This story takes place in an alternate universe where the events in the episode Virus did not happen.
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"He's in here."
Paramedic Craig Brice examined the woman's face as she directed him through the doorway. The corners of her hazel eyes were drawn into tired, frightened folds and her cheeks were white with fatigue. Under his intent gaze she drew her worn corduroy bathrobe tighter around her chest. Hacking coughs echoed from the dimness beyond the doorframe. Stepping into the room he blinked, willing his eyes to adjust more quickly to the gloom. Moonlight from a bare window outlined a figure curled under the bedclothes. Brice knelt beside the bed.
"I thought it was just a relapse, you know. He was sick last week," said the diminutive woman.
Bob Bellingham crowded past the frightened woman. "What's his name, ma'am?" he asked setting down the oxygen bottle and the biophone.
"Alex. Alex Sharp. He came back from riding -- he goes everyday -- feeling bad and went to bed. He just kept getting worse." Abruptly, she slumped against the door jam and began to shake. "He threw up his dinner."
Brice quickly checked the man's airway and took his pulse. Sharp's skin was too warm; in the darkness he could barely see his patient's sweat moistened face. "Pulse 116, thready and he is diaphoretic," said Brice, surreptitiously wiping his hand upon his pants. "Fever."
Bellingham nodded, writing the figure into the patient care form.
"Please help him," she implored.
"We will ma'am," reassured Bob.
Craig pulled back the blankets. The sick man didn't move. "You said he had been ill. What was wrong?" He positioned his stethoscope around his neck.
The woman looked blankly at him for a second. "Strep throat. He -- we -- both caught it from my nephew."
"Was he under a doctor's care?"
Bob pulled the b.p. cuff from the case and handed it to Craig.
"Respirations 30 and shallow with bilateral rales. Bellingham, the O2, please." Brice placed the mask over Alex's mouth and reached across, adjusting the flow. He looked at the wife. "Is he taking any medications?" Pausing while wrapping the rubber bladder around Sharp's arm, he glanced up at Bellingham and pointed with his chin toward the bedside lamp.
"Maybe; it's around here somewhere." She started digging through the nightstand drawers, locating a brown plastic prescription bottle and handing it to the firefighter. "Here..."
"Ma'am..." Bellingham took the medication from her. "Amoxicillin," he read, glancing at Brice.
"Heather," she interrupted.
"Can we turn up the lights?"
Mrs. Sharp turned on a small bedside lamp. "Yes..."
The bulb flickered, revealing the ashen, blue tinged face of their patient. Sharp moaned as the light hit his partially closed eyelids. Feebly he struggled to cover his eyes.
Brice inflated the cuff.
Staring down at her husband, Heather bit her lip. "Alex told me the light was bothering his eyes."
Bellingham made another note on the paper. Bending he retrieved the orange field radio from the floor and set it on the bed, preparing to contact the base station. He paused, his hand on the receiver. "Ma'am, did he tell you anything else -- about his symptoms?"
"Sir," prompted Brice, watching Sharp's response.
"His head hurt..." she answered, twisting the edge of her bathrobe between her hands.
"Sir!" repeated Craig more loudly.
Alex's lashes fluttered.
"Sir, can you tell me where you hurt?" Brice shifted, causing his boots to squeak on the polished wooden floor.
Sharp mumbled, making unintelligible sounds.
"Did he say anything else, ma'am?" queried Bob.
"No..." Heather ran her fingers nervously through her curly hair. "Oh, yes! He said his neck was stiff."
Brice slid his hands beneath the prone man's head, palpitating the back of his neck. He nodded to his partner. "Muscle spasm." He retrieved his penlight from his belt and quickly checked the victim's pupils. "Pupils equal and sluggish."
Bob put down the pen and lifted the biophone's handset. "Rampart, this is Squad 16. How do you read me?"
After a pause the radio crackled to life. "Unit calling repeat," answered the voice of the new ER resident Dr Marguerite Frances.
"Rampart this is Squad 16 we have a..." Bob paused, covering the mouthpiece with his hand. "How old is he?" he mouthed at Mrs. Sharp.
"Fifty-five," she replied.
"Fifty-five year old male, complaining of headache, fever, stiff neck and vomiting. Pulse 116 and thready; b.p. 90/50; and respirations 30 and shallow with bilateral rales..."
"105 axillary," announced Brice, wiping down the thermometer and standing. "I'm going to get the trauma box." He disappeared into the still dark hallway.
Bellingham nodded. "Temp 105 axillary. Patient is stuporous, pupils equal but sluggish. He is cyanotic and diaphoretic; skin is pale. He is under treatment for a strep infection -- Amoxicillin 250mg three times a day."
"10-4, Squad 16. Have you begun O2?"
"10-4, Rampart. O2 15 liters."
"10-4. Squad 16, start IV D5W, administer 250 cc fluid challenge and begin cooling measures," instructed Frances.
Brice returned, lowering the heavy case to the floor and squatted next to the bed, stiff fabric of his turnout pants rustling. He unfastened Sharp's nightshirt, removing the soggy garment, and pulled a paper wrapped sheet from the trauma box. Draping the thin fabric over the feverish man, he began pouring water from a plastic bottle, cooling his victim. "Sorry for the mess, ma'am."
Tears glittering in her eyes, Heather shook her head.
10-4, Rampart, " Bellingham repeated the orders. He pulled a bag of IV solution and an administration set from the drug box. Outside, Bob could hear the ambulance. "Ma'am would you please, show the ambulance crew in."
Brice held the bell of the stethoscope in place on Sharp's arm and began to reinflate the blood pressure cuff. Abruptly, the man went rigid and began to shake. He dropped the bulb and grabbed the biophone. "Rampart, this is County 16."
"Go ahead, 16."
"Patient is having a seizure."
"10-4, 16. Administer 6mg Ativan IV push. Monitor respirations."
Craig clamped the radio handset against his shoulder, writing. "6mg Ativan IVP," he said, repeating back the order. Nimbly his fingers traced along the edge of the tray in the drug box, locating and extracting the medication.
On the stretcher in front of him, Sharp continued to convulse. Quickly, Brice reread the label on the pre-filled cartridge before inserting it into the syringe. The feverish sweat of his patient dampened the IV tubing, making the plastic slip between his fingers as he pushed the needle into the medication port. Craig held his breath, counting and waiting for the seizure to stop. After a long moment the ailing man's body stilled, his head rolling limply back as his muscles went slack. Sharp's gasping breaths slowed and his face darkened.
Head still pressed against the receiver of the biophone, Craig placed his hand on the patient's diaphragm. "Rampart, respiratory rate down the 10 and labored. Requesting esophageal airway."
"10-4, 16. Go ahead with the airway."
Brice removed the perforated, balloon tipped tube from the packet. As he methodically spread lubricant down the length, he looked out the back window of the ambulance, estimating the time of arrival.
Dr Marguerite Frances straightened. She glanced at the night charge nurse, Gabriela Pena. "Looks like pneumonia and meningitis." A lock of hair escaped from the tight bun on the top of Frances' head and hung across her face. Sighing, she blew the offending strands from her cheek. "Draw blood for a CBC, ABG, and SMA 20. Put a foley in. Get cultures of blood, urine and sputum." She took a deep breath. "Prep him for a lumbar puncture and then let's get chest films and skull series."
"Yes, doctor," replied Gabriela, pulling a pair of trays wrapped in heavy blue paper sheets from the cabinets.
Frances watched as a young student nurse entered the treatment room and started placing ice packs against the patient's skin. "After you obtain the cultures, start him on Penicillin G, 5 million units IV, Doxycycline 100mg IV, 125 mg Dilantin, and 10 mg Dexamethosone," she ordered. "Keep up the cooling measures, we need to bring his fever down. And call me when he is ready for the lumbar puncture." Marguette stepped into the hall.
Bellingham lounged behind the counter next to the base station, watching Brice carefully place the last of the new supplies in the drug box. Bob's turnout coat dangled from his bent knee, trailing on the floor. "Craig," he began seriously, "you need a woman."
Craig frowned. "My love life or lack there of is none of your business. And don't you think that is a disrespectful way to describe a relationship?" he asked, never looking up. "What would your wife say?"
Bellingham snorted. "She thinks you need a woman too."
"What makes you think so?" Brice asked after a long pause.
Bob pointed to the neatly arranged trays. His partner snapped the box closed, nearly catching Bellingham's finger. Bob yanked back his hand. "You need a few distractions in your life. It might relieve some -- uh -- tension..."
Thank God, thought Brice gratefully, looking up from the pile of requisition forms requiring his signature. The new resident stood in the hallway, holding a chart and gazing over her glasses at the two paramedics.
"Doctor," acknowledged Bellingham, sitting up straight. "How is he?"
"Not so good. I think he has a bad case of meningitis."
Craig studied the doctor. The woman's face was drawn into a tense frown.
Frances smoothed her hair back. "You gentlemen will need to start on prophylactic antibiotics and I'm going to want to see you again in two days." The doctor slipped her hands into the pockets of her labcoat. "Did you bring Mr. Sharp's wife in?"
"Yes," answered Bob. He jerked his head toward the lobby. "She's in the waiting room."
"Thanks," said the resident, turning. The heels of her shoes clicked as she walked down the corridor.
Walking toward receiving, Brice pulled the handi-talkie from his turnout pocket.
Bellingham trotted to catch up. He held up the packet of pills. "It's not the taking medication for the next two days I mind, it's the orange pe..."
"Squad 16, available," announced Brice into the radio, rather more forcefully than needed. He hurried through the electric doors to the squad.
"10 - 4," acknowledged the dispatcher, her voice sounding slightly irritated.
Bob dropped the pills into his pocket and climbed into the squad. "Getting squeamish in your old age, Craig?" he asked, laughing at his partner's prudish behavior.
"Bob, there are times when the appellation Animal truly suits you." Brice closed the door.
Bellingham leaned forward in the passenger's seat, gazing through the windshield at the full moon. Suddenly, he howled. Beside him Craig jumped. "That's what my wife says."
Brice looked his partner, who was picking his teeth with a pen cap, and threw the squad into gear, committing an act of transmission violence. Five hours, 16 minutes and I am off-shift.
"Roy, am I weird?"
The question cut across the shift change bustle in the locker room. Paramedic Roy DeSoto froze, his fingers wrapped around the collar button of his shirt. He stared at John Gage. His partner's face was furrowed with bewilderment. This is too easy. "Uhhh...."
"Yes," interrupted fireman Chet Kelly, grinning broadly.
"Shut up, Chet. I wasn't talkin' to you." Gage scowled at the bushy-haired fireman with sufficient intensity to cause him to turn back to his locker.
Do I want to know what brought this on? Roy asked himself. No. He hung his shirt on a hanger. "It depends on your definition of weird...."
John glared at Roy. "Ha ha. You know Dianne?" The last part of his question was muffled as he stripped off his shirt.
DeSoto nodded. Dianne was Johnny's girlfriend of the month.
"Dumped again, Gage?" jeered Chet, removing his prize bell-bottom jeans, revealing a pair of boxer shorts covered with large red hearts, each sporting a little nose and mustache.
"What do you mean again?" demanded Johnny.
"Again -- as in yet another woman deciding her life would be complete without you." Kelly reached into the locker for his pants. "Like Vivian..."
Roy took advantage of exchange between the two firemen to quickly pull on his uniform shirt. If he dressed fast enough he could be in the day room drinking coffee before Johnny finished arguing with Chet.
"For your information, I dumped Vivian."
"Just before she dumped you..."
"No!" Gage pressed his hand against his chest. "I dumped her when she started pointing to small children and saying how much she'd like to have one that looked like me."
Roy looked up in mute horror, his hand clutching his shoes and socks. That pause cost him his escape. Johnny's eyes locked onto him. DeSoto fought the urge to sigh.
"In your dreams, Gage..."
"Anyway, I wasn't talkin' to you, I was talkin' to Roy." Johnny pointedly turned his back to Chet.
Defeated DeSoto sat.
"Roy, she said I did things no normal person did."
She's got that right, decided DeSoto, shaking his head. Slumping, he debated which was worse, having Gage rant about his love life or having Gage in a snit because Roy had ignored him. He gritted his teeth and added up his remaining vacation days for the year.
"She said I was unpredictable. Me!" Johnny stood his uniform pants half on, pointing to himself with a look of amazement on his face.
"You'd be disappointed if she said you were." DeSoto bent to put on his shoes and socks.
"That's not the point!"
"Of course not, whatever could've made me think it was..."
Roy sighed. At full rant, Gage was impervious to sarcasm.
"The point is, she said I'm weird." Johnny looked at Roy. "Am I?"
Standing, DeSoto closed his locker and headed for the coffeepot. He stopped with his hand on the door to the apparatus bay. "Like I said, it all depends on your definition of weird." He quickly stepped through the door.
"He's sinking fast," announced Frances, her eyes frowning over the mask hospital infection control regulations required for staff tending meningitis cases. In the bed in front of her lay Alex Sharp; his chest rising and falling with the forced evenness of the mechanical rhythms of a respirator. The man's pasty, swollen face was slick with sweat, which was soaking the pillow case and running down his neck onto the plastic circulating water cooling blankets. "He's had several seizures and his intracranial pressure is rising. He's also anuric, and his lungs are wet..."
Kel Brackett looked up from the stack of flowsheets, he held. "Have you got the labs back on the spinal fluid?"
"Yes, glucose normal, protein slightly elevated, WBC 450 per cubic millimeter, gram stain negative..."
Kel nodded. "Consistent with a partially treated bacterial infection."
"Or aseptic meningitis."
"Cultures?" Brackett stepped back from the bedside, allowing a gowned nurse access to the patient.
"Just the usual flora..."
"S. pneumoniae, H. influenzae," lectured Kel, "can all cause meningitis."
Frances closed her eyes and nodded. "But none were present in disproportionate quantities."
"Let's try changing the antibiotics to Cefotaxime, Vancomycin and Rifampin. Maybe they'll knock it out." Brackett watched the nurse check the ventilator.
"If this doesn't work...." Marguerite's voice trailed off.
Kel looked down at the unconscious man and frowned.
Roy stared into the long ugly gash in the ground surrounded by men and excavation equipment; the newly exposed dirt formed a damp brown slash against the dry yellow earth of the hillside. From his vantage point several yards from the trench, he could just make out the top of the boards, which had once supported the earthen walls. The broken wood jutted from a mound of dirt at crazy angles. Beside him the foreman babbled about 'virgin earth' and trapped man's wife. On the opposite side of the ditch, Chet Kelly and Marco Lopez had positioned a roof ladder on the ground along the crumbling edge in an attempt to distribute the weight of rescuers and prevent any further subsidence. Johnny stepped lightly from tread to tread, examining the depths and pulling on his leather gloves.
Captain Hank Stanley stopped next to Roy, holding a pair of heavy metal struts used to support the emergency shoring. He watched Gage balancing easily on the narrow strips of metal. "Want to explain to me why he can't walk across the apparatus bay without falling on his butt?" asked Stanley, leaning closer to DeSoto and pointing to Gage with his chin.
Roy stifled a laugh. He turned and pulled the biophone and drug box from the compartment.
The foreman darted behind DeSoto, grabbing Stanley's arm. His blue eyes blazed beneath the orange rim of his hard hat. "Bernie's still trapped in there! When are you gonna start diggin'? Are you just gonna stand around and talk?" he demanded, his voice a near shout.
"Sir, as soon as my men have fully assessed conditions," replied Hank calmly, "we'll begin digging." He met the man's angry gaze. "If we start without properly shoring up those walls, we could bring down the rest of the trench and suffocate him."
The angry man released Stanley's arm and, muttering, withdrew to stand with his men.
"John, what'd ya got?" asked Hank, walking over to where Chet and Marco stood. He set down the supports and looked across the excavation. Carrying an armload of boards, Engineer Mike Stoker joined the officer.
Gage stared into the hole. A muscular black man, his face streaked with sweat and yellow dust, was pinned on his back beneath a spill of earth. Under its weight, the man gasped noisily for air. Johnny could see the remains of improperly placed planks, studding the pile of dirt. When a heavy backhoe had been moved near the trench, the weight had caused a softer vein in the earth to slip and the moving soil had burst through the inadequate shoring, burying the hapless construction worker. "Looks like the pressure from the backhoe," he gestured over his shoulder, "was too much for the shoring. Burst through where it was weak, started a chain reaction that brought down the rest of that wall." The unsupported sides continued to crumble, sending occasional cascades of dirt across the pinned man's face.
"Cap, want me to move it back?" asked Chet, pointing at the large machine.
"No, I'm afraid any disturbance might bring it all down." Hank studied the ditch estimating the quantity of supplies needed to support the walls.
Without taking his eyes off the scene, John stepped a few feet further down the ladder. "Cap, he's pinned on his back under -- uh -- about eight foot of dirt -- buried to his neck. He's really havin' trouble breathin'. I'd like to get some O2 down to him."
Hank examined the remaining shoring at the far end of the trench, near the trapped worker's head. There were an insufficient number of metal pylons supporting the planks, however the structure seems stable for the moment. Stanley decided. "Marco, drop a second ladder down there. Johnny, wear your air mask."
"Ok, Cap," answered Gage, stepping from the ladder and trotting toward the squad. Hurriedly, he retrieved his SCBA, ladder belt, a coil of rope, the trauma box and oxygen tank.
Stanley tugged on the knot attaching the rope to Gage's safety harness, double checking the line, while Johnny secured his SCBA. Behind the paramedic, Lopez and Kelly had leaned a ladder against a metal brace. The lower end pointed toward the victim. "Any slippage and you get out of there."
"Ok, Cap" agreed Gage, his voice muffled by the air mask. With a quick glance at the boards supporting the walls, he stepped onto the ladder and climbed down into the ditch. The dirt at the bottom trench was soft and uneven beneath his feet. He squeezed under one of the support pylons. The construction worker looked at him, his eyes filled with desperation. "Roy," John said, reaching upwards, "hand me the O2."
Roy lay flat on the ground beside the excavation. He passed the heavy green cylinder down to his partner.
Johnny set the tank next to the man's head and placed the oxygen mask over his nose and mouth. "This should help you breathe. Can you tell me where you hurt?"
"My... back... chest..." gasped the man. "Help... me...."
"We're going get you out just a soon as we can." Johnny looked up. "Roy, a c-collar."
Lopez grabbed the brace from the case and gave it to DeSoto. Roy handed the collar to Gage. A trickle of soil seeping from between two boards behind John caught Roy's attention. "Johnny!"
John turned his head and, for a second, watched the wall. The unsupported lower edge one of the boards was inching forward. "I see it." He carefully wrapped the brace around the construction worker's neck.
The flow of earth accelerated. "Gage!" ordered Hank.
"Coming, Cap!" Johnny fastened the last Velcro tab. "We'll get you out," he reassured quickly passing under the strut and climbing onto the ladder. As Gage started up, the board gave way.
DeSoto gasped in horror, watching the ladder tip sidewise, spilling his partner to the ground. "Pull him up!" he yelled, reaching over the edge.
John grabbed the rope as he fell, kicking at the yellow tide of dirt. The ladder belt tightened around his waist as Marco and Chet hauled on the line, pulling Johnny upwards.
"Bernie!" yelled the foreman rushing forward, stopping when Mike caught his arm.
Roy caught the shoulder strap of John's airpack. His arm muscles cramped as he fought to drag John over the lip of the cut. "Pull!" Stanley reached past him, grabbing Gage's other shoulder. Together they hoisted the firefighter out of the collapsing trench.
Johnny lay on the ground where they had dumped him, gasping. Weakly he pushed back his facemask. "Oh man, that was close," he mumbled.
Hank leaned over the edge. The construction worker was covered. "Damn," he swore. "John, were you able to get the oxygen on him?"
Gage nodded. "Yeah, Cap." He shrugged off the SCBA and pushed himself to his feet.
"Kelly, Lopez, Stoker get the sides shored up over here," Stanley pointed to area by the buried construction worker's head. The tall man picked up a shovel. "Let's move!"
Kelly straightened and leaned on his shovel for a second. Sweat dripped into his eyes and soaked the sides of his shirt. Yellow dirt melted into mud on his face. Temporary shoring lined the sides of the ditch, supported by thick pneumatic struts. He grasped the shovel preparing to dig again. "Cap, how long?"
"Fourteen and half minutes," answered Stanley
"Chet, need a break?" asked Lopez.
"Not yet, Marco." Beneath his shovel, glistened a length of green tubing. He threw the shovel backward and knelt, beginning to frantically dig with his hands. "Cap, I found him!"
Behind the firefighter, DeSoto scrambled down the ladder. He joined Kelly, pushing dirt aside, unearthing the man's face and shoulders. The oxygen mask still covered the victims nose and mouth, but yellow dirt filled his ears and covered his eyes. Mud caked the man's dark lashes, formed by the moisture leaking from his eyes.
Holding his breath, Roy touched the side of the man's neck, the blood vessel pulsed rapidly under his fingertip. "He's alive!" shouted Roy. A cheer greeted his pronouncement.
"Let me in there, Chet," ordered John, clinging to the treads halfway down the ladder. Still digging, Kelly leaned against the rough wooden wall lining the trench to let the paramedic squeeze past. Gage knelt beside the man. He carefully brushed aside the last of the earth pressing on the man's heaving chest. "Get his legs," directed Gage.
"Backboard," called DeSoto, standing. Hank and Mike handed the long wooden spine board over the edge.
Kelly shoveled aside the dirt covering the victim's legs, careful not to move the limbs.
Pulling out his bandage scissors, John slit the front of the soiled shirt and ran his hands gently along the wall of the man's chest. "A couple of broken ribs on the right side," he commented, tracing his hands down the man's legs. "Possible right tib-fib fracture."
Roy looked at the walls of the trench. "Let's get him outta here."
Gage nodded, gesturing for Kelly to help them roll the patient onto the backboard.
"On three," directed DeSoto. "One... Two... Three." Together they rolled the man onto the board. Roy held his hands on either side of the victim's head, holding it still while Chet secured the straps and John positioned foam blocks and wrapped a thick strip of tape over the man's forehead. "Ok. Cap, Mike." They lifted the stretcher clear of the ditch.
Roy released the valve on the blood pressure cuff. "102/60."
John paused in assembling the biophone to record the reading. He finished screwing the antenna in place. "Rampart, this is squad 51. How do you read me?"
"Loud and clear. Go ahead 51." Dixie's voice crackled over the radio.
Peeling off the paper backing, DeSoto attached the conductive electrode patches to the patient's chest. "As a precaution, we're going hook you up and take a look at your heart," he reassured, snapping the leads of the patient cable in place.
"We have a male, approximately 50, victim of a cave-in. He was buried for about 40 mins. No preexisting conditions, no known allergies." John picked up the MICU form and read. "Pulse 112, respirations 24 and shallow, bp 102/60, pupils equal and reactive. Skin cool and damp. Patient is conscious. Possible right rib fractures and right tib-fib fracture. Patient currently on O2 15L and we are preparing to take a rhythm strip."
"10-4, 51. Establish IV, Ringers lactate and transmit a strip."
"10-4, IV Ringers." John slung the receiver over his shoulder. "Roy?"
DeSoto nodded. "Ready." He reached into the drug box, retrieving an IV set up and a bag of solution.
"Rampart, this will be lead 2," advised Johnny, switching to telemetry transmission. He waited half a minute. "Rampart, did you receive?"
"10-4, 51." Dixie paused. "Continue to monitor and transport."
"10-4, Rampart. 51 clear."
"Dixie, you're a woman," began Johnny, shifting the radio from one hand to the other.
"So I'm told," interrupted McCall in a long-suffering tone of voice, as she continued to fill out a laboratory request form.
"So, maybe you can help me...." Gage paused. "Am I strange?"
Roy sighed and rolled his eyes. He picked up the datascope and started wandering toward the door, hoping Johnny would follow.
"You know," replied John, rubbing at his dirt-streaked nose, "peculiar. Am I weird?"
Startled, Dixie fixed Roy with an incredulous stare, stopping him mid-stride. "What brought this on?" she asked.
DeSoto shrugged. "He got dumped."
"I broke up with Vivian," protested Gage, sitting on the counter behind the nurses' station.
"Johnny! You're filthy," scolded the nurse, pointing at the paramedic's dusty clothes and dirt caked hair. "Get down."
"Sorry," said John sheepishly, sliding off the ledge. "Anyway, do I act strange?"
"That all depends on how you define strange," answered McCall, signing the last piece of paper.
Crestfallen, Gage gaped open mouthed at the nurse, as she echoed Roy's words.
DeSoto choked on a suppressed giggle. He sputtered helplessly.
Glaring, John frowned at his coughing partner. "Gonna survive, buddy?" he inquired archly. Turning on his heel, he walked stiffly toward the entrance and activated the radio. "Squad 51, available."
Looking down the corridor at his colleague, Roy shook his head.
"One of those shifts?" McCall smiled.
"With Johnny, it's always one of those shifts." DeSoto tucked the scope under his arm. "Later, Dix."
