Isolation Ward

by Joshua Spanogle

  “Dr. McCormick?” he asked. He smiled broadly; I immediately liked the guy.

  “Tom?” He nodded. “Call me Nate.”

  “Call me Nurse Harrison,” he said, laughing. “Dr. Perry said for me to let you look around. There’s not much to see, but you can have your run.”

  “Thanks.” His book, I noticed, was Pragmatism, by William James. “A little light reading?” I asked.

  He stood. “Have a paper due on James next week. Gotta love the pragmatists. Philosophy that works. Not this BS Continental stuff where you read it and two hours later you want to put a bullet in your head because nothing means anything.”

  Nurse Tom Harrison walked around the nurses’ station to the door and pressed his ID to the card lock. It beeped and clicked and he pushed open the door. “James, Dewey, all those pragmatists. Views you can use,” he said.

  I wondered where I could get some of those.

  “‘Views you can use,’” I said. “That’s good.”

  “That’s a Tom Harrison original.”

  We moved into a short hallway flanked by three doors and three windows. At the end of the hall was a makeshift changing area, a screen pushed to one wall that could be moved across the hallway to block the view.

  “Master’s in bioethics,” Tom said. “Been working on it for two years and will probably be working on it till the Second Coming. Which is a problem for me, since I’m agnostic.”

  “Well, it’s the journey that counts, right?” He looked at me, and I could tell he was trying to size up whether I was pulling his leg or not. I wasn’t.

  “The journey. Right, Nate.”

  I stepped to one of the windows and peered inside. Though I’d half-suspected what I would see, I wasn’t prepared for the wash of adrenaline through my body. My knees went weak. The room was identical to the one I’d seen on Dr. Tobel’s videotape—comatose patient in a bed, surrounded by monitors. Room of the same dimensions. Of course, this could all be coincidence. . . .

  “Are there cameras in the rooms?” I asked. “For security?”

  “Sure.”

  “Could I see the monitors?”

  Tom looked at me oddly. “Sure. Why?”

  “No reason.” To keep Tom Harrison from processing that, I continued. “So each of these people has some pig organ inside them.”

  “Yeah,” Tom said.

  I walked the length of the hallway, looking in on each of the patients. Three women and two men, every one spookily the same, lying like the dead on their pristine beds. Oddly, the last room on the left was dark. “Why is one of the rooms empty?”

  “Oh, I don’t really know. I just got here last year, after she was gone. They said she’d died from an unrelated infection. Unrelated to the new organs, at least.”

  “She?”

  “Yeah. Originally there were four women, two men.”

  “They didn’t say what she died of?”

  “Not to me.”

  “Do you know her name?”

  Tom smiled. “Can’t tell you that, Doctor. Privacy rules.”

  I looked into the three rooms with the women, trying to recognize a face from the tape. But the woman’s face in the security tape had been hazy and low resolution, and it had been hours—only hours?—since I’d last viewed the tape. I went back to the empty room.

  “What room number is this?”

  “Room three,” he said. “Why?”

  I didn’t answer. Instead, I said, “Where do the pigs come from? The organ donors.”

  Tom was getting uneasy. He shrugged. “Doctor—Nate—I don’t know why you’re here. All I know is that Dr. Perry told me to let you look around. But I’m the wrong person to ask about any of this stuff. I just watch these poor blokes and give them their meds. You should talk to one of the company people or the lab people. There’s Harriet Tobel, a man called Falk who heads this thing. And there’s this very attractive doctor a young man like you should definitely meet. Dr. Chen—”

  “I’ve talked to them,” I said too sharply. “Is there anything you can tell me?”

  “No. I’ve probably given you too much as it is. They made us all sign a nondisclosure agreement.”

  “They made everybody sign a nondisclosure. So much for open and free science.” I rubbed at my face and decided I needed a shave. “So, what about infection control?”

  “Pretty simple, really. Even though the patients are on minimal immunosuppressive drugs, we treat them as immunocompromised. But actually, the company people are pretty freaked about any bugs these guys might have, so we take universal precautions when dealing with them. You know, to protect us as well as protect them.”

