure she’d moved, that her location, phone number, and e-mail had changed about five times since the last time I put in a change. She could be anywhere. On second thought: no, she was still in California. Born, raised, educated in the Golden State, there would be no reason for her to leave.

  “Alaine Chen,” I said aloud, and tried to summon up the mental image of her—the glossy black hair, the beautiful face, the legs that would launch a thousand ships. There was more pain than pleasure in that picture. I closed my little beaten leather address book and tossed it into the trash. Then I gathered all the other odds and ends of refuse from the apartment, threw it on top of the book, and carried the whole thing to the garbage chute.

  I folded the sheets and blankets onto the bed and generally readied my pied-à-terre for return to the landlord. Then, at four thirty that morning, I went for a long run. I did this—I ran—to clear my head and clear my body of the cigarettes I’d had in the past few days. I also ran to punish myself. That morning, I had a lot to punish myself for, so by the end of my five-mile loop, I was heaving bile into the gutter outside my apartment. But I finished in record time.

  Anyway, I figured I was done with the cigarettes. I’d let that be a hallmark of my time in Baltimore. Dirty habit for a dirty city, and I was on my way out of both of them. My career had taken a good punch in this city, and its sights and sounds—the very things that I used to enjoy—were beginning to annoy me. It was good I was getting out, I guessed.

  But maybe that was rationalization. I spit a last gob onto the sidewalk and went into the apartment.

  At six, I was showered and ready to go, leaving an apologetic note about the dirty towels. At six thirty, I was at the Health Department. This would be my final briefing of the team about the situation in Baltimore, the final transfer of information
. My flight was early, so I hauled my luggage along with me. As I sat it in the corner of the conference room, Tim stuck his head in.

  “Bethany Reginald died,” he said.

  “God. When?”

  “Last night around ten.”

  It always happens, these small connections physicians—even a non-clinical doc such as me—make with sick people. The stereotype of the unfeeling doctor aside, we get into this profession to help people. Whether as a thoracic surgeon or a family doc or an epidemiologist, we get into this to make people well. So, as corny as it sounds, Bethany meant something to me. She’d taught me that the mentally handicapped have lives, sex lives and love lives, as complex and nuanced as the rest of us. And now poor, retarded, sexually adventurous Bethany Reginald was dead.

  “Has anyone told Helen Jones?”

  Tim looked at me blankly. “Bethany’s friend,” I said. “The index case. She and Bethany were lovers.”

  “I don’t know. I’ll make sure someone does. At least no one else has gotten sick in the last twelve hours. We have pretty extensive surveillance going on, and nothing. Each hour with nothing new is another victory.” He looked at his watch. “Briefing in seven minutes.”

  It was a roundup of the usual suspects plus Beth and Andy—the new EIS officers—and John Myers and Pete O’Leary. Douglas Buchanan, Helen Jones, Bethany Reginald, and the web of sexual contacts was the subject of the meeting. Tim let me run the meeting. My swan song.

  I stood in front of a projection of the contact chart that Sonjit—God bless her—had finished the night before. The image covered an entire wall.

  I ran through the webs of sexual involvement, drawing attention to the fact that Bethany and Douglas sat in the center of those webs. Both of the boxes representing them had large dark slashes through them indicating they were dead.

  I moved on to my theories.

  “Though we still haven’t found a reservoir, there is some reason to believe that a rat may have transferred the disease to humans. The Jefferson properties, where Case Number Two, Deborah Fillmore, lived, may be the source, since we found ample evidence of rodent infestation. The disease symptoms bear some resemblance to the hemorrhagic fevers, and, I don’t have to tell most of you, Lassa, Machupo, and the other arenaviruses are found in rodent hosts. Baltimore is a major port, so it’s not unthinkable that some exotic rodents infected the local population. We might also be dealing with an indigenous, but previously unknown, arena-like virus. And until we find some indication this was intentional—mail or anything else—I think it’s best to assume the source is natural.”