Weapon of Choice

by Patricia Gussin

  Tim said, “I’m going to get Laura. Stay with Natalie until I get back.”

  “Naturally,” a voice she now recognized as Dr. Kellerman’s said, “if Dr. Jones is with Laura, get her in here, too. She’s trying to obtain ticokellin, and when it comes in, I want it for Natalie. But I’ll need Laura’s consent. I just hope the FDA didn’t cut the eligibility at age eighteen.”

  Natalie heard Tim leave, just as they came to take more blood. She needed to stay awake until her mother got there. She had to know about Trey. But she could not hold off the darkness.

  CHAPTER FIFTY

  FRIDAY, NOVEMBER 29

  Victor had considered sneaking in a bottle of champagne so they could celebrate his job offer, but quickly realized the complicated cocktail of medications in his son’s body would not mix with alcohol. Instead, he brought a bottle of carbonated white grape juice and two plastic champagne glasses.

  Victor found Matthew sitting up in bed watching television, a tray of bland food on the folding table in front of him and an intravenous running in his left arm. He looked pensive, but seemed to cheer up when he read his father’s expression of triumph. And triumph was right. He’d beat Norman at his own game. Hadn’t Dr. Minn as good as said that Victor’s compensation package would exceed what Norman had commanded? And most satisfying of all, Norman was among the dead.

  The other patients in that ICU had been so sick, Victor convinced himself, they’d have died even without his intervention. They’d looked terrible and had been on life support with ventilators breathing for them. Why dwell on them now? What was done, was done.

  Except, just before he’d left for the hospital, he had been unnerved by a call from Naomi Kantor. She said she wanted Victor to know that Norman had died of a certain staph infection, much like the type that he and Norman had worked on at the NIH. She’d caused him a moment of alarm when she added pointedly that Victor had been in the hospital where Norman died, and had actually visited and talked to her husband. Why, she’d wanted to know, had Victor happened to be at Tampa City Hospital?

  Victor wasn’t inclined to offer any explanation. But when she pressed, he’d said simply, “Visiting a friend.” He had no intention of sharing anything with that pretentious bitch, much less his new paternity. But neither did he want her asking around about him.

  Soon enough, she’d moved away from the dangerous subject to complain to Victor about her own plight—trouble contacting her children. Where were those ingrates when she needed them? Before hanging up, she’d actually thanked Victor for being there for her. Wait until she finds out who has her husband’s old job at Keystone Pharma.

  But now, here was Matthew, looking pinker and breathing on his own. Victor forgot all about Naomi Kantor. Matthew clicked off the TV set. Victor pulled the visitor chair close to the bedside and decided to tell Matthew the good news straight out. Pushing aside the tray of half-eaten food, he poured two glasses of juice.

  “What’s going on?” Matthew asked.

  “Two news bulletins,” Victor announced, raising his glass for a toast. “I’ve been offered a management job at Keystone Pharma, a big pharmaceutical company, and—”

  “That’s wonderful,” Matthew said, lifting his glass. “Let’s drink to that!”

  They each took a sip of the sweet liquid, each trying to pretend that it was palatable.

  “Sorry, I interrupted,” Matthew said. “You said you had two bits of news. That one will be a hard act to follow.”

  “No, the next one is even better,” Victor said, savoring this announcement. “The doctors said that I can take you home Monday. Only now it won’t be my home in Bethesda, but my new condo in Philadelphia.”

  Matthew’s reaction was not as warm as Victor had expected, nor did his son appear surprised. The doctors must already have told him that he would be discharged.

  “Victor, it’s not that I don’t appreciate all you’re doing.”

  Victor. Not Father.

  “Without you, I’d have had no one in Tampa to get me though this difficult time, but—”

  “I told you before, Matthew, that I will be here for you. Every step of the way. I know that AIDS is a tough diagnosis to accept, but there’s a lot of research going on. As a big shot scientist at Keystone Pharma, I’ll have access to all that research.”

  Matthew fixed soulful eyes on Victor. “I never had a father. And now, with the sacrifices that you’ve made for me these last few days, I feel that my most sacred prayer has come true.”

