Robin Cook - Vector

“Fine,” Chet said with a wave of dismissal. “You don’t have to listen to me. Hell, I know that you’ll just do whatever you want no matter what anybody else says.” Disgusted, Chet turned back to his own work.

“Could you page Dr. Kevin Fowler for me?” Jack asked the hospital operator. While he waited he held the phone in the crook of his neck so he could lift down his copy of Harrison’s Principles of Internal Medicine. The pages of the chapter on infectious diseases were dog-eared.

Jack turned to the section on anthrax. There were only two pages devoted to it. He was almost through reading when Dr. Kevin Fowler came on the line.

Jack explained who he was and why he was calling. Dr. Fowler was dumbfounded at the diagnosis.

“I’ve never seen a case of anthrax,” Dr. Fowler admitted. “Of course, I’m only a resident, so I haven’t had much experience.”

“Now you’re a member of a select group,” Jack said. “I was just reading there’s only been a handful of cases over the last decade here in the U.S., and all of those were the more common cutaneous form. The inhalational variety like Mr. Papparis had used to be called woolsorters’ disease. The patients contracted it from contaminated animal hair and hides.”

“I can tell you it was an extremely rapid downhill course,” Dr. Fowler said. “I won’t mind if I never have to take care of another case. I guess we get to see everything here in New York.”

“Did you do a history on the patient?” Jack asked.

“No, not at all,” Dr. Fowler said. “I was just called when the patient got into respiratory distress. All I knew about the history was what was in the chart.”

“So you don’t know what kind of rug business the patient was in?”

“I haven’t the faintest idea,” Dr. Fowler said. “Why don’t you try the attending physician, Dr. Heitman.”

“Have you got a telephone number for him?” Jack asked.

“Sure,” Dr. Fowler said. “He’s one of our staff attendings.”

Jack placed a call to Dr. Heitman but learned that he had been merely covering for Dr. Bernard Goldstein and that Mr. Jason Papparis was actually Dr. Goldstein’s patient. Jack then called Dr. Goldstein. It took a few minutes to get the doctor on the line, and he was less than friendly and rather impatient. Jack wasted no time in asking his question.

“What do you mean what kind of rug business?” Dr. Goldstein asked irritably. He obviously didn’t like being interrupted in the middle of his day for what sounded to him like a frivolous inquiry. His secretary had been hesitant to bother the doctor even after Jack said that the call was an emergency.

“I want to know what kind of rugs he sold,” Jack said. “Did he sell broadloom or something else?”

“He never said and I never asked,” Dr. Goldstein said. Then he hung up.

“He’s in the wrong profession,” Jack said out loud. Jack found the identification sheet in Papparis’s folder and saw that the body had been identified by the decedent’s wife, Helen Papparis. There was a phone number on the sheet and Jack dialed it. He’d been hoping to avoid intruding on the family.

Helen Papparis turned out to be exquisitely polite and restrained. If she was in mourning, she hid it well, although Jack suspected her extreme politeness was her method of dealing with her loss. After Jack offered his sympathies and explained his official position as well as the nature of the exotic diagnosis, he asked his question about Mr. Papparis’s business.

“The Corinthian Rug Company dealt exclusively in handmade rugs,” Helen said.

“From where?” Jack asked.

“Mostly from Turkey,” Helen said. Jack detected a catch in her voice. “A few of the fur rugs came from Greece, but the vast majority came from Turkey.”

“So he dealt with furs and hides as well as woven rugs,” Jack said with academic satisfaction. The mystery was rapidly being resolved.

“That’s correct,” Helen said.

Jack’s eyes dropped to the open textbook in front of him. Right in the middle of the anthrax section it described how the animal form of anthrax was a problem in a number of countries, including Turkey, and that animal products, particularly goat’s hair, could be contaminated with the spores.

“Did he deal with goatskins?” Jack asked.

“Yes, of course,” Helen said. “Sheepskins and goatskins were a large part of his business.”

“Well, I think we’ve solved the mystery,” Jack said. He explained the association to Helen.

“That’s ironic,” Helen said without a hint of rancor. “Those rugs have provided us with a comfortable life, including sending our only daughter to an Ivy League college.”

“Did Mr. Papparis get any recent shipments?” Jack asked.

“About a month ago.”

“Are any of those rugs in your home?”

“No,” Helen said. “Jason felt it was enough to deal with them during the day. He refused to have any of them around the house.”

“Under the circumstances that was a smart decision,” Jack said. “Where are these rugs? Have many been sold?”

Helen explained that the rugs had gone into a warehouse in Queens, and she doubted many had been sold. She explained to Jack that Jason’s business was wholesale and that shipments came in months before they were needed. She also said there no employees at the warehouse or at the office.

“Sounds like a one-man operation,” Jack said.

“Very much so,” Helen said.

Jack thanked her profusely and reiterated his sympathies. Then he suggested that she contact her doctor about possible prophylactic antibiotics even though he explained that she was probably not at risk since person-to-person spread did not occur and she hadn’t been exposed to the hides. Finally he told her she’d probably be hearing from other Department of Health professionals. She thanked him for the call, and they disconnected.

Jack swung around to face Chet, who couldn’t have helped but overhear the conversation.

“Sounds like you solved that one pretty quickly,” Chet said. “At least now you don’t have to put your life at risk by going out there in the field.”

“I’m disappointed,” Jack said with a sigh.

“What can you possibly be disappointed about?” Chet asked with exasperated disbelief. “You’ve made a brilliant and rapid diagnosis and you’ve even solved what could have been a difficult epidemiological enigma.”

“That’s the problem,” Jack said dispiritedly. “It was too easy, too pat. With my last exotic disease it was a real mystery. I like challenges.”

“I don’t know what you’re complaining about,” Chet said. “I wish some of my cases would have such nice tidy endings.”

Jack grabbed his open textbook of medicine and stuck it under Chet’s nose. He pointed to a specific paragraph and told his officemate to read it. Chet did as he was told. When he was finished, he looked up.

“Now that was an epidemiological challenge,” Jack said. “Can you imagine? A slew of inhalation anthrax cases from spores leaking out of a bioweapons factory! What a disaster!”

“Where’s Sverdlovsk?” Chet asked.

“How should I know?” Jack commented. “Obviously someplace in the former Soviet Union.”

“I’d never heard about that 1979 incident,” Chet said. He reread the paragraph. “What a joke! The Russians tried to pass it off as exposure to contaminated meat.”

“From a forensic point of view, it would have been a fascinating case,” Jack said. “Certainly a lot more provocative than picking up a case in a rug salesman.”

Jack got to his feet. After appearing so animated earlier, he now looked depressed.

“Where are you going?” Chet asked.