Weapon of Choice

by Patricia Gussin

  Just as suddenly, a solution suggested itself. Instantly, Victor acted on it. He had no time to analyze, to weigh the pros and cons. To consider anyone other than Matthew. He needed to proceed. He patted the pouch of his leather bag. Plenty. Not only enough culture material to kill Norman, but enough to kill every patient in the ICU. Infecting multiple patients would give him cover, camouflage. But he had to act. Now.

  Hunching, he reached into his pocket, removed a pair of rubber gloves, and pulled them on. The old man in the bed closest to him was not breathing on his own, either sedated or unconscious. He noted the name posted at the head of the bed: Bart Kelly. Physician: Dr. Nelson.

  Victor calculated that the hospital would be so busy trying to figure out how their ICU became infected with such a deadly, resistant bacteria that nobody would remember him. Nobody would connect his history with that of Norman Kantor, the intended victim. By then, Matthew would be safe in D.C.

  Gloves on, Victor reached into the culture transport pouch and deftly selected an impregnated swab from the secure carrier. He eased forward, inserted the saturated swab into the old man’s nostrils, swiveled it, and for extra measure, wiped it around the exposed end of the tube coming out the man’s nose. Done. Victor imagined himself looking like a concerned layman, just observing a patient.

  He moved to the next patient, next bed. Still no one was paying him the slightest attention. He leaned over a middle-aged woman in a deep sleep—sedated, maybe—but he’d have to be careful. His gloved fingers pulled out a second swab and gently wiped it on the woman’s cracked lips. She slept, and he applied as much pressure as he dared. The inoculum would be smaller, but surely enough to jump-start the noxious bacterium.

  In the third bed, Victor found a younger woman. Tubes going everywhere, but the woman’s eyes were open. Had she seen him with the swabs? Should he infect her—or just move on? Instant decision needed.

  Victor moved to the next bed. The cleaning lady mopped, her back to him, oblivious. He knew he had to hurry before staff flooded the place. The old man in this bed mumbled incoherently, moving his lips, not awake, but not asleep either. Not as many tubes running into him. Victor decided to pass him by. Why, he didn’t know.

  Next, a man on a ventilator. Older. Eyes closed. Mancini, another Dr. Nelson patient. Victor pressed his third swab around the tube coming out of the patient’s mouth, returning the used swab, as he’d done each time, to its secure holding container.

  Now he was about ten feet from Norman Kantor’s bed. How long had it taken him to process three patients? Only a minute or two, but it seemed like hours. After Norman, he’d get out.

  Victor’s heart rate accelerated as he moved to Norman’s bedside. Hovering over his one-time mentor, Victor steadied his hand. How propitious. Norman would succumb to the very staphylococci he claimed to have conquered. Except the staph that would be painted around and inside his nasal mucous membrane was several generations more virulent and much more resistant to that flawed antibiotic Kantor had developed for Keystone Pharma. This staph would eat away at the insides. A painful but deserved reality for the old bastard who denied Matthew a chance to live.

  Victor grinned as he proceeded with the inoculation. Norman’s eyes were closed, his breathing regular with a light snore. Victor deftly inserted the swab into Norman’s first nostril. Norman stirred; his eyes fluttered for an instant. Second nostril done. The bacterial load would be more than adequate, but he could not resist Norman’s open mouth, so when he replaced the used swab, he reached in for another that he quickly inserted inside his cheek, pressing against Norman’s gums to release the maximum bacterial load. Norman opened his eyes a slit, and a smile seemed to form as he recognized his former colleague. But the smile faded to a grimace as he fell back into slumber.

  Inoculating Norman had taken only seconds. Victor looked around. The mopper was working herself out of the room, approaching the door, blocking his immediate exit. He should stop now. He’d infected his target, his primary mission accomplished.

  The pathetic-looking boy in the bed next to Norman stirred and seemed to call out. Norman knew that he needed to get out of there, but he had to wait for the lady mopping the floor to move away from the door.

  “Water,” he thought the boy was trying to say, but his voice was too weak for Victor to be sure. Victor approached the bed, hoping to placate the kid. Like most of the ICU patients, he was hooked up to multiple tubes and instruments. But unlike the others, he was awake, eyes focused on Victor in an alert stare. What had this kid seen?

