Don Pendleton - Critical Effect

The nurse looked for any sign of tomfoolery in Blancanales’s expression, but obviously she could only detect altruism in those legitimate lines.

“Why don’t you gentlemen have a seat in the lobby, and I’ll see if I can get Dr. Corvasce to come talk with you.”

“That would be great,” Blancanales said. As his cohorts turned and headed for the door, Blancanales gestured toward Lyons’s retreating form and added quietly, “Don’t mind Irons there. They don’t let him out much.”

She smiled, giggled and quietly replied, “I can see why.”

Blancanales winked and then retreated to join his friends.

A LMOST AN HOUR HAD PASSED before a tall, distinguished man exited through the double set of hermetically sealed doors leading from the infectious disease ward. His lanky form strode toward Able Team in confidence, the gray eyes studying them resolutely on approach. The three men got to their feet as the man reached them. After handshakes and introductions all around, Dr. Michael Corvasce led the trio to a nearby coffee bar with an outdoor veranda.

Gray afternoon clouds had rolled in and brought the smell of rain with them. It felt as if the humidity levels had doubled in just the few short hours since they had arrived, and it had only served to sour Lyons’s mood. He’d decided to let Blancanales and Schwarz do most of the talking, content to just sit back and listen.

“I’m a little surprised to see the CDC got you boys involved,” Corvasce said pleasantly as they sat at an umbrella-covered table.

“It’s not really such a big surprise,” Schwarz said. “We understand they didn’t seem too interested.”

“You can say that again,” Corvasce replied with a frown. “Hence why I can’t understand your interest in the case.”

Blancanales cleared his throat. “Listen, Doctor, we realize you’re probably not at liberty to tell us a whole lot about the condition of either of these patients. But we would appreciate any latitude you could show us.”

“Well, between us, I’ll save the politics for Dr. Kingsley. We’ve been trying to contact my patient’s parents since he arrived, but apparently they’re on vacation somewhere in South America and their housekeeper barely speaks English. I’ve had to pull in the hospital administration and work through an interpreter, who is now calling all over the Western Hemisphere trying to locate these people. So, I’m not going to worry about patient confidentiality at this point if you can assure me you’re here strictly in the best interests of the public health.”

“I can promise you that is definitely one certainty,” Blancanales said.

Corvasce nodded. “That’s good enough for me. Basically, Willis Mallow is a twenty-year-old male who came into the emergency room night before last almost unconscious after complaining of a stomach ache and then collapsing. At first we thought your standard, run-of-the-mill frat party, but we quickly realized something else was going on when his tox screen came back negative. Not that that means anything. These days, kids are into all kinds of stuff, including a combination of legitimate pharmacological agents that produce a short and intense euphoria just before they kill you.

“Dr. Kingsley was actually on call that night, but I got involved because it was right during shift change report and I was the oncoming attending. We went down to the ER and I agreed to examine Willis because a second emergency had been brought in and they were immediately calling for Kingsley, stating the patient was exhibiting many of the same signs and symptoms as Mallow. By the time we got done stabilizing both boys, we’d come to the conclusion they were suffering from the same problem. What we didn’t know was exactly what the hell that problem was.”

“Are you any closer to a diagnosis?” Schwarz asked.

Corvasce shook his head and took a sip of coffee before continuing. “Frankly, both of us are completely stumped. Once we’d ruled out drugs or alcohol, we obtained thorough histories. Both kids were athletes in good health, and neither had traveled recently to any foreign countries. They’re regularly screened for steroid use, so coupled with their negative drug testing, we were able to rule that out immediately. Tell me, are you guys at all familiar with cholinesterase poisoning?”

All three nodded. They had once faced a terrorist group bent on launching poisonous chemicals against targets all over the world simultaneously using stolen missiles. They had nearly failed in that mission, and none of them had ever forgotten the effects that would have impacted millions of people if they hadn’t stopped the terrorists in time.

“Ah.” Corvasce shook his head. “Acetylcholine is produced from nerve endings to stimulate smooth muscle and parasympathetic nervous response. In cholinesterase poisoning, the patient suffers from excessive vomiting, diarrhea and profuse sweating. Body temperature and blood pressure fall rapidly, heart rate increases. If the condition goes untreated, the patient will suffer a condition known as disseminated intravascular coagulation. Third-stage shock in simplest terms. Multiple organ failure usually follows shortly thereafter.

“In both of these cases, that’s the way they acted, except there were some opposite signs I’d never seen before. Urticaria, high fever and polycythemia vera, which is typically an idiopathic condition only seen in patients suffering from congenital heart disease. Neither youth has such a disease, and right now they’re both at very high risk for clots or severe hemorrhaging. That’s why we’ve had to admit them to the ICU wing.”

“If you could put your finger on this at all,” Blancanales interjected, “would you say these kids were poisoned?”

Corvasce shrugged. “Possibly, but if so, it’s unlike any poison I’ve ever seen. It’s almost as if they’re suffering from part cardiac disease, part allergic reaction. But the sudden onset and other environmental factors, coupled with their age and unremarkable past medical histories, does certainly suggest exposure to some type of pathogen.”

“Would somebody with experience in microbiology have the expertise to concoct a pathogen of this nature?” Lyons queried.

“Oh, most certainly,” Corvasce replied immediately. “Why? Do you think this was purposeful?”

“I never said that.”

“But we have to consider it a possibility,” Blancanales added quickly, throwing his blond friend a furious look. “For the good of the public health, you understand.”

Corvasce rendered a thin smile. “Yes. I understand.”

Something in the physician’s eyes told Able Team he understood all too well. While Lyons had played a good game with the nurse—passing himself as more of a fumbling bureaucrat than a highly trained antiterrorist—he’d studied the files of both doctors thoroughly during the trip to St. Louis. All of Able Team admitted they would have expected more cooperation from Corvasce than Kingsley. Of the two doctors, Corvasce had attended medical school at a university of significantly lesser prestige, and had not nearly as many awards and credentials. It was always easier to get the down-to-earth folks to spill their guts than some stuffy, high-brow type who wore monogrammed shirts and drove a BMW with vanity plates. For now, they had enough information to go on. The four men made a little small talk before thanking Corvasce and leaving the hospital. As they drove toward the college, they talked over what he’d told them.

“Sounds like this would be right up the alley of a schizoid like Simon Delmico,” Lyons began.

“Now, Ironman,” Blancanales chided him, “you know better than to believe everything you read in a person’s psych profile. I mean, we never believed any of the stuff the shrinks at Stony Man Farm have said about you.”