Stopped at a traffic light, Roy risked a glance sideways. John was slumped against the door, staring intently at the passing scenery as though he had never before seen the markets and car dealerships lining Carson's main street. He hadn't said a word since leaving Rampart. Even radio traffic about a small brush fire working in the hills north of Pasadena failed to provoke comment. Johnny radiated an aura of affronted irritation. DeSoto sighed softly; Gage was in high sulk.
"Johnny," began Roy carefully.
Gage scowled and watched his partner out the corner of his eye.
"I'm sorry. I..." Biting his upper lip, DeSoto hunted for the right words. "I didn't know she meant so much to you."
John turned his head looking at a spot on the floor of the cab. "She didn't."
"Then this is somewhat serendipitous."
Gage shrugged. "It isn't the girl."
"Then what're you so upset about?"
"Man, you've been married too long," said John vehemently, staring at his partner. "It's what she said."
The light changed. Roy accelerated at a slightly greater rate than was strictly necessary.
Gage swiveled in the seat to face DeSoto. "I keep thinking about our dates. What I did, what I didn't. I can't see where I did anything unusual. But... Well, I keep getting dumped." John frowned a little, his expression a bizarre mix of bemusement and dejection.
Thinking fast, Roy took a deep breath. "Seems to me it's a good thing that you two've broken up. She clearly didn't appreciate your -- uh -- unique qualities."
Johnny looked up, his face brightening. "Yeah. Yeah, you're right."
Dr Richard Briggs lifted the wrist of the body lying on the stainless steel table in front of him. "Alex Sharp," he read, his words shaped by a prim English accent. Richard matched the name on the plastic hospital ID bracelet to the autopsy permit. He looked up at the pathology assistant standing across the autopsy table. "Meningitis?"
"That's what the report says. But they haven't been able to isolate the causative organism."
Richard studied the muscular, well-formed body of the once healthy man. Other than the marks left by his recent ordeal, the corpse bore none of the usual indicators of prolonged ill health. "Any chronic illnesses?"
The assistant shook his head. He flipped through the papers; suddenly he looked up, raising his eyebrows. "He died within forty-eight hours of admission. No response to any of the antibiotic treatments," he said, setting down the chart and positioning a dissecting tray.
"Well, let's see what we find." Briggs lifted the scalpel and began to make a deep Y-shaped incision extending from the collarbone to pelvis.
Taking a sip from a steaming cup of tea, Briggs sat at his desk and reviewed his notes. The phone rang. "Pathology, Briggs speaking." He listened for a moment. "Just finished the gross exam. The tissue samples and toxicology are being processed now. They should be ready tomorrow," his voice trailed off as he took another swallow.
On the other end of the phone, Brackett sighed. "What can you tell me?"
"Not much at this point, Kel. His lungs, kidneys, spleen, liver and heart were all seriously affected. Multi-system organ failure ultimately killed him."
"Any pattern to the meningeal inflammation that might suggest a causative organism?" Brackett's voice was tight.
"No." Richard set down his mug, remembering the generalized reddened irritation of the thick membrane covering the brain and spinal cord. Unlike some of the common bacterial sources of meningitis, which favored particular structures within the central nervous system, this microbe showed no such selectivity but instead destroyed indiscriminately. Briggs gazed at autopsy report diagrams resting onto the journals covering his desk. "Any more cases?"
"Not yet," replied Brackett, grimly.
"I'll be all right, I just want to be alone for a while. Thank you, Helen." Heather Sharp hung up the phone. She dropped on the vinyl-covered chair at the kitchen table and cradled her head in her hands. The formica was covered with documents dropped off by the lawyer and the funeral home; a heavy brass key to her husband's safety deposit box sat atop the pile. Biting her lower lip, she turned the key between her fingers, feeling the dark empty pit left by Alex's death swell in her throat. Tears splattered on the papers.
Heather closed her eyes. A dull red throbbing drummed behind her temples. Wearily, she struggled to her feet and staggered down the hall to get some aspirin.
Helen Levine skirted the low hedges separating the two yards and climbed the concrete stairs of Alex and Heather Sharp's house. Carefully, she shifted the warm casserole dish from one hand to the other and rang the doorbell. No one came to the door and the hallway beyond the ornately carved wooden panel stayed silent. Helen pushed the bell again, but still the door remained closed.
"Heather," she called, setting the dish upon the stoop and peering through the window. All she could see was the green shag carpeting of the empty entry. Walking around the side of the house she looked down the driveway. The bright red car was parked in front of the garage. "Heather," Helen repeated, panic lacing her voice. She ran down the walk, going home to get the spare key.
Frances looked up for the stack of papers and shook her head. "Bottom line -- it's still a mystery. We just don't know what killed Mr. Sharp."
Kel Brackett leaned back against the thick padding of his chair and traced his finger along the edge of the blotter. He glanced at Early, sitting next to the resident. "The lab will continue to try and isolate the cause."
The gray-haired doctor looked up. "I still think it's entirely possible we're dealing with some sort of an arbovirus," he said, referring to a class of tick and mosquito borne central nervous system viruses.
"Joe, then I'd expect to see a cluster of cases." Kel turned over the autopsy report. "I've made a few phone calls. No other hospital in the area has admitted any meningitis cases of unknown origin."
Early bowed his head. "I still suspect an arbovirus. He may not have contracted it in L.A. His wife told me Alex had taken a business trip to the Middle East a few weeks ago. Maybe we're looking at West Nile or Rift Valley Fevers."
Marguette pursed her lips. "UCLA Med Center should have the sera necessary to test for those."
"While they're doing that, let's alert the staff to be on the look out for unusual meningitis cases." Brackett handed the file back to Frances. "In the mean time, I'm inclined to regard this as an isolated incident."
Early waited for the door to close behind the resident, he looked up, meeting Brackett's intent gaze. "Let's hope this was just isolated case," added Joe, standing up.
Beth Shaw padded barefoot into the kitchen. She stopped, inhaling the heady aroma of nutmeg, parmesan cheese and fresh chocolate cake. She stretched, luxuriating in the deep nap of her bathrobe, her skin still tingling from repeated scrubbings. After bathing the new admission on the surgical floor, a homeless man with gangrene, Shaw had briefly considered going to Central Service and having herself run through the autoclave. I'm going to burn my uniform, she decided, reaching into the refrigerator and closing her hand around the empty space where the orange juice pitcher should have been. Damn! Bending, she rummaged through the freezer hunting for another container of concentrate.
As Beth straightened, she found herself at eye level with symmetrical mounds of parsley, chopped asparagus, sliced zucchini and dewy shelled peas, all stacked on the cutting board. Craig Brice stood across the island countertop from her. Carefully, he fished mushrooms from a bowl of cold water, neatly slicing them. His face was frozen in a familiar expression of completely inward-directed concentration. Shaw doubted he was even aware of her presence. I'll change that. Her hand tightened on the juice can, melting the thin layer of frost coating the surface.
Beth stood behind Craig, watching the smooth, economical movements of his back muscles beneath the knit of his shirt, as he cut the fungus with mechanical precision. Abruptly she reached forward, lifting his shirt and thrusting the frozen can against his bare belly.
"Argh!" yelped Brice, dropping the knife, which sliced unevenly through a mushroom. He jumped backwards. Neat piles of vegetables toppled.
Shaw twisted, pulling them both to the ground. She buried her face in his hair. Um, he smells good.
"Hey, you made me ruin the mushrooms," he whined, sliding free of her grasp and getting to his feet.
"No, Craig, I made you ruin a mushroom. One mushroom -- which will not taste any different for being unevenly bisected." She pushed herself upright and sat cross-legged at his feet, smiling up at him. "What's the special occasion?"
He pushed the vegetables back into neat piles. "At 7:32 p.m. it will be exactly one year since you asked me to move in." As Beth started to giggle at this manifestation of his eidetic memory, Craig frowned. "I don't find this particularly amusing."
Brice picked up the mushroom and held it before her lips. "Here, eat the ruined one."
She took the mushroom on her tongue. "I don't know how you manage to cook a meal at the station. What if you get a call?" Shaw asked, chewing. Smoothing her robe, she climbed to her feet.
Severely, Craig looked at her. The mischievous sparkle in her green eyes forced him to choke back a grin. "That is unavoidable," he answered, pulling her against him.
"Sweetheart, so am I," she replied, kissing him. Shaw could taste his smile.
The sauce can wait, Brice decided, looking into her eyes. He twined his fingers in Beth's hair. Behind them, the pile of asparagus collapsed.
Doctor Frances paused outside the door of the exam room. Her head was pounding. A wave of nausea washed over her causing her to break into a cold sweat. Closing her eyes, she leaned against the wall trying to catch her breath.
"Doctor?" asked Gabriela Pena, touching Marguerite's arm, "Are you all right?" She peered at the young resident; the woman's face's was flushed and she was shaking.
Marguerite started to nod, stopping as the muscles in her neck cramped. A shiver of fear prickled along her spine, as she recalled the meningitis patient she had seen earlier in the week. It's a coincidence; you've been on antibiotics. "I'm just tired," she mumbled, trying to reassure herself.
"Why don't you go to the on call room and lay down. We're pretty quiet right now." Pena seized the resident's elbow to steady Frances as she pushed away from the wall.
"It's hot in here," Marguerite commented abstractedly. She took a half a dozen faltering steps. A storm of gray spots danced at the edge of her vision. Abruptly, the corridor tilted.
Gabriela caught the doctor as she collapsed, cushioning her fall. Frances vomited. Gurgling sounds emerged from Marguerite's throat and her lips turned blue, as she began to choke. Pena rolled the unconscious woman on her side and frantically used her fingers to clear Frances' mouth. "I need some help here!" she shouted.
<![if !supportEmptyParas]> <![endif]>
Beth rolled over and pried open an eyelid. She was freezing; Craig had stolen all the covers again. Cocooned in the bedding, he squirmed restlessly, poking her with a well-padded elbow. A guilty conscience disturbing your sleep? A thin slash of light from the street lamps leaked through a gap in the drapes and fell across his pillow. Only a lock of his brown hair was visible, sticking out from beneath the comforter. She seized a loose corner and dragged the blanket back over her shoulder. The smooth surface was damp. Shaw slid her hand beneath the covers and touched Brice's shoulder, sweat saturated his pajamas and drenched the sheets.
Alarmed, Beth sat up and turned on the lamp. "Craig?" She pulled the blanket away from his face and pressed her hand against his forehead. His skin burned below her palm. He is way too hot! The paramedic's face was flushed and dripping with perspiration. "Craig?" she repeated, climbing out of bed.
Brice coughed, setting loose rampaging beasts inside his ribcage and skull. "Beth," he moaned, "my head hurts." The weak light of the bedside lamp bored into his eyes; he tried to turn away but his aching back wouldn't let him move. Squinting, he lifted the blanket to cover his face.
Shaw pulled the comforter from his hands, exposing his sweating body to the cooler room air. "Craig, let me get this off you. You're running a high fever." She desperately wanted to get him uncovered and take his temperature.
"No!" Shivering, he grabbed weakly at the edge of the bedding.
Gently, she disentangled his fingers from the blanket.
Craig's mouth filled with saliva. "I'm goin' to be sick," he slurred. Mired by the mass of clinging damp sheets, he struggled to stand. He collapsed.
Beth barely managed to break Craig's fall, cushioning his head with her own legs as they landed in a tangled heap. His vomit soaked her nightgown and spattered the wooden floorboards. With the sick paramedic lying shaking and gasping across her lap, she fought back panic, battling to think like a nurse and not a lover. In the golden lamplight Brice's skin was blanched and shrunken, his face drained of color. "Craig? Sweetie?" asked Shaw, while she checked his airway, wiped his mouth and rolled him off her legs. Brice was semiconscious. His pulse was fast and weak, the fluttering of a dying bird under her fingertip. The apparent stiffness of his neck combined with the high fever, headache and vomiting added up to the terrifying prospect of a central nervous system infection. Possibly meningitis, she thought, remembering the patient he had had last week. Damn! Reaching up and grabbing the pillows, she positioned them to support Craig on his side so he would not aspirate if he vomited again. Beth scrambled for the phone.
Brice lay beside the bed, eye level with the gap beneath the dust ruffle. Menacing gray lumps were visible under the bedstead, twitching and heaving with each breath he took. "Beth!" he wheezed.
"...672 Onrado St." Shaw paused listening. "Yes, I'll wait on the line until they get here. Hang on..." She covered the receiver. "Craig?"
The dust leaned ominously toward him, threatening to engulf him -- like the killer pink bubbles on the British spy show Beth liked to watch. "Help me..." He raised a hand in front of his face, trying to fend off the menacing blobs. The pressure in his head was nearly unbearable. "They are going to get me. They will choke me to death!" Brice gasped for air, panic spreading across his face.
"He's having trouble breathing," she said, dropping the phone. She fell to her knees beside his prone form and re-assessed his airway. Clear. Respirations -- fast and shallow...
"The dust thingies!"
Brice pointed to the massing balls of lint, hair and fuzz.
Shaw lifted the dust ruffle. "For Pete's sake," she sputtered. Half crawling, half kneeling, she clambered through the bathroom door and grabbed a towel, soaking it in water. Draping the cool cloth over his forehead, she covered his eyes. "If you can't see them, they can't get you." He relaxed against her knees. Fumbling with the snaps, she opened his pajama top, baring his chest to the cool night air. Brice's hand lay limp on the polished floor, nailbeds blue. She could hear a faint wheeze every time Craig inhaled. Controlling her own breathing, Beth grabbed the phone and demanded, "What's the ETA on the squad?"
Kel Clark parked the squad parallel to the curb, killing the lights and siren. The final flashes of the lights reflected onto her freckled checks. A slender band of streetlights twinkled on the foothills of the mountains to the east of the city. A faint pink band, harbinger of the coming dawn, outlined the dark bulk. Her partner Karen Wolfe lifted the microphone, "Squad 45 at scene."
"10-4, Squad 45."
Karen snapped her turnout coat over her t-shirt and gave the chinstrap of her helmet a quick tug while sliding from the squad. Throwing open the bay, she snatched the biophone and drug box, leaving the O2 and the defibrillator for her partner. An uneven brick walk led to the small 1920's bungalow. "Fire department," Wolfe announced knocking on the door.
A slender red-haired woman dressed in an unevenly buttoned man's shirt and oversized sweat pants opened the door. Finding herself suddenly at eye level with Wolfe's Adam's apple she stepped backwards. "He's in the bedroom." She turned and led the way down the hall.
Karen followed the woman into a small bedroom. A man lay on his side by the bed, supported by pillows, forehead and eyes covered by a wet towel. Vomit covered the floor by his head. Next to Wolfe's heavy rubber boots was a soiled, very flimsy aqua negligee.
"He has a fever of 104.6, pulse 100 and weak, respirations 28, and is diaphoretic and cyanotic," recited the redhead.
Clark slipped past Wolfe. She gaped at the woman.
"I'm a nurse." The woman pulled the shirt tighter. Feeling a sudden need to explain further, she continued, "At Rampart. Beth Shaw."
Karen knelt beside the man, placing her helmet on the floor and uncovering his eyes. "Brice!" She preformed a quick check of his airway and circulation.
"Geeze," whispered Kel, looking from his pale face to the lingerie to the woman wearing Craig's clothes.
Karen unrolled the BP cuff and placed the stethoscope in her ears.
"He complained of a terrible headache. Nuchal rigidity, photophobia, confusion and positive Brudzinski's sign. He vomited once..." Beth suddenly stopped, drained. Her knees shook. "He was just fine when we went to bed."
Kel's eyebrows climbed above her bangs at the phrase 'we went to bed'. Quickly, she averted her face to hide her surprise
"BP 108/70," reported Karen, sliding a thermometer beneath Craig's tongue and placing her hand on his diaphragm, counting. She listened to his chest.
"Wolfe," mumbled Brice around the thermometer, while trying to roll on his back. "Help me."
"Brice, just lay still." Karen held his shoulder, preventing him from moving and looked up at the nurse. "Ms. Shaw said you threw up. You'd better stay on your side for a while. Correct, protocol and all." She smiled at him. Outside Karen could hear the wail of the ambulance siren. She started the O2, pulled the thermometer from his mouth and placed the mask over Craig's face. "104.6."
Setting the orange box on the bed, Clark opened the biophone screwing the antenna in place. As Karen called out the rest of the vitals signs, Kel quickly scribbled the readings onto the patient care form on her clipboard. She glanced up meeting Brice's gaze. He had been her preceptor during her clinicals and as he looked at her with those cool gray eyes, she had to fight off an irrational urge to write more neatly. Turning her head, Kel lifted the receiver. "Rampart this is Squad 45. How do you read me?"
"Craig -- uh -- Brice, do you have any allergies?" asked Wolfe.
"Dust," he replied promptly.
Karen rolled her eyes. A delirious Brice is still a compulsive Brice. She looked questioningly up at Beth, who shook her head. "Are you taking any meds?"
"No," answered Shaw.
"We read you loud and clear, County 45. Go ahead," crackled the radio.
"Rampart, we have a 31 -year old male complaining of a severe headache, fever, confusion, stiff neck and vomiting -- sudden onset. BP 110/80, pulse 108 and weak, respirations 24 and shallow with rales, temperature 104.6. Patient is pale and diaphoretic. Lips and nailbeds were blue, but have pinked up on administration of 15L O2. Patient vomited several times before arrival, approximately 600 cc's. No known allergies, no medications." Karen paused. "Do you copy?"
"10-4, 45. IV D5W, TKO and begin cooling measures. Take seizure precautions and transport immediately."
"10-4, Rampart." Karen opened an administration kit and prepared the IV, while Kel read back the orders. The ambulance crew stopped in the doorway behind her.
"Clark," moaned Brice, pushing away the mask and grabbing her hand while Wolfe swabbed his other arm. "Get it away from me..." A coughing spasm drown out the rest of his words.
Kel slipped the mask back into place. "Brice, you need an IV."
"Not the needle. That," Brice gasped, gesturing to the space under the bed. "Ouch!" He winced as the Karen slid the needle into his vein.
Kel followed his pointing finger. She could see nothing other than a little dust beneath the bed, marring an otherwise immaculate floor.
Something inside Shaw's head snapped. "Enough, with the damn dust bunnies, Craig! I told you we would protect you."
Clark looked at her partner. Karen's shoulders shook with suppressed laughter as she taped the IV tubing in place. Trust Craig Brice -- the prefect paramedic -- to hallucinate about killer dust bunnies.
"We'll cool him off enroute," instructed Wolfe. She gestured for the ambulance crew to help her lift the ailing paramedic onto the stretcher. "No blankets. Keep him on his side." She lifted the O2 bottle onto the litter. Pausing for a second, she placed her hand on his shoulder. "Craig, we're going to take good care of you."
"I'll bring the squad in." Kel grabbed the defibrillator and stood.
"I'm riding in with him," announced Beth.
"Ma'am," said Wolfe, snapping the drug box shut, "family only."
"I'm his wife," lied Shaw, daring them to contradict her.
The paramedics stared at her. The tall one opened her mouth to speak.
"Beth," called Craig. "Don't leave me."
Shaw stared into Wolfe's hazel eyes. "I won't."
Karen shrugged. "You'll have to ride up front. Let's go." She scooped up the drug box and biophone, following the stretcher down the hall.
The warm still air was heavy over the sun baked red Tennessee clay. Cracks spidered between petrified tire tracks and broke the hardpan road surface. The heavy smell of pitch seeped from the pulp wood forest. Nettles, pokesalle, cockleburs and stonecrop grew along the ditch banks. A spill of kudzu smothered an entire stand of white pine in its deadly embrace. A gnarled dogwood, the pointy green ovals of its leaves bug eaten, spread it blood red seed pods in memory of the Easter crosses its flower petals bore. Barefoot, Mike Morton followed the track to his grandmother's house....
A hand tightened around his shoulder, shaking him. "Granny," he mumbled.
"Dr. Morton," repeated the voice.
Mike blinked sleepily at the nurse. He was twenty-six hours into a thirty-six hour rotation. I thought med-school was hell... At least rude people didn't wake you. "What?"
"Squad 45 is bringing in a possible meningitis case."
"Ok." Rubbing his eyes, he rolled off the vinyl couch in the staff lounge, cringing at the crick in his back, and stepped out into the chaos of shift change. He trotted down the hall toward the exam rooms.
Beth's nose itched beneath the mask, an ironic attempt on the part of the ER staff to prevent further exposure. It would be difficult to be any more thoroughly exposed. Her head was swimming. She had just spent ten minutes on the phone explaining to the nursing supervisor why she was not currently on her floor. Exhausted Shaw dropped onto a hard metal stool in the corner.
Dixie kept looking from the nurse, who had accompanied Craig, to the sick young firefighter lying on the table. One of the medics from 45's had grabbed McCall's arm as she had entered treatment room and whispered that the woman had told them she was his wife. Stop, she commanded herself firmly, his personal life is none of your business. Still, Brice had always given every indication he had regarded the paramedics as a monastic order. Now you know why.
Morton removed the bell of stethoscope from Brice's chest wall and slid the instrument into his pocket. Frowning and straightening his back, Mike looked over the top of his mask at McCall. "Possible meningitis secondary to pneumonia. Get a chest film, SMA 20, CBC, and urinalysis. CSF, blood, sputum and urine cultures." He looked down at his patient. Craig was no longer agitated and, except for the chills that shook his body, he lay deathly still. "Set up for a lumbar puncture. As soon as we get the cultures, except for the CSF, start him on Cefotaxime 2.0 g IV and Vancomycin 1.0g IV."
Brice lay on his side, squeezing his eyes tightly shut against the searing lights of the exam room. He had been as startled as Morton when he had begun fighting the physician while the doctor checked his pupillary response. He reached for the last shred of rationality he possessed to block the shame of lying weak and sick before his colleagues. Dixie slid pillows beneath his flank and head, supporting him a fetal position, and began covering his bare back with various drapes. The flexing of his neck and hips made his head throb. "Beth," he groaned, trying to roll over and ease the pain.
Watching the surgical drapes slip away from the cleansed area on the paramedic's lower back, McCall bit her lip in frustration. Trying to maintain sterile technique with the confused is so fun. "You need to stay on your side."
Morton placed his hand against the middle Craig's back. If he rolled any further over he was going to fall from the table. "Brice, you must not move during the test!" He shot McCall at harsh look. "Dix, hold him still."
Beth walked over to the opposite side of the exam table. She looked at the older woman. "Dixie, let me." Shaw gently put one hand on the back of Craig's neck and placed her other arm behind his knees. The acetaminophen must finally be working, Shaw decided. He was no longer shivering.
Brice looked into her eyes. "I feel awful."
Beth lovingly rubbed her fingers on his neck. She met his gaze and heard what he really was saying -- Beth, I am afraid. "Shh," she whispered softly. "We'll take good care of you." His muscles relaxed.
"Craig, you may feel some pressure as we insert the needle. You must remain still," said Morton.
Brice reached up and held her wrist. A sharp pain radiated from just above his tailbone. His fingers tightened as the needle slid between his vertebra.
Dixie stood next to Mike, passing him the manometer and sample tubes and trying not to faint as the inflexible young man held his lover's hand.
"Dixie." Dr. Morton leaned against the counter at the nurses' station, arms crossed over his chest. "Brice responded on the Sharp case. He was prescribed prophylactic Rifampin, right?"
McCall pursed her lips briefly. "Yes. What are you getting at Mike?"
"You know these paramedics better than I do. Do you suppose he didn't take it?" He absently rubbed his hand over the tattoo on his forearm.
Dixie snorted. "Craig Brice does not disobey orders."
"Forgot to take it, then."
"Brice does not forget," she replied, shaking her head and setting down her pen. "What is bothering you so much that you are grasping at straws?"
Morton tipped his head back and rubbed his chin. "Marguerite was on antibiotics too. We may have a drug resistant strain," he answered, quietly.
Dixie looked at the chart on the counter in front of her. She slowly exhaled, imagining the lethal potential of such of bacteria.
Kel Bracket came around the corner and stopped at the nurses' station. "What's wrong with you two?" he asked in a teasing tone. Sensing their somber attitudes, he immediately sobered. "What's up Mike?"
"One of the paramedics who responded on the meningitis case we had earlier this week has apparently contracted it."
"Not unheard of," said Bracket.
"He was on Rafimpin." Mike looked into Kel's eyes.
"He didn't take it. Some of these guys act pretty macho -- think they are immune..."
"Craig Brice," interrupted McCall, looking up at Bracket.
Kel smiled tightly. "I see your point." He turned back to Morton. "Resistant strain?"
"Possibly. The cultures won't be back from the lab for another 24 hrs. Could be viral."
"You think it is the same bug that killed Alex Sharp?"
Mike slowly nodded. "Possibly."
"Have you called the County Health Department?"
"I was just about to." Wearily, Mike pushed away from the bench and began fishing in the drawer beneath the phone for the list of important phone numbers. "Dixie contact the fire department, have them locate Brice's partner and send him in for an exam," he instructed, pulling out the plastic covered sheet of paper. "Find out if an engine company rolled on the Sharp response. Get the paramedics who picked Brice up back in here. And call his wife, girlfriend -- whatever she is -- and have her to come in as well. I want to see everyone exposed."
"Dix, be as discrete as possible, explain the situation but don't cause a panic," added Kel.
