So as she shampooed her hair, she had every right to be singing.
She was so lost in thought about Tom Fitzpatrick and her song she didn’t notice that the water in the tub wasn’t draining, until it began lapping at her ankles. Yet the stopper lever was set on open.
Puzzled, she bent down and put her hand in the water. She groped around the drain and found the problem—a huge clot of hair.
Chapter 11
AS HUGH MONROE began the superficial examination of Ginny Barroso’s body, his mind was running on several tracks. He was the heir apparent to succeed the chief medical examiner, who’d just retired, not those interlopers they’d brought in to interview. He told himself that the other candidates were merely window dressing to make it look like a real search, that everyone realized he was the logical choice. But deep down he knew he had made enemies who could hurt him on this. So it was no time to be demonstrating any inadequacies, like that case he’d done earlier today. What was her name . . . Mary Beth Cummings.
Except for some kind of scalp condition that had caused her to lose her hair, he hadn’t found evidence of any significant pathology. So why had she collapsed and died? He didn’t know. Of course, the tox results weren’t back yet, and there might be something instructive in the tissue sections. But still it was disturbing to have seen nothing.
He recorded a small scar on Ginny Barroso’s left forearm, and a couple of recent contusions on the outside of her left leg. She’d also broken several fingernails on her right hand, probably as she struggled from the car after the crash. Pretty minimal stuff for an accident that had killed both occupants of the vehicle. He shifted his attention to her scalp, intending to look for signs of head injury.
He had been doing this kind of work so long that his pulse no longer shifted gears when he walked into an autopsy suite, as it had when he was a much younger man. But when he saw that this woman, too, had been losing her hair, the years rolled away.
Two cases in the same day with a scalp condition; one suddenly dead on her apartment steps for no apparent reason, the other dead after an accident that had barely left a mark on her. His interest aroused, he moved faster. Soon, he was in the cadaver’s chest, his scalpel severing the major vessels that anchored her heart.
Now the organ was in his hand.
He visually inspected all its glistening surfaces, then focused his attention on the coronary arteries, which encircled the organ like serpents. Running a gloved finger along the right coronary, he found it utterly normal in appearance and resilience. But while his finger was traveling along a major branch of the left coronary, he encountered a suspicious firmness. He picked up his scalpel, made a cut across the vessel, and let the remaining blood drain out. Then he parted the cut edges and peeked inside.
“Well, hello, my dear.”
“DR. MONROE, THERE are some people here to see you: Drs. Collins, Boyer, and Ash. It concerns . . .” She checked her notes. “The Cummings and Barroso cases.”
Michael Boyer had learned about the death of Mary Beth that morning, the day after it happened, from the circulating nurse as he was preparing a patient for gall bladder surgery. She didn’t know any of the details except to say that it didn’t appear to be a criminal matter. So all through the surgery, in the back of Michael’s mind, he wondered if the transplant virus had anything to do with her death.
Immediately after the surgery, as he began calling around trying to get more details on the Cummings death, he’d learned that Ginny Barroso and her husband were also dead. Now he really began to worry. Then, when he was told the Barrosos died in an auto accident, he didn’t know what to think. Realizing all three bodies were probably in the medical examiner’s possession, he called and verified that. He’d then rounded up Chris and Ash, and they’d all headed for the morgue to find out what had happened.
“He’s in his office,” the secretary said. “It’s down the hall to your left, third door on the right.”
As they all filed out, Chris prayed the deaths they were there to inquire about were some monstrous coincidence unrelated to the virus they’d all carried.
Below Hugh Monroe’s name on his office door, there was a big brass knocker shaped like a whale. Michael rapped the whale three times on the underlying brass plate, sending the sounds echoing down the uncarpeted hallway.
“Come in.”
They found Monroe dressed in green scrubs. He was seated at a huge desk with a glass top, several stacks of file folders neatly arranged near his right hand. On a table behind him was a glass case containing a model of a large gray whale. The walls were covered with color photos of whale action shots. Here too the floor was uncarpeted, as though the designers figured that even the offices might occasionally need to be hosed down.
Monroe was a small, tidy man with a big brush mustache. He didn’t get up, but made them all reach across his desk to shake his hand as they introduced themselves.
“Please, everyone have a seat.”
When they’d arranged themselves in the chrome and leather visitors’ chairs, Monroe said, “What’s your interest in the Cummings and Barroso cases?”
As Michael explained, Monroe became upset. “You mean to tell me that those bodies were infected with some unstudied virus, and I wasn’t informed?”
“Dr. Monroe, with all due respect,” Michael said, “how could we have informed you when we didn’t know what had happened?”
“They should have all been wearing ID bracelets with your phone number and instructions to call you if they needed medical attention.”
“In retrospect that seems like a good idea,” Michael said, “but we had no idea anything like this would occur. We’ve kept close track of the virus in the blood of the three and have found that it disappeared about a week ago and hasn’t reappeared. So we thought the immune system might have destroyed it, and they wouldn’t now be infectious in any way.”