  This is what Victor had been waiting for, wanted more than anything else, sacred prayer. He closed his eyes, squeezing them tight for a moment before he felt them fill with tears.

  Matthew reached for his hand. The touch was soft even though Matthew’s hands were bony, the skin thin and still a little blotchy.

  “Father,” Matthew said, “my doctor came in and we talked. He said I could be released if I had home care to keep up the intravenous antibiotics for another two weeks. Then I can travel. I’ll need to find an HIV specialist in San Francisco.”

  “San Francisco?” Victor must not have heard correctly.

  “When Mom got so sick that she needed me with her in Florida, I left my friend—friends in San Francisco. I always intended to go back. After Mom died, I stayed in Florida to sell the house, settle all her affairs. But then I got sick, met you, and you rescued me.”

  “Don’t go back,” Victor heard himself plead. “I just found out I had a son. If I’d known, I’d have never left Cindy to deal with a child. I never even told her why—” Victor let his head slip into his hands. “I was so ashamed. I just couldn’t tell her.”

  “Why ashamed?” Matthew asked gently. “Tell her what?”

  “That I had testicular cancer. That I had to have a bilateral orchiectomy. They castrated me. Did a radical node dissection down there.” Victor pointed to his crotch. “Radiation. Chemo. One of the drugs, cisplatin, did tubal damage to my kidneys. I was a wreck. I didn’t want to put all that grief on Cindy. We both were graduating from the University of Florida. The diagnosis was my graduation present, and I left to live with my parents in Bethseda. Eventually, I got my Ph.D. in D.C., lived with my parents until they died. Still do live in the same house.”

  “Geez, I never knew,” Matthew said, gripping Victor’s hand more tightly, tears starting in his own eyes.

  “Your mother never knew,” Victor said. “I never called her. She never called me.”

  “But she knew how to contact you,” Matthew said. “Thank God that she sent you that letter.”

  “I tried to spare her pain and suffering,” Victor said, looking up through tears, “and I never knew she was pregnant. If only I had, things would have been so different. So you see, Matthew, you need to come live with me. I can’t lose you again.”

  His son looked so vulnerable, too fragile to live anywhere but with him. Maybe he did have friends, but Matthew was his biological son, a bond too powerful to ignore.

  “Father, I have a special friend in San Francisco who needs me. We love each other and we want to spend the rest of our lives caring for each other. You see, he’s HIV positive, too.

  Victor had not even considered this. That Matthew was involved in an intimate relationship that would take precedence over their father-son relationship. Should he invite Matthew’s friend to live in his condo, too? Matthew would have a companion. Lover, to be clear. Minn had said that the condo was spacious. Should he encourage this unusual arrangement?

  “Bring him to Philadelphia. At least until you—”

  “Father, San Francisco is the best place to be for HIV. They have more experience, more tolerance, than doctors anywhere else.”

  Victor nodded, knowing that AIDS was just making its way around the country. Washington D.C., New York City had cases, but Matthew was right about the concentration of cases and HIV care in the Bay Area.

  “Come out and visit. Get to know my friend. How about that?”

  Victor felt deflated. But lo
ts of men had sons in different parts of the country—and with his new salary and access to Keystone’s jets, he could visit Matthew regularly and bring Matthew to Philadelphia for visits. For a while, he’d be transitioning to corporate life at Keystone. Maybe this idea would work. He wouldn’t even have to explain to anyone at work that he had a gay son with AIDS. The corporate world, like everywhere else, was full of ignorance and hate. Fear, too. Right now, he could concentrate on his new job, knowing his son had a support system in San Francisco.

  “Son, I want what’s best for you. But you’ll need to spend a couple of weeks here until you’re off the antibiotics. Why don’t we talk about this later?” He welcomed the beginning of a smile he could see in Matthew’s eyes. “I’ll respect your decision and I can help with anything. Meantime, tomorrow they want me to spend all day at Keystone Pharma. They’re expediting the hiring process so they can prioritize research. Because of some staph epidemic in Tampa at the same hospital where you were admitted. Thank God I got you out of there in time.”

  “In Tampa?” Matthew said, releasing Victor’s hand. “I hope Dr. Nelson is okay, and that attractive resident who’s always with her. Michelle Wallace. Those are two special women.”

