Robin Cook - Outbreak

“I’m not sure that twenty-one deaths can be considered a triumph,” said Marissa. “Worse still from an epidemiologic point of view, we failed. We never found out where the virus came from. There’s got to be some kind of reservoir. Just imagine the media reaction if the CDC had been unable to trace the Legionnaires bacteria to the air-conditioning system.”

“I think you are being hard on yourself,” said Ralph.

“But we have no idea if and when Ebola will appear again,” said Marissa. “Unfortunately, I have a feeling it will. And it is so unbelievably deadly.” Marissa could remember too well its devastating course.

“They couldn’t figure out where Ebola came from in Africa either,” said Ralph, still trying to make her feel better.

Marissa was impressed that Ralph was aware of the fact and told him so.

“TV,” he explained. “Watching the nightly news these days gives one a medical education.” He squeezed Marissa’s hand. “The reason you should consider your time in L.A. successful is because you were able to contain what could have been an epidemic of horrible proportions.”

Marissa smiled. She realized that Ralph was trying to make her feel good and she appreciated the effort. “Thank you,” she said. “You’re right. The outbreak could have been much worse, and for a time we thought that it would be. Thank God it responded to the quarantine. It’s a good thing, because it carried better than a ninety-four percent fatality rate, with only two apparent survivors. Even the Richter Clinic seems to have become a victim. It now has as bad a reputation because of Ebola as the San Francisco bathhouses have because of AIDS.”

Marissa glanced at the clock over the steam table. It was after three. “I have a meeting in a few minutes,” she apologized. “You are a dear for stopping by, and dinner tonight sounds wonderful.”

“Dinner it will be,” said Ralph, picking up the tray with their empty cups.

Marissa hurried up three flights of stairs and crossed to the virology building. It didn’t appear nearly as threatening in the daylight as it had at night. Turning toward Dubchek’s office, Marissa knew that just around the bend in the hallway was the steel door that led to the maximum containment lab. It was seventeen after three when she stood in front of Dubchek’s secretary.

It was silly for her to have rushed. As she sat across from the secretary, flipping through Virology Times with its virus-of-the-month centerfold, Marissa realized that of course Dubchek would keep her waiting. She glanced at her watch again: twenty of four. Beyond the door she could hear Dubchek on the telephone. And from the telephone console on the secretary’s desk, she could see the little lights blink when he’d hang up and make another call. It was five of four when the door opened and Dubchek motioned for Marissa to come into his office.

The room was small, and cluttered with reprinted articles stacked on the desk, on the file cabinet and on the floor. Dubchek was in his shirt-sleeves, his tie tucked out of the way between the second and third button of his shirt. There was no apology or explanation of why she’d been kept waiting. In fact there was a suggestion of a grin on his face that particularly galled Marissa.

“I trust that you received my letter,” she said, studiously keeping her voice businesslike.

“I did indeed,” said Dubchek.

“And…?” said Marissa after a pause.

“A few day’s lab experience is not enough to work in the maximum containment lab,” said Dubcheck.

“What do you suggest?” asked Marissa.

“Exactly what you are presently doing,” said Dubchek. “Continue working with less-pathogenic viruses until you gain sufficient experience.”

“How will I know when I’ve had enough experience?” Marissa realized that Cyrill had a point, but she wondered if his answer would have been different had they been dating. It bothered her even more that she didn’t have the nerve to withdraw her earlier rebuff. He was a handsome man, one who attracted her far more than Ralph, whom she was happy enough to see for dinner.

“I believe I will know when you have had adequate experience,” said Dubchek interrupting her thoughts, “… or Tad Schockley will.”

Marissa felt cheered. If it were up to Tad, she was certain that she would eventually get the necessary authorization.

“Meanwhile,” said Dubchek, stepping around his desk and sitting down, “I’ve got something more important to talk with you about. I’ve just been on the phone with a number of people, including the Missouri State Epidemiologist. They have a single case of a severe viral illness in St. Louis that they think might be Ebola. I want you to leave immediately, assess the situation clinically, send Tad samples and report back. Here’s your flight reservation.” He handed Marissa a sheet of paper. On it was written Delta, flight 1083, departure 5:34 P.M., arrival 6:06 P.M.

Marissa was stunned. With rush-hour traffic, it was going to be a near thing. She knew that as an EIS officer she should always have a bag packed, but she didn’t, and there was Taffy to think of, too.

“We’ll have the mobile lab ready if it is needed,” Cyrill was saying, “but let’s hope it’s not.” He extended his hand to wish her good luck, but Marissa was so preoccupied with the thought of possibly facing the deadly Ebola virus in less than four hours, that she walked out without noticing. She felt dazed. She’d gone in hoping for permission to use the maximum containment lab and was leaving with orders to fly to St. Louis! Glancing at her watch, she broke into a run. It was going to be close.

IT WAS ONLY AS the plane taxied onto the runway that Marissa remembered her date with Ralph. Well, she should touch down in time to catch him as soon as he got home. Her one small consolation was that she felt more comfortable professionally than she had en route to L.A. At least she had some idea of what would be demanded of her. Personally, however, knowing this time how deadly the virus could be, if indeed it was Ebola, Marissa was more frightened at the thought of her own exposure. Although she hadn’t mentioned it to anyone, she still worried about contracting the disease from the first outbreak. Each day that passed without the appearance of suspicious symptoms had been a relief. But the fear had never completely disappeared.

The other thought that troubled Marissa was the idea of another Ebola case appearing so quickly. If it was Ebola, how did it get to St. Louis? Was it a separate outbreak from L.A. or merely an extension of that one? Could a contact have brought it from L.A., or could there be an “Ebola Mary” like the infamous “Typhoid Mary”? There were many questions, none of which made Marissa cheerful.

“Will you want dinner tonight?” asked a cabin attendant, breaking Marissa’s train of thought.

“Sure,” said Marissa dropping her tray table. She’d better eat, whether she was hungry or not. She knew that once she got to St. Louis she might not get the time.

As Marissa climbed out of the taxi that had taken her from the St. Louis airport to the Greater St. Louis Community Health Plan Hospital, she was thankful for the elaborate concrete porte cochere. It was pouring outside. Even with the overhead protection, she pulled up the lapels of her coat to avoid wind-driven rain as she ran for the revolving door. She was carrying her suitcase as well as her briefcase, since she’d not taken the time to stop in her hotel.

The hospital appeared an impressive affair even on a dark, rainy night. It was constructed in a modern style, with travertine-marble facing, and fronted by a three-stories-tall replica of the Gateway Arch. The interior was mostly blond oak and bright red carpeting. A pert receptionist directed Marissa to the administration offices, located through a pair of swinging doors.