by Ross Pennie
“And the uncle’s gas bar on Longwood Road is a long way from all three places.”
Hamish shrugged off their disappointment at the lack of obvious connections and returned his attention to the computer. “His basic blood work’s okay.” He clicked on an icon that brought up Bhavjeet’s chest X-ray. After they’d studied it together for half a minute, Hamish said, “I don’t know why they ordered this, but it looks okay to me. You agree?”
Zol pointed to the top segments of each lung. “No scarring or infiltrates in the apices?”
“I don’t see any. So, despite his South Asian provenance —”
“No evidence of TB, past or present.”
“Not bad,” Hamish said. “Now let’s look at the results from the spinal tap.” He clicked on a different icon.
“I’m getting to know what to expect if it’s polio,” Zol said. “Okay if I try my hand at interpreting the results?”
“Be my guest.”
“So, starting with the cell count: only five reds.”
“A nice clean tap.”
“And 350 whites.” Zol knew that cerebrospinal fluid obtained from a spinal tap should have no more than ten white blood cells per cubic millimetre. Bhavjeet’s fluid had 340 cells too many. “That’s up, but well less than a thousand or two. So not suggestive of a bacterial infection.”
“Agreed.”
“And the cells are 85% lymphocytes and 15% neutrophils. That rules out bacterial meningitis.”
“I never say never in this business. But we didn’t think he had a bacterial infection anyway. He’s not sick enough. Well, not yet.”
As Zol was acutely aware, if Bhavjeet did have poliomyelitis, he could become seriously ill in a matter of a day or two. Paralysis could set in, and it could last anything from a few days to forever. Or, if he was lucky, he could escape the paralysis and go home in a week.
“What do you think of the CSF protein and glucose results?” Hamish asked.
“Normal glucose. Protein is up just a tad.”
“Your verdict, Doctor Szabo?”
“Given the history, the signs you elicited on physical exam, these lab results, and the fact we’ve seen eight cases in the past two weeks, it’s got to be poliomyelitis.”
Hamish rested his chin on his hands. “Our Parvovirus-W at work. Poor devil.”
“Does he need the CT scan of his head?”
Hamish gave the screen three taps. “There. Cancelled. We have our diagnosis, so we can safely spare the uncle that expense, at least.”
Zol pictured the hospital bills that lay ahead for this family. A couple of weeks of intensive-care treatment could bankrupt them. And if Bhavjeet remained a quadriplegic for the rest of his life, what would become of him? A young guy with an expired tourist visa and no means of support was in a tough spot. The immigration people would be on his case sooner or later. But at least the province’s government health service knew better than to try to get blood from a stone.
Hamish closed Bhavjeet’s record and straightened in his chair. “Will you go back in and explain everything to them? Tell them what the lad can expect over the next few days?” He paused then added, “You’re better with this sort of people than I am.”
“Just what sort of people are they, Hamish?”
“Well . . . you know . . .”
In the general hubbub of the department, no one seemed to be listening. Zol kept his voice down anyway. “You mean brown people from the subcontinent?”
“I didn’t mean —”
“You didn’t mean to say that I must understand three somewhat cagey Sikh gas jockeys from Pakistan because I’m marrying Tasha?”
“Well . . . um.”
“Yes, um. My marrying into Natasha Sharma’s Indian Hindu family doesn’t make me a cultural expert on everyone from South Asia. Not any more than your having a Muslim lover from Bosnia makes you an expert on the sex lives of subsistence farmers in the Balkan States.”
Hamish let out a long, dramatic sigh and shook his head. “My relationship with Al isn’t just about the sex, you know. It’s a lot deeper than that. Hell’s bells! Why do you heteros always think gay men care only about screwing and decorating?”
Zol held up his hands and crossed his index fingers in front of him. “Truce! Truce! I’m sorry, Hamish. I overreacted.” With his wedding approaching and Tasha’s mother still not warming to him, Zol knew he was overly sensitive to having certain buttons pushed. “Look, let’s not get hung up on stupid stereotyping. You’re my best friend, for God’s sake.”