  I thought of the man having sex with the vegetative woman, no condom—definitely not universal precautions.

  I stood in front of one of the rooms occupied by a woman. There she lay, waxen and still, but otherwise looking pretty healthy. “What does the bioethicist in you say about what’s going on here?”

  “About what?”

  “About this.” I stretched my arm toward the motionless woman.

  Tom laughed. “The work they’re doing here has a great potential to save many lives. No more shortages of organs. Imagine that. Really wonderful. But I’m enough of a utilitarian to think that . . . well, they’re not treating these people as people. These poor folks are a means to our ends. I wonder if that’s right.”

  I turned away from the comatose woman and smiled. “Tom—Nurse Harrison—that was the most noncommittal answer I’ve ever heard. You’ll make a great bioethicist.”

  He laughed again.

  On the way out of the suite, Tom took me to the nurses’ station. There, on the desk, were six monitors. One, labeled “3,” was dark. In the others, I saw the exact same view I had on Dr. Tobel’s tape.

  Here, I thought. The rape happened here.

  CHAPTER 63

  Pig organs, a rape, a weird outbreak in Baltimore, Harriet Tobel’s concern about the outbreak, her death. So, these things seemed to be connected, and it was worthwhile pursuing the connection. Well, seemed to be connected might be too strong. They possibly might have a chance of being connected.

  I sat at the computer in the library, got to PubMed, and ran a search on PERV. A hundred and twenty papers came up. Despite the acronym, the authors of these papers were not interested in pedophiles. They were interested in something close to my heart and my career: viruses.

  The PERV is the porcine endogenous retrovirus, a bug that lies dormant in pig cells. Most pigs carry a number of different variants incorporated somewhere in their genome, and at least three varieties have been shown to infect human cells. The PERVs—and I have to admit I love the name—are the little goblins of porcine xenotransplantation. The fear is, by introducing pig tissue into humans via grafts and transplantation, these viruses will jump the species barrier and infect the host. In the pig, PERVs are largely inert, due to thousands of years of coevolution. The two species, you could argue, learned how to get along, much like the cytomegalovirus, which infects well over half the human race and rarely has severe consequences. I mean, it’s not in any parasite’s interest to kill off its host, because that, in the end, kills the parasite, be it a virus, a bacterium, or a worm. However, you put a PERV in close contact with a new organism—people, in this instance—you run the risk of detonating some major biological fireworks. Think about HIV. Many theorize it grew up in monkeys and is relatively inert in them. But once HIV jumped to humans, to virgin territory that hadn’t evolved adequate defenses . . . Well, everyone knows the rest of the story.

  I blazed through a couple of papers to refresh my memory on the porcine retroviruses. Some elements didn’t add up: retroviruses didn’t make people bleed like what we were seeing in Baltimore. I might expect cancer, I might even expect an AIDS-like syndrome, but not the brutal picture painted by the dead Bethany Reginald and Deborah Fillmore.

  I printed out a paper with the most recent information on detection and left.

  Ti
me to assess, to sit and try to figure out where I should be going. I needed somewhere quiet, away from the library and the med school and the possibility of another encounter with the past. And my car seemed like the place to be. In any investigation—I’m talking epidemiological here—there’s a lot of sitting and thinking. Not really the stuff of action shows.

  As it turned out, however, I did get something more exciting than a tranquil half hour to myself. It was getting late, and the ranks of the faculty’s luxury cars and the students’ decades-old beaters had thinned. From the outside, my rental looked fine, sitting, appropriately, between an old Toyota and the sparkling new Porsche. As I approached the car, though . . .

  “Son of a bitch.”

  Something was missing. Hell, not something. Everything. All my things, which had been in the backseat, were gone. The bag with my clothes, gone. The bag with the video from Dr. Tobel, with Dr. Tobel’s HIV vaccine work, gone. My goddamned toothbrush. Everything.