Joe Early came out of the elevator and headed straight for the coffeepot. His face was draw into a grim frown.
Instinctively, Bracket stepped out of the way, only a fool got between Joe and a cup of coffee when he looked like that. Despite the circumstances, a faint expression of amusement played across Kel's chiseled features. The good doctor has been indulging one of his minor vices, staying out too late in jazz clubs.
Early filled a mug and drank deeply. After half a cup, he turned around and faced his colleagues. Raising an eyebrow, he noted the collective mood. "What's going on?"
"Mike," Kel gestured toward the handsome young doctor with his thumb, "may have a patient with another case of that drug resistant meningitis."
"Meningitis, huh," mumbled Early into his coffee. "Seems to be our week for it. I just got off the phone with an old med school buddy, who's in private practice over in Compton. He is sending us a possible case -- secondary to pneumonia. Presented with shortness of breath, high fever, headache, nuchal rigidity, photophobia, positive Brudzinski's and Kerig's signs and nausea. She collapsed during the exam -- septic shock, it sounds like." He took another swallow. "A nurse named Kate Saxon."
"Who?" asked McCall.
Dixie looked at Kel. "She was on duty the night Brice brought in his patient."
"Mike, you'd better place that call to County Health, now." Bracket folded his arms over his chest and frowning exchanged glances with Early and McCall.
"I'm on it," replied Morton, quickly dialing the phone and pressing a finger in the opposite ear. "This is Dr Morton at Rampart..."
"Dixie was isolation ordered for Brice?" asked Bracket.
"Yes, for the first 24 hours. But, Frances has completed 24 hours of antibiotics, by now. She is no longer in isolation."
Bracket shook his head. "Dixie call infection control and have Frances and Brice placed in strict isolation -- until we know what we're dealing with. Set up a treatment room up to handle Joe's patient with all the necessary precautions."
"Fourth case? What fourth case?" demanded Morton, interrupting the conversation and raising his hand for silence. He listened for a moment and then covered the receiver. "St Francis admitted another possible case during the night. Rampart staff -- Brenda Mackenzie."
Joe appraised Dixie with a critical eye. "One of your girls, Dix?"
"Nurses," she corrected abstractedly, reaching past Morton to pull the weekly duty roster from the drawer. She raised her head suddenly. "Mackenzie was also on the night Mr. Sharp was brought in."
Joe looked at Kel. "If this is the same bug, we better clean house... I think we need to round up all the staff who had unprotected contact with Sharp and Frances and check them out as well."
"When?...Uh huh...Thank you." Frowning, Morton returned the receiver to the cradle.
Bracket asked, "More bad news?"
Mike sighed and nodded. "Alex Sharp's wife is in the county morgue." He rested his hip against the metal supply cabinets. "The Health Department wants us to take a full set of cultures from all our victims and send them to Sacramento."
Bracket nodded. The Health Department took any outbreak of nocosomially acquired infections very seriously. "Dix, I think we should expand our precautions down here. Isolation for all suspected pneumonia and meningitis cases. Give instructions for the triage nurse to have any patients presenting with symptoms of either condition be admitted to a private exam room, immediately. Barrier nursing techniques are to be used by everyone in contact with the patient until the causative organism is identified."
McCall picked up the phone and started dialing.
"Kel," said Mike, "Five of the six people we know had close contact with Sharp got sick; this is pretty virulent. I think we'd better make that two sets of cultures and send the second one to Atlanta."
Bracket bowed his head, studying the tips of his shoes for a moment. The Centers for Disease Control were very interested in any drug resistant strains. He looked at Mike. "Use my office and call the CDC. Tell them what we've got."
"Kel, let's hope this is enough." Early glanced up from his coffee catching his friend's eye.
Captain Jerry Beck glared at the empty spot in station 16's role call line up. The young paramedic detailed from 110's winced at the regard paid to the vacancy. One of B shift's paramedics, Mark Westphal, hovered near the dorm, waiting for Bellingham to show up.
"Where's Bellingham?" demanded Beck, letting the irritation he felt creep into his voice. He watched his crew shake their heads and trade nervous glances. He sighed. This shift had started badly and was showing no signs of improvement. First there had been a call from headquarters telling him Brice was out sick and a PM from 110's would be assigned to cover Craig's unprecedented absence. Now, Bob was missing.
"I'll call him, Cap," volunteered Carlos Hernandez, a slender dark skinned man with a trace of a limp. He disappeared into the dayroom.
"Jerry," called Beck's B shift counterpart from the door of the office, "telephone."
Jerry hurried into the small room, picking up the receiver from the cluttered desk. "Captain Beck." He listened for a couple moments, shaking his head. "No, he isn't in yet. I'll tell him when he gets here."
Carlos appeared at the door
Biting his lip, Beck returned the handset to the cradle, staring at the black plastic for a moment. "No answer?" he asked turning to Hernandez.
"Susan's out of town?"
"I think so. Santa Monica with family, I believe."
"Call dispatch, have them send a squad to Bob's to do a well being check."
"Cap?" Carlos's eyes went wide.
"That was Rampart. Brice is extremely ill. He may have caught something from a patient they had a couple of shifts ago." He paused taking a deep breath. "They want Bellingham to come in for tests."
Dr. Dana Swenson lay in bed, eyes closed, listening to her alarm clock ring. Her heart pounded with a different -- silent -- alarm. The dark feeling had started on the plane trip back from Geneva, a formless dread of something gathering and preparing to go terribly wrong. Her mother, a great believer in omens and signs of all sorts, would have said it was a premonition, but Dana believed that they existed only in memory. She slammed her hand down on top of the clock, silencing its protest, all the while trying to quiet the sirens shrieking within her chest. Pushing back the sunshine yellow sheets, she climbed from the bed and walked past her luggage, sitting unopened and neglected after her late night arrival, on her way to the bathroom. She stepped into the shower and tried to dismiss the feeling as a product of permitting herself to sleep too late, thereby succumbing to jetlag.
Swenson poured herself a cup of coffee from the new, exorbitantly expensive machine, which dripped steaming water through ground beans. This little extravagance made coffee in the time it took her to assemble her percolator -- a device that now seemed as arcane as the rows of Soxhlet extractors in her ex-husband's lab. "The Elixir-of-Life," she sighed, drinking deeply and wandering toward the living room window.
Outside stretched the green and civilized expanse of one of the suburban housing tracts that made up Marietta, GA. In the front yard across the street, three young girls circled, chanting and falling. By her feet, sprawled her briefcase, spilling its contents across the floor. Atop this month's copy of Journal of Virology lay two thin black and white prints of electron-micrographs. Yesterday, as the World Health Organization Conference on Emerging Viruses concluded, Dr. Gutsche had handed her the pictures saying, "I wonder if the dinosaurs knew their days were numbered?" Swenson bent, picking up the stiff sheets of slick paper. Shadowy threads snaked across the surface, looking for all the world like spilled spaghetti -- filovirus, Marburg. This agent was one of a number of newly discovered viruses, all so deadly they made highly lethal infections like Yellow Fever look like a cold. Dana forced her eyes from the photographs. She found herself watching the little girls at play and chanting along. "...Ashes, ashes. We all fall down."
The phone rang, startling her and causing her to spill the coffee. "Shit!" she exclaimed, shaking the liquid from the prints and grabbing the receiver. "Hello?" She dropped the photos onto the table.
"Dana..." the voice was that of her boss, Dr. Mark Neufeld. "We have an developing situation in Los Angles..."
She covered the mouthpiece of the receiver, nodding as he described the outbreak of a mysterious central nervous system infection. The dark bands outlining the viral protein sheath stared back at her from the pages. Unbidden, images of nurses and nuns dead or dying in their beds in Sierra Leone and the smell of wards become charnel houses came back as she listened. Cold sweat began trickling down her back. I hate LAX, she thought as stared at the photos laying beside the phone.
"Hello! Fire Department!" Martin Wu turned to his partner and shrugged. He raised his fist and pounded on the door even harder. "Hello! Anybody home?" Sighing, he glanced at the houses on either side, each nearly identical twenties era balloon-frame houses with large porches. "Carl, want to see if the neighbors have a key?" As Carl Darcy trotted across the yards, Martin set the heavy biophone on the stoop and walked around the side of the structure, peering in the windows.
"Marty," called Darcy. Behind him stood an elderly woman, wearing a purple and green paisley housedress, her white hair gathered beneath a bead-spangled hair net. Carl fitted a key into the lock, turning the knob. "Ma'am, you'll have to wait out here." He scooped up the drug box and O2. Carl hated well being calls, the never knowing what you were getting into made him nervous. He sniffed the air cautiously as he opened the door. At least he didn't detect 'that smell' on this one, which was a good sign.
"Hello?" called Martin peering through doorway down the hall. At the end of the hall, next to a half-finished nursery was a closed door. Wu pushed the thin wooden panel open. "Carl!" His partner crowded into the hall behind him.
"It's the Anim... Bob Bellingham."
On the gold shag carpeting, Bellingham lay on his side, tightly wrapped in a thick quilt. His eyes were closed and shrunken back into his head, his lips and fingers were blue, and the sound of his rapid, labored breathing filled the room. A thin trickle of drying blood ran from the corner of his mouth, staining the carpet, and the blanket around his waist was wet. The sour smell of vomit permeated the air.
"Oh my God! Bob?" Darcy knelt beside the fallen paramedic. "Bob?" he repeated, quickly checking Bellingham's airway. He could hear wheezing with each shallow breath Bellingham took.
Wu lifted his HT. "LA, This is Squad 110, please respond an ambulance to our location."
"10 - 4, 110," replied Sam Lanier's calm baritone.
Darcy carefully pressed his fingers against Bob's neck, feeling for a pulse. The sick man's skin was very warm beneath his hands. "Bob!" he repeated sharply, uncoiling the oxygen tubing and slipping the mask over Bellingham's mouth. "Help me get this off him," Carl instructed, glancing at Martin and disentangling the quilt from the fallen firefighter. "He is burning up." Displacing the mask, he placed his fingers just below Bellingham's lower lip and gently pulled it down, peering into Bob's mouth. "His tongue is bleeding and swollen, looks like he bit it. I wonder if he had a seizure." Darcy rested his hand against Bellingham's diaphragm.
Martin gazed at the limp form. "Postictal?" He opened the drug box, passing the blood pressure cuff to his partner.
"Maybe," murmured Darcy, positioning the stethoscope against Bob's arm and inflating the cuff. He pulled open the sodden nightshirt and listened to the paramedic's breathing. "Respirations 38, shallow and labored. Retractions. Ronchi and rales -- lungs sound really congested. Rate 110 and thready, BP 90/60."
Martin paused while setting up the biophone and scribbled the readings onto the MICU form.
Darcy peeled back each of Bellingham's eyelids and rapidly flicked the beam of his penlight over surface. Bob's hazel irises slowly contracted. "Pupils equal, responsive but sluggish. His neck muscles are in some kinda spasm," Carl mumbled, around a mouth full of flashlight, pulling his hands from beneath Bob's neck. "Stiff as a board." He pressed his knuckles hard against Bellingham's sternum. "Bob!"
Bellingham's eyelids fluttered, he moaned weakly and tried to push away Darcy's hand.
Wu pressed the biophone receiver to his ear. "Rampart, this is County 110. How do you read me?"
Carl slid a thermometer into the ill firefighter's armpit.
"Unit calling repeat," crackled Morton's voice.
"Rampart this is County 110. How do you read me?"
"We read you loud and clear. Go ahead 110"
Martin continued entering information on the patient care sheet as he talked. "We have a male, approximately 35 years old, semiconscious with a high fever, stiff neck and chest congestion. Victim may have had a seizure; his tongue is bitten and there is evidence of incontinence...."
"10-4," interrupted Morton, quickly. "110, is the patient Bob Bellingham?"
Carl raised his eyebrows at the doctor's question.
Wu meet his partners gaze and shrugged. "Affirmative, Rampart."
"110, use gloves when handling the patient and take precautions to avoid contact with secretions or bodily fluids."
"Now he tells us," grumbled Darcy, glancing at the urine soaked blanket then pulling a package of gloves from the drug box. He slid his hands into the latex and removed the thermometer from Bob's armpit. "105, axilliary." He grimaced at his partner.
"10 - 4, Rampart...." Wu continued to relay the vital signs.
"I want to get a wet sheet on him, start cooling him off." Carl squeezed past Martin and sprinted down the hallway to squad. He returned with a burn sheet and bottles of sterile water. He cut away the soiled pants and covered Bellingham with the sheet, saturating it with water.
"...Rampart we are administering O2 15L -- but patient is still cyanotic -- and have initiated cooling measures."
"10-4, County 110." Morton paused. "IV normal saline, 250 cc/hr, monitor for signs of fluid overload. If a seizure occurs administer 5-10mg diazapam IVP, titrated to effect. Transport as soon as possible.
Carl quickly cut strips of tape, stretching them across his leg. He held the bag of saline up to the light, inspecting it before attaching the tubing.
Wu finished transcribing the orders. "10 - 4, Rampart. IV NS, 250 cc/hr. Diazapam 5-10mg IVP." He set down the radio and pulled on gloves, preparing to assist his partner.
Darcy inflated the bp cuff. As he swabbed the puncture site, he glanced up at Wu. "What's with all the precautions and how did he know our patient was Bellingham?"
Martin removed the suction catheter from Bob's mouth and replaced the oxygen mask. Bellingham drew ragged gasping breaths. The sick paramedic had vomited again. Wu turned away from his ailing colleague, who lay on his side covered with a wet sheet, and picked up the clipboard.
Bob moaned slightly and stiffened in a seizure. Wu looked up, seeing Bellingham twitch. Quickly, he fished a preloaded syringe of diazapam from the drug box, swabbed the resealable bubble on the IV line and injected the dosage ordered by the doctor. Bob relaxed. Martin heaved a sigh of relief. Then Bellingham stiffened again, pulling on the straps that secured him to the stretcher. Harsh grunts accompanied the tensing of his muscles, weakening and trailing off as the jerking continued. Seizure followed seizure. Beneath the oxygen mask pink tinged foam collected at the corners of his blue lips.
Martin grabbed the biophone. "Rampart, this is squad 110."
"Go ahead, 110," replied Morton.
"Patient's in status. We've administered 10mg diazapam, push, with no effect."
"10-4, 110. Repeat dose, insert esophageal airway and support respirations if needed."
"10-4." Wu grabbed an airway and the bag valve mask. Pivoting on the balls of his feet, he turned toward the narrow communicating window. "Stop!" He slid the length of tubing down Bellingham's throat. Rapidly, he assessed the airway placement. "OK. Hit it, he's going sour!" he yelled, tearing the wrapper from syringe. The driver raised his hand in acknowledgement as he reactivated the lights and siren. Martin felt the rig accelerate as he inserted the needle into the medication port.
Something soft and hairy grazed Craig's arm, leaving behind an icy trail. Exhausted, he tried to brush away the offending object, but his arm refused to move. A harsh, metallic odor filled his nose, displacing the smoky smell still clinging to his hair after an early evening fire. Suddenly sharp teeth sank into his forearm.
Panicked, Brice opened his eyes. Instead of the soft beige blanket, a layer of silken threads covered his bunk in the dorm. Huge brown spiders walked along his arms and legs. The many black glittering eyes of one spider stared at him with cold regard, as the sienna chitin of the armored jaw moved among the bristles surrounding its mouth. Its fangs were fastened into his arm; blood leaked from his flesh, staining the white threads binding him. Frantically he struggled to free himself, but the web cut his skin like steel. His movements only excited the arachnids. They swarmed over his body, crawling on his thigh, his chest, his hand.... One huge specimen crept onto his face; he could feel its furry legs on his lips and inside his nose. Ignoring the pain, he tore his arm free and with a bleeding hand slapped away the spider....
Mike stood next to one of the beds in a small room, which had been converted into a makeshift ICU and isolation ward, watching the nurse take the last sample for the CDC. Abruptly, Brice's eyes sprang open and he feebly pushed away the swab.
"Take it easy Mr. Brice," instructed the nurse.
Morton grabbed the paramedic's arm.
"Spiders," Craig groaned, blinking confusedly and panting for air. Fear slowly faded from his features, as he looked around seeing a blurry, arachnid free hospital room. Reflexively, he groped for his glasses. The painfully bright lights lanced deep into his head.
"Please, lay still. I have to get one more culture, Mr. Brice." The nurse cupped her hand around his chin. "This won't hurt."
Brice closed his eyes, enduring the indignity of having a cotton swab stuffed up his nose. Sweat prickled beneath his skin, he had never been so hot in his entire life. The bed was spinning like the Tilt -O-Whirl he had ridden as a boy; the ride had made him throw up then and he felt like doing it now. His mouth tasted like dirty gym shoes, which wasn't helping. He gagged.
"Got it?" Mike asked, looking at the nurse.
She nodded, placing the swab into a narrow, stoppered vial half filled with a viscous yellow goo. She dropped the tube into a plastic bag, inserted the folded form identifying the sample into the pouch on the outside of the bag and laid it among a dozen others containing different swabs or vials of various bodily fluids.
Gently, Morton replaced the oxygen mask over the ailing man's face. After a moment, Brice began to quiet and breathe more slowly.
Craig gratefully sucked down the enriched atmosphere within the mask, feeling his breathlessness ease. Sleep began to pull him under.
Joe Early stepped into the room, he was covered from head to toe in the blue Tyvek of isolation garments. "How is he, Mike?"
The young doctor shook his head. Over the past day Brice's condition had quickly worsened. "Not good at all." He looked down at the motionless paramedic and thinking Craig was again unconscious, continued. "His latest chest x-ray shows extensive involvement of both lungs. Despite aggressive management, his fever is still rising. He is disoriented. And the last neuro shows deficits indicative of increasing intracranial pressure."
Behind his mask, Early frowned. "The labs?"
"PCO2 up, PO2 and pH down. There are some abnormalities in liver enzyme levels. His BUN is up..." began Morton.
Now fully awake but unable to open his aching eyes, Brice lay, listening to the doctors. His heart pounded as he sorted through their words. A wave of panic crashed over him, followed by a strangely welcome numbness.
Joe turned away from the bed and watched the nurse wipe the outsides of the sample bags with a disinfectant solution. She packed the bagged vials and tubes into a foam block, which she pushed into another plastic bag. The orange and black infectious materials label screamed at him from across the room. "Frances and Mackenzie aren't doing any better either. Margaruette is on a vent and her liver and kidneys are failing. It looks like she has already suffered brain damage." Early stopped, remembering the young student nurse, Kate Saxon, who had died during the night.
"Bellingham sounds like he's in terrible shape. Joe, I doubt any of them are going to make it," concluded Morton softly. He turned and walked away from the bed.
Brice forced his eyes open. He could master the unpredictable situations he encountered in the field; he could control this. The doctors were wrong, he was not dying. "You're mistaken," he tried to scream at the insensitive young doctor. Instead of a yell, all that emerged was feeble moan. A nurse came over and murmured to him, soothingly. She stroked his face with a cool wet cloth. Her expression was etched with pity, clearly she agreed with the physician's assessment. "You're wrong," he whispered at their receding backs, clenching his fists weakly, afraid to go back to sleep.
The slender leather strap of her overloaded satchel dug into Dana Swenson's shoulder as she staggered through the doors of Rampart's ER, weighed down by her briefcase and a pair of heavy cases. Dana set down the two metal boxes, dropped the rental car keys into her pocket and leaned against the wall massaging her sore hand. A statuesque, middle aged nurse approached her.
"May I help you?"
Swenson fished in the pocket of her suit jacket and pulled out a business card. "Dr. Dana Swenson, CDC." A flicker of some unidentifiable emotion flared behind the nurse's eyes. "I'm looking for Dr's Morton and Brackett." She offered her hand.
"Dixie McCall, head nurse." She took Swenson's hand. Dixie gestured to a young attendant who was busy with rags, a bucket of disinfectant and a gurney. "Kenny, take those," she pointed to the cases, "to the nurses' station."
Dana followed Dixie down the corridors past the doors of the exam rooms and a ward full of curtained observation beds. The halls vibrated with the rhythms of a busy urban teaching hospital's emergency department. Swenson stepped aside as a doctor hurried by, going from one treatment room to another. The nurse turned left into a small alcove off the main hall, lined with metal and glass cabinets, and nodded toward two men standing next to a bank of radios and UHF telemetry units.
"Drs. Morton and Brackett," McCall announced, quietly.
Swenson listened as the tall, dark haired doctor talked to the paramedics on the other end. "...rate 32, with rales, BP 128/84..." crackled the radio.
The doctor pressed down on the transmit key. "10-4, 99. IV D5W TKO, take seizure precautions and transport." He took a deep breath. "99, keep contact with patient to a minimum."
"IV D5W, TKO and transport. 10-4, Rampart."
Dana remembered the doctor she had just seen going from one room to the other and found herself reliving the experience of walking the ward of a small hospital in the African bush, abandoned to the spirits of the dead and dying. As an epidemiologist, she knew when new and deadly bugs jumped from their normal wild hosts into humans, they found their way into a hospital, carried by those seeking care. There they burned their way through the staff, turning the caregivers into unwitting killers. She had seen it too many times. It was happening again, only here there was no isolated African bush into which to escape.
"Mike, Kel," began McCall, "this is Dana Swenson from the CDC."
"Miss Swenson," greeted Brackett.
"Dr. Swenson," corrected Dana. "Sounds like you have another possible case..."
Swenson shifted in the chair facing Brackett's desk, crossed her legs and rested the cup of stale coffee on her knee. She had had spent the last ten minutes listening to a synopsis of the material she had read on the flight from Atlanta and assessing the dynamics of the situation in which she found herself. The tall, young black physician was the favored protégé. He was possessed of a quick aggressive intelligence and a prickly demeanor. And it was immediately obvious Brackett was an uncompromising, ambitious doctor. A GBMS, she thought, using the uncomplimentary acronym applied by nurses to his type. As head of the ER, he was clearly unaccustomed to having his judgement challenged in his own domain. The head nurse was harder to pin down. Her manner suggested she had a military background and was one of the tough types who gravitated toward a career in "the pit". Swenson felt the woman's cool blue eyes on her. Definitely, a force to be reckoned with.
Dana sighed and set down the mug. "While we will continue efforts to identify the agent, I am more concerned with preventing further spread."
Mike leaned against the wall and looked over Dixie's head at the epidemiologist. "We have instituted isolation procedures for all suspected cases."
Swenson nodded. "Good. But, you need to extend your precautions to field personnel -- paramedics, firefighters, ambulance attendants... Anyone who routinely comes in contact with the sick."
Brackett sat up straight. "Quite aside from the difficulties of identifying possible cases and implementing barrier nursing techniques in the prehospital setting, you have the potential for real panic here." He tapped his desk repeatedly with his pen for emphasis.
"What kind of panic do you think you'll have when these people start spreading the disease throughout the city?"
"That hasn't happened."
"Are you sure? You've already got two infected paramedics." She looked into the doctor's eyes and motioned toward the ER entrance and the darkened city beyond the doors. "How many people out there did they treat?"
Kel leaned back and glanced at Mike and Dixie. The CDC doctor had just shoved the fears he had been trying to avoid right into his face. He picked up the phone. "Operator, get me the County Health Commissioner."
The courier parked the van in the parking lot of the CDC visitors' center on the Micheal Street. Picking up a large cardboard box, he slipped from the driver's seat and ran through the rain.
A bored security guard looked up at the dripping man standing in front of the counter. "Can I help you?"
"I have a delivery for a Dr. Mark Nuefeld." The courier pushed the box and a clipboard across the counter.
The guard picked up the phone and dialed. "Dr. Nuefeld's office, please." He signed the receipt and looked at the address on the box. "L.A. hunh?" He pointed to the rain soaked lot. "Bet you wish you were still there."
"...A tranquilizer gun -- like the one Marlin Perkins uses on rampaging lions -- should be standard equipment on all squads," ranted Johnny.
DeSoto followed Gage into the locker room. His partner made squishing noises as he walked and an impressive puddle had been left in the squad by the skinny paramedic. Roy stood relishing his dry clothes and watching Johnny fume and strip off his wet uniform. For once John had been knocked into the swimming pool by the errant pet/relative/lawn furniture and not him. "Sounds like a good idea," mused Roy.
"Really?" asked Johnny, stopping mid-toss, fingers wrapped around his balled up undershirt.
"Might be useful for psychotics and agitated partners..."
"Very funny!" Gage threw the wet clothing into the back of his locker.
Roy wrinkled his nose, thinking of mildew.
John reached into his duffel bag for fresh underwear. "Why I bother to talk to you is beyond me...."
Roy shook his head. It's going to be another long shift.
"Gage," interrupted Chet, emerging from the latrine with a toilet brush in hand. "I've been thinking about your women problems."
DeSoto rolled his eyes. It's going to be another really long shift.
"You've been thinking about my women problems?" Thumbs hooked under the waistband of his clean briefs, John stood staring at Kelly.
"While cleaning the head? Why do I sense a crack coming on?"
"Johnny, just ignore him and get dressed. I don't want to go on a run with you trying to put on your shirt while I'm driving," instructed Roy.
