Weapon of Choice

by Patricia Gussin

  Visitors. Natalie. She needed to check on Laura’s daughter the minute she’d finalized arrangements for the CDC’s rapid-response Emergency Operation Implementation Program—EOIP. Stacy had been on the ICU clerk’s phone with the CDC for almost an hour. Ever since Laura was called to the E.R.

  Once the CDC program was in place, Tampa would receive all manner of federal support. Stacy would be gratified, but after the EOIP team arrived, she knew her role would be zip. She’d simply be a researcher who happened to stumble into this bio disaster.

  Research. The cultures in her Atlanta lab. Stacy needed to get back there tomorrow. She should leave tonight, but if she could get in touch with Charles, maybe she could convince him to go to the lab and do the culture transfers. Certainly he wasn’t too ill to cover her in an emergency scenario like this? Stacy wanted to stay to support Laura—and honestly, to observe the EOIP team in action.

  On Stacy’s advice, a communication center had been set up on the seventh floor at the opposite end of the building from the ICU. All patients other than those in the ICU had been moved from the seventh floor to a quarantined area in another wing of the hospital. As soon as Laura returned to the ICU, Stacy would suggest they check on Natalie.

  She’d just hung up with the logistics director of the EOIP team when she spotted Laura rushing toward her.

  “Stacy, I have bad news.” Laura tried to catch her breath. “Maybe you know? We have two staff members presumably infected. One is my chief resident. What if—”

  No, Stacy had not heard. This faulty communication would come to an end when the EOIP team arrived.

  Laura’s beeper went off and she dialed from the clerk’s phone.

  Stacy watched her friend’s face go pale.

  “Thank you.” She hung up. “Another patient, Norman Kantor, died in the ICU. Fulminating infection. Total organ shutdown. He was in here because of a pulmonary embolus following hip surgery.”

  “Norman Kantor? Was he a microbiologist?” Stacy repeated. Laura confirmed he had been. “How weird is that. I know him. I thought about calling him as a consultant. He was an NIH microbiologist who left and went to Keystone Pharma. Ironic, he’s a world-class expert in staph, the developer of ticokellin.”

  “The wheels are in motion to get some down here. Not easy, cutting through the bureaucracy with a side effect like aplastic anemia. I think it’ll happen, but probably not tonight. Tomorrow’s more likely.”

  “Stacy, we need that drug. I know there have been cases of aplastic anemia, but what the patients need here, right now, is an antibiotic that will kill that staph. It’s ironic and sad that Norman Kantor couldn’t get the drug he invented.”

  “Laura, before you get all gowned up to go inside the ICU and before the CDC descends, let’s go spend time with Natalie.”

  “I promised to check on her boyfriend,” Laura said in a low voice. “But I got called to the E.R. Never even got to his chart.”

  “Natalie’s boyfriend is one of the sicker ones,” Stacy said. “I still can’t imagine your little girl with a boyfriend.”

  “If he doesn’t make it,” Laura said, “Natalie will never get over it.”

  If she survives. Stacy hoped Laura couldn’t read her mind.

  CHAPTER FORTY-FOUR

  FRIDAY, NOVEMBER 29

  The house was empty when Charles returned home from the Palace Hotel. Why wasn’t Banks waiting with further instructions? He wondered whether there was something else he should be doing now. He and the chef had carefully plotted how they’d coordinate tomorrow’s mission. The Palace Hotel restaurant would be closed to the public tomorrow to accommodate the Atlantic Daily Reporter’s celebratory banquet. For dessert, the banquet service would provide only the hotel’s signature profiteroles.

  Charles had first tasted profiteroles when he’d visited London with his parents. Since then, he’d always been on the lookout for them on dessert menus, but none had equaled the ones he’d devoured at tea in that London hotel. Never could he have imagined the wonderful puffs of chocolate and cream as the delivery vehicle for a bioweapon.

  He’d only half listened when Collins explained how the shell was pâte-à-choux. Whatever the heck that was.

  “Means the pastry for forming little cabbage shapes.” Chef Lonnie continued, “First, I add the flour to boiled butter and water and beat till it forms a smooth ball of dough. Then I cool it to lukewarm, add eggs, beat, pipe the dough onto sheets, and bake.”

