Robin Cook - Contagion

“That might be,” Jack said. “But this is a unique circumstance in a lot of ways. I think it requires knowledge that Lou doesn’t have. Besides, I sense it might do a world of good for my self-confidence to follow this thing through. Whether it’s obvious or not, my ego has taken a beating over the last five years.”

“You are a mystery man,” Laurie said. “Also stubborn, and I don’t know enough about you to know when you are joking and when you are serious. Just promise to be more careful than you’ve been the last few days.”

“I’ll make you a deal,” Jack said. “I’ll promise if you agree to take rimantadine.”

“I did notice there were more influenza deaths downstairs,” Laurie said. “You think it warrants rimantadine?”

“Absolutely,” Jack said. “The CDC is taking this outbreak very seriously, and you should as well. In fact, they think it might be the same strain that caused the disastrous influenza outbreak in 1918. I’ve started rimantadine myself.”

“How could it be the same strain?” Laurie asked. “That strain doesn’t exist.”

“Influenza has a way of hiding out,” Jack said. “It’s one of the things that has the CDC so interested.”

“Well, if that were the case, it sure shoots holes in your terrorist theory,” Laurie said. “There’s no way for someone to deliberately spread something that doesn’t exist outside of some unknown natural reservoir.”

Jack stared at Laurie for a minute. She was right, and he wondered why he hadn’t thought of it.

“I don’t mean to rain on your parade,” Laurie said.

“That’s okay,” Jack said, preoccupied. He was busy wondering if the influenza episode could be a natural phenomenon, while the other outbreaks were intentional. The problem with that line of thinking was that it violated a cardinal rule in medical diagnostics: single explanations are sought even for seemingly disparate events.

“Nevertheless, the influenza threat is obviously real,” Laurie said. “So I’ll take the drug, but to make sure you hold up your side of the bargain, I want you to keep in touch with me. I noticed that Calvin took you off autopsy, so if you leave the office you have to call me at regular intervals.”

“Maybe you’ve been talking to my mother after all,” Jack said. “Sounds remarkably like the orders she gave me during my first week at college.”

“Take it or leave it,” Laurie said.

“I’ll take it,” Jack said.

After Laurie left, Jack headed to the DNA lab to seek out Ted Lynch. Jack was glad to get out of his office. Despite the good intentions involved he was tiring of people giving him advice and he was afraid Chet would soon be arriving. Undoubtedly he’d voice the same concerns just expressed by Laurie.

As Jack mounted the stairs he thought more about Laurie’s point concerning the influenza’s source. He couldn’t believe he’d not thought of it himself, and it undermined his confidence. It also underlined how much he was depending on a positive result with the probe National Biologicals had sent. If they were all negative he’d have scant hope of proving his theory. All he’d have left would be the improbable cultures he’d hoped Kathy McBane had obtained from the sink trap in central supply.

The moment Ted Lynch caught sight of Jack approaching, he pretended to hide behind his lab bench.

“Shucks, you found me,” Ted joked when Jack came around the end of the counter. “I was hoping not to see you until the afternoon.”

“It’s your unlucky day,” Jack said. “I’m not even on autopsy, so I’ve decided to camp out here in your lab. I don’t suppose you’ve had a chance to run my probes…”

“Actually, I stayed late last night and even came in early to prepare the nucleoproteins. I’m ready to run the probes now. If you give me an hour or so, I should have some results.”

“Did you get all four cultures?” Jack asked.

“Sure did,” Ted said. “Agnes was on the ball as usual.”

“I’ll be back,” Jack said.

With some time to kill, Jack went down to the morgue and changed into his moon suit before entering the autopsy room.

The morning routine was well under way. Six of the eight tables were in various stages of the autopsy procedure. Jack walked down the row until he recognized one of the cases. It was Gloria Hernandez. For a moment he looked at her pale face and tried to comprehend the reality of death. Having just spoken with her in her apartment the day before, it seemed an inconceivable transition.

The autopsy was being done by Riva Mehta, Laurie’s officemate. She was a petite woman of Indian extraction who had to stand on a stool to do the procedure. At that moment she was just entering the chest.

Jack stayed and watched. When the lungs were removed he asked to see the cut surface. It was identical to Kevin Carpenter’s from the day before, complete with pinpoint hemorrhages. There was no doubt it was a primary influenza pneumonia.

Moving on, Jack found Chet, who was busy with the nurse, George Haselton. Jack was surprised; it was Chet’s usual modus operandi to stop into the office before doing his day’s autopsies. When Chet saw it was Jack, he seemed annoyed.

“How come you didn’t answer your phone last night?” Chet demanded.

“It was too long a reach,” Jack said. “I wasn’t there.”

“Colleen called to tell me what happened,” Chet said. “I think this whole thing has gone far enough.”

“Chet, instead of talking, how about showing me the lung,” Jack said.

Chet showed Jack the lung. It was identical to Gloria Hernandez’s and Kevin Carpenter’s. When Chet started to talk again, Jack merely moved on.

Jack stayed in the autopsy room until he’d seen the gross on all the influenza cases. There were no surprises. Everyone was impressed by the pathogenicity of the virus.

Changing back into his street clothes, Jack went directly up to the DNA lab. This time Ted acted glad to see him.

“I’m not sure what you wanted me to find,” Ted said. “But you are batting five hundred. Two of the four were positive.”

“Just two?” Jack asked. He’d prepared himself for either all positive or all negative. Like everything else associated with these outbreaks, he was surprised.

“If you want I can go back and fudge the results,” Ted joked. “How many do you want to be positive?”

“I thought I was the jokester around here,” Jack said.

“Do these results screw up some theory of yours?” Ted asked.

“I’m not sure yet,” Jack said. “Which two were positive?”

“The plague and the tularemia,” Ted said.

Jack walked back to his office while he pondered this new information. By the time he was sitting down he’d decided that it didn’t make any difference how many of the cultures were positive. That fact that any of them were positive supported his theory. Unless an individual was a laboratory worker it would be hard to come in contact with an artificially propagated culture of a bacteria.

Pulling his phone over closer to himself, Jack put in a call to National Biologicals. He asked to speak with Igor Krasnyansky, since the man had already been accommodating enough to send the probes.

Jack reintroduced himself.

“I remember you,” Igor said. “Did you have any luck with the probes?”

“I did,” Jack said. “Thank you again for sending them. But now I have a few more questions.”

“I’ll try to answer them,” Igor said.

“Does National Biologicals also sell influenza cultures?” Jack asked.

“Indeed,” Igor said. “Viruses are a big part of our business, including influenza. We have many strains, particularly type A.”

“Do you have the strain that caused the epidemic in 1918?” Jack asked. He just wanted to be one hundred percent certain.