  I swore a lot and I swore loudly. A couple of kids—undergrads, two Asian girls—glanced over at me and hurried away. I used the word fuck a few more times; the girls quickened their pace.

  On the slim hope that the considerate thieves had placed my belongings in the trunk, hoping to hide them from less considerate thieves, I popped the boot. Nada.

  So, all I was left with were the clothes on me, my cell phone, pager, PDA, my notebook, and the printouts from the library. Great, I thought, absolutely great.

  Now, I am not fucking stupid. Rash, maybe. Arrogant and insecure, sure. But not stupid. Car vandals don’t case medical school parking lots in this part of California in the middle of the day; normal car thieves don’t have the expertise to jimmy locks on a new-model Buick. And the coincidence of my showing Alaine Chen the videotape, of everything around me shutting down, and, then, of my only “evidence”—if you could call the tape evidence—disappearing . . . Well, now things did not seem on the up-and-up.

  Without really thinking about it, I hustled up to Dr. Tobel’s lab, intending to find Dr. Chen.

  But no one was there. The lab doors were locked. I knocked and got no response, so I knocked some more. A guy walking down the hall saw me. “They’re all gone,” he said. “I heard Dr. Tobel died.”

  “Thanks,” I said, and kept knocking. The guy looked at me quizzically and I glowered at him; he scurried away.

  Like I said, I wasn’t really thinking, so my hand was red and smarting by the time I remembered that I had Dr. Tobel’s ID badge in my pocket. I fished it out and swiped it across the black pad next to the door. The pad beeped and the door clicked. I pushed it open, stepped inside, and let the door swing shut behind me.

  I guess you could say I was pretty pissed off about the car, and I indulged in a minute of vandal reverie—pictured myself smashing beakers and slide boxes, wiping out computers, leaving freezers open, torching lab notebooks. Feeling somewhat cleansed, I put on a pair of latex gloves and began to search.

  I booted up all the computers, which, not surprisingly, were password protected. I paged through lab notebooks, but because I was unfamiliar with the protocols they described, what they contained meant little to me. Then I did what I’d planned to do in the car. I sat and thought.

  Dr. Tobel’s office, nerve center of this little empire.

  I walked to the private office’s door and tried the handle. Locked. There was no card access here, just a plain old key, which I didn’t have. There was, however, a window—a tall, narrow pane of glass above the doorknob.

  Having broken a window in Dr. Tobel’s house made it easier to break a window in her office. I was aware of the difference—one was a rescue situation, the other a true breaking-and-entering deal—but didn’t really care. I figured it was payback for the car.

  I lifted a fire extinguisher from the wall across the lab, heaved it back, and drove it through the window. The glass shattered and fell; then there was silence. I waited for the sirens, the rush of white-shirted security guys. More silence. I reached in through the broken window, unlocked the door, and entered.

  So now I was a bona fide criminal. Tim Lancaster would not be pleased.

  I booted the computer on the off chance it wasn’t protected with a password. It was, so I turned it off and began looking through the files in the credenza. Déjà vu. In an exact replay of what Brooke and I had found in Dr. Tobel’s study, the files had been cleared. More exactly, all documentation having to do with Chimeragen had been cleaned out. Not surprising, I thought, but disturbing.

  I took the few files that were there—the current HIV work—and sat at her desk, paging through them. Just as in her office at home, there was a lot of chaff: old studies, the printouts from too many literature searches. At the back of one file, however, I found something that looked more interesting—“Human Trials.” I began to read.

  It was a grant proposal—actually, an incomplete grant proposal—for human trials for an experimental HIV vaccine. According to what I had in my hand, no trials had ever occurred, and, from the sketchy look of the application, no one had even applied for monies to conduct the trial.

  Something jumped out at me. A computer printout of a long series of letters: AATGCCATATGCCT, and so on. A genetic code. I scanned across the letters and estimated it to be only a few thousand nucleotides long, meaning this was either a fragment of a larger string of DNA or a complete short piece. There was no identifying information on the sheet of paper to let me know what the code was, and the paper itself was loose, fitted just behind the aborted grant application. Weird. But at least it was something concrete. I closed the file.