“I’m sure you don’t always know if a body is carrying HIV and, because of that, have adopted safety practices in your autopsy attire,” Ash added.
Remembering that it wouldn’t be wise to antagonize anyone at this sensitive stage in the search for a new chief examiner, Monroe backed off. “Of course. I was just thrown a little by what you told me.”
“Even though the virus was no longer in the blood of the three victims and didn’t appear dangerous,” Ash said, “we were concerned that there might be a long-term problem. Who was driving the Barrosos’ car?”
“The wife,” Monroe said.
“Did she have the accident because she died at the wheel?”
“Actually, no. The driver of the pickup she hit said she was alive afterwards.”
“But could she have been impaired in some way just before the accident?” Michael asked.
Chris was thinking that they should just let Monroe talk, when he said, “Why don’t I simply tell you what I’ve found?
“I have to say that this was a tough one. I examined the Cummings woman first and was completely baffled, because except for acute hair loss, she appeared perfectly healthy. I thought she might have been on some sort of chemotherapy, but I didn’t find any evidence of cancer or any surgeries that might have removed a tumor. And she looked well nourished. No reason at all for her to have died so suddenly. Nor did toxicology find anything. So I was stumped. Until I examined Virginia Barroso.
“When I started her autopsy . . .” Monroe’s face was now glowing as he recounted his great triumph. “I found no marks on her to suggest she’d suffered more than minor bumps in the accident. Yet she was dead. To my surprise, I soon discovered that she too was suffering from acute hair loss. Later, when I was examining her heart, I found a large thrombus totally blocking a major branch of her left coronary.”
“So she died of ventricular arrhythmia induced by a cardiac infarct,” Michael said. “A heart attack.”
>
Barely able to conceal his irritation at having his conclusion snatched away from him, Monroe said, “That was the immediate cause, but the question is why did she make that thrombus? Answer. Because the wall of the affected vessel was grossly inflamed. But the Cummings woman’s coronaries were unobstructed and not obviously inflamed. So what killed her?
“Of course, before I knew the history of those women, there was no real reason to believe their deaths were related. The hair loss in both could have been totally coincidental. But I had a hunch . . .”
It was obvious to Chris that Monroe was taking every opportunity in his account to make himself look good. Even so, she listened with rapt attention, for she’d already heard enough to know for certain that had the two women never cared for her father, both would still be alive.
“The driver of the pickup the Barrosos hit said the wife appeared to be blind after the accident. She was also under the delusion her clothes were on fire and she was being burned alive.
“As I said earlier, I didn’t find any external head injuries that might account for blindness. But after examining the tissue sections from her brain this morning, I’m pretty sure I know what happened.”
No one had ever held Chris’s attention more fully. Michael and Ash were equally riveted.
“Considering what I found in her heart,” Monroe said, “you may be thinking there were clots in the vessels serving her visual cortex. But that would be highly unlikely. To make her totally blind, as she appeared to be, clots would have to arise in the vessels on both sides of the brain at the very same moment. Otherwise, she would have had some sight left. Realizing something was wrong, she would have moved onto the shoulder of the highway. No, the facts attending the accident show that she became blind in both eyes simultaneously.
“Have any of you ever heard of scintillating scotoma?” He paused to see if he had any takers. “No?” Happy that his audience was so ill informed, Monroe continued. “It’s a condition in which sight suddenly fails, but instead of darkness the afflicted individual sees bright multicolored montages. Interestingly, the condition always lasts almost exactly twenty minutes. It’s caused by vascular spasm.
“When I examined the brain sections, I found evidence of inflammation in the branches of the cerebral arteries that serve the visual cortex. So that’s what caused the accident—vascular spasm with resulting blindness. I also found evidence of inflammation in some of the cerebral vessels serving the thalamus. It’s my belief that the burning pain she felt was caused by spasm in those vessels as well, setting off the well-known phenomenon of central pain. A burning sensation is the most common modality reported by patients suffering from this condition.
“Which brings us to Mary Beth Cummings. Not to draw this out any longer . . . She showed microscopic evidence of inflammation in all the same vessels as Virginia Barroso. So it’s my contention that she too died of cardiac arrhythmia, caused in her case, by coronary artery spasm without a thrombus.
“Just out of curiosity, I also looked at sections of the scalp in all the victims. Both women showed massive inflammation and cell death in the region of the germinal matrix in most of their hair follicles. That’s why their hair was falling out. The matrix cells had stopped making hair, so a discontinuity developed in the hair shaft, allowing it to be easily pulled loose.”
“What about Dominic Barroso?” Chris asked.
“Not as advanced. But I definitely saw signs of inflammation in all the same places as the two women. In my opinion, if he hadn’t died from injuries he received in the accident, he soon would have suffered the same fate as the others.”
“Well, there’s no doubt in my mind that the transplant virus is responsible for this,” Michael said sadly. He looked at Chris. “It sounds like when the virus left the blood it set up shop in the vessels Dr. Monroe discussed and hadn’t really disappeared at all. Just went into hiding.”
