Weapon of Choice

by Patricia Gussin

  Charles had two concerns. He had been mulling over what Russell’s wife had told him. She thought that The Order was planning an explosion or water contamination. She’d shared her fears with him. Had she shared them with anyone else? Could Russell have gone to the police before The Order took him out? If he had, they’d know Charles’s name. Would they put him on a watch list? Could they be following him? He couldn’t help feeling smug. He’d done nothing to arouse suspicion. He’d gone to work yesterday, come home sick, had a visit from his boss, stopped by the Palace Hotel, but what of it? Then he’d gone to his friend’s viewing and back home.

  The second concern was more worrisome. After the profiteroles had been served tonight, it would take at least an hour for people to start getting sick. Charles had to hand it to Will Banks and The Order for choosing the dessert course. The victims would go home, start feeling ill during the night with fever and muscle pain. By morning they’d have difficulty breathing, high fever, extreme muscle pain, and horrible sores all over their body. They’d then start pouring into area hospitals. By mid-afternoon, panic will have set in, and by evening, the staph would have invaded body tissue. External lesions eating through skin and muscle. Internal organs under attack and susceptible to failure. This was the nature of the staph they were engineering at the CDC. Bioterrorism, masquerading as biomedical research. No wonder USAMRIID brass at Fort Detrick threatened to shut down this program just as they had a parallel effort several years ago at the NIH. In 1969, the United States outlawed organisms for bioterrorism, and in 1970, toxins.

  Of course, he couldn’t be sure of the timing of symptoms since his staph had only been tested in vitro—test tubes, petri dishes, not in vivo—people or even animals. But Charles was still uncertain as to what would happen to him. Why hadn’t he been instructed what to do or where to go after dessert had been served? Was someone from The Order going to whisk him out of the Palace? Banks, perhaps? By tonight would he be in one of The Order’s safe houses? Somewhere in North America or overseas? Maybe Canada, The Order liked to hang out in Canada. Or the Caribbean. Maybe the South of France—he’d mentioned Nice to Will. There was an excellent biotech lab there. Perfect for someone with his skills.

  Charles walked the perimeter of his property and when he’d come full circle he checked his watch. Ten o’clock. The sky was blue, the sun promising to take the chill out of the air. All was serene among the rhododendrons and Charles promised himself that wherever he ended up, he’d plant lush beds of the spectacular plant. He’d read that the genus rhododendron, which includes azaleas, grew almost anywhere in the world.

  He’d gone outside without a jacket and it was time for him to say goodbye to his grounds.

  Entering the warmth of his home, his mind drifted to his lab at the CDC. Had he left any trace yesterday? When Stacy got there, would she find anything out of order? She was a suspicious, small-minded woman, always looking to find something that he’d done wrong.

  And how long would it take the CDC to track the Palace outbreak to him? But so what? He’d be far away from Atlanta, with a whole new identity. And the pride of his parents.

  According to the plan, Charles had two hours before he was scheduled to enrich the media for his cultures. He strolled through his house to the front door and out to the porch to pick up his copy of the Atlanta Constitution. As he turned to go indoors, he opened the paper and scanned a front-page headline, “Fatal Staph Infection Rampant at Tampa Hospital.”

  Was it possible that Stacy had something to do with this? Could she, too, be trying to commit mass murder with the staph strain from the CDC lab? Impossible.

  CHAPTER FIFTY-SIX

  SATURDAY, NOVEMBER 30

  Laura slept until Tim tapped her on the shoulder at nine thirty on Saturday morning. Three and a half hours of sleep since the alarm had awakened her on Thanksgiving morning, fifty hours ago. Like the old days when she’d been a resident, only she’d been younger then.

  “I thought you’d want to wake up, but I hated to—”

  “Of course, Tim.” Laura sat up. “How is Natalie?”

  “I just checked.” Tim sat down next to her on her cot. “Her heart rate is rapid, her PO2 is low despite optimal ventilation, her temp’s at 104.8.”