John glared at his partner. "I wanna hear this."
Kelly watched Gage transfer the small buckskin covered pouch he always carried from his wet pants to the pocket of the dry pair. "Well, Johnny it's all cultural."
Roy briefly debating banging his head on the locker door and then discarded the idea, deciding it would be more usefully to bang Chet's against the wooden panel. "Joanne sent some nice fresh peanut butter cookies. Your favorite," he offered John, desperately.
"What?" demanded Gage, stopping with his pants half-on.
"You heard me. It's all cultural...." Kelly looked innocently into John's face.
"You been readin' anthropology books again?"
Roy elbowed Johnny. Gage glared at him again, but finished putting on his trousers and pulled on his tee shirt.
"No it's really very simple..."
"Oh, I'm sure it is," said John, his voice dripping with sarcasm as he buttoned his uniform shirt.
"Yes, you're not making the right responses to your date's actions." Chet dropped the toilet brush into the bucket by the sink.
"And those are?"
"You wouldn't know, see..." The bebop sounded, cutting off Kelly's remark.
DeSoto glanced quickly at the ceiling, offering a prayer of thanks to whatever Saint protected the partners of lunatics.
"Station 51, motor vehicle accident SR 314, mile marker 26. Nearest cross street Arroyo Lane. SR 314, mile marker 26. Time out 11:05."
John grabbed his shoes and socks and sprinted for the Squad.
At the bottom of a poorly lit, narrow metal and concrete stairway in the Sacramento office of the California Health Department was a glass walled cubical. Inside a tiny air conditioner, wedged high in a recessed window, ran year-round. A gun-metal gray teletype sat in the middle of the room. Three hundred and sixty-five days a year the teletype waited, listening for a message, sitting still and silent. A thin wire ran down the side of the machine and disappeared into a small hole in the wall. The wire emerged in a windowless basement office where a tired looking, middle aged black woman sat, typing. At the appropriate time the wire would carry current to a bell, alerting the outside world.
Abruptly inside the rough textured metal housing, the round metal type element began to whirl, flying back and forth, pressing the ink-impregnated ribbon against the paper. "****EXTREMELY URGENT****," it wrote. In the office the bell rang.
The woman came in and waited for the message to finish printing. She tore the copy from the machine and read. Frowning, she picked the receiver of the black phone on the wall behind the teletype. "Dr Voorhees, please." While she waited, she decided to call her daughter in Los Angles and suggest she come home for a visit. "Dr. Voorhees, this is Myrna. We just got a wire from the CDC..." She listened. "Yes sir, about the Los Angles situation. They are advising, we direct EMS personnel use strict isolation precautions in the field on all suspected cases of pneumonia, meningitis or other febrile illnesses...."
As he climbed down from the engine, Hank quickly sized up the accident site. A yellow and purple VW microbus sat mired to its axles in mud about 200 feet into a field of alfalfa. Other than a thick coating of dirt the vehicle seemed undamaged. A long set of skid marks traced its path across the centerline and off the blacktop. A man wearing an embroidered shirt and torn jeans stood staring stupidly at the front of the bus. A half a dozen runny-nosed children peered out the windows of the van. Through the open passenger door, Stanley could see a slender, dark haired woman in a soiled, tie-dyed skirt sitting in the driver's seat. She pressed a rag to her bleeding forehead, alternately berating the man and comforting the children. No one appeared to be seriously injured.
Across the road, a red pickup perched precariously on its side, nose down in a disused aseca. The front end of the truck was accordioned back into the cab and a thin plume of steam leaked from beneath the crumpled hood. Through the communicating window Hank could see a gray-haired man crushed against the steering wheel. As soon as Stanley's feet hit the ground, he smelled the sharp tang of gasoline.
"Marco, pull the reel line and wash down that gas." Pointing to the bus Hank ordered, "DeSoto, you take care of the Grateful Dead's roadies, over there. Gage, check out the pickup."
Grimacing at his partner, Roy muttered. "Why do I always get the Haight-Ashberry refugees?"
Pulling the trauma box and the radio from the compartment, John smiled and shrugged. "It's your obvious nonconformist tendencies." He sprinted across the road, escaping his partner's glare.
"Kelly, go give Gage a hand," instructed Stanley
DeSoto grabbed the drug box. A patrol car crunched to a halt behind the engine. As he trudged across the uneven ground, he watched Vince Howard climb from behind the wheel and approach the Cap, adjusting his equipment belt as he walked.
"What have you got Hank?" Vince asked, surveying the scene.
"That bus over there," he pointed, "and this pickup. Doesn't look like they hit each other. I think all damages occurred when they ran off the road..." Stanley's voice faded as Roy neared the minibus.
"That nut almost hit us!" shrieked the woman, pointing at the pickup. "He was driving on the wrong side of the road." Blood streamed down her face, dripping on her blouse.
Standing by the hood of the bus, the man looked blankly at Roy, his blue eyes curiously dark, pupils dilated. "Man, did'ya see all that dirt, go everywhere." He smiled. "It was so cool."
Open-mouthed, DeSoto stared at him, rendered temporarily speechless. On drugs most likely. He turned his attention to the vehicle's occupants. "Ma'am, what happened?" he asked, kneeling beside the open door and setting down the drug box.
"Weren't you listening?" The woman sighed disgustedly. "I said, he nearly hit us."
"Sorry, ma'am. I meant what happened to your head?" Roy opened the drug box, retrieving a 4x4. Tearing the package, he pressed the bandage against the cut. "Hold this, please."
She pushed his hand away. "I just bumped it on the steering wheel. Check on my babies." She waved toward the back of the van.
Kicking away clumps of upturned sod, DeSoto freed the side door of the bus and leaned his head inside.
Six children -- Roy judged to range in age between twelve and three -- gawked at him. All had dirty faces and most looked like they were suffering from colds. The youngest stared wide-eyed at him, nervously twisting her curls until abruptly she began to cry. A boy, whose mouth looked like he had been snacking on soil, leaned forward and asked, "Are you the fuzz?"
"No," smiled DeSoto, "I'm a fireman."
A tow headed little girl gazed up at Roy. "Daddy likes mushrooms. Do you?"
"Sally," said the woman sharply.
DeSoto reached back inching the drug box out of the reach of the two adults.
"Mommy, Sally wet herself again," whined another child.
"Are -- are any of you hurt?" stammered DeSoto.
Mutely they shook their heads. "Are you going to arrest us?" persisted the boy, seemingly excited by the prospect.
The paramedic shook his head. "No. You see..."
"You dummy," began the oldest, poking his sibling in the ribs. "He's not a cop, but he is a square..."
Roy's head began to throb.
Johnny paused on the lip of the ditch, studying the mutilated vehicle, judging the stability of wreckage. The truck did not, in fact, lie flat upon its side, but instead leaned upon the mangled remains of a signpost, listing dangerously. Gage pulled on his gloves and scrambled down the weed-choked bank; halfway to the bottom the thick grasses gave way to mud and he slipped, landing knee deep in green scum-covered water. A sheet metal chest in the bed of the pickup, bearing the tag 'Port-a-Vet', had split open, spilling glass vials and various pieces of veterinary medical equipment on the ground. A blue bottle of disinfectant bobbed in the stagnant water, filling the air with the smell of bleach. He bent trying to peer through the windows without get too close to the unstable vehicle.
"What'cha got, Gage?" asking Stanley, standing on the bank, his hands resting on his hips. Behind him, Marco finished washing away the gasoline slick.
"The truck is resting on a metal post." Straightening, Johnny placed one outstretched hand atop the bent fingers of the other, sketching the relative positions of the truck and sign. "Before I can tell for sure, we're gonna have to stabilize this mess." He deliberated a moment. "Cap, let's run a line from the axle to that pole," he suggested, pointing to a telephone pole along the shoulder of the road.
"Kelly, Lopez, get ropes, chocks, and a pry bar."
"I need the trauma box," added John.
Hank looked at the unsteady hulk and beckoned to Gage. "John, come up out of there until we get this secured."
"Ok, Cap." Splashing to the edge, he grabbed a handful of the long weeds and hauled himself up the slick incline. Rivulets of foul water streamed down his legs. Ignoring the mess he began digging through the trauma box, retrieving a cervical collar.
Stoker crossed the highway, returning from checking on DeSoto
"Pal, what's Roy got?" asked Stanley, peering across the road, watching a second police car pull on the shoulder, just past the Squad.
"A headache," remarked Mike, dryly.
"Minor injuries, Cap. He's sending the mother and kids into Rampart as a precaution." Stoker shrugged. "The 'father' is as high as a kite. Vince has called Child Protective Services."
Stanley lifted his radio. "LA, this HT 51, dispatch a second ambulance to our location."
"10 - 4, 51."
On the opposite side of the vehicle, Kelly skidded down the bank and waded toward the front axle. He passed a loop of rope behind the tire, tying off the line. "Ready, Marco."
Lopez wrapped a short length of steel cable around the base of the telephone pole and attached it to a block and tackle. Expertly, he threaded the rope through the pulleys. "Tension," he yelled, taking up the slack in the line and pulling it tight.
Chet rested his hand lightly on the rope as it rose into the air, judging the tautness. "Hold!" he called, waving at Marco to stop. "We're secure, Cap."
"Ok, John." Hank grabbed two heavy wooden blocks and clabbered into the ditch with the paramedic. He shoved one below the side panel of the pickup bed and the other under the crushed front fender, providing additional support. Reaching underneath the sprung hood, he disconnected the battery cables.
Johnny pulled his safety glasses down and thrust the clawed end of a pry bar beneath thick black gasket surrounding the cab's rear window. Angling the tool upwards, he pushed, popping the pane of glass from the frame.
Hank reached past the younger man's head, grabbing the edge of the window. He helped Gage pull away the glass.
With a quick sideways sweep of his foot, John kicked away the debris covering the damaged lid of the equipment box mounted behind the cab. Kneeling, he leaned through the newly-made opening, holding the c-collar beneath his arm. The thin sheet metal flexed under his weight, dunking his knees and calves into the putrid water. A muscular, late middle-age man lay unconscious, pinned against the steering wheel. Blood leaked from a gash on his head and a bruise darkened his forehead.
Gage folded himself into the narrow gap between the roof and the back of the seat. Pressing his finger against the man's neck, he was rewarded by a fast beat. The victim's skin was clammy under John's hand. Holding his breath he listened to his patient's respirations, assessing the condition of the airway. Clear. He reached down feeling for a radial pulse. It was weak, barely palpable. B.P. around 80. Moving further into the wreckage, he examined the crumpled interior. The force of the collision with the opposite wall of the ditch had shoved the dashboard back and downwards, trapping the victim's legs. John grimaced when he saw the unnatural bend in the man's upper leg. He gingerly wrapped the collar around his patient's neck.
Hank knelt in the muck next to the paramedic.
Twisting John looked back. "Cap, he's alive but is pinned up under the dash. Looks like he's got a broken femur. From the pattern of damages, I wouldn't be too surprised if he also has a broken pelvis."
"Kelly, Marco," called Hank. "We need to get the roof off and roll the dash."
"Sure thing," replied Chet, pulling the safety glasses from his helmet and positioning them over his eyes.
Kelly snapped together the couplings on the hydraulic lines connecting the jaws to the compressor. He nodded his readiness to Marco. Lopez pressed the pry bar beneath the edge of the windshield, levering it free, and together the two men lowered the pane.
"Cap, can you hand me the short board, tape and the O2?" asked John, his face flushed from the awkward position into which he had been twisted.
"Ok," replied Stanley, gesturing for Stoker to fetch the equipment Gage had requested.
Outside the compressor roared to life. Reaching through the front window of the truck, Marco held out a folded yellow emergency blanket. "Johnny, we're ready to cut off the roof."
"Wait until I get him boarded."
"Ok." For a split second Marco glanced away from the wreckage and up at the arriving ambulance.
"Gage," said Stanley, passing the supplies to the paramedic.
Johnny placed the oxygen mask over his patient's mouth and nose. He slid the board behind the unconscious man, strapping him firmly to the wooden support. Carefully John wrapped adhesive tape around the injured man's head, securing it to prevent any further movement. Gage unfurled the blanket and covered the victim. "Ready, Chet."
Kelly positioned the cutting blades of the jaws against the upright that rose at upper edge of the windshield. With a sudden, loud snap the metal gave way. Quickly, he severed the three remaining supports. Stanley and Lopez pulled away the roof.
DeSoto climbed down the weedy incline.
Hank glanced at the fair-haired firefighter. "You done over there?"
"Yeah, they're on the way to Rampart. Vince is riding in with them." He quickly scanned the scene.
"Roy," said John, "Call Rampart and get permission to start a pair of IV's, Ringers. I gotta 50 year-old male with a possible fractured femur and pelvis, probable internal bleeding and a head injury. Pulse 112, respirations 28, BP 80, palpitated estimate. I've started O2, 15L. It's going to take a while to extricate him."
"Ok," answered Roy, pulling himself back up the steep bank.
Marco pushed the pry bar into the gap between the hood and the fender, exposing the engine compartment. Chet nipped the hinges, detaching the hood, and then began to cut into the supportive upper rail behind the firewall.
While they worked, Gage crouched next to the trapped victim, his face averted from the flying debris. Over the noise of the compressor, he could hear his partner talking to Rampart. The fetid ooze was seeping slowly into his shoes and the clouds of mosquitoes disturbed by their rescue efforts were eating him alive. Johnny's irresistible attractiveness to hungry female mosquitoes made him feel like the insect equivalent of an all-you-can-eat Happy Hour buffet. "Hurry up, Chet," he muttered disgustedly, while trying to ignore the high pitched insect whine and to resist the urge to slap futilely at the annoying swarms.
Under the blanket, the injured man began to moan and struggle. "Easy," he reassured, lifting the plastic and sliding his head underneath. "You've been in an accident. We're gonna get you out." The man continued to fight, panicked by the confining straps. Johnny placed a hand on his shoulder. "Take it easy. You must stay still. Do you understand me?"
"Yes," he moaned softly.
"My name is John Gage, I'm a paramedic with the fire department. We'll have you out in a few minutes. What's your name, sir?"
"Dr. Arthur Eckstein," mumbled the trapped man, dreamily. "I must've fallen asleep. Was so tired."
"Don't worry about that right now, Dr. Eckstein." Outside, metal snapped loudly and Arthur started. "Relax, doc. We're havin' to cut away some wreckage. Can you tell me where you hurt?"
"My right leg, hip, shoulder and lower abdomen." His voice faded to a barely audible whisper and his eyelids fluttered shut.
Lopez leaned into the cab, causing the vehicle to shift slightly. With practiced ease he sliced through the rim of the steering wheel with the Jaws, clearing the obstruction.
Johnny carefully probed the doctor's abdomen, his patient groaned in response to the touch and the muscles beneath his finger were tense. He peered worriedly at the man's face. Roy, move it! "Are you allergic to anything?" he asked, raising his voice slightly.
Eckstein made an unintelligible noise.
Marco attached a chain to the steering column, preparing for Chet to pull back the dashboard. "Johnny, we're almost done."
Gage nodded to DeSoto. "Doc?" he asked loudly, looking at his patient.
Roy crawled beneath the protective sheeting. "Rampart says go ahead with the IV's." He handed his partner the blood pressure cuff and supplies.
John quickly measured Eckstein's blood pressure, before inflating the cuff to raise a vein. "76/50." He swabbed down the site and inserted the needle and cannula.
"I'll get the long board." Roy scooted out from under the yellow blanket.
Stanley made a final adjustment to the position of the chain. "Go ahead, Kelly," he signaled the curly haired fireman to start the jaws. With a screech, the dash began to rise.
Lopez crouched next to Eckstein, watching the gap between the dashboard and the man's legs widen. Slowly, incrementally, the heavy frame rolled away. "Stop!" shouted Marco, feeling beneath steering column, measuring the space. "He's free."
DeSoto wedged the foot of the backboard into the cleft formed by the side of the seat and the doorframe; Hank and Mike moved to opposite sides of the wooden slab, grabbing the handles. Roy straddled the board, taking hold of the edges of the short board.
Gage wrapped one hand around the seatbelt latch and placed the other arm under Eckstein's thighs. "One... Two... Three." He released the belt.
Smoothly Roy guided the unconscious man backwards. As he fastened the straps he could hear the hiss of the blood pressure cuff.
"B.P.'s way down." Gage pulled the stethoscope from his ears and looked up at the ambulance attendants. "Load and go." He scrambled up the bank.
"Roy," said Dixie. The nurse signed the patient care form. Looking wet and irritated John slumped against the supply cabinets behind her. She handed him the clipboard.
"Hi, Dixie." Roy frowned at McCall's distant manner. "You ok?"
"Yeah." She looked up and gave a wan smile. "Just a little preoccupied, I guess."
"How's our patient?"
"On his way to surgery," she replied.
"Ready to go?" asked Gage, lifting the handitalkie and pushing away from the counter. His shoes were squishing again.
"Squad 51, available."
"10 - 4, 51." acknowledged Sam Lanier.
Johnny started toward the Squad. "Not yet noon and I'm on my third uniform. At the rate I'm going, I'll be in my turnouts by dinner."
Not quite ten-thirty and thanks to the broken percolator at home and a solid string of runs, I haven't had my first cup of coffee yet, thought Roy, morosely. "I hope your other shoes are dry."
"So do I."
As the passed the staff lounge DeSoto detected the scent of coffee. "Let's grab a cup of coffee."
"Roy." Johnny's brow furrowed with disgust. "I'm soaked!"
"It will just take a second. Think how good a hot drink will feel."
"I'll pour it down my legs," muttered the paramedic. Sullenly, John followed Roy into the staff lounge. The air conditioning was turning his sodden trousers into an ice cold, clingy mess. Walking through the door, Johnny tugged at the inseam of his pants trying to separate the wet fabric from his skin. Station 45's female paramedics sat at the small round table -- staring at him.
"Belch and spit while you're at it, Gage," commented Karen Wolfe.
John felt his cheeks burn.
Roy choked back a laugh, remembering Joanne making a comment of the same sort to him. He headed for the coffeepot and filled two cups, knowing that the way the day was shaping up this might be his only chance for caffeine.
Johnny shot a venomous look at his partner and flopped down on the couch. He slid down the vinyl surface until his chin rested on his chest. "Gonna drink both those yourself?"
"Roy," greeted Kel Clark, smiling warmly at the DeSoto.
"What's that smell?" asked Wolfe. She sniffed, turning to face 51's paramedic. "Gage?!"
"Our last run."
"What was it, man down in a cesspool?"
"Old irrigation ditch -- almost the same thing," replied John ruefully, picking off the bits of dead plants stuck to his pant legs. He gave up on the quixotic task and instead sipped at the coffee, grimacing at the scorched taste. He eyed the two off duty paramedics in civilian dress. "I've heard the department is considering a more causal cut of uniform. But this is ridiculous."
"Be nice Gage, or we won't share our gossip." Kel rubbed her arm.
"What're you two doing spending your day off at Rampart?" inquired DeSoto.
"Doctors wanted to check something out," answered Karen.
DeSoto gave Wolfe a quizzical glance, prompting her to continue.
"You're ruining my story," interrupted Clark mildly, raising her eyebrows at her partner. "I'm getting there, Roy."
Both men gazed expectantly at the woman, while she took a long swallow of coffee.
"Well?" demanded Gage, finally.
"We had the weirdest call," started Kel, setting down her cup and reciting the paramedic equivalent of 'once upon a time'.
"Ain't that the truth," her partner sighed.
Roy leaned against the counter and refilled his cup.
"We roll on a sick call. Get there, a woman wearing her boyfriend's clothes answers the door. She takes us in back, our victim's lying on the floor with a aqua teddy balled up next to him...."
"MI during -- uh -- in bed," said Roy.
Johnny grinned as his straight-laced partner tactfully avoided the word sex in the presence of ladies. "Which one had been wearing the teddy?"
"Shut up, Gage. She's discoursing," snapped Karen.
DeSoto swallowed a smile at his partner's miffed look.
"You'll never guess who the patient was," continued Clark. She paused watching the men's faces. "Craig Brice."
"Brice had an MI?" asked Roy.
Wolfe gave the fair-haired firefighter a 'you kind of missed the point' look. "No."
"Some kind of infection, meningitis maybe," responded Clark.
"Oh man," said Gage softly. The corners of his mouth quirked downward for a moment.
"Is Brice ok?" Roy looked toward the door, imagining the terrible effects of CNS infections.
The younger woman shrugged. "I don't know. He was running a high fever, was disoriented and somewhat shocky when we got there...." Her voice trailed off and she bowed her head. "I just don't know."
"Apparently he caught a unusual strain from a patient," said Karen. "The doctors are having to use a different treatment. That’s why we're here; they wanted to change the medication they've got us on."
For a few minutes the paramedics sat in silence. Finally, Karen broke the somber quiet. "Craig'll be all right. The bacteria will be bored to death by all the trivia stored in the man's gray matter."
Involuntarily, Roy snorted.
"So, Craig Brice and a woman," mused Johnny, incredulously.
Kel nodded sweetly.
"Playing doctor," added Karen. She lifted her cup of coffee, concealing her amusement at Gage's befuddlement. No use ruining her enjoyment by getting him worked up over people teasing him.
"Brice and a red..." He stumbled over the word, his tongue refusing to place the words 'Brice' and 'teddy' in the same sentence. "Lingerie?" he finally squeaked.
"Aqua," corrected Kel.
"It wasn't turnouts." Karen grinned broadly at the various expressions warring for a place on the paramedic's face.
DeSoto sputtered into his coffee.
"Brice and a woman?" muttered Johnny still struggling with the concept.
Wolfe leaned back in her chair. "Not just a woman, Gage, a 'babe'."
Kel traded knowing glances with her partner. "You know the red-headed nurse on the surgical floor?"
"I wish," sighed John. He abruptly sat up as the implication of Clark's question hit him. "Beth?!"
"Beth," affirmed Karen.
"How'd Brice catch a woman like her?"
"Especially, when all you can catch, Junior, is a cold." Roy sipped calmly at his coffee, while Johnny scowled at him.
"People get into all kinda kinky things. Maybe she likes the way he organizes," chuckled Clark, draining her cup. "I haven't gotten to the best part...."
"There's more?" asked DeSoto. "I'm not sure Johnny can take anymore."
"We get him packaged and Beth announces she's going to ride in with us. Karen tells her: 'no, family members only'." Kel paused. "She looks us right in the eye and says she's Craig's wife."
"Wife!" exclaimed Gage, bursting into laughter.
"Maybe they're married..." Roy stopped as all three paramedics stared at him in open mouthed shock.
"DeSoto, those two are shacked up," asserted Karen.
"Living in sin," said Kel.
Johnny chuckled. "Come on, Roy. I wanna get into dry clothes before our next run." He grabbed his stunned partner's arm and dragged him out the door. "See ya later."
Dana let her universe narrow to the clamped piece of tubing and the needle she was inserting into the sampling port. Carefully, she aspirated a few cc's of urine into the syringe, transferred the liquid to a labeled sample container, and unclamped the tubing, all the time aware that a slip of the hand could cost her her life. Swenson dropped the contaminated equipment into the red biohazard container and handed the flask to the nurse filling another shipping carton with samples. Only then did she allow herself to look at her patient.
Sweat dripped off Bob Bellingham's face. His ragged breathing was unnaturally loud despite the delirious half-voiced ramblings of his roommate, Craig Brice. Dana again saw the x-ray films Mike had clipped to the lightbox in radiology. A thick gray haze had filled the gaps in the normally translucent web-like pattern of healthy lungs. The paramedic was drowning in seepage of his own damaged cells. Swenson spread the cooling blanket back over Bellingham; he moaned weakly as the cool surface touched his skin. It was the first sign the sick man had given that he was even aware of his surroundings. Drifting in the fog of fever and rising intracranial pressure, Bob had remained unresponsive as Dana had examined him, staying still and silent even when she palpitated his abdomen, tracing the swollen arc of his liver.
"There's been no response to any of the antibiotic regimens we've tried. The cultures are all negative and serological testing hasn't turned anything up." Morton's words were muffled by an isolation mask. He looked intently at the epidemiologist. "Do you suppose we're looking at something environmental -- some kind of toxin maybe?"
Straightening, Dana looked at the doctor and shook her head. "It's not impossible, but there isn't that much a wealthy corporate lawyer and his wife and a pair of firemen would have in common. Usually poisoning victims share similar lifestyles."
"It would only take one place," remarked Mike.
"Did the tox screen turn anything up?" Swenson studied the monitor over Bellingham's bed. "Organophosphates?" she speculated, running through the list of toxins that could cause similar symptoms. Organic phosphate compounds prevented a critical enzyme from functioning causing severe neurological problems.
"Serum cholinesterase levels are normal." At the sound of the doctors' voices Brice began a louder agitated mumbling. The nurse rushed to his side, dipped a cloth into a basin of cold water, sponged his face, and murmured soothingly.
"Organometallics, maybe?" She frowned. "Particularly organomercury compounds. There was a cluster of cyano-methyl mercury guanidine poisonings, back in '70 in Alamogordo New Mexico, with similar symptoms."
Morton shook his head. "We thought of that -- no heavy metals."