  Victor heard a sudden buzz of conversation at the door of the room, and knew he had only an instant left. He drew out a fifth swab. Hastily, he forced open the kid’s mouth and pressed the swab firmly against his perfect teeth, releasing millions of the deadly bacteria. If the kid had suspected him, he’d be dead by the time he’d recovered enough strength to make sense of whatever he’d seen.

  Victor glanced up at the boy’s name: Trey Standish. Then he turned away with not so much as a twinge of remorse. Moving slowly, methodically, just a concerned relative leaving the unit, he felt like the angel of death. He was the angel of death.

  Finished with the report session, the nursing staff began to drift back toward their patients in the ICU.

  As they passed Victor on his way to Matthew’s room on Thanksgiving Day, the tiniest flash of guilt made him hesitate for a split second. Should he warn them? Tell them to defend themselves with protective garments, to use proper infectious-disease techniques? Of course, he could not. Victor ignored the nurses, as they approached the newly infected patients on Thanksgiving Day, handled contaminated endotracheal tubes and oral secretions, and then, probably without even washing their hands, moved on to the next patient.

  Contamination and rapid spread. He had to get Matthew out of there. Now.

  Victor approached the nursing station as if he’d just arrived. Again, he inquired about Matthew. This nurse, a woman with short gray hair and a commanding air, gave him her full attention. She set down the stack of charts she’d been carrying and looked him directly in the eye. “Are you a relative?”

  “Father,” Victor said.

  “Okay.” She grabbed Matthew’s chart and headed to the isolation room. “I see you’ve been his only visitor.” They’d arrived at Matthew’s cubicle door, and the experienced nurse pointed out the fresh gowns and caps and slippers and masks that had to be worn inside.

  “Taking him home today,” Victor said.

  The nurse stared, hands on ample hips.

  “Not home, home,” Victor clarified. “He’s being transferred up north where they have more sophisticated medical care. Arrangements are being finalized and medevac will be here soon to take him.”

  “Nobody told me,” she said, with a grimace. “We’re understaffed today. Why today? Can’t it wait?”

  “Afraid not.” Victor set down his bag, checking that the combination lock was set. Then he slipped on the sterile gown and tied it in back.

  By this time tomorrow, this hospital will be under siege. And Matthew and I will be a thousand miles away.

  “Well, since you’re here, I might as well give you an update. Mostly good.” The nurse recited some numbers: temperature curve, blood pressure, lab values, oxygen saturation. Victor listened intently. By the numbers, Matthew was getting better.

  But as Victor approached Matthew’s bed, he cringed. Matthew still looked very ill. The entire extent of his skin seemed covered with raised, purplish blotches. His eyes were closed and sunken into their sockets. How could this be better?

  “Matthew?” Victor whispered, holding his breath as Matthew’s eyes flicked open and a smile broke through the blotches.

  “You’re here?” Matthew said with a shy smile. “Thank you.”

  Victor was reminded of their first meeting. The day after Cindy’s burial. They’d met at her house, now Matthew’s, in Clearwater. Victor had had no idea what to expect from this son whom he’d never known existed. He could
react with any emotion from hateful anger to passive indifference. But Matthew offered instant acceptance and blamelessness and gratitude. Father and son had talked for hours, unveiling to each other their hopes and fears. Matthew had been a good son to Cindy, and he’d offer Victor nothing less. Although Victor wondered if Matthew could ever come to call him “Dad” or “Father.” He hoped the day would come.

  “Matthew, I was here early yesterday, you were too sedated. But now you’re doing so much better. I’ve made arrangements to take you to a hospital near my home in Bethesda where you’ll get the best possible care and I can see you every day.” Victor realized that he’d made tight fists with both of his hands, he was so intent on his mission.

  “What do the doctors say?” Matthew asked. His voice was faint and scratchy, affected by the tube in his trachea for the past three days.

  “I’m getting you out. This morning as soon as you sign the papers.”

  Matthew looked bewildered. He tried to lift his hand, tied to a board to support his IV line. “You think?”

