Michael Palmer - Fatal

Finally, the crew stepped aside and Matt resumed his position at the bedside. This time, his examination would be more detailed, including the critical visualization by ophthalmoscope of the retinas in the back of Jane Doe's eyes. He was relieved to see pulsation in the veins there, as well as a sharpness to the margins of the optic nerves. Loss of either would be a grave sign, indicating significant brain swelling from trauma and/or prolonged lack of oxygen.

"So, Dr. Rutledge, I understand you called?"

Grimes.

Matt turned slowly to face the Belinda police chief. The two of them had had some conflicts over the years, usually surrounding some action or other Matt was running against BC amp;C. Matt also complained more than once of being harassed with tickets — parking and speeding. Grimes was ex-military and kept the town on a pretty short leash. A displaced northerner with some sort of degree in criminal justice, he had adopted something of a mountain accent. He was divorced, with a kid in Florida someplace that Matt heard he never saw. Their contrast in styles alone would have strained their relationship, but Grimes's connection with Armand Stevenson and the other directors of the mine all but sealed their enmity.

Over the years, the police chief had appointed himself as a one-man watchdog committee to step in whenever Matt didn't have an appropriate permit or was posting notices against a town ordinance. Matt suspected Grimes or his lackeys were behind the disappearance of most if not all of the magenta fliers.

"I just asked for a policeman," Matt said, "not the policeman."

"You're a very important person to us," Grimes replied, smiling civilly. "What do you have?"

Matt gestured to his patient. At the sight of her, Grimes's lips tightened noticeably.

"This woman plunged off Niles Ledge and into the lake," Matt said. "One of the two kids who rescued her said he heard several shots. The other kid doesn't think so. She's got a big bruise over her eye. That may be why she's unconscious, but she also has a scalp wound that could be from a gunshot. I'm legally required to report any possible shooting."

"Thanks for telling me that, Doctor. From time to time I forget some of the laws. How long was she underwater?"

"I estimate two minutes minimum, four maximum. She had no ID, so in addition to reporting the possible bullet wound, I hoped maybe you could find out who she is."

Grimes stepped forward, set his hands on the bed rail, and gazed down at the woman.

"Her name is Nikki Solari," he said flatly. "She drove down from Boston to attend Kathy Wilson's memorial service earlier today. I spent some time talking with her there. Wilson was her roommate. You know who she was?"

"I know about her, and I've heard some of her music, but I didn't know her personally."

"Well, she was hit by a truck in Boston. Died instantly."

"I heard something about it from Hal Sawyer. Apparently he knew the family and Kathy."

"Yeah, he was at the service. Well, this woman played fiddle in Kathy Wilson's bluegrass band."

Matt decided that playing fiddle was close enough to pianist. He was mentally patting himself on the back for astutely concluding that Nikki Solari's hands were those of an artist, when Grimes added, "She only played music as a hobby. She's actually a pathologist — a coroner up in Boston. Spends her time working up to her elbows in gore and guts."

Matt immediately stopped the patting.

"What do you think about that wound above her ear?" he asked.

Grimes studied it.

"I guess it could be from a bullet," he said. "But it could just as easily be from something else, like a broken branch."

"Well, we'll find out for sure when she wakes up."

Grimes suddenly whirled to face him.

"You just make sure that she does!" he snapped.

Much of what I write here of my infection with the Lassa virus and my miraculous recovery I gleaned from conversations with those who cared for me during my thirty-day hospitalization. I use their accounts because I was delirious for much of the time, and remember almost nothing.

The words were those of Dr. Suzanne O'Connor, a missionary physician. She was working in the central Nigerian city of Jos in the spring of 1973 when a patient, Lila Gombazu, crazed with fever, clawed through her rubber gloves and broke the skin on the back of her hand.

Cloistered in one corner of the Library of Medicine at the NIH, Ellen Kroft read O'Connor's harrowing account with a dry mouth and an unpleasant fullness in her chest.

The poor woman who scratched through my glove went into convulsions the next day. In spite of the most heroic measures we could muster, she began hemorrhaging from her nose, womb, and rectum, and died horribly, crying out at the end for her children, two of whom, she had no way of knowing, were already showing symptoms of the disease. Twelve days after my encounter with Lila, my good health and the crush of work caring for our patients had driven the incident to the back of my mind. That day, a Monday, I mentioned to one of the nurses that I had a stuffy nose and scratchy throat, and thought I might be coming down with the flu. Tuesday was more of the same, although the discomfort in my throat was steadily worsening. I couldn't possibly take time off from my work, though. The hospital was filled to capacity and then some. I put myself on a high dose of penicillin and tried to force fluids past the inflammation and the raw, white sores that now dotted my palate and pharynx.

On Wednesday, I was making rounds on our patients when I was seized with uncontrollable shivering and profound weakness. Perspiration soaked my clothing as if I were standing in a thunderstorm. My temperature at that moment, as taken by one of the nurses, was 105 degrees Fahrenheit. Within an hour, I was a patient in my own hospital, moaning piteously from the pain in my muscles and joints, unable to take fluids because of the gaping, deep ulcers in my throat, and soiling myself and my bed with uncontrollable diarrhea. The next morning, I was delirious. My temperature had risen to 107 despite vigorous efforts to keep it down. For days, I am told, I lay unconscious, unable to take nourishment or fluids, oozing red blood from my rectum, and coughing up blood as well.

From the beginning, the diagnosis of Lassa fever was strongly suspected. My associate Dr. Janet Pickford made valiant efforts to fly experts from the CDC to Nigeria along with serum from a woman who had recovered from the disease and had circulating antibodies against it. Unfortunately, the government of Nigeria, angry about having the disease named for the village of Lassa, located along the Nigerian border with Cameroon, delayed issuing visas to anyone involved with my case. Finally, those State documents were approved, and on the tenth day of my illness I received an infusion of the woman's convalescent serum. By then I had required more than a dozen blood transfusions, and had been delirious or in a coma for almost the whole time. I had lost nearly thirty pounds from a frame that was slender to begin with, and was a mass of bruises and sores. My urine and stool were bloody, as was the mucus from my chest.

Incredibly, within just two days of receiving the serum, my condition began to improve. A miracle, everyone said. Gradually, the hideous ulcers in my mouth began to heal, and I was able to take nourishment. Over the next two weeks I regained much of my strength as well as my will to live. What I did not completely regain was my hearing, which was lost to the virus in both ears, and which has only returned slightly in my right. I would wish the illness of Lassa fever on no one, and pray that, with time, a cure or vaccine for this most terrible hemorrhagic virus might be found.

Ellen closed the book called Closer Than You Think — Infectious Diseases in a Shrinking World, and sank down in her chair, staring across the library at nothing in particular. Sixty-one. That was how many cases of Lassa fever had been reported in the U.S. over the past couple of years. Sixty-one and counting. Not that it mattered to Ellen whether the cases were here or in Africa, but for the time being at least, Omnivax was going to be administered here. And the Lasaject component of the supervaccine was, she had come to believe, the weak link in the chain. Now, a day after a very sobering, highly charged meeting at the office of Dr. Richard Steinman, she wasn't so sure.