"I'll get the lab in Atlanta to run a complete assay, but I doubt you missed anything."
"Ok. And in the mean time?"
"Good supportive care." Swenson turned from the stuporous paramedic to his partner, who struggled feebly with the nurse, ranting about spiders, blobs of dust, squads and being toned out. "And hope we find something soon."
DeSoto walked into the dayroom hoping to have enough time to read the sports page before starting lunch preparations. He nodded a greeting to the engine crew and pulled out the chair.
"Roy, what's for lunch?" asked Marco as he finished emptying the dishdrainer.
"Sloppy Joes," replied DeSoto, reaching for the paper. "Joanne's special recipe."
"I suppose they beat Gage's hamburgers," grumbled Kelly from the couch.
Roy glared at the fireman.
Chet held a scarred yellow tennis ball in front of Henry and tried to interest the dog in the toy. Henry obligingly sniffed the ball. Kelly tossed it across the room, the yellow sphere bounced once and rolled into the corner. "Go get it boy!" Henry glanced up at Kelly and then laid his head on his paws.
Mike looked up from the business section of the LA Times. "If that dog chased anything he'd have a coronary."
Roy shook his head, while rooting through the stack of newsprint. And Johnny and I'd have to figure out how to defib him.
Lopez turned away from the cabinets. "Sloppy Joes are better than those whatever-they-were's that you served last shift, Chet."
"Fallafel," prompted Kelly.
"Yeah, feel-awfuls," muttered Marco.
"Deep fried sawdust," added DeSoto, finally locating the sports section on the opposite end of the table.
"I fix a healthy vegetarian meal, and this is the thanks I get," griped Chet. "The problem with you guys is that you won't try anything new."
Leaning forward, Roy reached across table and dragged the paper over. A tattered paperback lay neatly atop the stack. A little too neatly, thought DeSoto, reading the title -- Animal Magnetism: The Art of Attracting Women. He glanced up, startled. Chet's face was a study in innocence. "Yours?" he asked.
Kelly looked at DeSoto, his eyes twinkling.
An ugly suspicion reared its head, causing Roy to grimace. "Johnny?"
Poorly concealed amusement lurked behind the firefighter's bushy mustache. He nodded, breaking into a broad grin.
Roy stared at Chet, horrified. Swallowing hard, he paused, listening. John's whistling echoed in the apparatus bay as the paramedic swept the large floor. "Why?" Across the table, the paper rustled as Mike set down the section he had been reading. Macro leaned back against the counter, settling in for a better view of the fireworks.
"Gage has been having so much trouble with the chicks lately. I thought I'd help him out."
"No, I mean, why do you hate me?"
"Yes," answered DeSoto, pressing a hand against his chest, pointing to himself in an unconscious imitation of one of Gage's gestures.
"You don't have to ride with him," continued Roy. "You don't climb in the tiny cab of that squad with a ranting Gage...." He broke off as the door of the storage closet slammed and Johnny strolled into the dayroom, still whistling.
John went straight to the stove and poured a cup of coffee.
"Get rid of it," mouthed Roy silently at Chet, pointing to the book.
Kelly shook his head.
"What's for lunch?" asked Johnny, sipping the steaming beverage while opening the refrigerator and examining the contents.
"Sloppy Joes," chorused Stoker and Lopez.
"Cool," grinned Gage, seating himself next to DeSoto and searching through the stack of newspaper. "With the bits of green pepper?"
DeSoto nodded, stricken mute with dread.
"You know, Roy," began Johnny, pausing in his hunt to cant his head and stare at his partner. "I still can't believe that Brice has a live-in."
Nodding, Roy tried to figure out how to slip the book under the table without attracting John's attention. He settled for praying to be toned out and resting his forearm in front of the slim volume to hide it from the other paramedic's view.
"Brice?" asked Chet, incredulously.
"Our Craig Brice?" echoed Lopez, looked to DeSoto for confirmation.
"I wouldn't call him ours," started Roy.
"Yeap," interrupted Gage, "Brice."
"You won't find that in the Fire Service SOP's," remarked Mike, dryly.
Marco grinned, shaking his head. "Who?"
"Beth Shaw." Johnny resumed his examination the paper, flipping open the life-style section and reading the horoscopes.
"Isn't she the nurse you're after, Johnny?" Chet raised his eyebrows inquiringly.
Roy groaned, the topic of conversation had returned to John and women. Let me try to eat, shower, sleep... and the alarm goes off. But when I need to distract Gage, the damn thing is silent, he mused, reflecting on the basic injustice of the universe.
"I wasn't after her. I was just admiring her -- form."
Chet opened his mouth and started to speak.
DeSoto glowered at the curly haired firefighter. "This is all rather ghoulish. Brice is seriously ill and you two are discussing his -- uh -- girlfriend. Could we please talk about something else?" He continued to stare at Kelly.
John shrugged. "Sure, Roy."
"Hey, Johnny," began Kelly, ignoring DeSoto's glare. "How'd the Dodgers do last night? More importantly, do you owe me a buck?" He scratched the dog behind the ears.
John looked for the sport section. "Ahh, there it is," he said, reaching for the folded newsprint in front of Roy.
DeSoto slammed his palm down on the paper.
"Roy!" exclaimed Gage, cocking his head and raising his voice in protest. "I'll give it back as soon as I read the scores and get Chet's money. Sheesh." He yanked the sport section and the book lying on top out from under his partner's hand. Beaming with anticipation, John began to push the book aside until he saw the cover.
DeSoto watched the title register with all the force of a blow. His partner tensed, as he became aware of the expectant gazes from the other men in the room. Roy stifled a groan.
Gage exploded. "Chet!"
"What?" asked the fireman, his expression carefully bland.
"What's this?" Johnny waved the book in the air.
"A book. I'd have thought you'd be able to recognize them by now..."
"I know it's a book, you twit." Gage stood and walked over to the couch.
Kelly refused to flinch as the paramedic towered over him; instead he gazed up innocently. "You've been having so much difficulty with your love life lately. After all you just lost a girl to Brice."
John turned a delicate shade of purple. "My love life's none of your business. And I didn't lose anyone to Brice."
"I thought if, maybe, you knew the basics of dating...."
"Johnny," said Kelly, shaking his head solemnly. "I am tryin' to help."
"I'm doin' just fine without your help." He pointed at Chet, using the book like a bayonet. Behind Gage, Lopez and Stoker exchanged knowing grins.
"Chantelle, Lisa, Janice, Vivian, Dianne...." listed Kelly. "Beth...." He grinned evilly.
Roy swallowed a smile. Chet has a point there.
"Now wait a minute," sputtered Johnny, pointing to himself. "Beth and I weren't even going out. I never even asked. And, I dumped most of them. Not the other way 'round...."
The bebop sounded. Roy glanced gratefully at the ceiling at he pushed the chair away from the table. "Engine 36, Truck 127, Squad 51 in place of Squad 36. Structure fire with injuries. 4 - 5 - 0 - 1 Hawthorn, cross street Rose. 4501 Hawthorn. Time out 10:43."
Sighing disgustedly, John frowned and turned his back on Chet. As he sprinted through the door, he threw the book savagely at Kelly. It spun, falling short of the fireman, and slid beneath the couch. Wagging his tail once, Henry hopped down and crawled beneath the sofa. Faint growls and the rustling of paper emerged from the narrow space.
"Henry seems to be enjoying your book," commented Mike.
"Hey, you mutt, "said Kelly, getting down on his hands and knees and reaching beneath the couch. The growling intensified. "I spent a whole quarter on that."
Bracket slumped at his desk. A veritable mountain of paperwork covered the desk and spilled onto an adjacent chair. Rubbing his aching head, Kel fished a bottle from his desk, fumbled with the cap and washed the two aspirin down with a huge swallow of cold coffee. Grimacing and closing his eyes, he leaned back and let himself drift.
A knock at the door made him jump. "Come in!" he snapped, straightening.
Dana opened the door a crack and leaned her head in. The dark-haired doctor sat at his desk, blinking bleary-eyed. "Dr. Brackett," she said, "Got a minute?"
Kel waved at an empty chair.
"I just got back from St. Francis. This morning, they admitted a meningitis/pneumonia case..."
"I think so." Dana continued, "And, she was treated for a fractured wrist two days ago at Rampart -- by Marguerite Frances."
Brackett exhaled slowly, abruptly and completely awake.
Swenson nodded. "I'm expanding our quarantine."
Roy stared at the trunk of the rusting muscle car in front of the squad. A twist of coat hanger was threaded through the empty hole that had once housed the lock to secure the lid. A tanned teenage boy drove, paying more attention to the radio than to the road. Rippling waves of heat shimmered on asphalt between the cars in the pre-rush hour gridlock. Hot air and diesel fumes blew in the open window. The line of cars inched past the light. In the seat beside him, Gage was bent forward over the dash, scribbling in his notebook. One more mile, thought DeSoto, stifling a sigh. He was sweaty, tired and his ears tingled with the sunburn feel of a light burn.
Johnny looked up and squinted through the windshield. He frowned. "This is nuts. You'd think the city'd do something." A smear of soot spread down the side of his face and ran under his chin outlining a ghostlike image of his SCBA mask.
Roy looked at his dirty hands gripping the steering wheel, his fingers involuntarily tightening at the thought of another Gage tirade. Give me strength, he prayed. This is better than him going on about Chet. "Like what? Transplant a few thousand commuters to Gardena?"
"Well, there's that construction on the Harbor Freeway. They need to use a different detour...."
DeSoto's stomach growled loudly interrupting Gage. "I just hope we get back to the barn in time for dinner. Not that we'll get a chance to eat it."
"Shh," hissed Gage, "you'll jinx us."
"Johnny," started Roy.
"Squad 51, call operations when you return to quarters." Sam Lanier's voice cut across the rumble of traffic and DeSoto's comment.
"10-4, Squad 51," acknowledged John. He hung up the microphone. "I wonder what this," he nodded toward the receiver, "is all about?"
"We'll find out soon enough," said Roy, watching the lines of cars and listening to his stomach rumble. "I bet it's about us not getting dinner again."
Roy turned on the flashers and glanced into the sideview mirror watching as the shift change traffic from the refinery dropped back to a respectful distance. Slowly, DeSoto angled into the drive.
"Squad 51, in quarters," said Gage, clutching the radio handset and writing the time into the booklet.
As he backed into the bay, DeSoto could see Stoker standing by the office door. "Roy," called the engineer.
Johnny snapped the notebook closed and dropped the pen into his pocket. "I'll make that call," he offered, slipping from the vehicle.
Roy climbed out of the squad. Mike's expression made him nervous. A pile of large cardboard cartons leaned incongruously against the wall by the dayroom.
"Roy," began Stoker, shifting uneasily. "I just talked to the Captain over at 16's, Bob Bellingham is in the hospital. He's really sick."
Inhaling sharply, DeSoto raised his head, remembering what Wolf and Clarke had told him about Brice. "Meningitis?"
Mike shrugged. "I don't know. They think Bob caught something from a patient. The doctors wanted to know how to reach his wife."
Biting his lower lip, Roy turned away. The printing on the boxes caught his attention -- 'Disposable isolation gowns.' From the Captain's office leaked Gage's voice, "Tomorrow, 13:00 at the county health department headquarters...."
"Thanks for telling me, Mike," whispered DeSoto.
The engineer shook his head and turned back to the dayroom.
Rubbing at the grim coating his neck, John walked into the bay. "There goes our day off," he remarked, waving with his thumb to the office and the phone. "There is a emergency meeting for paramedics and EMT's at the Health Department tomorrow." Gage examined the black smear on his hand.
"About those?" asked Roy, pointing to the carton of gowns with his chin.
Frowning, Johnny glanced away from his partner's face at the stacked boxes. He read the label and nodded.
"Bellingham is sick too." DeSoto looked into Gage's eyes. "They think he caught it from a patient."
Johnny shook his head slowly.
Beth stared out the fifth floor window and watched an ambulance back into the space marked 'Code 3 Only'. A paramedic and attendant climbed from the back supporting a stretcher between them. For a brief second, the bright lights of the ambulance bay illuminated the paramedic's blue uniform while casting deep shadows across the man's face. The trio disappeared, leaving driver to pull the rig away from the entrance to a small service area. At the edge of the complex, a hospital security cruiser drove slowly among the rows temporary buildings filled with classrooms, offices and labs. A few stranglers, ending their shifts late, walked to their cars, staying in the pools of light around the tall streetlamps.
Behind her, the door opened a crack. Beth watched the reflection on the glass as a gowned and masked woman leaned through the door. "Come in, Mary," she invited the charge nurse in.
"I hear someone is refusing their meds."
"Just the sleeping pill," corrected Shaw turning from the window.
"Rest is important in resisting any infection." Mary took the other nurse's arm and led her to the bed. "I'll not have one of my patients staying up all night worrying." Her brown eyes twinkled over the mask.
Beth let Mary guide her into a reclining position. "How is Craig?"
Mary busied herself with the blanket. "I can't..."
Shaw's expression hardened. "Don't give me that patient confidentiality run around. I work here."
"According to the paramedics you’re Craig's wife."
"Then I have a right to know," said Beth firmly.
Sighing in defeat, Mary started, "He's not so good...." She summarized Brice's condition. "He's doing better than the others."
Blinking fast, Beth forced back tears. "I heard about Kate." She looked out the window. She caught her reflection on the pane -- hair unbrushed, pale, blank faced, red eyed -- she looked like the women who waited beside the beds of their sick and dying loved ones.
"How did you..." The nurse stopped. "When did you two met?"
"He had an accident a couple years ago, spent some time on my floor," shrugged Shaw. "When he got better he asked me out. One thing led to another and here I am. Last night was our anniversary." Tears began to stream down her checks.
Mary poured a glass of water and handed it Beth. She waited for the other woman to collect herself. "He keeps calling your name, I think he intends to be around for a few more anniversaries."
Shaw forced a weak smile. Unless this bug has other plans, she thought.
Morton stood in the door of the conference room, Dana had commandeered for a command post. He gazed past the stacks of papers.
The white board hanging on the opposite wall was covered with lists of names. Each column was headed by the name of a victim, underneath were the contacts gleaned from numerous interviews of victims and their friends and families. Individual names that appeared on more than one list were circled. Red and green lines connected the blue lettered names to one another. And every line had its origin at Alex Sharp -- the index case.
A shiver ran down his spine as Morton remembered the man's face -- the face of the unfortunate who had become an unwitting murderer. Mike turned off the lights.
Gage walked through the doors of the exam room holding aloft a bag of normal saline, following the gurney. On the stretcher a long-haired, bearded filthy drug addict fought against heavy padded canvas restraints. The man screamed, kicked and cursed, favoring passing female members of the staff with anatomically impossible suggestions. Johnny's lips curled at the waves of stench spread by the man's struggle.
"You stuck a ...." shrieked the man, glaring wild eyed at Gage.
"I see you brought us another happy customer," remarked Brackett loudly, looking at the patient.
"...ing big needle in me. Get this thing outta me."
"Settle down," snapped Brackett. The patient yelled back.
John grimaced. "He's had 1.2 mg Narcan." The addict spewed forth a stream of profanity and sexual epithets directed at the paramedic.
"Shut up," ordered Dixie, glaring. The man fell silent.
"I'm guessing that the line between respiratory arrest and shouting was at 1.15 mgs." Gage looked at the salvia streaming from the corners of the addict's mouth and the glassy eyed stare the man now had and decided the leave, quickly. "You need me anymore, doc?" he asked, edging toward the door.
"No. Thanks, Johnny."
Gage let the door fall shut behind him. He paused, listening. Suddenly he heard liquid spattering against the tile floor. "Argh! Dixie!" bellowed Brackett. Whistling, John walked to the washroom, last time this same addict had thrown up all over him.
Signing the last form and half listening to the radio traffic over the HT, Roy watched his partner walk down the hall. Gage stopped abruptly as Dixie steamed out of the treatment room, cutting him off. "You knew he was going to do that," accused the nurse.
John feigned innocence. "No. But he does have a track record of that kind of thing."
McCall frowned at the paramedic.
"This time I was just lucky." Gage bounced on his toes.
"Johnny you are many things, but lucky isn't one of them." Dixie settled on the stool behind the counter. "Hi, Roy."
"Hi, Dix." Roy glanced at the ceiling. "How are Brice and Bellingham?"
"Yeah, how're they doin'?" added Johnny.
The nurse's face went somber. "Not so good."
"Do they know what it is yet?" asked DeSoto.
"Not yet," answered Dixie softly.
Swathed from head to toe in green surgical scrubs Dr. Jeffery Boyd, a post-doctoral fellow in virology, propped his foot against the bench in the locker room deep inside one of the laboratory buildings dotting the CDC's park-like campus and tied the strings on the disposable shoe cover. Grunting, he stood and slammed the door of his locker. A man of average appearance distinguished by his agile, steady hands, Boyd was part of the small fraternity of scientists who were dedicated to understanding the biology and chemistry of highly lethal viral agents.
"Have you looked at the cultures from Los Angles?" asked Mark Neufeld, sitting on the bench next to Boyd. He covered his pale hair with a cloth cap.
"Not yet." Jeff slid the heavy rubber respirator mask over his head and adjusted the thick straps. He pulled a pair of thin latex gloves from the box. "I was just heading in to see how they're doing," he declared, walking over to the airlock doors that separated the lab from the preparation area.
Boyd lifted the silver latch securing the incubator, opened the door and pulled a rack of narrow flasks from its bloodwarm interior. Carefully, he set the cell cultures on the stainless steel counter next to a microscope. A half a dozen thin rectangular bottles lay on their sides in the red wire rack. A fraction of an inch of nutritive media covered the monolayer of monkey kidney cells coating the bottoms of the flasks, for unlike bacteria viruses required living cells to reproduce. He pulled one bottle from the bottom of the rack and frowned. A healthy culture was clear, but this one was turbid with sheets of coagulated material floating in the broth. Every flask in the rack had a similar appearance.
Neufeld peered over his postdoc's shoulder. "Bacterial contamination; they're blown." The corners of his eyes pulled in a grimace. Common germs spread by careless laboratory technique or dirty equipment occasionally seeded the culture media and poisoned the fragile layer of host cells.
Jeff slipped the flask beneath the objective of the microscope and bent to look through the eyepieces. "Maybe," he mumbled, doubtfully. A mosaic of cells riddled with lifeless holes came into view as he focused the instrument. Beside one hole was a cell twenty times the size of its neighbors and peppered with two dozen tiny brown flecks. "I don't think so. I'm seeing syncytia," he announced, referring to the large, multinuclear cells formed by the damaging actions of certain viruses.
"Lemme see," said Neufeld. Leaning over he looked though the microscope and then slowly stood up. "Better get these," he gestured toward the flasks, "under the electron microscope and see what's in there."
"Ok," said Jeff, reaching for a package of conical centrifuge tubes and a pipette. As he worked an electric shiver of excitement rippled through his stomach, stopping before it reached his hands, which continued their work undisturbed.
The small eighth floor conference room at Rampart was very crowded. Doctors, nurses and health department officials filled every chair and stood against the walls. Two boxes of doughnuts sat on the table, surrounded by a sprinkling of crumbs and powdered sugar. Dana caught the faint, bitter smells of coffee and antiseptic soap, as she shuffled through the stack of thin teletype printouts, reviewing the results wired from Atlanta. In one corner of the room stood a group from St Francis. The gray-haired neurologist, Joe Early, sat at the far end of the table, munching on a pastry and writing on a sheet of paper clipped within a pale yellow folder. Brackett and McCall had positioned themselves on either side of her. Even the Chief officer in charge of paramedics was present, his stiff white cap resting on the table in front of him. The room was strangely quiet, despite the wall to wall crowd. People occasionally whispered but mostly they waited shoulder to shoulder in a funereal silence.
Speaking quickly and precisely, Brackett described the outbreak. Papers rustled as people browsed the mimeographed sheets detailing the course of the infection. Dana picked up her copy and leafed through. High fever, altered mental state, seizure, nausea, vomiting, meningeal inflammation, desquamation of the respiratory tract epithelium, splenomegaly, enlarged kidneys, liver inflammation, increased intracranial pressure, acute renal failure... A parade of deadly symptoms, she thought, as Brackett droned on. A photo of a microscopic view of a fragment of Alex Sharp's lung lying on the table drew her attention. She studied the image. The sample had been treated with a histological stain that had attached to the delicate tissues of the aveoli walls, ringing the grapelike air sacks with purple. The normally hollow chambers were distended by the leakage from damaged tissues and plugged with the remains of ruptured cells. Brackett's next words shattered her reverie.
"...The mortality rate so far is 100%."
A nervous stir rippled around the room. Standing in the far corner, Morton shook his head and stared into his empty coffee cup. Swenson could sense McCall tensing.
"Dr. Dana Swenson, of the Centers for Disease Control, will discuss the efforts to identify the causative organism," said Kel by way of introduction.
Dana stood, clearing her throat nervously and clutching the papers; she hated public speaking. "We believe the syndrome is viral in origin." Briefly she summarized the clinical features that suggested a non-bacterial source of the infection. The head of the laboratory services scribbled frantic notes.
"Serological testing has ruled out Western Equine, Saint Louis and Eastern Equine encephalitises," Dana continued. "Along with a variety of Brunyavirus infections, including LaCrosse and California encephalitises, we've also been able to eliminate some of the more exotic possibilities -- Japanese B encephalitis, West Nile Fever, Rift Valley, Kyasanur Forest disease, Powassan encephalitis, and Oropouche. Post-mortem examinations of brain tissue were negative for rabies," Swenson paused, uncomfortably aware of the many eyes on her, expecting her to provide a miracle solution. "In short, everything we've tried has come up negative with the exception of some ambiguous results on hemagglutination tests for measles," she added, referring to the blood test for active antibodies against the measles virus. Briefly, she closed her eyes, again seeing the array tiny wells filled with red sludge and minute red buttons of destroyed cells. Rather than being clumped together in the bottom of the tube by the action of the virus, the blood cells had aggregated in tiny lumps, forming a loose ring, a reaction that indicated the presence of some neutralizing antibodies.
"Atypical measles can cause meningioencphalitis," offered a young doctor from St. Frances, gesturing with long narrow fingers.
"Yes," replied Swenson, "but the age group is wrong. The bulk of the victims would've had measles as children. Now, if they were younger...." She let her words trail off.
"Then positive test results aren't that surprising," added Morton, shifting.
"Except that the titers are too high for a childhood illness and too low for a current infection." Beside Dana, Kel leaned back watching his former student with a trace of pride visible on his face.
"Most of the victims are medical professionals. We generally have well developed immunities," commented Mike. He ignored the snorts of amusement as his colleagues recalled the old jokes about health care workers having immune systems capable of killing squirrels in the backyard.
Dana nodded. "Still, the levels are suggestive of some sort of ongoing immune response, perhaps to a similar virus."
"Convalescent sera should...." started a fair skinned young resident.
"No one's convalescing," interrupted Brackett, savagely.
In her seat next to Swenson, McCall changed position, frowned and bowed her head. Slowly she flipped the stapled pages of the handout, the sheets of paper making a mournful noise.
Richard Briggs pushed a bundle of photographs across the table. "A measles like agent makes some sense, though." He pointed to a slide of the cross-sectioned spleen. Abnormal large voids and fused cells peppered the diseased tissue. "There's evidence of similar cytopathic effects." He looked at Kel, watching the doctor nod, agreeing with his assessment of the microorganism's familiar pattern of cellular damage.
Brackett examined the picture and then handed it to the doctor behind him. "However, the clinical course of the infection is inconsistent with measles," he commented.
"Based on some very preliminary results from cell cultures, I believe we're dealing with a completely new member of the paramoxyviridae family - related to measles and respiratory syncytial viruses," postulated Dana. "A hyper-immune response due to past exposure to a similar agent could be causing or aggravating some of the symptoms we're seeing." The epidemiologist took a sip from the glass of water sitting in front of her. "Now, this is far from conclusive," she cautioned.
Morton pushed away from the wall. "Does the CDC have any suggestions for an effective treatment regime?" The doctor's voice was tight and his eyes dark and clouded.
Swenson pursed her lips and slowly shook her head. She could sense the young man's emotions, he fairly radiated a halo of aggravation and frustration. "As soon as the virus is isolated, the appropriate cell culture and animal studies can start, however it will still be some time before we can expect results. The only recommendation the CDC can offer is to continue supportive care: fluids, anticonvulsants, antipyretics..."
Mike sighed, loudly and angrily.
Brackett interrupted, "And that we keep burying the dead."
Dana looked away. After a long moment she continued, "At this time supportive care is the only course of action the CDC can endorse."
"That's easy for you to say," began Kel.
"No, Doctor," started Swenson, her voice rising in irritation. "It's not. However, without additional data, the CDC can not condone any other treatment." She met Brackett's gaze, her jaw tightening. For a subjective eternity the dark-haired doctor glared at her. Finally, he turned away.
"Prevention and containment," announced Dixie, into the silence that followed.