  “Medevac plane. Not to worry.” Victor pointed to the IV bag. “All that stuff’s going with you. Time to say goodbye, to Tampa City Hospital.”

  “What’s wrong with me?”

  Victor’s eyes welled up at Matthew’s feeble, abrasive voice. “Plenty of time to discuss that later,” he told his son. “Now I’m going downstairs to the business office to get the paperwork started. Once I move the bureaucratic mountains and get you to George Washington Hospital, you’ll be fine.”

  On his way out the door, Victor heard, “What did Dr. Nelson say about the biopsy results?”

  CHAPTER TWENTY-TWO

  THURSDAY, NOVEMBER 28

  THANKSGIVING DAY

  The kitchen was too noisy, so Laura took the call in her parents’ bedroom.

  “Tim?” She knew her voice sounded strident. “Are you there? Is Natalie okay?”

  “Everything’s fine, Laura. I’m enjoying the abnormal quiet in your normally crazy house. About Marcy’s chocolate chip cookies. Only two left. Those boys must have gobbled them all up. I brought you Tastykakes from Philadelphia. Looks like I’ll have to break into them.”

  “Enough about your snack addiction; how’s Natalie?”

  “I assume she’s just fine.”

  “Assume?

  “Here’s what she wrote: ‘Dear Dr. Tim. After the family left, I started to feel better so I went over to a friend’s. I’ll be back before long. Don’t worry—I’m fine.’ ”

  “What? Natalie’s gone? She was still vomiting when we left. I thought maybe you would have to take her to the E.R. I mean, I’m glad that she’s okay, but she should have stayed home.”

  “Teenagers,” said Tim. “Thank God I don’t have kids.”

  “You could’ve been on your way here with her by now. Natalie knows how important getting together is for Grandma and Grandpa.”

  “You’re an adults’ doctor, Laura. I’m in pediatrics. Kids get sick fast. They get better fast. Natalie had one of those eighteen-hour gastrointestinal viruses. You’d better hope the whole family doesn’t come down with it.”

  “As soon as she gets home, will you put her in the car and get over to my mom’s?”

  “Will, do, babe. How are the college boys? And how’s my favorite, Patrick? And that sassy Nicole?”

  “They’re all fine. Going at each other as usual. But I love having them all together. So get here quickly with Natalie, okay?”

  “Yes, ma’am. You did have one message. Hope you don’t mind, your message light was blinking, thought maybe you wanted to tell me something. A Dr. Worth, calling about his son. Knew you weren’t on call, but said he still needed to talk to you.”

  Whatever Mr. Worth needed, Ed Plant could handle when he made rounds.

  “I’m pretty sure his son has AIDS,” Laura said. “You have any experience with the HIV virus?”

  “Unfortunately, yes. We’re starting to see it in kids who’ve had transfusions. With the kind of heart surgery I do, most of my patients need blood—so they’re at risk. I’m really scared about the epidemic potential. And the social implications are tough, too. Is your patient homosexual?”

  “I don’t know.” But Laura’s attention had drifted. Until this conversation with Tim, she had never even considered the implication, the possible risk of the HIV virus to her own family.

  “Tim, what about Patrick? He had transfusions during his heart operation. Was the virus out there in the blood supply seven years ago? I can’t believe I’ve never even thought about this before.”

  Her youngest son, at the age of seven, had undergone major surgery for a tumor in his heart. A benign tumor, she had to keep reminding herself. Patrick was fine now, with no cardiac restrictions. Just a scar all the way from his belly button to the top of his sternum—a scar he’d loved to show off when he was younger, but now kept hidden under his shirt.

  “The best we know, it didn’t show up on our radar screen until 1981. So I don’t think we have to worry.”

  For a moment, Laura’s attention shifted away from her family. “But what about now? How can we prevent our patients from getting blood tainted with this deadly virus?”

  “Blood tests. Maybe urine. Too early to know. Right now all the flack about patents on the test kit puts more emphasis on geopolitics than on diagnosis. Who cares if it was invented in the U.S. or France or Timbuktu?”

  “I can’t think about this anymore now, Tim, but thanks for being there for Natalie. Soon as you lay eyes on her, put her in that car, and get out here. You won’t make dinner, but we’ll save all the leftovers. Count on it.”

