Robin Cook - Contagion

“I wanted to inquire about Katherine Mueller,” Jack said.

“God rest her soul,” Gladys said. She made the sign of the cross. “It was a terrible thing.”

Jack introduced himself by displaying his badge, then questioned whether she and her co-workers were concerned that Katherine had died of an infectious disease.

“Of course we’re concerned,” she said. “Who wouldn’t be? We all work closely with one another. But what can you do? At least the hospital is concerned as well. They have us all on antibiotics, and thank God, no one is sick.”

“Has anything like this ever happened before?” Jack asked. “What I mean is, a patient died of plague just the day before Katherine. That suggests that Katherine could very well have caught it here at the hospital. I don’t mean to scare you, but those are the facts.”

“We’re all aware of it,” Gladys said. “But it’s never happened before. I imagine it’s happened in nursing, but not here in central supply.”

“Do you people have any patient contact?” Jack asked.

“Not really,” Gladys said. “Occasionally we might run up to the wards, but it’s never to see a patient directly.”

“What was Katherine doing the week before she died?” Jack asked.

“I’ll have to look that up,” Gladys said. She motioned for Jack to follow her. She led Jack into a tiny, windowless office where she cracked open a large, cloth-bound daily ledger.

“Assignments are never too strict,” Gladys said. Her finger ran down a row of names. “We all kinda pitch in as needed, but I give some basic responsibility to some of the more senior people.” Her finger stopped, then moved across the page. “Okay, Katherine was more or less in charge of supplies to the wards.”

“What does that mean?” Jack asked.

“Whatever they needed,” Gladys said. “Everything except drugs and that sort of stuff. That comes from pharmacy.”

“You mean like things for the patients’ rooms?” Jack asked.

“Sure, for the rooms, for the nurses’ station, everything,” Gladys said. “This is where it all comes from. Without us the hospital would grind to a halt in twenty-four hours.”

“Give me an example of the things you deal with for the rooms,” Jack said.

“I’m telling you, everything!” Gladys said with a touch of irritation in her voice. “Bedpans, thermometers, humidifiers, pillows, pitchers, soap. Everything.”

“You wouldn’t have any record of Katherine going up to the seventh floor during the last week or so, would you?”

“No,” Gladys said. “We don’t keep records like that. I could print out for you everything sent up there, though. That we have a record of.”

“Okay,” Jack said. “I’ll take what I can get.”

“It’s going to be a lot of stuff,” Gladys warned as she made an entry into her computer terminal. “Do you want OB-GYN or medical or both?” she asked.

“Medical,” Jack said.

Gladys nodded, pecked at a few more keys on her terminal, and soon her printer was cranking away. In a few minutes she handed Jack a stack of papers. He glanced through them. As Gladys had suggested there were a lot of items. The length of the list gave Jack respect for the logistics of running the institution.

Leaving central supply, Jack descended a floor and wandered into the lab. He did not feel he was making any progress, but he refused to give up. His conviction remained that there was some major missing piece of information. He just didn’t know where he would find it.

Jack asked the same receptionist to whom he’d shown his badge the day before for directions to microbiology, which she gave him without question.

Jack walked unchallenged through the extensive lab. It was an odd feeling to see so much impressive equipment running unattended. It reminded Jack of the director’s lament the day before that he’d been forced to cut his personnel by twenty percent.

Jack found Nancy Wiggens working at a lab bench plating bacterial cultures.

“Howdy,” Jack said. “Remember me?”

Nancy glanced up and then back at her work.

“Of course,” she said.

“You guys made the diagnosis on the second plague case just fine,” he said.

“It’s easy when you suspect it,” Nancy said. “But we didn’t do so well on the third case.”

“I was going to ask you about that,” Jack said. “What did the gram stain look like?”

“I didn’t do it,” Nancy said. “Beth Holderness did. Do you want to talk with her?”

“I would,” Jack said.

Nancy slid off her stool and disappeared. Jack took the opportunity to glance around at the microbiology section of the lab. He was impressed. Most labs, particularly microbiology labs, had an invariable clutter. This lab was different. It appeared highly efficient with everything crystal-clean and in its place.

“Hi, I’m Beth!”

Jack turned to find himself before a smiling, outgoing woman in her mid-twenties. She exuded a cheerleader-like zeal that was infectious. Her hair was tightly permed and radiated away from her face as if charged with static electricity.

Jack introduced himself and was immediately charmed by Beth’s natural conversation. She was one of the friendliest women he’d ever met.

“Well, I’m sure you didn’t come here to gab,” Beth said. “I understand you are interested in the gram stain on Susanne Hard. Come on! It’s waiting for you.”

Beth literally grabbed Jack by the sleeve and pulled him around to her work area. Her microscope was set up with Hard’s slide positioned on its platform and the illuminator switched on.

“Sit yourself right here,” Beth said as she guided Jack’s lower half onto her stool. “How is that? Low enough?”

“It’s perfect,” Jack said. He leaned forward and peered into the eyepieces. It took a moment for his eyes to adapt. When they did, he could see the field was filled with reddish-stained bacteria.

“Notice how pleomorphic the microbes are,” a male voice commented.

Jack looked up. Richard, the head tech, had materialized and was standing to Jack’s immediate left, almost touching him.

“I didn’t mean to be such a bother,” Jack said.

“No bother,” Richard said. “In fact, I’m interested in your opinion. We still haven’t made a diagnosis on this case. Nothing has grown out, and I presume you know that the test for plague was negative.”

“So I heard,” Jack said. He put his eyes back to the microscope and peered in again. “I don’t think you want my opinion. I’m not so good at this stuff,” he admitted.

“But you do see the pleomorphism?” Richard said.

“I suppose,” Jack said. “They’re pretty small bacilli. Some of them almost look spherical, or am I looking at them on end?”

“I believe you are seeing them as they are,” Richard said. “That’s more pleomorphism than you see with plague. That’s why Beth and I doubted it was plague. Of course, we weren’t sure until the fluorescein antibody was negative.”

Jack looked up from the scope. “If it’s not plague, what do you think it is?”

Richard gave a little embarrassed laugh. “I don’t know.”

Jack looked at Beth. “What about you? Care to take a chance?”

Beth shook her head. “Not if Richard won’t,” she said diplomatically.

“Can’t someone even hazard a guess?” Jack asked.

Richard shook his head. “Not me. I’m always wrong when I guess.”

“You weren’t wrong about plague,” Jack reminded him.

“That was just lucky,” Richard said. He flushed.

“What’s going on here,” an irritated voice called out.

Jack’s head swung around in the opposite direction. Beyond Beth was the director of the lab, Martin Cheveau. He was standing with his legs apart, his hands on his hips, and his mustache quivering. Behind him was Dr. Mary Zimmerman, and behind her was Charles Kelley.