Michael Palmer - Fatal

"I'll do that," a voice beside them said. An older woman, battered as the rest of them, had crawled over from some part of the cave they had yet to inspect. "You go check the boy," she said. "I'll do my best here. My name is Ellen. Ellen Kroft."

Nikki knew her ankle was broken. She had felt the crack of bone and the explosion of pain when the woman Matt was calling Tarzana — 160 or 170 pounds — blindsided her. Now she simply bit at the inside of her lip and did her best to cope with the pain. They were in a fearsome predicament with a finite air supply and no obvious way out of the cave. The last thing the others needed was to worry about her.

The newcomer, Ellen Kroft, essentially uninjured, kept pressure on Fred Carabetta's wound while Matt used his ear as a stethoscope to examine the lungs of Colin Morrissey.

"I think he's moving enough air," he said, "at least for the moment. His coma seems to be getting a little lighter, too."

"Let's hope he's sane when he wakes up."

"With his larynx swollen nearly shut, I don't think he's going to pose much of a problem. How's your leg?"

"Fine," Nikki said perhaps a bit too quickly, adding, "It aches some."

"Think you can put weight on it?"

"I… I doubt it."

"I watched you working on this man from over there," Ellen said, gesturing toward the darkness to her right. "You're both doctors?"

"I'm Matt Rutledge, an internist from Belinda, and this is Nikki Solari from Boston. She's a pathologist."

"How many others are there in here besides us?"

"Do you know of any?"

"No. I was tied up here for a time, then injected with something that knocked me out. When I came to, I was covered with dust and pieces of rock. I assume Grimes untied me while I was unconscious, then blew up the cave. He's the police chief here."

"Oh, we know who he is. You assume right about him. In addition to that guy and the four of us, there are two people — a woman and a girl — with lumps on their faces like his. They don't seem to be badly hurt, but the woman is pretty wild. We've tied her up for now. The girl's still unconscious." Matt lowered his voice. "Then there are two security guards from the mine over there. One of them's dead, the other probably paralyzed."

"And two more men who came in with us are missing," Nikki added.

"Do you know why Grimes did this to us?" Ellen asked.

"I don't know why he included you," Matt replied, "but as you can see, the local mine has been illegally storing toxic chemicals in here. We were about to expose the whole business. Grimes is in bed with the mine owners."

With Kathy's fatal prion disease not adequately accounted for, Nikki had never felt completely comfortable with Matt's contention about the mine.

"Not to muddy the water," she said, "but what Matt didn't say was that a number of people from this area have developed a syndrome of horrible facial lumps and progressive paranoia. Matt thinks it has something to do with these chemicals. I'm not as certain about that as he is. Do you have something to do with the mine?"

"No. I've never been in this area before."

"Then, why?"

"Well, believe it or not, I came because a man broke into my home in Glenside, Maryland, and swore he would kill my granddaughter unless I did what he wanted me to. I was able to learn who he might be, and traced him back here to Tullis, but I needed to get a look at him before I could be certain he was the one. Your police chief was supposed to help me do that and also take a statement from me, but we never got that far."

"I don't understand," Matt said, turning back to check on Morrissey. "Who was the man you came about?"

"His name was Sutcher. Vinyl Sutcher."

Stunned, Nikki and Matt stared at one another.

"Perhaps you'd better tell us more," Nikki said.

Fred Carabetta had lapsed into unconsciousness. His steady, sonorous breathing formed the background for Ellen's account of her place on the blue-ribbon Omnivax commission; of Lynette Marquand's politically motivated pledge to the American people; of her terrifying encounter with Vinyl Sutcher; and finally, of the fruits of Rudy Peterson's dogged pursuit of the truth behind the outbreaks of Lassa fever. For a time after she had finished, nothing was said. Matt's eyes closed as he spun through the kaleidoscope of his memories, searching to connect with something… something he knew was there.

Suddenly he looked up at the two women, his expression grim.

"The Lassa fever vaccine was tested here," he said.

"What?"

"I don't know exactly when, sometime between when I left for college and when I came back to practice. A drug company paid all the doctors in the valley for each patient they could convince to get the shot. After I came back to go into practice here, a bunch of the older docs were joking about it one day in the lunchroom at the hospital. Here none of them had ever even seen a case of Lassa fever in their lives, and now, with a bunch of the town immunized, none of them ever would. That was the gist of what they were laughing about. A couple of them didn't even know what the disease was, even though they signed up a number of their patients and gave them the shot. I actually think I remember them saying that they got a hundred dollars a head, and that some of them shared that money with the patients. It was all perfectly legal as far as I know — docs and patients are both paid all the time for participating in research protocols or drug testing. I don't know how many in the valley were given the test shots."

"Four hundred," Ellen said. "Four hundred of all ages. I saw the summaries of the field trial, but I never noted down where it was conducted."

"How many years ago?" Nikki asked.

"I don't know," Matt replied. "Maybe ten."

"Oh, God," she exclaimed.

"What?"

"Matt, don't you see? Prions. The latent period between exposure to the germ and development of symptoms can be as much as ten years or even longer. That's where the Belinda syndrome is coming from — from the vaccine, not from these barrels of poison. The tissue culture cells that the virus was grown on must have been contaminated with prions right from the start. It seems likely they would have used monkey tissue. If so, maybe the monkeys that the cells came from originally were infected."

"But — "

"You were right all along about the mine storing toxic waste. You were right and you were passionate about what you believed. Grimes knew about this dump and probably sent you that note to keep pushing you in this direction so you wouldn't ever search for the truth about the cases you discovered."

"But why would he do that?"

"He must have a stake in the vaccine."

"If he does," Ellen said, "he's on the verge of becoming an extremely wealthy man. Lasaject is one of the most expensive components of Omnivax. In the next year, especially when older children and adults are immunized in addition to newborns, tens of millions of doses are going to be administered. What's this about prions? What are they?"

"The germs that cause Mad Cow disease and other neurologic illnesses as well," Nikki said. "We think they're responsible for the condition that man has, and also the woman who attacked me, and the girl over there. The symptoms don't appear for years after exposure, and there's essentially no test to see if someone without symptoms has contracted the disease."

"You think everyone who gets the vaccine will get infected with prions?"

"I doubt it. Those who get the disease probably have some sort of genetic predisposition to the effects of the prions. In Britain, despite the hundreds of thousands of people who ate contaminated beef, relatively few cases of Mad Cow disease have been reported."

"How many of the original four hundred do you think have developed prion disease?"