  CHAPTER FIFTY-ONE

  FRIDAY, NOVEMBER 29

  “Outstanding job, Stacy—you blew the whistle on what looks like a Class A disaster at Tampa City Hospital. But if you don’t come and deal with our cultures here in Atlanta, well, I don’t have to tell you—”

  “Yes, Stan, I understand,” Stacy told her boss. Rank had its privileges.

  And she did understand: decades of research down the tubes. Charles Scarlett had to be the king of the pricks. He wouldn’t be working for long at the CDC, Stan Proctor had as good as said. The boss had gone personally to Charles’s house to convince him to show up at the lab tomorrow to replate the cultures. Charles, who had appeared the picture of health, had refused. Blatant insubordination, Stacy figured. But Stan—even at his management level—would have to contend with layers of bureaucracy to fire anybody from a government job.

  The cultures were her problem now.

  “So we’ll send a plane to bring you back to Atlanta tonight. The plane will leave from the private terminal in Tampa at eleven p.m., so you won’t get that much sleep tonight. At seven a.m., the director wants to see you in her office. She’ll want to debrief you on exactly what you found in Tampa. She plans to go there herself, even though the rapid response team should have the situation under control. The media will be hounding her, so it’ll be best if she’s at the scene. Since staph is the culprit, I’m going down, too. Same plane you’ll return on, so we’ll cross paths in the airport. Be sure to go to the private terminal.”

  Stacy wondered whether she really was born for management. Disrupted plans; pressure from the media. But private jets sounded okay.

  Members of the EOIP team were arriving in droves—she had no idea how many—doing what they do, responding rapidly. There were protocols for situations like this, and Stacy wanted desperately to see them in action, to observe and learn. But she was a good soldier and would be on that plane to Atlanta as ordered. Her first ride on a private jet.

  Nine o’clock. Two hours till her flight. Tampa International was only a half hour from the hospital. And, tonight, no need to allow extra time for airport lines. She headed for the hospital’s microbiology lab.

  Soon after she’d arrived at Tampa City, Stacy had visited the hospital lab director to request special tests on the staph organisms growing out of the ICU victims’ cultures. She also had asked him to sequester a small sample for her to transport to the CDC, where they had sophisticated testing equipment to characterize bacteria strains. She had just enough time now to collect her test results and pick up the sample.

  Two uniformed men blocked Stacy’s access to the lab. Their uniforms looked more like army than local police, but the men wore no identification.

  “Ma’am, this area is off-limits.” The shorter of the two guards held up his hand.

  Stacy needed to get those cultures. A question was beginning to form in her mind. Something about this outbreak. She needed to see the sensitivity results for the ticokellin that Keystone Pharma had flown down for testing. “I’m Dr. Jones—CDC,” she stated. “I need to see the lab director.”

  “Sorry, no exceptions,” the man said. “There’s a dangerous bacteria in there.”

  “Will you go in and let him know I’m here?” she asked. “It’s vitally important.”

  The two men exchanged glances. Clearly, neither wanted to go anywhere near that laboratory door.

  “I am from the CDC,” she said again, trying to exude confidence. “I’m doing my job here.” She presented her Center of Disease Control ID badge. Neither moved to touch it.

  The two men nodded at each other. The burly one said, “Go ahead.”

  Stacy found the lab door locked, but when she knocked, she recognized the tech who opened it. She found a cluster of lab technicians grouped around a management type with a strident voice. “Nobody will leave the quarantined area until we give the clearance.”

  The announcement elicited a chorus of groans. Terrified at the prospect of quarantine, she bolted for the lab director’s office. The door was closed. Without knocking, she opened it, finding him on the phone. “Honey, I don’t know when I’ll be home.” Startled, he looked up to see her. “Yes, I’m okay, but I’ve got to go.” A pause. “I love you, too.”

  “Do you—”

  “Dr. Jones, I hope this helps. I have the test results you requested and the material. All securely wrapped, but be careful. I don’t have to tell you about how contagious this is. Your CDC people are moving fast with the quarantine, too fast for me.” He handed Stacy a wrapped package and a manila folder, and directed her to the exit on the opposite side of the hall. “Go. They haven’t locked that one yet.”