Hamish’s entire head turned cardinal red. Throat, cheeks, and scalp. Several moments went by before he spoke. “Seriously?”
“Of course, seriously.”
Hamish wasn’t the sort of guy who had ever cultivated friends. The loner streak in him was strong. Having a best friend who wasn’t your lover was clearly a revelation to him. And when Zol allowed himself to think about it, he knew he was much the same himself.
Hamish said nothing in reply, though Zol could see the wheels were turning.
“And, yes,” Zol said, “I will go back and explain everything to Bhavjeet and his family. If the auntie is there too, at least one person in the room will remember a kernel of what they need to know.”
Hamish smiled. And then he touched Zol’s arm. He’d never done that before.
Almost an hour later, back in his street clothes, Zol found Hamish at the computer.
“How did your guys take the news?” Hamish asked.
Zol couldn’t remember being this exhausted or emotionally tapped out. “A bomb went off as soon as I told them we’re calling it poliomyelitis.”
“What do you mean?”
“I tried to break it to them gently, but as soon as I said the P-word, the auntie’s eyes rolled back and she sank to the floor. Thank God, she didn’t hit her head.”
“A vasovagal?”
“Yeah, a dead faint. I clocked her pulse as low as forty before it recovered. Her husband and son helped me get her feet in the air, and she came around pretty quickly. But then, oh my God . . .”
“What?”
“The auntie and the uncle started wailing.”
“I hate that.”
“And they haven’t stopped. The charge nurse, Cheryl, heard the ruckus and came in to help. She paged the social worker. Until he arrived, I did my empathetic best to get Auntie and Uncle to calm themselves and listen to a modicum of reason. The social worker is doing his best to help them see that there’s always hope, but they’re not buying it. In their minds, they’ve got Bhavjeet already cremated or buried, or both.”
“What’s behind the fuss?”
“Sad family tales back in Punjab. We forget how difficult life is for so many people in that part of the world. It’s like we imagine them living on a different planet.” Except, Zol mused, we share the same one with them, and that made it sadder.
“And exactly what does this have to do with our patient and his poliomyelitis?”
“The family relationships are a little tricky, so bear with me. Bhavjeet’s auntie, the one who fainted, had an uncle and a brother who developed polio as children. They were left with withered, badly deformed legs and became the subject of ridicule. As the family put it, they were shunned as cripples with no prospects for marriage or education. The uncle died begging on the streets. The brother ekes out a living selling trinkets at the railway station in Lahore.”
Hamish had gone quiet and looked more pensive than usual. “Lahore, that’s in Pakistan, right?”
“A huge city in Punjab Province. Not that far from the border with India.”
“I suppose I don’t need to remind you that Pakistan is one of only three countries in the world where the poliovirus has not been eradicated. Has Bhavjeet been immunized?”
“You’re thinking he could have rea
l polio, not Parvo-W? Classic polio brought in by a recent visitor from Pakistan?”
“It’s possible. We didn’t get a straight answer when we asked if anyone had recently visited them from back home.”
“What’s the incubation period of classic polio?”
“As opposed to our very own Parvo-W variety?”
Hamish did a quick Google search and the answer flashed on the screen: seven to twenty-one days. “There you are,” he said. “We need to find out if they’ve had any visitors directly from Pakistan within the past three weeks. If not, the answer is simple and immediate — Bhavjeet has our Parvo-W, not their classic polio.”
“But either way,” Zol said, “his spinal fluid is going to be tested for viruses, right?”
Hamish tapped a few strokes on the keyboard and hit enter. “It’s in the works. Whatever he’s got, we’ll find it.”
“But I can’t help thinking,” Zol said, “here’s poor Bhavjeet, presumably safe and sound in Canada where few people alive can remember our country’s last scourge of epidemic polio. And then, he gets caught in a wave of something that’s just as bad and looks identical to —”
“But is completely different . . . I guess they call that irony.”