  Strange, Dr. Tobel. What the hell is going on here?

  CHAPTER 64

  I walked out of the building. Still no security, so I was a free man for a while, at least. I dialed CDC and had them put me through to the lab. It was almost eleven East Coast time, but the CDC labs are often 24/7 affairs, or at least 18/7, and there was a good chance someone would be around. I didn’t just need someone, however.

  A woman answered the phone. “This is Dr. Nathaniel McCormick, Special Pathogens Branch. Is Dr. Vallo there?”

  “No,” she said.

  “Do you know where he is?”

  “Home, I’d guess.”

  “Then I need that number.”

  “We can’t give that out.”

  “Of course you can. This is an emergency. I’ll take the flak for it.”

  She sighed. “What’s your name again?”

  I told her, and could hear her flipping through pages, presumably to check that I actually worked at CDC. A moment later, she came back on the line. “Don’t tell him who gave you this.”

  “I don’t know who gave it to me. Thanks.”

  Repeating the number over to myself, I punched it into the cell phone. The phone rang until an answering machine picked it up. No way Ben Vallo would be out that night, just after a big blowup in Baltimore, just before a big blowup in Louisiana. In fact, I was surprised he wasn’t at the lab. I redialed.

  A sleepy man answered.

  “Ben,” I said.

  “Who is this?”

  “Nathaniel McCormick.”

  “Ah, Christ . . .”

  “Listen, I need you to do something for me—”

  He went from asleep to totally awake and ticked off in five seconds. “Nate, you know how much shit I went through for you? You sent down every goddamned thing in Baltimore. I’m surprised there’s a city left. I figured I’d tested every last molecule in the whole damned place.”

  I heard another voice in the background and heard Vallo say, “Go back to sleep.”

  “This is different,” I said.

  “Sure it’s different. You know, this is the first night in a week I’ve gotten to sleep before two?”

  “That’s why they pay you the big bucks—”

  “Goddamn it, Nate, as soon as I get a promotion, I’m going to request a secretary whose only job is to tell you to go fuck yourself every time you ask m
e for something, but I don’t know if we could afford the overtime.”

  Ben Vallo was a microbiologist a few years out of a postdoctoral gig at Duke. A year or two older than me, he had been at CDC since he finished his education. Because he was young and because, all appearances to the contrary, he liked me, Ben was the first person I called to do anything. And he never turned down the work. It was the fastest way to the top, and he wanted to get to the top fast. Why he chose to bottom-feed in governmental bureaucracy, I was still trying to figure out.

  “You done?” I asked.

  “I have a kid I haven’t seen awake in three days. His first soccer season, and I’ve seen one game. One game, Nate.”

  “You done?” I asked again.

  “No. I haven’t eaten a meal at any place but the cafeteria on Clifton since you called the first time, and I’ve been farting like a wizard ever since. You give me rat piss, rat shit, rat cum, dust from kitchen site 1a behind the refrigerator, dust from kitchen site 1c behind the stove. I’m sick of it.” There was a pause. “I’m done.”

  “Okay. Ben—Dr. Vallo—I want you to run RT-PCR on the samples you have from Deborah Fillmore and Bethany Reginald.”

  “I have run PCR on them, McCormick, for about a thousand different bugs.”

  “PERVs?”

  “PERVs? The pig things?”

  “Yeah.”

  “Why the hell would I do that?”

  “You wouldn’t. That’s why I’m asking you now.”

  There was some harrumphing. “Let me get a pen.” Again I heard Vallo say, “Go back to sleep.”

  “Okay,” he said, “PERVs for Fillmore and Reginald. You going to make me look up the sequences for the primers, too?”

  “No. I have them here. I’ll e-mail them tonight.”

  “You’re a goddamned saint.”

  “Tell that to Tim. I also have a sequence I’d love you to run against what we have down there. See if it matches anything in the database.”

  “That’s it?”