by Jan Coffey
“Mr. Newman,” she said hoarsely.
“Please, call me Austyn,” he said, approaching her. The head of the hospital bed had been raised and a couple of pillows were propped up beside her. There were no IVs or any other monitoring devices hooked up to her. His gaze went over the place where her leg should have been.
He saw, pinned to her hospital gown, a gold charm. He recognized it as the one the woman at the clothing store in Erbil had given Fahimah.
“My sister tells me that she owes her freedom to you.”
Now he was embarrassed. He looked at Fahimah and shook his head. “All I can say is that I’m sorry, though I know that will never be enough.”
“Let’s not discuss politics,” Rahaf said, wincing. She was sounding very tired and short of breath. “We all are victims…every one of us.”
It was obvious that she was in a great deal of pain. Dr. Mansori had mentioned that, other than shots of morphine to ease her suffering, she wouldn’t allow treatment that would needlessly prolong her life. She moved slightly and motioned to a chair near the bed.
“Please sit down,” Fahimah said, repeating her sister’s gesture.
Austyn did as he was told but not before Fahimah brought another chair that was by the window closer to the bed, too, where she could sit.
“Fahimah tells me you’re facing an epidemic in America.”
Austyn summarized the situation, focusing first on the strain of bacteria they’d never seen before—with the exception of what had been discovered in Rahaf’s laboratory. He gave her as much background information as he had on the cases discovered since that first outbreak. He also mentioned the latest suspicion that some kind of cold medication might be infecting the victims.
Rahaf listened to everything he said. Despite her pain and obvious discomfort, Austyn could see she comprehended every word.
“My study initially started on a family of Panton-Valentine leukocidin,” she began softly, “which, as you know, is toxic to cells. They can cause leukocyte, or white blood cell destruction, pneumonia and Necrotizing Fasciitis...”
Austyn pulled out a pen and paper, and scribbled her words as fast as he could. She told him the details of the study that she’d been doing prior to the discovery of something unexpected, the mutation of the bacteria into a super-microbe. Despite her illness and physical frailty, her mind was sharp and clear. She had no trouble remembering anything.
“Although MRSA…methicillin-resistant staphylococcus aureus…has traditionally been seen as a hospital-associated infection, MRSA strains have begun to appear outside of hospitals and clinics in recent years. This specific strain is definitely a community-associated one,” Rahaf told him.
“As you know,” she continued, “MRSA strains are resistant to the usual antibiotics, but a curious interbreeding with community staph has led to the genetic acquisition of a PVL factor, which in turn has produced a series of changes that make these strains particularly invasive, as well as resistant.”
“My understanding,” Austyn said to her, “is that staphylococcal infections are an issue only when the individual has suffered a skin break or an open wound, but this isn’t always the case with these victims.”
Rahaf closed her eyes for a moment, and Austyn looked at Fahimah.
“There is no need to do this now,” he said. “I don’t want to tire you.”
“No, Austyn,” Rahaf said. “Just give me a moment.”
Fahimah kept her eyes on her sister’s face, and Austyn could read the sorrow there. Rahaf drew in a deep breath and looked at him.
“What you say is true.” She nodded. “My laboratory experiences were in a controlled environment. But my contention is that, in the real world, this strand can colonize in the mouth and the throat. You see, it is in the genetic combination of these three microbes: staphylococcus, carried by thirty percent of healthy adults in their nose, the strep infection that must be present in the throat, and an outside staphylococcal cassette chromosome, introduced separately that forms the basis for the creation of the deadly new strain…you have a name for it.”
“We just call it NFI,” he said. “Necrotizing Fasciitis Infection.”
As she continued to explain, it became clear that outside of a laboratory environment, the victim had to have a strep infection for the NFI microbe to mutate. Austyn thought of all the cold medications they were testing in the US. This narrowed the field down to medications relating to a sore throat where the victim actually has strep throat.
Fahimah gave her sister some water.
“If this is too much for you, we can stop and get back to it later,” he told her again.
“No,” she said adamantly. “You see, I was so frightened of this NFI, that I destroyed everything. Not only what Fahimah did for me at the lab…but any documentation I had outside, too.” She touched her head. “What is left is here.”
Austyn understood now the need to remove the bacteria through the amputation. “Can you tell me about the remedy you took to survive?”
Rahaf motioned to Fahimah and sipped some more water first. “Most classes of antibiotics were discovered in the 1940s and ‘50s. You know that they work by blocking synthesis of the cell wall, DNA, and proteins within the bacteria.”
Austyn knew this. “And I know that most of today’s antibiotics are simply a variation on that original concept.”
“Exactly. The fact that they work in similar ways may be one reason why bacteria are developing resistance,” Rahaf told him. “Now, this remedy was not something that I discovered. It is a product presently under testing by one of your pharmaceutical companies. The antibiotic was discovered by isolating a certain microorganism from a sample of soil from southern Africa.”