Swenson drew a quick breath. "Based on the evidence we have at this point..." The epidemiologist nodded to the nurses and doctors who had helped her gather detailed patient histories. "...the incubation period appears to be 4-7 days and pattern of spread doesn't yet indicate just how long an individual is contagious before manifesting symptoms. This virus appears fairly virulent and we suspect it spreads between human hosts via respiratory aerosols."
"Every case thus far is directly linked to Alex Sharp. Unfortunately, Mr. Sharp and his wife died before we were able to perform comprehensive interviews. Therefore, the source of his infection hasn't been determined." She stopped and nodded toward Brackett.
"Everyone who's had unprotected contact with the sick, has been infected. It's very important that strict isolation be maintained," began Kel, setting down his coffee cup. He and the Director of Nursing described the details of the infection control plan developed with the Health Department and the CDC.
While Brackett talked, Dana studied the faces around the table, in more than one she could discern fear. She could feel her own heart race if she let herself think too much about the lethal cargo that could be riding hidden inside the blood of yet unidentified and unsuspecting victims.
"I know this places a tremendous strain on nursing staff," finished the Director smoothly, her tight brown curls bouncing briskly as she nodded. "If you're too frightened or too tired function, we don't want you in with the patients. So you must let your supervisor know if you feel you're unable work in quarantine. Hopefully, this'll be over soon."
Swenson looked the uniformed fire department officer, who sat clicking his pen and looking over his notes. "But despite current quarantine procedures, we've got to be ready for a cluster of cases over the next few days, due to exposure to infected fire department and emergency room personnel," concluded Dana, laying the handful of teletypes on the table, their edges crumbled and damp from her nervous death grip.
Roy shifted on the hard metal folding chair in the large multipurpose room in the county offices. On a platform in the front of the room, an overweight man demonstrated the correct method for removing an isolation gown without becoming contaminated.
Idly DeSoto doodled in the margin of the mimeographed notes. The specter of infectious disease had always been there. Hepatitis, TB, meningitis... Always things we could treat.
On the stage, the man mimed washing his hands. "Hand washing is still your front line of defense against infecting yourself, your patients or your family...."
A block of ice formed in Roy's throat, choking him. Joanne! he thought.
The night nurse stuck the piercing pin into the port on the IV, twisted the two pieces together and squeezed the drip chamber. As she bled the air from the line, Brice fixed his reddened, glittering eyes on her. Gritting her teeth beneath the mask, she braced for a comment on her technique. The day before he had critiqued her needle selection, but now he lay silent. "Mr. Brice?"
The paramedic didn't respond. Instead he continued to stare through her.
"Mr. Brice?" she repeated, rapidly completing the IV bag change. "Talk to me, Mr. Brice."
Craig's lips moved, soundlessly.
"Can you hear me?" she asked, shaking down a thermometer. Alarmed the nurse pushed the call button and then took his temperature.
"What's up?" asked the charge nurse, pushing the door open with her hip.
"Mary, his temp is up to 105."
"Ok, call Dr. Morton," directed Mary. "I'll get a cooling blanket and some ice."
Craig meticulously made tiny adjustments to the tuner of his crystal radio, clearing the static from the signal. The slightly tinny sound of Christmas music preformed Guy Lombardo's band came through his headset. He looked out the bedroom window. Before him in the darkness spread the lights of the Murdoc Airbase housing tract that everyone called 'Weary Housing'. The Hayes had wrapped the Joshua tree in their yard with Christmas lights. The crazy 'snowman', Craig's mom had made from white spray paint and tumbleweeds, grinned stupidly at him from under its moth-eaten hat.
Brice sat down at his desk/workbench. He picked up the model of the P-39 and examined it. It was a Christmas present for his father. All that remained was to apply the registration numbers. He picked up the tiny brush and dipped it in the white paint. Taking a deep breath, he braced his arm and began to carefully brush the number 128360 onto the tail of model.
Craig watched his mother select boxes from beneath the Christmas tree, handing them to his father and grandmother. She handed his dad the painstakingly wrapped hat box containing the model. Craig's hand tightened around his new baseball glove and he held his breath as his father slid his fingers beneath the tape, unwrapping the present.
Allen Brice held up the carefully painted plastic airplane and turned it, inspecting the workmanship. The blue and red of the lights on the Christmas tree reflected on his short brown hair, cut in the severe lines of military fashion. His face remained expressionless. "Thanks, son," he said, setting down the model. He picked up another box.
Libby Brice shot her husband a dark look. She reached over and gently lifted the model. "It's beautiful, Craig." Gingerly, Libby turned the plane over, admiring the fine brushwork. Her eleven-year-old son's attention to detail constantly astounded -- and worried -- her. Turning to her mother, she remarked, "It's just like the plane Allen flew in the war."
Allen raised his head. "No," he said, reaching for the model. "Mine had a military camouflage paint job." He pointed to the areas of the plane where the pattern would have been applied.
Craig bowed his head. Blinking back tears, he let the new glove drop.
"Well, it's still a very nice model," asserted his mother.
Abruptly Craig stood. "I'm going outside to play." He scooped up his new glove to give a plausible excuse for his sudden departure. As he fled down the hall he could hear his mother's voice.
"Allen, he worked on that model for months. You could've at least told him he did a good job."
"A well-done task is its own reward," quoted his father. "Besides if a man thinks he's doing good enough he'll never improve."
Craig found his lips moving, soundlessly repeating his father's maxim as he pulled on his jeans. He bent tying his sneakers.
"Allen, he's a boy, not one of your pilots..."
Outside, Brice walked past the landing light stanchion, rising between his neighbors' houses. "I hate Christmas," he whispered kicking a loose stone. On the horizon before him was the thin purple haze of the Tehachapi Mountains. He scrambled down the crumbling edge of the wash, skidding past clumps of dried rabbit brush. His feet hit the smooth, hard bottom of the wash and he began to run. He let the rhythm of breath and movement swallow him.
Brice willed his hand to push the freezing cold ice packs from his groin. Concentrating he made a mental list of the muscle groups he needed to contract to accomplish the task. When he reached the muscles in his fingers, his arm finally twitched. A latex covered hand caught Craig's wrist. The fingers felt slender and feminine. Brice tried to pull away but he was too weak to break free of the woman's feather light grasp. He opened his eyes. The bright lights set loose another surge of nausea, his stomach lurched, but there was nothing left to bring up. He swallowed trying to ride out the waves of dry heaves.
"Mr. Brice." The young nurse looked down at struggling paramedic. She checked the indictor for the cooling blanket's temperature probe, his fever was only slightly reduced. "Mr. Brice, leave those there."
"Cold," he moaned, breathlessly. And naked! Under the plastic cup of the oxygen mask he licked his dry lips.
"You have a high fever and we need to get your temperature down."
"Ms..." Brice studied the thin strip of the nurse's face he could see around her cap and mask. She was a friend of Beth's but he could not remember her last name. "Ms... Uh -- Mary." A coughing spasm left him arching his sore neck and gasping for breath.
Mary lifted the oxygen mask and wiped his mouth. "Just lie still and don't try to talk."
Craig squinted distrustfully at the room. He could not shake the lightheaded sense of disconnection, which made him feel as though he were watching everything through a thick pane of glass. Out the corners of his eyes he could just catch suspicious movements in the shadows, movements which stopped when he looked directly at them. From beneath the bed he could hear the murmuring of the blobs of dust. He stared at the drawn curtains around Bellingham's bed, their worn, stripped surfaces bulging oddly around the equipment that filled the crowded room. Behind the drapes the rhythmic hissing of a ventilator echoed. "B... Bob?"
"Shh," she looked into Craig's gray-blue eyes. "We're taking good care of him."
With his steady hands, Jeff Boyd used a pair of tweezers to lift a tiny circle of wire mesh and place it on the end of a heavy metal rod, which slid into the center of a six and a half foot tall cylinder. With a quick twist of the wrist, he sealed the door of the electron microscope. He flicked a couple switches and the lights in the room went out and the lower rumble of a vacuum pump rose. Boyd dropped into the chair in front of a huge bank of gauges, buttons and glowing screens. The green glow from the phosphor on the CRT flashed off the rim of his glasses.
On the minute copper screen in the heart of the chamber was an impossibly thin slice of wax impregnated green monkey kidney cells, the cellular debris from the culture flasks. Passing through the slice was a beam of electrons, able to resolve details much smaller than the coarse, several thousand Angstrom limit imposed light waves.
On the screen before Boyd appeared the fuzzy outlines the tiny protein, sugar and lipid structures that make up the machinery of a living cell. Slowly Jeff adjusted the controls that moved the electron beam, imaging different parts of the cell. He searched among the structures until he came to the bilayer of fats and proteins that formed the boundary of the cell. There nestled among the shadowy hairs of the proteins, which studded the membrane and regulated the passage of nutrients, was a swollen bud. Bingo, he thought adjusting the microscope. Sticking out of the wall was a newborn virus, preparing to burst forth from the cell.
Jeff reached up, making sure the camera was loaded. He began scanning the cell membrane and snapping pictures. When he finished, Boyd pulled the cartridge of film from the camera, dropped it in his pocket and picked up the phone. "Mark, I got 'em," he announced, unable to keep a quiver of excitement from his voice.
Boyd spread his pictures across his adviser's desk, laying the stiff sheets of paper on the mounds of journals, reprints and notes. Leaning back in his chair, Neufeld pulled a ruler from a drawer and measured the virus and scale bar. Then he opened a thick hardbound volume and flipped through the pages, comparing the virus in the photographs to the images in the book. Jeff shifted, nervously, feeling the eyes of the dozens of brightly colored carved masks Mark had collected while on virus hunting trips throughout Latin America and Asia. After a half an hour of evaluating the shadowy images, Nuefeld handed Boyd a sheaf of laboratory reports. "I think we can safely say that this is definitely a new member of paramoxyviridae."
Jeff nodded. "In the middle of Los Angeles."
Nuefeld stared into the empty eyeholes of one his masks. "Yes, in the middle of L.A. Print more copies of these." He waved the pictures. "And have a courier take them out to Dana." He stood his chair creaking. "Get the rest of those cultures to Jerry, we need a better handle on the life cycle and sensitivities of this beast."
Joanne leaned back and settled against Roy's side. On the TV, a local used car dealer paraded down rows of vehicles with a large male lion on a leash. "...Top dollar on your trade-in. Lowest prices in town and I'm not lion-in'." Joanne groaned. Upstairs a floorboard creaked, she stiffened listening for the footsteps of one of the children. Instead the dog padded down the steps and whined at the sliding glass door. She walked over and let the animal out into the dark backyard.
At the door to the living room Joanna stopped. Roy's head was tipped against the back of the sofa, his eyes half closed and his breathing slowing into the quiet cadence of sleep. Carefully, she eased down onto the sofa and lay her head in his lap. DeSoto mumbled and shifted slightly. The commercials ended and the late night news resumed.
The anchorwoman talked briefly about the hostages in Iran and the presidential campaign, before beginning the local reports. "...State and County Health Department authorities confirm an outbreak of a mysterious new form of meningitis...." The picture changed from the interior of the studio to an auditorium. Two men in dark suits stood at a podium emblazoned with the Seal of the County of Los Angeles. "...Three people have died and six others are ill...."
Beneath her head, Roy's thigh muscles tensed. Joanne looked up. Her husband was no longer asleep but was studying the screen intently. His expression was dark and clouded. "Something you've had to treat?" she asked.
He continued to stare at the television.
"Roy?" repeated Joanne, propping herself up on her elbows.
DeSoto shook his head. "No, not yet." He listened carefully to the rest of the report.
"Good," she said, lying down again. "It sounds nasty."
"That's what the meeting the other day was about," he added, slowly. "Craig Brice and Bob Bellingham over at 16's have contracted it." Roy's voice was nearly inaudible.
"Bob!" exclaimed Joanne. "Susan must be beside herself."
"Yeah," agreed DeSoto, gazing into the darkness beyond the window.
Joanne choked back her request that Roy be careful, knowing that expressing such sentiments would only upset him. Instead she snuggled into his arms.
In the predawn darkness of the hotel room, Dana's pager began to beep. Moaning, she groped along the bedstand and picked up the unit, acknowledging the page. She picked up the phone and dialed. "Mark," she started.
Abruptly she sat up and turned on the light. "What?"
"What the hell is going on out there?" demanded Nuefeld, his voice crackling indignantly over the phonelines. "The wire services are full of stories of a killer plague in middle of downtown L.A."
"What!" repeated Swenson, kicking back the bedclothes. "Hang on." Dropping the receiver, she staggered to the door and wrenched it open. Lying on the hall carpet was the morning newspaper. 'Torrence Lawyer Source of Deadly Meningitis Epidemic.' screamed the headlines. Groaning, she stumbled back to the bed, retrieved the phone and read further. The article named Sharp and described the spread of the disease from infected health care workers. Shit! Shit! Shit!
"Sorry, I'm back," she stammered, continuing to skim the article.
"You're going have full-scale panic out there. People are going to get hurt."
Swenson stared at the coarse paper and black ink, remembering the slender weeping boy sitting alone on the hard red clay ground of an abandoned Ghanaian village, lost in the panicked tide of humanity fleeing a epidemic burning through the bush. "I know," she whispered bleakly.
"They've got the names of victims. How did that information get out there?"
"We have a leak."
Her boss sighed exasperatedly. "Tell me something I don't know. Where?"
Dana closed her eyes, her head pounding. "There are lots of people involved -- state and county health departments, the fire department, two hospitals, coroner's office..." Dropping the paper, she paused. "I don't know."
The line was silent for a minute. Finally, Mark replied, "I guess all you can do at this point is damage control."
"No comment!" Kel Brackett's angry voice ricocheted off the walls.
Dana paused halfway through the door of the ER. In the waiting area she could see hospital security escorting away a persistent reporter. Swenson made it three steps before Brackett emerged from lobby, flanked by a pair of hospital administrators. "Dr. Swenson," he called, his voice heavy with barely contained fury.
"I saw it."
Kel caught the woman's arm and hustled her down the hall to the relative privacy of the base station. "You have a leak."
Dana pulled away. "The story is a local that the wire services have picked up. The leak is here."
Kel flushed at the suggestion of one of the Rampart staff talking to the media. "My people don't leak."
"Someone did," commented Swenson, shrugging. "Who is irrelevant at this point. But it isn't going to help to have a lot of hot head doctors telling reporters, 'No comment.'" She gazed pointedly at Kel.
Behind Brackett, one of the administrative types nodded. "We need to do something to repair the damage."
"A nice preemptive press conference." Dana began to sweat at the thought of more public speaking.
"I have patients, I don't have time for this kind of nonsense."
"Make time, doctor," snapped Swenson.
"Kel," started the other administrator, "we need you there."
The dark haired doctor shook his head in irritation. "Ok," he agreed reluctantly.
Nurse Gina Jones hurried off the elevator clutching a cup of coffee. She stopped abruptly. The swinging doors, which divided the hallway, had been closed. Large yellow quarantine signs were plastered on both doors and carts of isolation garb stood outside. Through the windows she could see equipment and supplies lining the corridor. The entire floor had been converted into a quarantine ward.
"Susan, what's happened?" she asked the pretty young nurse sitting behind the counter transcribing orders.
"We got three new cases during the night," answered Susan Grey.
"No. And the doctors are afraid there will be a lot more."
"Oh my God," murmured Gina, her eyes going wide.
"Report's going to start, you'd better get in there. Mary's in a foul mood."
"Shit," hissed Jones, gulping down her coffee. Tossing the Styrofoam cup in the trash, she scurried into the small locker room behind the nurses' station.
Jones followed the night shift charge nurse through the hall, listening to a brief summary the various patients' conditions. Under the mask her nose began to itch.
"...316 A, Craig Brice. He is getting real bad. We've been using some pretty aggressive cooling measures, which in combination with the antipyretics have brought his fever down. He's still very confused. Leave the broom by the bed..."
"The dust bunnies again?" Gina interrupted, looking through the window in the door into the room. Eyes closed, Brice was sandwiched between two cooling blankets and kept shifting restlessly.
The nurse smiled slightly and nodded. "Depresses his breathing less than a sedative." She looked down at her notes. "His oxygen saturation is down and his lungs sound like crap. They're probably going to have to intubate soon." Flipping to the next page and frowning, she continued, "316 B, Bob Bellingham. His last neuro showed cranial nerve abnormalities. His kidneys have failed and, despite the vent, his pO2 is still falling."
Beyond the thin pane of glass, Bellingham lay unmoving, pillows elevating his swollen feet and hands. His face was a mottled blue and gray. He is not going to make it, realized Gina, studying his bloated features.
"The doctors have tried mannitol and furosemide, but he has not responded. There have been some transient dysrhythmias...."
As if triggered by the nurse's words, the cardiac monitor alarm began ringing. Inside the room the nurse on duty touched Bob's carotid, checking for a pulse.
"I'll help her." Jones pushed open the door. "You call the code."
The hose was hard and heavy between his hands. Brice found himself panting as he pulled the line up the steep stairs, hauling it around the sharp corner of the landing. Getting out of shape as a paramedic, he thought in disgust, fighting to control his breathing. Sweat trickled down his face, pooling against the soft rubber seal of his SCBA's facemask. He crouched closer to the floor. At the nozzle, just out of sight, walked Betty. He had read about her in Firehouse Magazine; serving with the Birmingham Fire Department, she was first female firefighter in Great Britain.
A fleeting streak of orange light appeared in the thick blackness. The fire was just ahead, already writhing in Betty's stream of water. Hot droplets fell onto the faceplate of his mask and soaked into his turnouts. The air was heavy with suspended particles; the fire was burning oxygen lean, filling the room with an explosive mix of incomplete combustion products and finely divided particles of carbon. Come on guys, ventilate this place! Still Betty pushed on, approaching the roaring yellow-orange band chewing away the floor.
Abruptly, the hose went limp between Craig's hands. "Charge the line!" he screamed, turning back toward the stairs. "I got no pressure!" The furnace-like heat beat him down onto his belly; Brice hugged the hot floor. A hand tugged at his turnouts. Betty pointed back down the line and slapped his leg sharply, urging him to move faster.
Brice kept his palm on the collapsed hose as he crawled back into the black smoke. The fire pursued them, raging at their interference. It spread along the ceiling, turning the heavens black and yellow. His helmet struck something -- hard. Stars swam in his vision as Craig traced his hand along the door, which had fallen closed, blocking their escape. He fumbled at the knob unable to open the door. "Locked!" Impotently, he pounded his fist upon the heavy metal panel.
Dragging the now useless hose along as a guideline back to his position, Betty crawled along the wall feeling for an exit. Returning, she shook her head and gestured for Brice to tear the wall apart.
Craig pulled his axe from his belt and sunk the blade deep into the plaster and lathe. He tugged the handle feeling the wall crumble. He hacked an opening. Suddenly, ferociously, the flames burst clear of the smoke and engulfed Betty. She rolled backwards, turnouts ablaze. Her face was twisted in a horrified shriek; the sound of her pain was smothered by the thick mask and the roaring of the fire. He rolled her over and over, smacking at the flames until she lay still and smoking.
Unable to stand and lift her, Brice wrapped the nylon webbing of his emergency harness beneath her arms, dragging her through the narrow gap. He bit his lip, refusing to acknowledge the pain his ungentle movements must be causing her. Pulling the fallen woman behind him, Craig crawled along the junction of the wall and floor, looking for the stairs. Desperately, he tried to suppress his panting and conserve air.
The yellow-orange light flared, illuminating the back of his gloves, then the hot breath of the flames swallowed Brice. The ceiling fell in a yellow and black cascade. Betty screamed once and was silent. He could feel his ears burning. Brice watched his skin bubble up, in angry red and white blisters swelling between the tatters of his dissolving turnouts, and then blacken. His blood seeped out of cracks in his charred skin and hardened.
This is what it is like to die, he reflected, recalling the time he had been trapped with DeSoto and Lopez in a collapsed building. I feel nothing. He hadn't been afraid then, he wasn't now.
Against his face, he felt the rubber of his SCBA soften and melt, oozing across his features, fusing to the skin, leaving him defenseless in the toxic fumes. The carbon heavy smoke penetrated his lungs, choking him. Craig gasped, the breath igniting in his lungs, spreading the flames slowly through his veins. He forced open his eyelids, staring the demon in the face, even as smoldering cinders dropped onto his eyes. Then the pain started...
"360 W sec! Clear!"
Craig fought to sit, throwing back his head to get more air into his lungs. He could not understand the voices beside him, knowing only that they were loud and angry. "Betty!" His hands kept slipping on the smooth bedrails as he tried to pull himself upright. He fell against the rails, hanging over the edge of the bed.
"Nurse Jones! Get Brice!" shouted Bracket.
Gina nodded to the doctor. She turned from Bellingham's bed and hauled Craig back onto the mattress. "Mr. Brice..." The delirious man grabbed her, threatening the protective mask she wore. For a moment they grappled, then she snared his wrist, forcing him to let go, shoving him against the pillows.
"No conversion," snapped Morton, staring at the cardiac monitor.
"Again 360!" Bracket slid the defibrillator paddles into place against Bellingham's chest.
"One. Two. Three... 360," counted a gowned nurse.
Beneath his mask, Mike grimaced at the flat line that ran across the monitor screen. "Asystole..." The nurse slipped past him, placing her hands beside Bellingham's breastbone, resuming CPR.
In the next bed Brice managed to push himself up onto an elbow. "Can't... breathe..." he panted, sweat pouring down his face. "Fire..." His skin was dusky.
"Epinephrine 1:10,000, 1.0 mg IVP." Kel dropped the paddles onto the crash cart and shoved past the nurse who was performing the chest compressions. The crowded room thwarted his restless movement.
Morton pushed the excess medication from the prefill and injected the drug. Beyond the white bandages covering the IV line, Bob's hand was blue and bloated.
Gina caught Craig, as he slid backwards, gasping for air, the muscles in his neck tensing with breath. She glanced at the overhead monitor, his oxygen saturation had dropped even further. "Damn!" she whispered. The young firefighter was slowly suffocating.
"Help... Bob..." mouthed Brice.
"Atropine, 1.0 mg..." ordered Bracket. He waited a few moments for the drugs to be forced through the dying man's body. "Stop CPR." He watched the scope, the thin line remained flat and unchanged.
The nursing supervisor, standing at the head of the bed, pressed her fingers against Bellingham's gray neck. "Still no pulse, doctor."
Jones lowered Brice back onto the pillows. His head lolled awkwardly. She raised the head of the bed a little more and wrapped her fingers around his wrist.
Morton swore under his breath.
"Resume CPR. Repeat epinephrine and atropine!" Bracket could feel sweat begin to trickle down his sides. Mike nodded to him, as he injected the drugs into the IV line.
The nurse continued performing chest compressions. The minutes stretched as she worked.
Gina pressed the stethoscope against Brice's chest, even though she no longer needed the device to hear the fluid in his lungs.
"How long," demanded Brackett, staring at the monitor.
"Twenty-two minutes," supplied the nursing supervisor.
"Thank you," said Kel.
"Stop CPR," said Morton, his voice ragged and soft.
The supervisor shook her head.
Jones unrolled the blood pressure cuff, wrapping it around Brice's arm. She slid the stethoscope into her ears.
Kel sighed. "Time of death 7:47 am." The cardiac monitor continued its eerie wail. "Turn off that damn noise," he snapped, turning on the nurse who stood, still panting from her exertions.
"Yes, doctor," she murmured, pushing the appropriate button.
The room fell silent, except for Craig's labored breathing.
"Doctor Morton," called Gina, looking again at the bedside monitor. "His O2 saturation has fallen to 78%." The nursing supervisor gazed at Jones' patient, her expression clearly telling Gina that she expected to be repeating the just completed code in a few hours.
Morton stripped off his outer pair of gloves and pulled on new ones.
"Pulse 130 and weak, Respirations 44 and labored, BP 116/80," reported Jones.
Mike pressed the stethoscope to Craig's chest and listened for a moment. "Ok, let's knock him out and put him on a vent."
"Yes," Gina pulled a cart from the wall, using her hip to clear a path through the overcrowded room. She nodded to the supervisor, who left to get another respirator.
Craig moaned weakly.
Jones placed the ambu bag next to his head.
Morton looked down at the semiconscious paramedic and raised his voice slightly. "Brice, we are going to paralyze you, so you don't wear yourself out, and put you on a ventilator." Mike lifted his head, meeting Gina's gaze as she handed him a laryngascope and an ET tube. "Pavulon 0.6mg, IV push."
As she slid the needle into the medication port, she looked into Brice's slitted, glittering eyes and whispered, "This may be a little frightening but you will feel much better." She pushed the plunger. In a few moments his arm went slack in her hands.
Nervously Dana took a sip of water and blinked in the bright lights. A whispering crowd of reporters and cameramen seethed in front of her. The small auditorium, normally used for lectures, was packed. To one side of her, sat officials from the state and county health departments, the fire department and St Francis. On the other sat Rampart's public relations director, who kept sneaking anxious glances at Brackett. The doctor stood at the podium, wearing a fresh lab coat and hair neatly combed, calmly answering questions. It's not fair, thought Swenson disgustedly. She on the other hand could feel her heart pounding and was uncomfortable aware that the panty hose she had yanked on in preparation for the press briefing were twisted awkwardly.
