Robin Cook - Contagion

“I assume the ‘other’ hospital refers to the competition,” Jack said.

“Most assuredly,” Terese said. “We feel it would be in bad taste to mention the General by name, especially in light of the problems it’s been having.”

“Their problems are getting worse,” Jack said. “They’ve had an outbreak of another serious disease. This makes three in three days.”

“Good God!” Terese exclaimed. “That’s awful. I certainly hope this gets to the media, or is this one going to be a secret?”

“I don’t know why you keep making this an issue,” Jack snapped. “There’s no way it can be kept a secret.”

“It would be if AmeriCare had its way,” Terese said heatedly.

“Hey, are you guys at it again?” Chet said.

“It’s an ongoing argument,” Terese said. “I just can’t get over the fact that Jack does not feel it is his job as a public servant to let the media and hence the public know about these awful diseases.”

“I told you I’ve been specifically informed it is not my job,” Jack shot back.

“Wait! Time out,” Chet called out. “Listen, Terese, Jack is right. We can’t go to the media ourselves. That’s the chief’s domain via the PR office. But Jack is no slouch in all this. Today he went flying over to the General and implied right to their faces that these recent outbreaks aren’t natural.”

“What do you mean, not ‘natural’?” Terese asked.

“Exactly that,” Chet said. “If they are not natural, then they are deliberate. Somebody is causing them.”

“Is that true?” Terese asked Jack. She was shocked.

“It’s gone through my mind,” Jack admitted. “I’m having trouble explaining scientifically everything that has been going on over there.”

“Why would someone do that?” Terese wondered. “It’s absurd.”

“Is it?” Jack asked.

“Could it be the work of some crazy person?” Colleen offered.

“That I’d doubt,” Jack said. “There is too much expertise involved. And these bugs are dangerous to handle. One of the current victims is a lab technician.”

“What about a disgruntled employee?” Chet suggested. “Someone with the knowledge and a grudge who’s snapped.”

“That I think is more likely than some madman,” Jack said. “In fact, the director of the hospital lab is unhappy with the management of the hospital. He told me so himself. He’s had to lay off twenty percent of his workforce.”

“Oh my God,” Colleen exclaimed. “Do you think it could be him?”

“Actually I don’t,” Jack said. “Frankly, too many arrows would point to the director of the lab. He’d be the first suspect. He’s been acting defensive, but he’s not stupid. I think that if this series of diseases has been spread deliberately it has to be for a more venal reason.”

“Like what?” Terese said. “I think we’re all jumping off the deep end here.”

“Maybe so,” Jack said. “But we have to remember that AmeriCare is first and foremost a business. I even know something about their philosophy. Believe me, it is bottom-line oriented all the way.”

“You’re suggesting that AmeriCare might be spreading disease in its own facility?” Terese asked incredulously. “That doesn’t make any sense.”

“I’m just thinking out loud,” Jack explained. “For the sake of argument let’s assume these illnesses have been deliberately spread. Now, let’s look at the index case in each incidence. First, there was Nodelman, who had diabetes. Second, there was Hard, who had a chronic orthopedic problem, and lastly there was Lagenthorpe, who suffered from chronic asthma.”

“I see what you’re suggesting,” Chet said. “All of the index cases were the type of patient prepaid plans hate because they lose money on them. They simply use too much medical care.”

“Oh, come on!” Terese complained. “This is ridiculous. No wonder you doctors make such horrid businessmen. AmeriCare would never risk this kind of public relations disaster to rid itself of three problem patients. It would make no sense. Give me a break!”

“Terese is probably right,” Jack admitted. “If AmeriCare was behind all this, they certainly could have done it more expeditiously. What truly worries me is that infectious agents are involved. If these outbreaks have been deliberate, the individual behind them wants to start epidemics, not just eliminate specific patients.”

“That’s even more diabolical,” Terese said.

“I agree,” Jack said. “It kind of forces us back to considering the improbable idea of a crazy person.”

“But if someone is trying to start epidemics, why hasn’t there been one?” Colleen asked.

“For several reasons,” Jack said. “First of all, the diagnosis has been made relatively rapidly in all three cases. Second, the General has taken these outbreaks seriously and has taken appropriate steps to control them. And third, the agents involved are poor choices for creating an epidemic here in New York in March.”

“You’ll have to explain,” Colleen said.

“Plague, tularemia, and Rocky Mountain spotted fever can be transmitted by airborne spread, but it is not their usual route. The usual route is through an arthropod vector, and those specific bugs are not available this time of year, especially not in a hospital.”

“What do you think of all this?” Terese asked Chet.

“Me?” Chet asked with a self-conscious laugh. “I don’t know what to think.”

“Come on,” Terese prodded. “Don’t try to protect your friend here. What’s your gut reaction?”

“Well, it is New York,” Chet said. “We see a lot of infectious diseases, so I suppose I’m dubious about this notion of a deliberate spread. I guess I’d have to say it sounds a little paranoid to me. I do know that Jack dislikes AmeriCare.”

“Is that true?” Terese asked Jack.

“I hate them,” Jack admitted.

“Why?”

“I’d rather not talk about it,” Jack said. “It’s personal.”

“Well,” Terese said. She put her hand on top of the stack of storyboards. “Dr. Stapleton’s disdain for medical advertising aside, you men think these sketches are okay?”

“I told you, I think they’re great,” Chet said.

“I imagine they will be effective,” Jack grudgingly agreed.

“Do either of you have any other suggestions we could use regarding preventing hospital infections?” Terese asked.

“Maybe you could do something concerning steam sterilization for instruments and devices,” Jack said. “Hospitals differ in their protocols. Robert Koch was involved with that advance, and he was a colorful character.”

Terese wrote down the suggestion. “Anything else?” she asked.

“I’m afraid I’m not very good at this,” Chet admitted. “But why don’t we all head over to the Auction House for a couple of drinks. With the proper lubricant, who knows what I might come up with?”

The women declined. Terese explained that they had to continue working on the sketches. She said that by Monday they had to have something significant to show to the president and the CEO.

“How about tomorrow night?” Chet suggested.

“We’ll see,” Terese said.

Five minutes later Jack and Chet were heading down in the elevator.

“That was the bum’s rush,” Chet complained.

“They are driven women,” Jack said.

“How about you?” Chet asked. “Want to stop for a beer?”

“I think I’ll head home and see if the guys are playing basketball,” Jack said. “I could use some exercise. I feel wired.”

“Basketball at this hour?” Chet questioned.

“Friday night is a big night in the neighborhood,” Jack said.

The two men parted company in front of the Willow and Heath building. Chet jumped into a cab, and Jack undid his medley of locks. Climbing on his bike, Jack pedaled north on Madison, then crossed over to Fifth Avenue at Fifty-ninth Street. From there he entered Central Park.