  “That’ll be my motivation, babe. And to see you, of course.”

  Laura felt the smile spread over her face. Yes, it would be good to see Tim. Since Steve’s death, he had been her only steady male confidante. She knew Tim wanted to take their relationship beyond trusted friendship.

  CHAPTER TWENTY-THREE

  THURSDAY, NOVEMBER 28

  THANKSGIVING DAY

  Collette knew everything. About her and Trey, that they’d had sex, how in love they were, and about how they wanted only to be with each other. After everyone left for Grandma’s, Natalie called her friend. Collette had cried with her when she found out about Trey’s accident and his awful injury. Collette even knew about the medical and legal issue—Trey’s father’s factory using beryllium, the mineral that was supposed to cause lung disease in workers.

  Neither Natalie nor Trey knew what the truth was: maybe beryllium did injure workers or maybe they were trying to rip off Trey’s dad’s business. Anyway, the two of them had made a pact not to dwell on this potential disaster and just keep their relationship from their parents to avoid any static. They’d kept their secret. But now with Trey in the ICU, if Natalie wanted to get in to see him, she’d have to tell his family she was his girlfriend. She would do anything to be with Trey, including face up to his family—and hers.

  Natalie asked Collette to cover for her. In case her mother called, figuring that if Natalie wasn’t home, of course she’d be at her best friend’s—“tell her I’m feeling better, just not well enough to travel to my grandparents’. Say I’ll be home tonight—say whatever you have to say.” Collette would know how to handle her mother.

  Then Natalie flung off her pajamas, showered, and dressed in what she considered her most demure dress. She found the keys to the Impala and headed for the hospital. She’d cried most of the night, off and on, and hadn’t slept. Her eyes were red and puffy and she didn’t take the time to tame her blonde, wavy hair. Nicole would never leave the house looking like such a freak. But though Nicole always had plenty of boyfriends, she’d never had one as awesome as Trey and she’d never been even close to being in love.

  When Natalie arrived at the main entrance of the hospital, she bypassed the Information volunteer, walked straight to the elevator with a friendly wave. It was twelve thirty. Her mom and the kids had taken forever to leave and she had t
o get back before Tim became worried. That gave her an hour.

  As she passed the ICU waiting room, she glanced inside to see if Trey’s parents were in there. She didn’t know the ICU rules, just that visitors were limited and couldn’t stay long. She tried to remember all the stuff Mom told her that time a few months ago when she and Nicole had agreed to go along on rounds. Mom thought they should all become doctors. Natalie thought she might want to be one, but not a surgeon like her mother.

  The sign on the ICU door said: VISITORS MUST BE 16 YEARS OLD. No problem, Natalie was seventeen. She stepped inside, and walked directly to Trey’s bed. A man with jet-black, tousled hair sat slumped forward in the only bedside chair. A faint snore confirmed that he had drifted off to sleep. This must be Mr. Standish. How would he react to her?

  Concerns about Mr. Standish vanished once she got a glimpse of Trey. Her knees buckled and she grabbed the metal headboard for support. She’d expected him to be all bandaged up, some sort of body cast, but he looked so gray and frail and lifeless. Not caring whether his father woke, Natalie leaned over and kissed Trey. His lips felt dry, almost shriveled, except for a tiny speck of frothy mucous. With her hand she brushed back strands of black hair from his forehead, which felt very hot.

  As Natalie had expected, Trey was hooked up to lots of tubes and drains. Both legs were in casts and elevated. She thought his breathing seemed labored, but that machine beeped a steady beep. He had not responded to her kiss, but perhaps he was numb—she knew he would be getting pain meds. The doctors wouldn’t just let him suffer.

  “Excuse me?” she heard a baritone voice before seeing the flicker of movement as the man in the chair looked up.

  Her lips were still hot from Trey’s, and she brushed at an annoying particle stuck to her lower lip. Before responding, she reached for a tissue from the box on the bedside table, and swiped it away.

  “I’m Natalie Nelson,” she said, her voice sounding squeaky and her whole body starting to shake. “Trey’s girlfriend. Are you his father?”