  Good thing Stacy had taken time with the microbiology lab director yesterday to explain her concerns. Her extra care had been repaid, she thought, as she secured the package in her bulky shoulder bag. Once she got this culture back to the CDC labs, she’d be able to test her hypothesis. Should she share her idea with Laura? First, she had to find her. Eager to see for herself how Natalie was doing, she headed toward Natalie’s room. Laura would be with her unless she was in the ICU.

  Ignoring the quarantine sign and after a perfunctory knock, Stacy stepped inside. Several health care workers, wearing protective clothing surrounded a slim, blonde girl with skin the color of slate. The person at the head of the bed was inserting a nasotracheal tube into one of the girl’s nostrils. A ventilator stood ready, a technician tweaking the settings.

  Laura stood at the foot of the bed alongside a tall man in protective garb. Tim. Laura looked stricken and Stacy wanted to rush to her, but she backed up to reach for a pack of sterile clothing. Pulling her shoulder bag with the staph cultures down around her waist, she quickly donned the protective covering. Under her gown, the lethal bundle protruded as if she were a few months pregnant.

  “Laura,” Stacy spoke softly, not wanting to disrupt the intense focus of the team working on Natalie.

  Laura looked up, tears streaming down her cheeks. Tim put an arm around her shoulders and pulled her closer.

  “She started to get worse about two hours ago,” Laura said. “Thank you, Stacy, for pushing Keystone and the FDA. The ticokellin just arrived at the Tampa airport. I have to sign the papers. I think it’s her only hope.”

  Laura spoke through tears. “Natalie’s course has followed the others’, and now she’s going into rapid decline. Septic shock. Pulmonary infiltrates. Azotemia. She needs that drug before all her organs fail. I just lost another patient in the ICU and her boyfriend is—”

  “On life support,” Tim finished Laura’s sentence.

  Stacy knew that Trey Standish would not make it. Even with the ticokellin. Once disseminated intravascular coagulation set in, you were out of options. In DIC, small blood clots
form throughout the body and quickly consume all the coagulation proteins and the platelets in the blood so that internal and external bleeding is unstoppable. And the clots themselves cut off blood flow to the organs. She’d seen the boy’s labs: prolonged bleeding time, no platelets. And she’d seen the boy, literally hemorrhaging from every organ in his body. No wonder DIC also stands for “death is coming.”

  “I don’t think he’s going to make it,” Stacy said, “but, Laura, I came to tell you that I have to go back to Atlanta. My boss called and they need me. They’re even sending a private plane to get me. Believe that?” Stacy wasn’t sure she was getting through to Laura, but she needed to say goodbye. “The CDC is on the way, mustering all its resources. Before I go, I’ll make sure that the senior clinician checks on Natalie.”

  “I understand,” Laura said, “and thanks so much for getting the ticokellin released to us. If Natalie gets it in time—”

  Stacy turned to leave, wishing that she could hug her friend, but touching was prohibited in that environment.

  “One more thing,” Laura said.

  Stacy turned. The ventilator was hooked up now, filling Natalie’s lungs with oxygen-enriched gases.

  “Will you promise to make sure that Natalie gets the ticokellin? Please?”

  CHAPTER FIFTY-TWO

  SATURDAY, NOVEMBER 30

  Natalie, seemingly lifeless except for the rising and falling of her chest, tore at Laura’s heart. She sat slumped forward in the bedside chair next to Tim. Keeping vigil, praying. Of her five kids, Natalie and Nicole claimed the softest spot in her emotional core. Still, she believed she loved all five of her children equally. All five had such different personalities, but she’d always felt more protective of the girls. These days she rarely thought about Steve, their father. Whereas most fathers would have cherished the adorable little twins, Steve had barely tolerated them. On the other hand, he’d been a good father to the boys. Had Natalie and Nicole’s emotional development been damaged by Steve’s attitude? Is that why they had such disparate personalities? Nicole, outgoing and aggressive; Natalie, sweet and compassionate? No way to know, but Laura blamed herself. She’d let Steve get away with it, too busy with her career to intervene.