  “You can’t overheat the bacteria,” Charles warned. “The strain will resist stomach acid, but it can’t withstand heat from cooking or baking.” Could this be his ‘sorry, it won’t work’ exit ploy?

  Lonnie wasn’t buying in. “Even I know that much,” he said. “It’s the cream phase where you’ll do your thing.”

  “Oh, yeah. Told you, I’m no chef,” he’d mumbled.

  “After the pastry shells cool, I split them in half and fill them with my special cream. That’s the trick, how I prepare my cream. I fill each round of choux pastry with enough cream so that when you place the top half of the pastry on it, the cream peeks out of the sides. The finishing touch is a drizzle of warm chocolate ganache.”

  Charles was about to ask what ganache was, but focused instead on the cream. The staph would go into the cream quite nicely. The smooth texture and the fatty nature of the cream would make the perfect carrier.

  “We do the final assembly just before serving,” Lonnie had continued, “so when dessert arrives, the chocolate sauce is still warm.”

  Lonnie had laid out all these steps methodically. Might as well have been coaching a sous chef, not plotting to kill hundreds of unsuspecting people.

  Charles had tried to be equally matter of fact. Kept his thoughts on the task at hand, not straying from the logistical into the moral or ethical realm.

  They came up with a good plan. Lonnie would thicken his cream, so that it would not overflow the shell and perhaps infect the kitchen or waitstaff. The profiteroles would be plated, and fifteen plates arranged on each large serving tray. Twenty-five trays. Just before Lonnie did his drizzle of chocolate sauce, Charles would introduce the bacteria into the creamy center of each of the plated profiteroles. Using a syringe, he would infect the creamy core of each dessert. The chef would control the flow of the trays. No one else would be allowed close enough to Charles to observe that he was injecting each dessert with an inoculum of staph no bigger than a speck. He would use gloves and sterile technique, as he did every day in his level P3 lab.

  “Let’s hope no waiter grabs one when I turn my back for two seconds,” Lonnie had said with a shrug. “Happens all the time.”

  Charles had assured him that no trace of live bacteria would remain in the kitchen. Neither man could predict whether, nor how, their deadly recipe could be discovered. The victims would not fall ill until after they’d left the hotel, so for about twenty minutes or so Lonnie would carefully monitor the dining room, collect any leftover whole profiteroles, or partly eaten, and put them immediately into the garbage disposal.

  At loose ends, Charles retired to his bedroom. Too keyed up to read, he’d watch some mindless TV show. Would the plan work? Charles speculated as he stretched out on his leather sofa. When would Banks reappear to let him know where they’d arranged for him to start the next phase of his life. He was an excellent scientist and under normal circumstances would have no problem getting a job. But with a new identity? The Order would no doubt have figured out all of that. As for his parents, what would they be told?

  “All in due time,” Banks had answered when he’d raised the question. What had he meant by that?

  Charles was trying without much success to relax when he heard a car pull up in the driveway. He waited for Banks to walk in the back door, but instead, he heard the front doorbell ring. Mystified, Charles hurried down the front stairway.

  Too early for the motion detectors to turn on the porch light. Through the glass pane framed in the polished oak door, a familiar fa
ce. Stanley Proctor, his boss—until Stacy Jones’s sudden promotion—stood on his doorstep.

  Does he know about the cultures?

  Charles slumped against the doorframe, trying to look composed, taking a deep breath to control his panic. Should he let Proctor in? What if he came to search for the cultures? But if that’s what he wanted, why come alone? The bacteria were an extremely high security risk. The CDC should be sending the army, not a puny middle-aged scientist. Charles inched open the door, hesitating just long enough to glance up and down the street. No federal agents, no soldiers. He opened it wider to let his visitor enter.

  “Stan?” Not only had his boss never before set foot in Charles’s house, but he was disoriented by Proctor’s sweatshirt and khakis. He’d never seen the man in anything other than a business suit or a starched lab coat. “Come in.”

  “Charles, I need to talk to you,” Stan said as they traversed the spacious entry hall leading to his luxurious living room.