Austyn wrote down the information. She told him the name of the company and how successful the product had been so far on mice. She said she heard it might be a decade before it became available for humans. Rahaf had gone to school with one of the lead scientists working on the project at the time, who had given her a sample of the product.
“If the compound passes clinical trials it will become only the third entirely new antibiotic developed in the past four decades.”
“Do you know how this antibiotic works differently from the others?” Austyn asked.
“It acts to block enzymes involved in the synthesis of fatty acids, which bacteria need to construct cell membranes.”
She had to stop again. The burst of energy Rahaf had gathered to give him this information was draining from her body. He hoped she would bounce back. But he could see the pain was too much.
“I need the nurse, my love,” she told her sister.
Fahimah ran for the door, and Rahaf beckoned to Austyn.
He went to her and held her thin hands. The hazel eyes met his. “She has suffered.”
He nodded.
“You make good on that suffering. You make sure she is taken care of.”
“She will be,” he promised her.
Forty-Seven
Washington Hospital Center, Washington, D.C.
They were calling it a mild heart attack. At least, this was what the initial ECG and blood tests indicated.
Faas was far from being out of the woods, but he’d made it clear that it was matter of national security for him to take a call from Agent Newman. Considering everything that was going on around the country, none of the doctors or nurses had a problem with it.
One of the nurses handed him a phone as soon as they rolled his bed into a curtained-off area. They told him he was only between tests. This was a rest stop only.
“Pressure of the job getting to you?” Austyn asked.
“No, I’m faking it. It’s a good way to get my ex-wife’s sympathy back.” Betty had been the one who’d called 911. She was at the hospital by the time the ambulance had brought him in. Now she was talking to the doctor in the hall.
“Great idea. How is it working?”
“So far, so good,” he said. “What have you got?
”
“Some very good things,” Austyn said. “But first of all, you should know that you’re the third call I’ve made. NIH already has this information, and so does our department. So you don’t have to leap out of bed and try to do everything yourself.”
The curtain opened and Betty walked in. She frowned at the phone in his hand. He made a sign that it will only take one minute.
“Tell me. Make it short.”
“All the initial victims at each site had to have strep throat, and they had to have an outside staph infection introduced, probably orally. So NIH is checking the inventory of the drugs these people had that might have something to do with that. Once that initial person became infected and decomposition began, the bacteria could spread in any of three ways: direct contact, airborne particles and insect transmission, depending on environmental conditions.”
“Interesting. Go on.”
“But there’s something else. I was talking to Bea Devera at the office. She said they’ve been getting about a dozen phone calls from some pharmaceutical company executive who claims he knows what’s going on. In fact, he’s already made a call to the White House claiming he’s behind the attacks, and that it’s not over.”
“Shit. Is anyone checking him out?”
“Yeah. Bea said the guy was on the research vessel with all those kids. She’s on her way to the hospital where he is, along with about a hundred other agents.”
“Okay.”
Faas took his wife’s hand when she came closer to the bed.
“I’ll talk to you later,” he said, handing the phone to Betty.
“What’s going on?” she asked.
“They’re all jerks. I have to have a heart attack for them to get their act together. They might just have the case cracked.”
She smiled. “See? This is what I’ve been telling you for all these years. You need to delegate more.”
Forty-Eight
Reynolds Pharmaceuticals
Wilmington, Delaware
Federal agents, local police, representatives from practically every health-related branch of government swarmed the buildings and grounds of Reynolds Pharmaceuticals. David Link’s suspicions were confirmed. Out of sixteen individual cases that were reported and the victims who’d already been autopsied, all had had strep throat, and a piece of the Strep-Tester—be it the outer paper or the tester itself—was found in all but one case.
Bill and Ned Reynolds were already going back and forth between the facilities. The packaging phase was identified as a probable source of the problem. Agents were focusing on a possible heat-induced chemical reaction between the clear plastic strip and the tester ingredients.
The important thing was that the shipment of the ten thousand testers had been halted, and an emergency announcement had been made regarding the initial five hundred.
At noon on Monday, however, 273 of them were still unaccounted for.
Forty-Nine
VA Medical Center, Maryland
“They should tout you as a national hero,” Sally told him on the phone.
“I’ll be happy if I don’t end up in jail,” David answered. A great weight had lifted off his shoulders when he passed on his suspicions to the Homeland Security agent who’d interviewed him though a glass partition at the hospital.
“Come on, now. They would never do that,” Sally protested.
“You never know. I called the White House and claimed that I was behind it all.”
“You explained to them that you were only trying to get someone’s attention,” Sally protested.
David could tell where this was going. She already had the mother’s voice on. The gloves were off and the claws were out. His wife was ready to take on the world for her family.
“I know. And I’m not too worried about it.” He smiled, leaning back against the chair in the lounge area.
