Michael Palmer - Fatal

The postage-stamp room featured a bed that was probably rented out as a queen, but looked smaller, and a fan-back, white wicker chair. In addition, there was a small, three-drawer bureau with some clothes neatly folded on top. Nikki padded to the tiny bathroom, washed her face with cold water, then brushed her teeth and hair with brand-new supplies that seemed to be waiting there for her. Her arms were a mass of bruises from IVs, blood drawing, and God only knew what else. There was a thick, tender scab, an inch or two long, just above her right ear. She felt certain she knew what had caused it, but with her thoughts careening about like bumper cars, she just couldn't seem to get her mind around anything specific.

She returned to the bedroom, settled onto the wicker chair, and dropped her feet heavily onto the bed. The impact was enough to visibly jar Matt, but he lay there undisturbed, his half smile suggesting that whatever his current dream, it was far removed from those that had been tormenting her. He had kicked the sheet aside, and lay there in a pair of sweat pants, naked from the hips up. He had the full waist and broad shoulders of an athlete past his prime, but managing to keep up. She had never been particularly drawn to men who wore their hair in a ponytail, but his seemed to fit his rugged features well. All in all, he was not Hollywood handsome, but he was damn attractive in most of the physical ways that mattered to her — and he had just saved her life. She knelt by the bed and studied the tattoo on his deltoid. It was — what had he said? — a hawthorn tree, about two inches high — beautifully rendered as far as she could tell. Because of her own unusual tattoo, she always paid attention to them on others. A tree was a first. There was a story there, she was certain of that. She brought her face up so that her eyes were just a few inches from his. She felt his breath and expected him to react in some way to her closeness. Nothing. He continued his sleep and, judging from his peaceful expression, his dream as well.

The clock radio on the bureau read seven-thirty, which more or less corresponded to the light filtering through the curtains. It seemed like waking her new roommate was going to take nothing short of a frontal assault, but not just yet. She shifted back onto the chair and sorted through what she could remember of the strange and deadly events since her departure from Boston. One thing, and maybe only one, was clear — Kathy Wilson was at the center of whatever was going on. She was one of at least three people from Belinda with a bizarre, terrifying, inexorably lethal syndrome. Matt was certain that a toxic exposure was responsible for the unusual constellation of signs and symptoms. His theory made as much sense as anything did, especially backed up by his discovery of large-scale toxic waste storage in a cave near the Belinda mine. But what was Kathy's connection with the mine? And why did the chief of police send men to kill Nikki and subsequently become obsessed with finding out whom she had spoken to about Kathy's condition?

At the moment, she didn't have the wisp of an answer to any of her own questions. But knowing Joe Keller as she did, if there was a clue in the anatomy of Kathy's nervous system, he would find it. There was a phone on the bureau with a note taped to it that local calls were free and long-distance calls had to be collect or credit card. Holding her breath, she dialed 1-800-COLLECT and placed a call to what she hoped her disrupted memory had held on to as Joe Keller's direct line. If the clock radio was correct, her boss would have been at the office for an hour already — possibly two — sipping his thick black coffee and working out anatomic and biochemical puzzles.

"Bless you," she muttered when his voice came on the line and accepted the prompt to say "yes."

"Joe, I'm all right," she said quickly.

"Thank God. People have been very worried about you. We even called the police."

Nikki started to explain that a chief of police was, in fact, responsible for her trouble, but quickly stopped herself. There would be time.

"I'm on my way home right now. I should be there by late tonight."

"Excellent."

"Joe, I've had some trouble in West Virginia related to my friend Kathy — the one you autopsied."

"What sort of trouble?"

"There are two other cases down here that looked and acted exactly like hers — neurofibromas and progressive paranoid insanity."

"Well, now, that is something," Keller said. "You see, your instincts were absolutely correct in this case. I am looking at the slides of Miss Wilson's brain right now. She has unmistakable spongiform encephalopathy."

Spongiform encephalopathy. Nikki caught her breath. The degenerative, transmittable, ultimately fatal nervous-system disease had a number of forms, including a syndrome called Creutzfeldt-Jakob disease; kuru, once found in the brain-eating cannibals of New Guinea; fatal familial insomnia; and bovine spongiform encephalopathy, also known as BSE, or more commonly, Mad Cow disease.

Excitedly, Nikki stretched out and kicked Matt firmly on the sole of his foot. He bunched his pillow beneath his head and pulled his foot away. She kicked him again, even more forcefully, this time with her heel against his calf. He moaned and began to stir.

"Go on, Joe," she said, knowing better than to ask if he was sure. "This is quite incredible."

"You say there are two other cases where you are?"

"In the town where Kathy grew up, yes."

One final kick and it was clear Matt had at last ascended to a higher plane of wakefulness. If he hadn't taken some sort of drug, he was a candidate for the Guinness Book of Records. Her clients in the coroner's office were easier to rouse.

"And these other cases," Keller asked, "they had spongiform encephalopathy also?"

"I don't know. Their brains appeared normal on gross exam, so the microscopic wasn't done."

SE was caused by germs known as prions — infectious protein particles capable of reproducing themselves without DNA or RNA. One of the characteristics of SE was that despite an often spectacular clinical picture, the brain looked grossly normal until sections of it were examined under the microscope, where diffuse, sponge-like holes could be seen. Another characteristic was that the incubation period of the disease was often a decade or more, during which time the victim might well be infectious to others.

"Did these cases of yours also have neurofibromas?" Keller asked.

Matt was awake now, pawing sleep from his eyes and looking over at her quizzically. She put a finger to her lips and motioned that she would fill him in momentarily.

"Yes, both of them. From what I have been told, there was nothing unusual about them on microscopic."

"Well, maybe and maybe not," Keller said. "I tried a number of stains and stain combinations on them, and found an approach that clearly distinguishes these lesions from the reference neurofibromas in my library."

Keller the ever-curious, Keller the intellectual. Nikki smiled just picturing her boss. He was forever playing with stains and with his department's powerful electron microscope. His library, in addition to the hundreds of texts, included hundreds, probably even thousands, of unstained specimens from every organ and countless disease states, each carefully catalogued. Evidently, among those unstained tissues were some run-of-the-mill neurofibromas — the reference specimens.

Spongiform encephalopathy with unusual neurofibromas. The Belinda syndrome, Nikki speculated… Or maybe Rutledge-Solari disease.

"Joe, listen, we'll be home between ten and twelve tonight."

"I should be here then."

"If you are, great. But if not, we'll see you tomorrow morning."

"We?"

"A doctor from down here saved my life two or three times recently. He's got more than a passing interest in this syndrome. He thinks it's due to a secret industrial dump spilling toxic waste into his town's groundwater."