  Charles stood silent as Stan gazed around the room, taking in the expensive artwork. All he said was, “Nice place.”

  Charles gestured for him to sit on one of the two matching love seats. “Can I get you something to drink?” He almost said, “My housekeeper left for the day,” then he realized how pretentious his lifestyle must seem to Stan who he knew had grown up in a blue-collar family.

  “No time,” Stan said. “I understand you went home sick today.”

  Shit. He’d forgotten all about that ruse. Had that been only this morning?

  “I had severe flu symptoms,” Charles said. “Better now, but I haven’t been able to keep down any food.” Good thing he’d not taken him into the den where the telltale leftovers of his late lunch sat on a tray.

  “There’s an emergency, Charles, and I need your help.”

  How in the hell could he know that the cultures were gone? And he wants my help?

  “What’s going on? Sorry I didn’t answer my phone today, I just felt too weak.” They all thought he was a wimp anyway. Now Stan would go back and report, “Guess what he said? ‘I was just too weak.’ ” So what? After tomorrow he’d never have to face Stan Proctor or anyone else at the lab again.

  “There’s a developing situation with a staphylococcal outbreak in Tampa, Florida. We’re sending down an EOIP team.”

  What did that have to do with him and the cultures? Charles sat down in the nearest armchair.

  As relief replaced panic, Charles’s attention lapsed. When he tuned in again to whatever Stan was saying, he heard, “We want Stacy to stay in Tampa to support the team. She discovered it and—”

  Stan continued talking without a pause as Charles tried to make sense of what he was saying. He’d told her that he was too ill to change out the cultures tomorrow. She said she’d come in to do it. And now—

  “It started in the ICU,” Stan’s voice intruded once more. “Two dead there, and it’s spreading to the staff. A medical resident—”

  So the boss had come here about Stacy. The visit had nothing to do with Charles or his pilfered staph.

  Relieved, yet angry, Charles worked to keep his tone neutral, “Stacy? How’s she involved?”

  “She got a call from an infectious disease doctor at Tampa City Hospital,” Stan said. “Called her at home, and she responded. Not exactly protocol, but good thing she did. The bottom line is that she can’t fly back now, so you need to replate the cultures, and you don’t look too sick to do so.”

  Screw you, Charles wanted to respond. Instead, he inquired about the staph in Tampa, surprised that it was so virulent, resistant to all antibiotics, that it shared so many characteristics of the strain that they were developing at the CDC. How convenient, he said to himself, that Stacy was involved. Could she have had something to do with this? Could she have taken a culture, too? That bitch.

  “Stan, from what you know, how similar is the infectious organism there to what we’d expect from our staph?”

  “Confirmed staph; unidentifiable strain; either wild or experimental, we don’t know; resistant to methicillin and vancomycin and everything else; site of inoculation unknown; rapid onset of shock and multiorgan shutdown, disseminated intravascular coagulation; the works.”

  “Skin lesions?” Charles held his breath as Stan responded. His bacteria had been engineered to cause necrotizing fasciitis. That’s why they called it “flesh-eating.”

  “A mottled rash on the trunk, but no bullae or pustules.”

  So the staph is not the same. Where had it come from? A spontaneous mutation? How strange that the only connection between this epidemic in Tampa and what was about to happen in Atlanta tomorrow night was—Stacy Jones? A coincidence? Maybe not.

  Charles certainly was not about to let Jones off the hook so she could go right on playing prima donna expert in Tampa. She’d have to come back to Atlanta and take care of business in the lab. Now, wouldn’t it be too perfect if she could join her people at the Palace tomorrow night for dessert?

  “No.” Charles stood up. “I cannot make it into the lab tomorrow. I am too ill. Now, Stan, I must ask you to leave.”

  CHAPTER FORTY-FIVE

  FRIDAY, NOVEMBER 29

  The shrill ring of the bedside phone jarred Victor out of a deep, delicious sleep. For a futile moment, he ignored the interruption, but knew that he’d not be able to recover the emotion-filled dream. He and Cindy and a little boy romped through a field of wild flowers, holding hands, and singing “Old MacDonald Had a Farm.”