  She leaned in to him as close as she could in their bulky isolation suits, feeling the tears start to trickle down her cheeks. “So high, even with the icepacks,” she said, her voice shaky.

  “Ma’am, I’m a nurse with the CDC, with the experimental drug,” a voice announced. Laura had never been called ma’am in this hospital.

  Laura looked to the tangerine polyester garbed person, a man this time, judging by the bass voice.

  “You already signed, waiving all liability, so I just have to confirm the patient’s identity.” He walked over to Natalie, picked up her hand in his gloved one, and checked her wrist bracelet. “Natalie Nelson. Yes.” Then he looked at Laura. “Ma’am, are you Dr. Nelson?”

  “Yes,” Laura said. Not wanting chitchat. Just wanting that drug flowing through Natalie’s veins.

  “This is the last dose we have in house,” the nurse said, holding up the vial of amber-colored liquid. “I was told to get it to this room. I’ve heard lots of people talking about you tonight. My CDC colleagues and the nurses here. They are real grateful for you being there for your patients, but honest to God, I didn’t know that your own daughter was one of the infected ones. God bless her, ma’am—I mean, doctor—and you, too.” Then he turned to Tim, “And her father—? God bless you, too.”

  “Thank you,” Laura managed to answer, as she watched the drug finally flow from the disposable syringe into the plastic tube inserted into Natalie’s arm.

  “Please, God,” she said aloud, followed by a silent prayer, the Memorare, “Remember, most gracious Virgin Mother, that never—”

  When the nurse left, Laura sat on the cot beside Tim, both watching the rhythmic rise and fall of Natalie’s chest.

  Tim held her hand until someone wearing a gown, mask, and the rest of the mandatory garb, opened the door to announce that he had breakfast, but they’d have to leave the patient’s room to eat. “Bacon and eggs and toast, orange juice, and a pot of coffee.”

  Laura was about to decline when Tim said, “You need your strength. We’re going out there. You are going to eat something.”

  She did. The coffee perked her up.

  Laura went to check on the remaining patients in the ICU. When she’d left them three and a half hours ago, two still had been alive, the younger woman with the colectomy for ulcerative colitis and an older man. They were infected with the staph, but their infection had started several hours after the first cases and so far had not been as severe. Why? she wondered. Especially the older man with heart disease.

  This time, while away from Natalie’s room, she wanted to personally check on her chief resident Michelle, on Bunnie the cleaning lady, and the other patients in the makeshift ICU. This was the second of seven rapidly assembled ICUs, Laura had been told. The number of staph disease cases continued to escalate.

  Laura really didn’t want to know the latest count, the CDC was tracking the epidemiology. But what had Bunnie tried to tell her in the E.R.? Less than twenty-four hours ago? Felt like a lifetime. The cleaning woman’s words haunted her. What had she seen? Something that might shed light on the disaster in the ICU? Was Bunnie still alive?

  Hampered by a sky-blue suit and the rest of the protective gear the CDC had provided, Laura made her way down the near-empty corridors. She thought about Tim. How she was leaning on him. How willing he’d been to step in, almost as a surrogate father. For all these years she’d been fiercely independent, but did she need somebody? Did her children deserve somebody, a man in their lives?

  CHAPTER FIFTY-SEVEN

  SATURDAY, NOVEMBER 30

  Alone in her P3 lab in the early hours of Saturday morning, among banks of sophisticated state-of-the-art gene sequencers and gas chromatograph-mass spectrometers and low-t
ech incubation baths and autoclaves, Stacy was free to experiment. On her own, unsupervised.

  However reluctant she’d been to leave the epidemiology drama in Tampa, now back in her lab, she was in her element. The only thing she hated about her lab was the fastidious entry-exit process and the cumbersome garb. She might as well be experimenting in outer space, contending with the full-body cover and controlled airflow through a mask that she’d never get used to.