“This family has been suffering under the shame of the disease for decades. I could feel it pressing against me like an evil force. The more they talked about the auntie’s crippled brother, the more the shame oozed from their pores like a bad smell. I think they feel tremendous guilt about leaving him behind when they emigrated.”
Hamish scratched the ginger stubble on his chin. “What did Kurt Vonnegut’s guy, Billy Pilgrim, say in Slaughterhouse-Five? You know, when bad things kept happening?”
He paused then answered his own question:
“So it goes. So it goes.”
Chapter 15
By the time Natasha let herself into Zol’s place on Scenic Drive that Friday night, it was almost eleven thirty. It had been a long day, and more so for Zol and the boys, who would still be reeling from the horrendous events at Paradise Barbers. Her tummy was filled with more than enough of her mother’s murgh dopiaza and dum gobi. It had been after ten o’clock when she’d arrived at her parents’ for supper. Her father was in bed asleep, and Mummyji was dressed in her nightclothes, too tired to start any arguments about missed meals and wedding details. She watched Natasha eat every mouthful of the dinner, looking for the merest hints of perceived imperfections. Despite the exhausting day, Natasha performed well under the boundless scrutiny, and they parted on good terms. As she left, Mummyji retired upstairs to read. She was working her way through the public library’s collection of Scandinavian noir. She’d mostly given up on bridal magazines.
Natasha locked the front door behind her and called Zol’s name from the entrance hall. There was no direct answer from her betrothed (she loved how he laughed when she called him that), but she received an indirect reply from his pipe. The power of love continued to surprise her. Who would have thought she’d learn to savour the aroma of premium-brand pipe tobacco?
She slipped off her shoes and followed the cedary scent into the sunroom, her favourite place in the house. She’d helped Zol do it up in uplifting yellows and blues and added a kilim rug with tangerine accents. Facing north, the sunroom overlooked the Niagara Escarpment’s breathtaking brow as it sliced across the bottom of the garden. Zol never closed the curtains, so the room offered a wide-open view of the night sky. Sometimes you could see the moon admiring itself in the vast, black sheen of Lake Ontario. There was no moon yet tonight, but perhaps it would put on a show a little later. For now, the lights of downtown and the lower city made for a handsome spectacle in their own right.
She found Zol asleep in his favourite leather armchair. Left to him by his father, the thing was a brown, scaly monster in desperate need of rehab. When Zol had asked her to redecorate the house, he said she should transform the entire place from his home to their home. He’d given her free rein. Except for the chair. It had to stay, and it couldn’t be sissified.
He sensed her presence and awoke with a start. He extended his arms in a long, sleepy stretch. “Oh . . . Hi . . . Is that my darling bride-to-be? Did I fall asleep for a second?” He squinted at the ashtray beside him and seemed relieved that the ash and dottle were exactly where they should be; he hadn’t dropped his smouldering pipe onto the carpet when he’d nodded off.
Before he had a chance to stand up, she bent down and kissed him on the lips. “You were dozing for more than a second, my dear betrothed.” Delighting in his smile, she took his hand and helped him out of the chair. “Where are the boys?”
“In Max’s room, I suppose. Snapchatting with their friends.” He looked at his watch. “I told them lights out by eleven thirty. They need their sleep. It’s been quite the day.”
“How’s Max’s forehead?”
Zol laughed. “I think he’s mostly forgotten about it.”
Max seemed to take everything in his stride, even more so than his coolheaded father. “Let’s say a proper goodnight to the boys.” She felt bad about not seeing them since this morning’s horrors in the barbershop. “And after that, you can tell me about your exploits with Hamish in Emerg.”
“You’ve been speaking to him?”
“Wedding stuff you don’t need to know about,” she said. “We didn’t talk for long. He was preoccupied.”
“Oh, yes, the flood. How bad is it?”
“The repairs are going to cost a bundle.”
“We did have a fascinating time in Emerg. He’s turning me into a proper clinician. Two tricky cases in one night.”