  “Hello,” he mumbled, resenting severance from the dream.

  “Is this Dr. Victor Worth?” The voice sounded vaguely familiar.

  “Yes, it is.” Victor checked the clock. Almost three in the afternoon. He’d slept for three hours. He needed to get back to the hospital. He felt his chest contract, realizing that he’d have to tell the little boy in his dream that he would die of AIDS.

  “Dr. Fred Minn. Keystone Pharma. We spoke briefly when you were here earlier this week.”

  “Yes.” You’re the prick who blew me off.

  “I am calling with a rather urgent request.”

  How strange. Keystone Pharma calling me?

  “I don’t need your ticokellin,” Victor said. “But I am disappointed that you refused to help me.” He wanted to add, “And your company screwed up a drug that I was responsible for discovering.”

  With a sly smile he thought of Norman Kantor. Was that traitor still among the living?

  “There’s been an outbreak of a virulent staph infection at a hospital in Florida,” Dr. Minn continued. “Resistant to methacillin and vancomycin. Two deaths already.”

  “Why are you telling me this?” Victor interrupted, feeling paranoid. Keystone Pharma knew that he’d wanted ticokellin sent to Tampa. Could they think I’m somehow involved.

  Dr. Minn avoided his question. “Dr. Worth, your former colleague at the NIH, Dr. Norman Kantor, was one of the victims. You spoke of Dr. Kantor when you were here, as I recall.”

  “Norman’s dead?” Victor tried to sound shocked.

  “I’m afraid so. Full-blown staph sepsis. Poor guy.” There was a momentary pause, then Minn said, “Happened at the same hospital where you wanted the ticokellin.”

  “Turns out I didn’t need it,” Victor said, needing to distance himself from the Tampa location.

  “I’m glad. But with this outbreak, we have a new situation. We’ve gotten calls from the CDC and the FDA to release the drug on an emergency compassionate basis, but that’s not why I’m calling.”

  Was this guy trying to connect the dots between Norman and Matthew?

  Victor took a deep breath, held it, trying to think. Norman was dead; mission accomplished. And right now, Victor thanked God that he’d had the foresight to dismantle his lab and scour his basement of all traces of bacteria. Although he still had to make that trip to the landfill. “What does all this have to do with me? I’ve worked with staph, but my agency disbanded the staph research program.”

 
; “Your name came up today. Next to Dr. Kantor, who developed the kellin line of antibiotics, you know more about resistant strains of staph than anybody except the CDC and USAMRIID scientists. Now that we’re facing a real problem, we need your expertise to pursue sister compounds to ticokellin.”

  “You may not know this, Dr. Minn, but it was I who developed the kellin line.” Have to watch it here. “And the wrong chemical from the series was taken to the clinic. You should have gone with biskellin, not ticokellin. I warned Norman about the propensity for side effects with the ticokellin’s binding profile, but he capitulated to management when the manufacturing costs for biskellin were deemed too high.”

  “Well, I can assure you, Dr. Worth, that manufacturing costs will no longer be an issue. We want to be back in the clinic with an effective kellin as soon as possible and we want you to lead the effort.”

  For a moment, Victor thought that he was hallucinating. After all the wheedling he’d done to try to land a research job at Keystone Pharma when Norman was there, he gets a bizarre phone call on a Friday afternoon. He sat down, speechless.

  Minn waited for a response that did not come, then went on, “I know this is sudden, but the situation is urgent. Our CEO, Paul Parnell, has already cleared your hire with the NIH. Realize that he has top-level contacts ever since Keystone Pharma developed the antidote to that mutated adenovirus causing hemorrhagic fever in Africa. As you must know, he got the Nobel Peace Prize for that.”

  “You contacted my employer?” Norman asked, not knowing whether to be flattered or incensed.

  “Just to clear the path. We’d like you to start immediately.”

  “I don’t see how I can do that,” Victor said. Even if I wanted to. And he did want to. He had to consider Matthew, who could be discharged on Monday.

  “We’d like you to come in tomorrow, meet with the Human Resources vice president, get the paperwork cleared. We hope you can begin working on Monday, with the scientists on your team.”