  Today, seclusion was her ally as she went about collecting a series of samples from the CDC’s staphylococcal culture bank. She had set the Tampa culture to run on autopilot while she gathered cultures that she hypothesized should show similar characteristics to Tampa’s. Stacy selected six specimens from the archived culture bank; two from the NIH’s discontinued research—one dating from earlier in their program and one from just before the program had been discontinued. And to the chagrin of the NIH, the research had been transferred to the CDC. If she recalled correctly, that was about the same time that Keystone Pharma had hired Norman Kantor. The other four specimens, she chose at random.

  And the CDC had taken NIH’s staph research further, as Stacy well knew. Her staph cultures were indeed resistant and more virulent. If her strain ever got into the population, by the time those infected were able to get to medical treatment, their organs would already be liquefying—and Keystone Pharma’s ticokellin would be completely useless. The thought made Stacy shudder. She loved her work and though she realized the endgame for developing such potent strains was to facilitate the development of new families of antibiotics, in her heart of hearts, she believed that such lethal research should be conducted exclusively by USAMRIID at Fort Detrick, Maryland, where biodefense was the mission and where security was ironclad.

  Once Stacy had her selected cultures all set up on automated equipment, she thought about calling home. She should be sitting around Mom’s living room gabbing with her sisters. That prick Charles Scarlett had been scheduled to work today. She’d counted on the four-day holiday weekend off. Too bad she’d had to leave so abruptly. Mom had wanted her to talk to her youngest sister Katie about her boyfriend. What had that been about? Stacy thought about calling home, but she knew that as soon as she got into the family chitchat, an alarm would go off and she’d have to attend to one of her machines.

  Besides, there were only fifteen minutes left for the Tampa culture. And then she could plug the data into her computer program and get an early idea of comparative results. Don’t forget to delete the results, she reminded herself. The culture that she was testing had not officially arrived in Atlanta yet.

  In the meantime, she did have time to go into the CDC culture database and prep everything in advance of replating her own, routine cultures. As things worked out, Charles’s absence today meant she had the lab to herself and could test the covert Tampa culture unobserved. Had Stan Proctor actually said he intended to fire Charles? An appropriate step, but would he be able to? Charles was a government employee. And he did know the lab backward and forward. The thought of training a replacement made Stacy groan.

  Stacy hated wasting time, and though she had to wait for the equipment to finish running her clandestine experiment before she went into the incubators, she logged into the tracking program that she and Charles shared. Immediately, she noticed that the timing seemed odd. Yesterday, Charles had been in that incubator longer than usual. Stacy idly wondered why.

  Nothing she could do now but wait. Wait for her experimental results. Wait to get into the incubator. Then she remembered—that banquet tonight. No way would she would finish here in time to attend. And thank goodness for that. Her hair and nails were a disaster. She had nothing to wear. She was dead tired, too.

  CHAPTER FIFTY-EIGHT

  SATURDAY, NOVEMBER 30

  “Dr. Nelson, is that you under the moonwalker disguise?” Michelle Wallace asked, her voice low and hoarse from the endotracheal tube, now removed. “Everybody looks like they’re from outer space.”

  Laura found Michelle alone in a room with four beds, two empty. Her chief resident sat propped up, a tray of clear liquids in front of her: orange Jello, brownish broth, a mug of tea. An IV bag hung over her bed, she still had a Foley catheter draining her urine, and nasal prongs clamped under her nostrils.

  “Michelle,” Laura could hear the relief in her own voice. “You’re going to be okay.”

  “I think so. I was the first to get the antibiotic. I told them I knew the risks, I had just researched the drug for you. If you hadn’t given me that assignment, I don’t know what I would have done.”

  “The ticokellin worked. Thank God,” Laura said, thinking as much about Natalie as Michelle. But had Natalie gotten the drug in time? She’d been given the last available dose, but what about all the other patients? Keystone Pharma had to send more.

  “From what they say, it starts working within the first four hours. I just wish Bunnie—” Michelle glanced to the empty bed next to hers. “She was too sick to give informed consent and her family was too scared of the side effects and she—They took her away a few minutes ago. And the lady in the other bed, she died too. You know her. She was the ICU clerk on duty when the patients in there started getting sick.”