Upstairs, they found the boys’ bedroom doors closed and no light seeping into the hall beneath either one.
Zol beamed a satisfied smile. “Looks like it’s all quiet on the Western Front.”
“Poor guys, they must be exhausted,” she said. “You’re sure Max’s forehead’s okay?”
Still beaming, he told her not to worry and led the way to the bedroom.
She’d repainted the walls a heritage shade of rich blue and energized the room with a perfect apple red in the curtains, duvet cover, and upholstered chair. The two of them dropped their clothes on the chair, brushed their teeth in the overly masculine bathroom, and slid between the sheets. She couldn’t imagine obscuring the delicious sensation of skin on skin by ever wearing pyjamas or a nightie again.
She nestled into the warmth of Zol’s chest and torso, then said, “So . . . you saw my girl, Jamila? And another patient?”
“Hamish assessed her while I was breaking the diagnosis to the other family. I had the auntie, the uncle, the cousin, and of course, the patient, Bhavjeet Singh Malik. The uncle had called 911 when they realized Bhavjeet was too weak to climb the stairs.”
“Bhavjeet? Sounds Punjabi. Are they Indian or Pakistani?”
“Pakistani. The uncle operates the Petro-Valu gas bar on Longwood Road. Bhavjeet is here as a visitor. He’s just nineteen. His parents are still back in Lahore.”
“Do we add Bhavjeet to our list? Is he polio case number ten?”
Zol cleared his throat. “Hamish was worried, at first, that it was classic polio. Imported directly from the sustained outbreak in Pakistan.”
“No, really?” She knew it was a possibility, given the polio situation west of the Indus River.
“But no, Bhavjeet has been in Canada for several months. That’s way beyond classic polio’s incubation period. And, if the family is telling the truth, none of them have been in contact with any recent arrivals from Pakistan.” Zol let out a long sigh and gave her a play by play of the auntie’s vasovagal attack and the family’s hysterics when he’d brought up the P-word. She had no trouble picturing the scene. She had family members who might react the same way. No wonder Zol looked so exhausted.
“Were you able to link Bhavjeet with either Petz Haven or C
athcart Street School?”
Zol explained how the family had denied such connections, and their gas bar and townhouse were a long way from the school. But it did remain possible that Bhavjeet had paid a few visits to the Petz Haven, only a short walk from Auntie and Uncle’s home.
“Well,” Natasha said, “an outing to a pet store could make a nice diversion for a bored teenager left alone after the other members of the household have gone to work.”
“Except, by the looks of Bhavjeet’s hands, he wasn’t staying home alone watching Netflix. Hamish and I are pretty sure Uncle had him rotating tires and doing oil changes at the family’s service station.”
“An under-the-table arrangement?”
“If he’s here as a visitor, it would be.”
She ran her pumice-softened heel along Zol’s shin and felt his shoulders relaxing. “When you think about it, it is too much of a stretch to imagine him handling the starfish or putting his hands in the tanks at Petz Haven.” Zol’s heartbeat was quickening against her back. “Where does Auntie work?”
“A garment factory of some sort. Out in Stoney Creek.” She reached up and stroked Zol’s earlobe. “What did Hamish have to say about Jamila? Does he think she’s our tenth case of polio?”
He kissed the top of her head. “I had to make that call to the cops. By now, they’ll have that Queenston Road Petz Haven sealed tighter than tight with their yellow tape.”
“Oh dear. I feel so bad for her. She sounds like a well-motivated kid. How sick did she look?”
“If we weren’t up to our necks in polio, you’d think she had a regular case of viral meningitis with some cerebral involvement. West Nile or Powassan or maybe herpes simplex. She had a fever, headache, stiff neck, confusion. Hamish spent a long time examining her limbs.”
She smiled, picturing Hamish scrutinizing the tiniest of details.
“He’s convinced that the girl’s muscles are too floppy for anything but polio. Her tendon reflexes are completely absent — not even a flicker.”
“Pretty typical, then. She’s slipping into the paralytic stage?”