“Would it be possible for us to get some blood samples and small pieces of the pertinent vessels as well as vessels from other non-involved sites in all the victims?” Ash asked. “I’ll check them for virus.”
“That can be arranged,” Monroe said. “But it’ll take a few hours.”
“Would you give me a call when they’re ready? I’ll come back and pick them up.”
“Sure.”
Ash gave Monroe his phone number, and Monroe jotted it down on a small piece of clean paper from a stack in a little wooden box.
“In return, I’d like to know what you find,” Monroe said. “For my report.”
Ash deferred to Michael.
“That’s fair,” Michael said.
“And someone needs to tell the health department what’s going on.”
Michael nodded. “I’ll do it.”
“Am I going to be seeing any more cases of this?” Monroe asked.
Intending to stay in Atlanta for a few weeks longer, so his status could be monitored at Monteagle, Wayne Collins had moved from Chris’s apartment to a small efficiency closer to the hospital. Before departing for the ME’s office, Michael had called him at his new place. Relieved to hear his voice, Michael had quizzed him briefly about how he was feeling. Hearing nothing ominous, he had asked Wayne to stay by the phone for the next couple of hours. Now, he was glad he’d done that.
“We’ve got one more person at risk,” Michael said to Monroe. “But we’re going to be watching him closely, so I don’t believe you’ll be meeting him.”
On the way to the car, the phrase “no harm, no foul” flashed on and off in Chris’s mind like a defective scoreboard. When there was no evidence the virus had harmed anyone, she had let the phrase ameliorate her feelings of guilt over the backup respirator. Okay, so now there was harm. So a foul had to be called. And it was hers to bear.
Chapter 12
“LOOKS LIKE YOU were right, Chris,” Ash said from the backseat as she pulled out of the ME’s parking lot. They’d all come in her car because Michael and Ash had driven to her office in Michael’s Porsche, and it was only a two-seater.
“About what?” Chris said.
“The virus ultimately causing problems.”
“Yeah, I think we can definitely classify what happened as a problem.”
“I wish I’d never started the pig transplant program,” Michael said from beside Chris. “I did it to save lives, not end them. We need to talk to your father right away. Do you know where his new place is?”
“I’ve never been there, but I know the building. It used to be a motel, but they converted it to apartments.”
MICHAEL KNOCKED ON the fading turquoise paint of Wayne’s apartment door.
“Anybody want a swim?” Ash said, looking over the railing at the litter- and algae-filled pool in the courtyard below.
Wayne opened the door wearing jeans and a T-shirt with Charles Dickens’s face on it. “What’s this all about?”
“We have to talk,” Michael said.
Wayne stepped back, and they all trooped into a small living room with rough textured walls and tan shag carpet that looked as though it held many secrets. The parts of a cabinet of some sort were spread all over the floor. Nearby was a yellow legal tablet.
“My latest writing project,” Wayne said, gesturing to the clutter. “I think this one really has a chance to make the USA Today top fifty. Hello, Chris.” His eyes lingered on her for a moment, then he acknowledged the others. “Michael . . . Dr. Ash, is it?”
Ash nodded.
“What’s the occasion?”
“We’ve got some bad news,” Michael said. “The two nurses who took care of you after the transplant are dead.”
“Oh my God. Not because . . .”
“It looks very much like it was the virus they picked up from . . .” Realizing he was about to make it sound as if it was Wayne’s fault, Michael hesitate
d, then changed his phrasing. “The virus you all shared.”
“Dead,” Wayne said, “because of me.”
“Don’t get weird on us,” Michael said. “That’s an absurd conclusion. But we are here to talk about you. I’m concerned that you may be in danger.”
“I feel fine. Better than I have in years.”
“Have you noticed any unusual hair loss?” Chris asked.
“No. What’s that got to do with anything?”
Chris explained, adding, “So you could be in the early stages, before symptoms appear.”
“Both nurses dead?”
Michael put his hand on Wayne’s shoulder. “I’m afraid so.”
“What about the one nurse’s husband?”
“Dead from the auto accident the virus caused when it made his wife blind in the middle of the expressway. His autopsy showed early changes that probably would have led to his death in the same manner as the nurses.”
Wayne looked at Chris, his eyes asking for help. “And I was just getting used to having a future.” He turned to Michael. “Can anything be done?”
“Return to the hospital and let us run some tests. The virus kills by disrupting the rhythm of the heart. There are drugs to stop that. And other drugs can combat the vascular constriction that leads to the heart problems and the other symptoms.”
Wayne lapsed into thought.
“There’s no other way,” Michael said.
“I don’t want to go back.”
“You need to be on a cardiac monitor with facilities nearby to treat you if anything develops.”
Wayne looked at Chris. “I was the first one to get the virus. Shouldn’t I already be dead or showing some symptoms?”
The Judas Virus Page 11