  Laura felt her heart plunge. The amiable desk clerk—the one she’d warned not to eat the apple—dead, too. And she never would get any more information from Bunnie.

  “Michelle, do you remember when I came down to the E.R. just after you and Bunnie got there?”

  “No, they said I was delirious. They told me you were there, though. I’ve been so worried about you, Dr. Nelson. You were there from the beginning, too. We all were so vulnerable. Even the woman who found Bunnie and brought her to the E.R. has it. They said she’s still waiting for ticokellin. But I don’t know; there are so many rumors. I can’t tell you how glad I am that you didn’t get it. And thankful that I got ticokellin in time. Now I just hope I don’t get aplastic anemia.”

  “Michelle, you’re doing fine, and we’ll be back in the operating room soon,” Laura said. “But we have to find out what happened here. Do you have any idea how a staph like this could take over the ICU? Any idea at all?”

  “No, Dr. Nelson, we’ve had a stellar infection control record. We were worried about AIDS since we’d not seen it in Tampa. So little is known about how the virus is transmitted, how to test for it, but staph—”

  “There’s just one connection that I can think of, but it’s so bizarre.” Laura decided that Michelle was alert and oriented enough to bring this up. “Matthew Mercer, our AIDS patient. His father—different last name—comes charging in here, demanding that we get ticokellin, claims it’s his drug, from his friend at Keystone Pharma. He was not successful, nor was I when I tried. Reasonable, since the trials had just been terminated.” Laura suppressed a chill—her daughter and Michelle had been subjected to this unsafe investigational drug.

  “But Matthew responded to the usual antibiotics for staph, didn’t he?” Michelle asked.

  “Yes. And Victor Worth took Matthew home in a medical jet on Thanksgiving afternoon.”

  “Good thing,” Michelle said, “with his compromised immune system, he’d be dead for sure. I really liked Matthew, but I dread what’s in his future.”

  “There’s one more thing,” Laura said. “I’ve been so distracted that I haven’t given it any thought. But that friend of Worth’s at Keystone Pharma. Turns out he had retired, and he was a patient in the ICU. Not our patient, but an overflow patient from the medical service. They were treating him for arrhythmias triggered by a pulmonary embolus. Name was Norman Kantor.”

  “I remember him,” Michelle volunteered. “A bit of a jerk, and his wife was a super bitch. What happened to him?”

  “A victim,” Laura said. “He’s dead.”

  “Holy shit. I mean, don’t you think that’s strange? Dying of a staph infection when that’s been your life’s work?”

  “Even stranger, with his former staph researcher coll
eague onsite?”

  Then Laura told Michelle that Natalie had been infected and that she was about to go back to her, check on whether the ticokellin was working.

  “I had no idea,” Michelle said. “The rumor mill isn’t perfect. This must be so difficult for you, don’t spend another minute here.”

  “Her boyfriend, Trey Standish, is dead, and I have to tell her. Michelle, that terrifies me, having to tell her.”

  “Oh my God, I had no idea—about him and your daughter. He seemed like a good kid. Nice parents, too. I spoke to them a couple of times, but I never saw your daughter with him.”

  “Long story,” said Laura. “On my way to Natalie’s room, I’m going to stop by the ICU to check on the two patients there. I keep wondering why they survived and the other five did not.” Could their cases help explain what had started this horrible epidemic?

  “Dr. Nelson, please get some rest. You look so tired. Almost as bad as I do, and I’ve been in a coma.”

  “Time for your lunch,” Laura said. “Too bad they didn’t give you the cherry flavored Jello.”

  “Thank you, Dr. Nelson, and thanks for coming to see me in the E.R. even if I can’t remember. All I remember about that night was Bunnie—hallucinating about some ghost doctor feeding all the patients in the ICU. ‘Evil doctor,’ she kept raving.

  Laura shook her head. She couldn’t ask what “evil doctor” had crossed paths with the cleaning lady in the E.R. Or, know for sure whether Bunnie had been hallucinating on her deathbed.