They’d given the run of the floor to him and Craig and Kirk. It looked as if they were done with the testing for now. So far, none of the tests had turned up anything wrong with any of them. But still, not a word had been said about when they’d be releasing them. Josh, at least, was supposed to go home tomorrow morning.
“Here it is,” Sally said. “They’re running it again”
Kirk had gone back to his room to sleep, and Craig was reading a magazine in one of the chairs. Craig and David had gotten sick of watching the same news, so they’d turned off the TV. David got up from the sofa and quickly switched it back on.
On the screen there was an aerial view of Reynolds Pharmaceuticals with cars and people swarming like ants around the building. A bright banner scrolling across the bottom referred to sixteen individual sites of the outbreak with 154 fatalities. The rest of the Strep-Testers were now accounted for.
“There goes my job,” David said to his wife. “Reynolds Pharmaceuticals can say goodbye to any more government contracts, and I’d say it’s a guarantee that they have their asses sued off for this Strep-Tester. I guess it’s a safe bet that I’ll be standing in the unemployment line next week.”
“We’ll manage,” she said with all her positive attitude.
David felt that he and Josh had missed taking the bullet by inches. Still, the magnitude of how close he’d come to killing his own son with the Strep-Tester made him go ice cold every time he thought of it. There were so many people out there who weren’t so lucky.
He and Sally finished talking for now, and he hung up. Of course, he knew before the hour was up, one of them would find a reason to call the other. It was strange to be in the same hospital but not be allowed to see each other.
“Are you really worried about your job?” Craig asked when David put the phone on the side table.
“I am more than worried about it. This is going to bury the company.”
“It’ll be tough with Josh still going through his treatment,” Craig commented.
David nodded. A national disaster had been minimized. But he hadn’t given any thought yet how to take care of the personal disaster that was brewing.
“This is one negative thing about working for the same company for so many years. You don’t have your resume ready to go out.”
Craig looked at him for minute. “That’s no big deal. I can help you with that.”
David appreciated the thought, and he said so.
“Have you considered getting out of pharmaceuticals?” Craig asked.
“After this past week, I’d say yes. I’m more than considering it.”
Craig seemed to be thinking about something, so David picked up the magazine from the table next to him. Before he found anything worth reading, though, Craig nodded to him.
“What would you think about getting into the homeopathic line? With your sales contacts, I know my wife’s company would be interested.”
David didn’t have to hear another word.
“Do they offer health insurance?” he asked.
Fifty
Taleghani Hospital, Kermanshah, Iran
For three days, Fahimah had been holding her sister’s hand. She was holding it now as the nurse gave Rahaf a shot of morphine. One of the doctors had stepped out only moments before. He’d whispered to Fahimah that these could be her sister’s last moments.
This time had been a gift.
She placed a kiss on the fragile fingers. Once again, there seemed to be no end to her tears. She had no will left to fight them. The sorrow was overwhelming her.
“We’re at the reflecting pool,” Rahaf breathed. “Do you see the hanging mist?”
Fahimah looked at her sister. Her hazel eyes were distant. She had a smile on her face.
“Yes, I do, my love. We are at Taghe-e-Bostan.”
“Do you remember her poems?” Rahaf asked. “The Saint of Basra?”
Fahimah didn’t need any book of verse. For five years the Sufi poet’s words had carried her. She recited them softly, as she remembered them. As she wanted to remember them.
“Oh my joy, my dream, my s
upport. My friend, my precious one, my intention. You are the soul of my heart, my hope. You are my comfort—your desire sustains me.”
Rahaf’s lips kissed their joined fingers. She closed her eyes.
“So many blessings you have given me, my sister. Now your love is my desire and my heaven. It clears the path to my captured heart. Now, so long as I live, I will not be apart from you. You are my strength when I despair. If you are pleased with me, then—my heart—my happiness has begun.”
The fingers relaxed in Fahimah’s hand. She reached out and touched Rahaf’s face. She was gone.
“I will not be apart from you,” she whispered. “Firishte.”
Fifty-One
Sahana refugee camp, the border of Iran and Iraq
Austyn was told that Kurds got together for only two formal social gatherings—weddings and funerals.
People had arrived from other camps, from Iranian villages and from Iraqi Kurdish villages. People had come all the way from Turkey. Amid what seemed to be thousands gathered on a green hillside to celebrate the life and mourn the death of the woman who’d worked courageously and tirelessly for them, Austyn was only interested in one.
As he watched her, he could see the resolve in Fahimah’s face.
Wave after wave of people approached her. Austyn didn’t understand most of the words spoken to her. But the signs of gratitude, affection, condolence were unmistakable.
Austyn was certain that Fahimah now understood the magnitude of the gift she’d given, not only to her sister, but to all these people during the five years that she had been imprisoned.
Two men played the ney, a smaller version of the flute, while another played a stringed instrument called the tanbur. The melody was heartrendingly sad. A woman sang. Austyn recognized the names of Rahaf’s family members mentioned in the song.