"Dr. Dana Swenson of the Centers for Disease Control," introduced Brackett.
Dana stood and walked toward the microphone, concentrating on not tripping. "Thank you, I'd like to explain the CDC's identification and control measures...." Quickly she gave a carefully edited synopsis of the epidemiological efforts and the quarantine measures.
At the end of her statement a report stood. "Brad Johnson, L.A. Times. Doctor, we have heard that some paramedics were infected. Do you believe the public is at risk from this mode of transmission?"
Among the panel behind her, Swenson could hear a rustle as the LACoFD Public Relations Officer shifted. "No, Mr. Johnson. We have instituted some new field protocols, which may appear a bit alarming to the public, but are intended prevent transmission of the illness from patients to health care workers and vice versa." Dana gestured for the fire department administrator to take her place. "Captain Anderson will be able better answer your question." Gratefully, Swenson retreated to her seat.
Mark Neufeld studied the sheets of paper in front of him, lists of tests to identify the surface proteins on the unusual double-fringed coat of the new virus. Leaning back in his chair, he gazed at a Balinese mask with its large red-lipped, wooden-toothed grin, and imagined the hairy protein fibers attaching to the molecules on the surface of the cell, anchoring the virus for its deadly attack. A knock disturbed his reverie.
"Mark," called Jeff stepping through the door. Jerry Chase, a biologist, followed the postdoc into Neufeld's office. "We got something for you." Chase handed Neufeld a sheet of paper and pair of Polaroids.
Mark glanced at the sheet, then carefully examined the snapshots. They were micrographs of a blood smear taken under ultraviolet light. Several cells glowed brightly.
"We have a fast test for the virus," explained Jeff, settling back against the bookshelves lining one wall of the office.
"Immunofluorescence," added Chase.
"How fast?" asked Neufeld.
Mark nodded, looking at the sheet outlining the procedure. "What's the catch?"
"It only gives an good result on blood samples from the initial two or three days of the illness." Jeff crossed his arms.
Nuefeld frowned. "What about other members of paramyxoviridea?"
"No response with mumps, parainfluenza types 1-4, or RSV. There is a very weak response with measles."
Mark shook his head. "They're cohorting patients out there. What you are saying is, there is a risk of misdiagnosing a atypical measles victim."
Jeff pushed away from the shelves. "The clinical pictures of the two illness are different. Right now they are diagnosing solely on presentation."
Slowly, Nuefeld nodded. "Ok. I'll send this out Dana." He picked up the phone and paused with the handset halfway to his ear. "Good work."
Johnny held his hands on either side of Chet's head, maintaining the alignment of the fireman's spine while Roy fastened the velcro straps on the sides of the rigid collar. Stoker and Lopez positioned themselves to support Kelly's hips and legs. Stanley knelt beside the Kelly, holding the backboard on its edge. "Almost done, Pal," reassured Hank.
"On three," instructed DeSoto, taking Kelly's shoulders. "One -- two -- three." Together the firemen eased their comrade on to his side, while Stanley slid the board behind Chet's back. "Down." They log rolled Chet onto the board.
Mike and Macro crawled up by the head of the backboard. Roy folded the edges of the new immobilization device around Chet' head. "You push this up like this and fasten it here. Then a strip of tape secures the whole thing." DeSoto moved. "Try it."
Chet gazed up at John, who continued to hold his head, while the Mike adjusted the support. "Johnny, have you ever considered taking a night class?"
"No," said Roy, in part to correct Mike, in part to interrupt Chet.
"You know, pottery, painting, meditation... Lots of desperate women in those classes." The firefighter's face remained expressionless. "Women who might be willing to overlook a few oddities."
Johnny pursed his lips and mouthed, "Oh?" He rolled his eyes.
Hank groaned quietly. "Do you gentlemen mind?"
"Sorry, Cap," apologized Kelly.
Gage watched his colleagues finish securing the straps. "Let's see if we did this right." He nodded to DeSoto. Together they rolled the board on the its edge.
Involuntarily Kelly gasped as the station tilted around him.
Roy caught his partner's eyes as John altered the placement of his hands. The dark-hair paramedic quickly sketched a movement in the air. Roy nodded slightly. Rather than easing the fireman down, he and Gage lifted the board into the air -- turned face down.
Chet let out a strangled squawk. "Put me down," cried Kelly. Johnny shook the backboard slightly. Chet moaned.
"Hey look, his head didn't move at all," grinned Johnny.
The bebop went off. "Squad 51, sick call. 1 - 0 - 0 - 3 West Lantana. Cross street Wadsworth. 1003 West Lantana. Time out 10:23.
Hank walked to the radio and Stoker pushed past heading for the door. Lopez grabbed the trauma box, snapping the lid shut and shoving the case into the bay. Quickly, DeSoto and Gage knelt, flipping the board over and setting Chet down. They scrambled for the squad.
"Squad 51, 10-4, KMG 365," acknowledged Stanley.
Chet listened to the squad pull out and waited for his colleagues to come and release him. A minute passed, then two. The hard wooden surface pressed painfully against his tailbone. "Hey guys! Come on! Let me up."
Johnny followed the young man up the narrow stairway. The building, part of the decaying neighborhood populated by CSUDH students, was a warren of tiny studio apartments. The oxygen tank kept clanking as it hit the tiled walls. "If this ever goes up..." Gage whispered, looking back at DeSoto and gesturing toward the severed pipe which had once been capped with a sprinkler head.
"She got sick last night and just hasn't gotten any better," said the man opening the door. He stood just inside, waving Gage through.
DeSoto crowded through the doorway. The one room apartment featured a refrigerator/hot plate combination in one corner and in the opposite corner a freestanding commode, framed by a sink and a minute shower stall. Every nook and cranny was crammed with the detritus of student life. The room was unbearably hot, melting the boyfriend's blond ponytail to the back of his neck.
"What's her name?" interrupted John.
"You’re her husband?" asked Roy.
The young man stared at DeSoto and shook his head. "She is running a high fever and can't breathe," continued the youngster.
Roy froze. He fought to conceal his fear as Johnny knelt beside the woman's bed.
Gage opened the drug box and quickly pulled out two masks and two packages of gloves. "Roy," he called, holding out a mask and gloves.
Numbly, DeSoto put on the isolation gear. He looked at the pale, sweating woman and his mind insisted on substituted Joanne's face for that of the stranger.
"Hey man, what are those for?" demanded the boyfriend, his voice tinged with panic.
"Linda..." began Gage.
Roy could hear Johnny's calm voice as he talked with the young woman, taking a brief history. He knew his partner was expecting him to handle the young man. Licking his lips, DeSoto tried to speak but the words stuck in his throat.
The man grabbed John's arm. "Why are you wearing those?" His eyes were wide with fear. He clearly had heard the news reports about the strange and lethal new virus.
"Calm down, sir," ordered Gage, prying the man's hand from his arm. He glanced quickly at DeSoto. "It's just a precaution."
"She has it?" demanded the boyfriend, clawing at Johnny shoulder.
"Roy!" John hunched down, raising his arms ward off the blows.
Checks burning, DeSoto seized the youngster's arms pulling him away from the kneeling paramedic, glad of the thin layer of latex that kept him from touching the man's damp skin. "Sir, please calm down. We don't know what's wrong yet." He forced the boyfriend down onto a folding chair, which had "Property of Temple Baptist Church" stenciled across the back. "You're preventing us from taking care of her." Convinced that the young man was going to stay seated, Roy opened the biophone and pulled out his pen. Mechanically, he transcribed the readings Gage called out.
"Rampart, this is Squad 51," Roy heard himself say. "How do you read me?" His hands and lips continued with the business of the call, while his mind ran in ever tightening circles. DeSoto found himself studying the boyfriend, watching the man's pale, worried face and nervous lip chewing. Roy kept imagining, he was in the young man's place watching the paramedics care for his wife. Despite the heat he shivered.
"...Roy, I'll ride in with her."
DeSoto looked away from the boyfriend and glanced down at the patient care form on the clipboard. Neat rows of his handwriting detailed objective findings, treatment rendered, and base instructions, none of which he had the slightest recollection of recording. One phrase screamed at him -- 'Use isolation precautions.' The young woman was strapped to the litter, packaged for transport, the oxygen cylinder lying between her calves. John stood, holding the biophone in one hand and the IV in the other. Mutely, DeSoto nodded at Gage and gathered the remaining cases. His uniform clung to his skin in sodden sheets.
"Roy," greeted Dixie, letting the door of the staff lounge fall shut behind her. The paramedic sat at the table, staring into a cup of coffee.
DeSoto set down the mug. "Does she have it?"
"Maybe." McCall frowned. "It will take a while for the lab work to get back. I'll call you."
"I'd appreciate it..." DeSoto stopped.
The nurse gave DeSoto a concerned glance. "Roy?"
"Sorry," he hesitated. "This one worries me, Dix."
McCall reached across the table, patting his hand. "Roy..."
Gage burst through the door. "We got another call."
Roy stood. "I'll be waiting to hear from you," he said to McCall.
After dinner, Roy stepped out of the apparatus bay into the parking lot, looking for Johnny. He shook his head. Marco was standing on the catwalk at the apex of the hose tower. Chet must have pulled off the con job of the century, for Gage instead of Kelly was standing at the base of the tower hooking wet lengths of hoseline to the rope hanging from a pulley atop the tower and hauling them up to Marco. Lopez hung the hose over the pegs on the rack running across the structure. "Lose a bet?" Roy inquired.
John snorted. "No. Chet is studying for the Engineer's exam." He bent and lifted another hose.
DeSoto raised his eyebrows. "You're helping Kelly?"
"I look at it this way," began Gage, straightening. He wiped his hands on the seat of his pants and scratched his head. "If Chet passes, he'll get transferred."
"Your altruism amazes me." Roy rested his arm against the tread of the ladder welded to the supports. He stared into the shadowed interior of the bay, recalling his performance on today's call. Uncomfortable, DeSoto shifted. "Johnny, about today..." he started.
Gage looped the last line over the hook and raised it into the air. "Roy, don't worry about it."
"I just kept thinking about Brice and Bellingham...." He stopped.
"Is that all?" called Lopez, stepping onto the ladder.
"Yeah, Marco." John walked around to the side of the tower, dragging the ends of the rope. The heavy metal hook escaped his grip. "Want to give me a hand?" he asked Roy, pointing.
Roy caught the rope and gently swung it toward John. He nodded to Marco as the firefighter walked past, headed back into the station.
"Thanks." Gage coiled the cord around the anchor. He leaned against the support pylon and looked at the roofs of the cars passing on the 405.
Roy sat on the metal mesh box, which sheltered the compressor used to test the lines. "I saw that woman in bed and..." His voice trailed off.
Johnny turned his attention from the highway and gazed at his feet, studying the ground. "You were afraid she had it. So was I."
"But you didn't freeze." DeSoto touched his tongue to his top lip and inhaled. "You just got right in there and did your -- our -- job."
"If I had any kind of sense, I would have hesitated too."
"I kept seeing Joanne and the kids." Roy stood up and paced nervously. "I've never worried about something from my job hurting them. Now..." He turned to face Johnny. "I could bring this home and -- kill them."
"There have been no cases among people using the protective gear while caring for patients."
"Using barrier nursing techniques in the hospital is a little different than trying to use them in the field." DeSoto stopped pacing and stood next to Gage.
John nodded. "True. But you're careful, Roy."
"I hope that's enough."
Captain Stanley stood just inside the apparatus bay, watching his two paramedics and trying to figure out how to break the news. He had just gotten off the phone with Jerry Beck over at 16's. Bob Bellingham was dead. Bellingham and DeSoto had trained together in that first paramedic class. Hank scrutinized Roy's tense features, knowing the man was deeply disturbed by the past weeks' events.
"Cap?" John studied the station officer standing in the shadows.
"What's happened?" asked Roy, his voice tight with alarm.
Stanley took a deep breath and shifted uncomfortably. "Uhh -- Bob Bellingham just died."
"Susan," whispered Roy, closing his eyes. When he opened them, he met Gage's concerned gaze. I hope you're right, he thought.
"The services will be on Monday." Hank cleared his throat awkwardly. "If you need to talk..."
"I'm fine Cap," replied Roy. Abruptly, he turned and walked into the station.
John looked at Hank and shook his head.
Gina adjusted her mask, pulled on her gloves, and picked up the medication tray. Beside her Susan Grey finished putting on her isolation garb.
"Looks like we got another patient," said Susan, nodding toward the gurney being wheeled over from the other wing -- the area used to quarantine the exposed but not yet ill.
Jones turned. The new victim was lying on her side, wrapped in a sheet, a mask covering her face. A lock of red hair had escaped from beneath the elastic band and hung across the woman's forehead. "Beth!" exclaimed Gina.
Susan took the tray from Jones' hands. "I'll take care of this. You get her settled in."
Jones pulled the thermometer out of Shaw's mouth. 104. Gina shook her head. Her friend kept one arm over her closed eyes.
Shaw had the fingers of her other hand tightly wrapped around the edge of an emesis basin. "Where's Craig?" Her voice was hoarse. Suddenly she closed her mouth and swallowed hard.
"He's next door." Gina peered closely at the ailing nurse. "Are you going to be sick?"
Beth gave a very slight shake of her head.
"He's resting better now." Reflecting, she decided that was not a lie, since Brice was sedated. Jones removed a bag of D5W and an infusion kit from the tray she was carrying. "Beth, I have to start an IV."
Shaw opened her eyes and glared balefully at Gina. "Did you wash your hands?" she insisted, groggily. She slid both arms beneath her sides.
Gina rolled her eyes. Nurses are the worst patients. But, the past few days had given her a certain expertise in dealing with the confused. "Yes, all washed," she reassured, holding up her hands, "and gloved."
Shaw squinted at Jones' upheld digits. "Fingernails?"
Jones turned her hands.
"Ok," she sighed, pulling an arm from beneath the sheet. Eyeing the foley kit on Gina's tray, Beth crossed her legs. "But any other tubes you might have in mind can wait until I'm unconscious."
"Around back," yelled the old woman, pointing down the brick driveway. Her arms fluttered in alarm.
Hank followed the woman behind the old frame house. The clutter of home renovation filled the back yard. His gaze followed the elder's pointing hand to a large wooden porch protruding from the back of the house. He stopped, abruptly and stared. Gage plowed into Stanley's back. "Watch where you're going, you twit," muttered Hank.
"Is this your house?" asked Stanley.
"Oh heavens, no. I'm their neighbor. They just bought the place and are fixing it up," commented the woman.
Hank nodded, taking in the improbable scene before him.
A woman sat, head and shoulders sticking up through the floor of the porch. She was berating a bearded man in a Harley t-shirt. He was lying on a chaise lounge with his arm draped across his forehead, making faint incoherent noises. "...Fat lot of good you are Nick! I could bleed to death and you'd lie there moaning."
A very young child approached DeSoto. "My mom fell through the floor."
The woman turned to the firefighters. "Thank goodness! I wouldn't have needed to bother you if my husband would've just brought me the circular saw."
"That's all right ma'am...."
"Mrs. Bell. That what we're here for," reassured Stanley.
John walked around the far side of the porch. He slid the drug box and the biophone on the wooden surface and bent to inspect the structure. The porch covered a sandy slope tilting away from the foundation of the house. A sheet of thin wood latticework surrounded the base.
Hank stood beside the porch and examined the hole the woman had fallen through. He turned. "Chet, get the K-12."
Roy eyed the old clapboard flooring. The many layers of old paint concealed but did not completely hide the effects of decades of neglect. "Let's check you out," he said, gingerly easing across the flooring to the woman's side. "Where do you hurt?"
"My left leg and my -- uh," she answered, looking meaningfully at the child.
"I understand," grinned DeSoto.
Gage looked at the husband. "Can we pull this off?" he asked pointing to the lattice.
The man moaned, "Oh dear...."
"Go ahead," called Bell. "It's ugly as sin, anyway."
Roy chuckled as he wrapped the blood pressure cuff around the Bell's arm.
Johnny grabbed a hammer from the pile of tools and began prying away the wood.
"Got it, Cap," said Chet, setting the K-12 on the ground and putting on the face shield.
Hank nodded his acknowledgement.
Bell looked up at Stanley as DeSoto measured her b.p. "I guess the porch should've been number one on the home repair list, not number two."
"I guess so." Hank surveyed the stacks of lumber spread throughout the yard. "Mike," he called, pointing to a pile of plywood sheets, "let's grab a couple of those and take some of the weight off these rotten boards."
Gage pulled the last few inches of the lattice free. Marco reached past his shoulder and helped lift the obstruction. Lying on his belly, Johnny squirmed under the floor. The dry earth was cool against his arms. The sound of the Hank and Mike dropping sheets of plywood into place echoed in the confined space. Bell was sitting on the ground, surrounded by pieces of broken clapboard. Several fragments jabbed into her thigh, however none seemed to have penetrated the skin. Deep ruts traced her path through the soft dirt. John could clearly see how she had gotten in such an unlikely position. When Bell had broken through the flooring, the soft earth had subsided, sweeping her feet out from under her and pinning her against the debris.
"Ma'am, I'm going to touch you." He traced his hands along her legs, feeling a suspicious swelling on her left calf.
Bell drew a sharp breath between her teeth as John touched her leg.
"Roy!" yelled Johnny, checking his hands for blood, "I have a possible tib-fib fracture. I'm gonna need a splint."
"Ok," replied DeSoto, looking up from the patient care sheet he was completing. "Marco, can you please get that for me."
"Cap," called Gage, "We're gonna need to cut at least four feet in front of her. Be real careful; some of these boards are sticking her."
"Ok," responded Stanley. He gestured for Kelly to begin cutting, pointing to a spot well beyond Kathy's feet. The firefighter started the saw.
At the sound of the K-12, Nick resumed his moaning.
The woman glanced at Roy. "I think you'd better check him, too."
"What happened?" asked the paramedic.
The child touched DeSoto's shoulder. "Daddy fell down."
"He -- uh -- fainted."
Roy struggled not to giggle as he faced the burly man. "I understand you're not feeling very well...." he began.
Gage watched the saw blade burst through the wood and begin cutting. Over the sound of the K-12, he could hear Roy talking to Rampart. He held tightly onto the board pressing against the woman's thigh. The wood jerked beneath his hand as the saw severed it. Grunting from the effort, he tossed it aside and carefully inspected the leg for further damage. "Ok! Stop!" Kelly and Stoker removed the remaining debris.
"That's so much better, thank you," said Kathy.
"John," called Lopez holding out the splint.
"Thanks, Marco." Johnny twisted, reaching back for the cardboard splint and adhesive tape. Gently he slid the support underneath the woman's leg and folded up the sides, taping the splint in place. "Cap, go ahead lift her out."
"Ok," answered Stanley, kneeling on the plywood sheet. He looped one arm under Bell's shoulder and other beneath her knees. "Stoker, get the other side. Kelly, you take her legs."
"Watch that left leg," warned Gage.
"Bring her forward a little, Mike," murmured Stanley, lifting. "Ok, now over toward me." The firefighters raised the woman above the broken flooring and placed her on the plywood beside the hole.
"Thank you." Kathy turned toward her husband, who was still being examined. "Nick? How is he?" she asked, looking at DeSoto.
"I can't find anything wrong, but we'll take him in with you. Just to be safe." Roy closed the biophone. "Cap, you wanna get her on the gurney."
Johnny scrambled clear of the porch. "Roy, you need me to get a Stokes?"
"No, I think he can walk."
"Ok," said John, brushing the loose dirt from his pants. He picked up the drug box and radio. "I'll bring in the squad."
John dunked the damp paper towel into the trashcan behind the stool at the nurse's station. He grinned as the paper flew over Dixie's head, bounced off the counter and into the metal can. McCall glared at Gage. "Hi, Dix," he said sheepishly.
"Morning Johnny." She began filling out a lab request form.
Raising his head, Roy glanced up from the supply requisition. "If you're done, you want to grab a few of these," he directed, handing the list to his partner.
"Sure," said Gage, rubbing his nose and reading the list. He took the key from Dixie's outstretched hand and began to pull wrapped medical supplies from the drawers. "Hey, Dix how's Mrs. Bell?"
"She's fine. They're taking her down to x-ray right now."
"Mr. Bell?" asked Roy, glancing up at the nurse. His blue eyes twinkled.
"Joe's in with him now. I think he's in worse shape than she is."
John chuckled. "Dix, pre-fills of epi?"
"They're right where they've always been. If they were a snake, they would bite you."
Johnny grimaced. "Oh, here they are." He dropped the packages into the cardboard box, closed the drawer and locked it. Sighing, Gage leaned back against the counter. "How's Brice?"
"Morton put him on a vent."
Roy inhaled sharply.
"He's critical." McCall set down the pen and closed her eyes.
"Anyone else sick?" asked John.
Dixie opened her eyes, meeting Roy's concerned gaze. "A bunch of my nurses. And Dr. Frances died during the night."
"Wow," breathed Gage.
DeSoto bowed his head. "I'm sorry." He paused. "How's Bellingham's wife?"
"About as well as can be expected."
"She wasn't exposed was she..." started Johnny. He fidgeted with a bag of Ringer's lactate.
"No, she was visiting family." McCall picked up the pen.
Roy shifted uncomfortably. "Dixie, what about the girl we brought in yesterday..." His voice trailed off.
"I was going to call you. The immunofluorescence tests are negative. She doesn't have it."
Roy gave a sigh of relief. "That's good."
"It's the only thing that is this morning."
Roy stood in the station shower, letting the hot water cascade though his hair and down his back. Warm soapy water swirled around and over his feet.
"See ya Tuesday," called Johnny, slamming his locker door.
"Take care," he replied, watching the suds whirl down the drain.
"Hey, Gage," hailed Chet. "You still going hiking tomorrow?"
"Yeap and nope."
"Yes, I'm goin' hiking. And, no, you can't come." The locker room door swung, sending a breath of cold air into the shower and muffling Johnny's voice.
"Gage, watch out for snakes." Kelly closed his locker.
"Ha. Ha," shouted John.
The door opened blowing another cold gust over DeSoto. "Go home and let the real firemen run the station now."
"Real fireman?" Kelly laughed. "Is that what that new wife of yours calls you, Josh?"
"Bye, Kelly." The B-shift fireman's voice disappeared into the dorm.
Chet paused in the door. "Later, Roy."
"Bye, Chet." DeSoto rubbed the bar of soap between his hands and again smeared the lather up his arms, over his chest and down his legs. As he bent over he remembered the face of the young woman, pinched with her struggles to breathe, and kept imagining Joanne or the kids stricken by this disease. Get a grip, DeSoto. They'll lick this thing; the docs will find a cure. Still the ice lump remained lodged in his stomach, refusing to melt in the hot water.
Savagely, he turned off the water. Enough, he decided, wrapping a towel around his waist and stepping from the shower. He caught sight of his uniform, lying on the bench, crumbled and soiled. Still... He shoved the garment into his bag, vowing to drop it off at the cleaners.
Dixie leaned against the door of the staff lounge, trying to hold back the chaos and terror she imagined beating at the wooden panel. The ER was a mad house and her replacement was two hours late. Ten new cases of the virus had been admitted and the waiting room was full of frightened people with headaches and sick stomachs, all of whom had seen the evermore alarming news broadcasts about the virus. Their panic had been leaking through the whole department and was now lapping at her shoes. McCall had been running since she had arrived. Joe had finally ordered her to take a fifteen-minute break. Taking a deep breath she straightened and stepped away from the door.
McCall dropped onto the hard vinyl sofa. Sighing, she kicked off her shoes and reached down massaging her aching feet. Dixie leaned back and closed her eyes. The thin blue fabric of the surgical scrubs wrinkled behind her back. Opening her eyes she stared wistfully at the coffeepot. In a few minutes she would get up, go in and check on how Dr Early was doing with Karen Wolfe, who was in exam 3 unconscious and in shock.
The door opened and a student nurse leaned her head in. The student's blue apron was limp. "Miss McCall, Sharon's found Mrs. Harper," announced the young woman, naming the evening shift head nurse. "She's in St. Francis."
Dixie pushed herself upright. "She has it?" A chill ran up her spine.
The student nurse nodded. She hesitated, open-mouthed, clearly uncertain about further disturbing the older woman.
"What is it?"
"We're almost out of emesis basins."
Dixie pulled on her shoes. "Well, call central service and don't just stand there," she snapped, taking her nervousness out on the young woman. McCall stood up.
The youngster scurried for the phone.
McCall stepped into the hallway. The commotion surrounded her like a freezing river.
Kel Bracket gestured from the base station. "Dix, 51 is bringing in another possible meningitis case."
She looked down the hall at the three treatment rooms with carts of isolation gear sitting outside. All but one were occupied. "Exam 2 is available."
The dark-haired doctor nodded.
Dixie stood next to one of the carts, pulling on a gown and gloves. She held the mask in her hands and walked toward receiving. Through the glass panes on the tops of the swinging doors, she could see the ambulance backing up to the entrance. The squad waited under the west wing for the driver to complete his maneuver. The cool shadows of the overhanging roof surrounded the back of the rig. One of the attendants hopped out, wearing a disposable paper gown, gloves, a mask, and a nervous expression. As the rear doors opened he reached in and pulled the foot of the stretcher free. Slipping on her mask, Dixie stepped into the afternoon heat and took hold of the gurney.
"You're here late," observed paramedic Aline Tsinhnajinnie, climbing down from the back bumper. Her face was covered by a mask. The dark brown haired woman straightened from the stoop-shouldered crouch forced on her by the low ceiling of the ambulance. Her hands never faltered as she squeezed the bag, ventilating her patient.
Dixie took the bag of IV solution and walked along beside the litter. Nodding toward her patient, Tsinhnajinnie said, "She had a seizure in transport, duration about 2 minutes."
Dixie looked at the woman lying unmoving and unresponsive on the stretcher. The sweat soaked her brown hair. Despite the O2, the woman's color was poor.
"We administered 5mg Ativan, IV push."
McCall pushed the treatment room door open with her hip.
"Last set of vitals, taken two minutes ago, are: Rate 100; bp 90/40; respirations 26 and shallow, we are assisting ventilation; temp 105.6; pupils equal and responsive but sluggish." reported Tsinhnajinnie, ducking beneath the tubing as McCall fitted the bag of fluids onto the IV stand. A nurse stepped forward and took over from the paramedic. Aline flexed her stiffening hand, then tore off the MICU form and handed it to Dr. Brackett. "Her name is Cindi."
The doctor studied the paper. "How long has she been ill?"
Tsinhnajinnie shrugged. "Roommate came back from a week of camping and found her on the floor of the bathroom. No idea how long she'd been there."
"Dixie, draw blood for a CBC, SMA 20 and culture. Urinalysis and culture. Set up for a lumbar puncture."
"Need me anymore?" asked the paramedic, standing by trashcan getting ready to remove her isolation gear.
Shaking his head, Brackett placed the stethoscope in his ears and listened to the woman's chest. "Let's get a chest x-ray and...."
Quickly Aline stripped off her gown, gloves and mask.
"Mark, I know this isn't Zaire," said Dana, balancing on one foot in her hotel room, while pulling the shoe off her other foot and holding phone clamped against her ear. "But, it's not a bio-containment lab in the CDC either."
"What'd you want Dana?"
Nuefeld's sigh was audible over the phone line. "How about something I have."
"Some trained hands, we have routine clinical laboratory needs." Swenson straightened and unfastened the collar of her blouse and the waistband of her skirt, letting the skirt drop to the floor revealing her slip. "I've already got one tech in quarantine after cutting himself on a sharp. Bloodwork is stacking up -- nobody wants to touch the stuff." She kicked the dirty clothes into a corner. "Not that I blame them."
"How are things otherwise?" He hesitated. "You sound tired."
"We'd six new cases today. I spent the entire day interviewing very sick, very confused patients." Swenson sprawled across the bed. "And I put thirty-one more people in isolation."
"I saw the wire."
"Mark, it feels like world's coming to an end."
DeSoto drew great gasping breaths. Open mouthed he stared into the darkness, trying to figure out where he was. Someone held his wrists and shook him. Roy's hands were wrapped around an imaginary ambu bag. Joanne's white face swam into focus.
"Roy?" she repeated.
"Joanne?" DeSoto's t-shirt and shorts clung to his flesh. He shivered.
"Shhh... It was just a dream." Joanne gathered her husband into her arms. After all the years of marriage to a paramedic she didn't ask, knowing sometimes the ugliness of his work visited during the night. He wouldn't speak, refusing to allow that part of his life into their bed. So she just held him.
Slowly Roy relaxed. He pressed his head against her chest, listening to her easy clear breaths, feeling her heart beating against his cheek. "Joanne," he murmured stroking her breast.
Tsinhnajinnie poured water into the battery and carefully drew a sample of the electrolyte into the tester. The brightly colored balls floating inside the tube caught a flash of light from a passing car. She wrinkled her nose at the acrid odor of the solution.
DeSoto walked into the back of the apparatus bay from the parking lot. The squad's hood was raised and the large red tool chest stood between the Engine and the smaller vehicle. A portion of the dark blue clad leg of his C-shift counterpart was just visible past the front panel. "Bert," hailed Roy, shouldering the hangers holding his freshly laundered uniforms.
Aline craned her neck and looked out from behind the hood. "Good morning, Roy."
"Sorry. Morning Aline." He walked toward the front of the bay. "Thought you were Dwyer..."
She squirted the acid back into the battery. "Never ask a boy to do a man's job; ask a woman if you want it done right." Dwyer's ineptitude with matters of motor vehicle maintenance was a department legend.
Roy snorted. Lowering his shirts and leaning against the engine, he watched Tsinhnajinnie screw the caps back onto the battery. The woman's strong brown hands were quick and competent. "You're depriving me of hours of amusement obtained watching Johnny try to retrieve those," he said, pointing with his chin, "from the depths of the engine."
Laughing, Aline slammed shut the hood and wiped her hands on a rag.
"Mornin'. Mornin'. Mornin'," called Gage, strolling in from the day room. He dropped his duffel bag onto the floor, next to Roy's feet and hooked his thumbs in the belt loops of his jeans. He grinned at the woman.
"Morning, Johnny," replied Roy. His partner's bullet-proof good spirits amazed him, Gage did not seem concerned by the spreading virus. Ever since the briefing several days before, DeSoto had been on edge.
Tsinhnajinnie nodded her greeting.
"Heard anything more about Brice?" asked Gage, scratching his nose. His expression grew solemn.
Aline frowned. "He's still critical, but the doctors are guardedly optimistic."
Roy bit his lip. "Anybody else got it?"
She bowed her head. "Karen Wolfe, Carl Darcy and Erik Ross, the engineer from 16's."
John whistled softly. "That both of the paramedics on B-shift at 45's and one from 110's." He looked at Roy.
DeSoto pursed his lips and exhaled slowly.
"How are they?"
Shrugging, Tsinhnajinnie tossed the rag into the trash. "Carl and Erik are pretty sick. And, Karen is real bad. They're not expecting her to survive the day."
"That's fast," whispered Roy.
"What I've seen of this, I'd rather go fast than slow." Aline turned and headed into the dorm.
"We'd better get changed," said Johnny.
Roy stared at the gold printing on the door of the squad. He kept imagining Joanne gasping for air, infected by his carelessness.
Gage elbowed DeSoto.
"What?" mumbled Roy, shaking his head.
"We'd better get dressed before role call."
Dana knocked on the door the of the small garage apartment. The rickety brown wooden porch was mushy under her feet and loud music leaked through the door. "Hello," she repeated loudly, pounding on the door.
The door opened and waves of punk rock music blasted past. "Oh, hi," answered a slender college-age woman, diving for the volume control. The young woman was dressed in a skin-tight black t-shirt and ripped jeans. A complicated, metal studded black leather harness ran from just below her breasts to her neck where it ended in a thick spiked choker. Two metal diaper pins had been thrust through the holes in the girl's pierced ears in place of earrings. "Can I help you?"
"I hope so." Dana showed the woman her ID. "I'm Dr. Dana Swenson from the Centers for Disease Control. Are you Melody-Jane Preston?"
"Yes, I'm MJ," answered Preston, eyeing Swenson nervously. She ran her hand over her spiked purple and black hair. "Is this about Cindi?"
"Yes, it is. May I come in?"
MJ stepped back slowly, gesturing for the doctor to enter. "Sit down," she said, offering Dana one of a pair chipped white painted chair. She straddled the other, resting her folded arms over the back. "They say she is very sick. But they won't tell me much, 'cause I'm not family."
"She is quite ill," nodded Swenson. "We need to know more about how she got sick."
Preston shrugged. "I was camping all last week with my boyfriend. She was already sick when I got home. She had thrown up all over the place." MJ nodded her head toward a cramped bathroom. "Big mess. At first I thought she had been partying, you know." She looked a Swenson, seeing if the older woman understood.
Dana nodded. How did you avoid being quarantined? she asked herself, watching MJ pick at her black painted nails. "You two are students at the university?"
"What are you studying?"
"Literature. Cindi is studying sign language."
Dana smiled. "Interesting." She chatted, getting Preston to relax. After a few moments, she shifted slightly on the chair. "Do you know if any of Cindi's friends have been sick recently."
"Not that I know of."
"Has she been anywhere? Out of the country maybe?"
"Cindi?" Preston laughed slightly. "Her family's poor folks, roustabouts from Texas. They live somewhere around Bakersfield." She turned and studied a poster promoting a record, showing a pair of children poking a pile of green jello and bearing the title Human Sexual Response. "She's never gone anywhere."
Glancing up from her notebook, Swenson saw Preston's façade in a new light. Despite the rumpled exterior and squalid surroundings, the girl was unmistakably a child of wealth and privilege. "No travel?"
"Does she have a job?"
"Yeah, works afternoons in Long Beach."
Dana lifted her head. "Do you know where?"
"I don't know." Preston frowned. "All I know is, she takes clothes to change into."
"Do you know what she does?"
MJ shook her head, suddenly embarrassed by her lack of knowledge. "She pays her half of the rent." Preston stood.
Closing her notebook, Swenson nodded. "Ms. Preston, I need you to come to Rampart."
"We need to do some blood tests and have the doctors check you out?"
MJ paled and backed away from the epidemiologist. "Why? I'm not sick." Her voice shook.
Dana smiled reassuringly. "It's just a precaution."
"No," declared Preston.
Sighing, Swenson placed her hand on the young woman's arm. "Ms. Preston you need to come with me. This is really for your own protection."
MJ pulled away. "What if I don't?" she demanded, moving toward the phone.
"Then I'll call the Health Department and they'll get a court order."
"You can't do that. My dad's a lawyer. I have my rights." Preston picked up the receiver.
"Go ahead and call him," advised Swenson, coolly. "He'll tell you that during a public health emergency the courts can and will issue such an order."
The young woman's defiance withered. She visibly wilted. "Let me get my purse," she said, quietly.
"Take a deep breath," urged the voice.
Brice tried to sink back into sleep. Hands pulled him onto his side and rested on his face. His head throbbed.
"Come on Brice, take a deep breath."
Groggily, he identified the voice as Mike Morton's. Leave me alone. He was supported in a semi-Fowler's position and a pair of hands continued to hold his shoulders. Craig inhaled, just to silence the annoying doctor. A tearing pain in his throat rewarded his efforts. He gagged.
Morton dropped the used ET into the biohazard bag and watched the paramedic gasp and retch. He waited for Craig's breathing to steady.
Brice pried his eyelids open and glared at the doctor.
Over his mask, Morton's eyes crinkled with a smile. "Check his vital signs every 15 minutes for the next hour. Watch his O2 sat."
"Yes, doctor," replied Mary, rolling Craig on his back, wiping his mouth and sliding an oxygen mask over his head. The nurse positioned pillows to support the sick man. "Better?"
Brice tried to nod, but was too weak to move his head. Against his will his eyes closed, leaving his questions unanswered.
The CDC epidemiologist looked at Mike. "Let's do another round of bloodwork."
"No," started Swenson, shifting, "I'm hoping we'll find a clue as to why he has survived so long." She looked down at Brice.
Wearily, Morton nodded.
In the dimly lit apparatus bay a faint rhythmic clicking bounced off the walls. Out of the shadows behind the engine emerged Henry, on his covert nocturnal rounds of the station. At the passenger side of the squad he stopped, sniffing at the dark jacket hanging from the mirror. Delicately, he inserted his muzzle into the pocket and licked a few cookie crumbs from the seams. Satisfied he padded back into the dayroom.
Abruptly the lights snapped on and the tones echoed through the large room. "Station 51, Engine 105, Truck 45. Automatic fire alarm. Educational Resources Building, CSU Dominguez Hills, 1 - 0 - 0 - 0 East Victoria Street. Use main entrance...."
The dorm door flew open and the crew spilled into the apparatus bay.
"1 - 0 - 0 - 0 East Victoria," repeated the dispatcher.
"Station 51, 10-4. KMG 365," acknowledged Stanley.
Gage pulled on his jacket and climbed into the squad. He grimaced as his hand encountered the wet interior of his pocket.
Stoker slowed slightly, gripping the steering wheel more tightly as the engine jolted over the low speed bumps separating the campus drive from the main road. A university police car waited just beyond the heavy bronze sign, lights flashing. The cop leaned out his open window. "The library is on fire," he yelled. "Follow me!" The cruiser pulled out in front of the rig, leading the way.
"Ok," replied Hank, rapidly surveying the scene through the windshield. People milled around the building. Smoke rose from the vents on the roof of a large glass and brick structure built halfway into the hillside. A three-story colonnade with narrow white metal pillars ringed the structure. Quickly Stanley counted floors and examined the edges of concrete slab decks visible at the bases of the windows. He eyed the lightweight roof and the arched atrium bisecting the library suspiciously. The architectural style reminded him of cross between a Roman villa and a Japanese temple. In the early morning gloom, the interior lights flickered before going out, revealing a thick pall of smoke hanging behind the floor to ceiling second floor windows.
Stanley lifted the microphone. "LA. Station 51 on scene. We have a three-story building with smoke showing. Respond a second alarm assignment and an additional squad."
"10-4, Station 51."
Mike looked into the sideview mirror, watching Marco leap from the jump seat as he braked to a stop by the fire hydrant. Lopez grabbed the four way, a hydrant wrench and the end of the suction hose. He dragged the line to the fireplug and braced it against the base with his foot. Waving his arm over his head, Marco gestured to the engineer. Stoker acknowledged the signal and nudged the engine into gear. Hose streamed out behind the rig.
An arpeggio of callout tones burst from the radio. "10-4, 51. Station 127, Engine 36, Squad 16 in place of Squad 36, and Battalion 14...."
Mike parked just short of the building and Roy drove the squad past the engine, stopping beyond the range of falling glass or masonry. As Stoker climbed from the rig, he could see the paramedics yanking their gear from the side compartments. Over the dying scream of the squad's sirens, the sprinkler system's water gong clanged. "Cap, we got active sprinklers," he called as Stanley sprinted by hose clamp in hand.
"Yeap," agreed Stanley, securing the jaws of the clamp over the hose. "Charge the line!" Straightening and turning toward the man at the hydrant, the officer sketched a circle with his fist in the air overhead.
Mike bent picking up the end of the suction hose. Expertly he twirled the couplings together and waved to Stanley. The canvas umbilical stiffened, feeding the pump.
Johnny trotted over, tightening the straps of his SCBA. Roy followed more slowly, studying the structure. A young man in a pair of beige coveralls broke away from the crowd. Soot streaked his face and gathered in black smears beneath his nose. He grabbed John's arm. "I can't find her!" He drew great gasping breaths.
"What? Is someone in there?" demanded Gage, holding both of the man's elbows.
The man nodded.
"Cap!" yelled John.
Hank walked over. "What'd ya got?"
Gage stared into the man's eyes. "Where did you last see her?"
"Second floor hall," he panted. "Too hot, couldn't find..." His knees folded.
Roy caught the man as he fell, easing the limp form to the ground. DeSoto pressed his fingers against the man's neck. "Marco, get the O2," he ordered.
Hank looked at Johnny, who stood bouncing eagerly on the balls of his feet, and then glanced toward the engine. Chet was reaching into the hosebed, pulling a stack of hose onto his shoulder. "Kelly!" he called, waving to the firefighter. "Gage, you and Kelly make a sweep of the third floor." Stanley held up his hand. "Gimme a report when you get in there."
Gage walked rapidly toward the building, pulling on his gloves and wrapping a length of rope around his waist. Kelly followed the paramedic.
"Be careful!" Stanley called after them. He turned to the police officer. "Could there be more people in there?"
The cop shrugged. "Library opens at seven. Building is unlocked at five." He pointed to far end of the structure. "There are classrooms and study areas."
Hank looked at his watch. 6:10 am, he read. "Are classes in session?"
"Summer school. It's finals week."
Staring up at the darkened building, the older man bit his lip. Kids studying. "Ok, try and find out if anybody else is missing," he ordered. He lifted his radio. "Truck 45..."
Gage stepped through the electric sliding door and reached up disabling the mechanism. The high arched ceiling of the lobby was concealed by smoke. Gray plumes leaked from ventilating grates along the wall. The bottom edge of a huge abstract painting was barely visible beneath the gathering cloud, the splashes of bright colors muted by the haze. Water cascaded from the open second floor gallery, pooling on the textured tile floor. The fire alarm wailed.
"Cap," started John, holding the radio close to his mask, "this is HT 51. We've got activated sprinklers on the east end of the second floor and heavy smoke." He looked at the air conditioning vents. "We need to get the building engineer in here, to shut off the AC." Behind him, Kelly was inspecting the pair of elevators sitting inert and dark, with their doors open.
"10-4, HT 51," answered Stanley, his voice distorted by the radio.
"Johnny," called Chet, nodding to three plexiglass covered floor plans fastened to the wall beside the elevators.
Gage leaned over Kelly's shoulder memorizing the layouts. "Stairs," he said, pointing and walking.
When Chet opened the second floor door, waves of heat and smoke shoved him against the floor. He edged onto the walkway overlooking the ground floor lobby. Long cloth banners dangled from the ceiling, flapping in the breath of the fire, their heavy fabric shrinking and scorching in the heat. John pushed past him, feeding out the long lifeline that would lead them back to this door. Kelly wrapped his fingers around the rope, feeling the rough spiral of the twisted fibers through his glove.
"Along the walls first," instructed Gage, his voice muffled by the SCBA. He kept his shoulder against wall, scrambling toward the stacks.
Johnny crawled through the door. Blackness engulfed him, the room was a maze of table legs, chairs and shelves. He followed a row of shelves, bumping into invisible obstructions. He reached out sweeping his arms along the floor, feeling for the soft body of a fallen victim. Fierce heat pressed down on his back, finding the back of his neck despite the heavy turnout collar. Behind him he could hear Kelly babbling and fumbling through the darkness.
"Gage, it's getting too hot," Chet cautioned.
John watched a flicker of deep red light ripple across the wall of smoke and disappear. The seat of the fire was just ahead of them. "Yeah, just a couple more feet." He inched forward, hands outstretched. The tips of his fingers touched something soft and yielding. "I got her," he cried.
"Good, let's get outta here."
Unable to stand in the killing heat, Johnny pulled a length of nylon web from his pocket and passed it beneath the unconscious woman's armpits. Tugging on the improvised harness, he dragged the woman to safety.
"Roy," called Johnny, trotting toward DeSoto, carrying the limp body of a slender woman. Her long hair flapped against his legs. Kneeling, Gage set the woman on the yellow plastic sheets Roy had spread on parking lot.
DeSoto quickly examined the woman, her chest heaved rapidly as she gasped and choked. Her eyes and nose streamed, and soot streaked her tongue. Deftly, Roy slipped an oxygen mask over the woman's mouth and began take the woman's vital signs.
John pushed back his mask, closing the valve as he did so. "She took a lot of smoke. It's really bad in there."
DeSoto glanced up at his partner. Gage's face was ashen from lack of sleep and his eyes glittered with the adrenaline rush of the fire.
"Roy, do you need him?" yelled Stanley, pointing to Gage.
"No, Cap. I can manage," he answered.
"John, we need some people to search the third floor class rooms."
" 'k, Cap," replied Johnny, checking the pressure gauge on his SCBA and climbing to his feet.
On his hands and knees, Johnny traced the edge of his palm along the base the bookshelves, counting the number of rows he passed. His every sense was dulled. The heavy gloves blunted the edges of the metal corners as they passed beneath his fingers. The hot darkness was total, he felt rather than saw the smoke veiled wall ahead. The hiss of his breathing echoed in the SCBA mask and drowned out other sounds. Sweat pooled against the rubber seal under his chin. Kelly was crouched a couple of yards behind him. As Gage advanced, he tried to relate the maze he was crawling through to his memory of the laminated floor plans.
"Gage, you sure you know where you're going?" asked Chet, from his position behind John's feet.
"Yes," snapped Johnny, grimacing. His shoulder bumped against the partition separating the row of tiny offices from the stacks. He scrambled a few feet further, hunting for the first of the half dozen rooms shown on the blueprints. "The offices are right up here." The guideline around his waist tightened briefly as Kelly pinned the line against the floor with his knee, pulling him off balance. The fireman then plowed into him. "Chet! Watch what you're doin."
"Sorry." Chet swept his arm along the base of the bookshelves, feeling for unconscious victims. "Sheesh, what's with you today? Get up on the wrong side of the bed?"
"No, I gotta to work with you." Gage located the door and pressed his hand against the wooden panel. "Cool," he commented, rising up on his knees and trying the knob. The heat engulfed him. "But locked."
Kelly crawled alongside Gage and probed the latch. "Move." Johnny rolled away and crouched out of reach of the flames, in the event a smoldering fire flared to life when the door was released. Expertly, Chet sunk the head of his axe into the jamb and pried. The flimsy lock snapped.
Cautiously John opened the door. Inside the air was clearer, pale gray patches appeared by the windows. "Hello?" yelled Gage, circling the desk in the middle of the room, groping and listening. Piles of books and papers littered the floor. In the gloom, his elbow brushed something soft and yielding. A huge stack of magazines balanced precariously on a chair, collapsed noisily and slick volumes rained down on him. "Ugh!"
"Johnny?" called Kelly, listening for his colleague's movements.
"I'm ok. Just knocked somethin' over." Gage emerged from the tiny cubical. "This place is a mess." The paramedic's voice was laced with disgust. He pulled a thick piece of chalk from his pocket and marked a large X on the door.
Chet snorted and followed John along the wall.
Kelly wedged the heavy firedoor open, preventing it from closing and blocking their escape route. Beyond the air was clearer and cooler. He could actually see most of the way down the hall. Behind him he could hear the roar of the fire. The atrium was lined on each floor by railed open walkways, which linked the halves of the building. Striking as the design was, it acted like a chimney. Punishing waves of heat and smoke roiled up from below. The trek from one wing of the library to the other had been an ear singeing, nearly unbearable experience. Chet knelt taking a couple deep breaths before standing. He groaned softly, Johnny was already up and working his way toward the end of the hall. Kelly climbed to his feet.
At the entrance to the next room, John paused, slowing his breathing. "Ready?" he asked. Perspiration soaked his entire body, pooling against the waist straps of his airpack and inside his boots. The superheated air was making him lightheaded.
"Yeah," nodded Kelly heading for the door across the hall.
Johnny laid his gloved hand on the panel. A wave of dizziness passed over him. I need some water, when I get outta here. The small classroom was empty of everything save ranks of desks and a veil of low hanging smoke. He slashed the chalk across the door.
"It's really hot in here," grumbled Chet, checking his air gauge and trotting after John. A loud crash reverberated through the hall. Kelly turned.
Gage reached for the door. His outstretched arm dimmed and blurred. Gray spots whirled at the edges of his vision. John blinked. Too hot, gotta get down, he thought, vaguely. The floor trembled nauseatingly beneath Johnny's feet.
Chet looked through the open firedoor. In the atrium the air was clearing and the soot stained walls on the opposite side of the building were slowly materializing out of the haze. Smoke spiraled up and out of a pair shattered skylights. "They're ventilating," he remarked, turning his attention back to the search.
John sat on the floor, propped up on one arm. He shook his head.
"Johnny!" exclaimed Kelly, dropping to his knees beside Gage. The paramedic's faceplate was slightly fogged; behind the air mask his face was pale and his expression strained. "Gage!"
" 'M ok," panted John. He braced his shoulder against the wall and staggered to his feet. Swaying he pushed away from the wall. Sweat trickled along his scalp.
Kelly grabbed Gage's arm and pulled it over his shoulder. "Gotten soft as a paramedic?" Johnny leaned heavily on him, frightening Chet. He wrapped his fingers around the waistband of John's SBCA, supporting the woozy paramedic.
Gage opened his mouth to reply, then closed it abruptly. He swallowed hard, battling his rebellious stomach into submission.
Chet peered into his face, frowning. "Let's get you outta here, before I have to carry you."
A cool hand rested on Craig's forehead, smoothing back his limp hair. Dixie stood beside his bed, her eyes exactly matching the blue of her isolation garb. "Miss McCall." The woman's name emerged from his throat as weak moan. He swallowed, causing the oxygen mask to shift uncomfortably on his face.
"Shh," she whispered. Dixie had come to work early to visit her nurses and paramedics before her shift started.
Stiffly Brice turned his head, forcing himself to ignore the vertigo that washed over him as he moved. Instead of seeing Bob lying motionless and ill, he saw folded sheets. "Bob? Where?" Gasping for breath he fell silent.
Dixie turned her head, staring at his IV.
"Nurse McCall," he wheezed, trying to grab her hand.
"He died several days ago," she replied, slowly.
Craig closed his eyes.
"His kidneys failed and he developed congestive heart failure."
An image of Bellingham's wife standing in the station parking lot -- holding Bob's hand to her swelling belly and his partner smiling as the baby kicked against his fingers -- floated before him. Brice could see the unborn child pointing at him, blaming him.
A jolt of panic shoot through Brice, McCall never used his first name. "Beth?" He struggled to rise; his head lifted a bare inch off the pillow.
Dixie pushed the paramedic back down. "Lie still! Yes, she's sick, but she's strong."
"So was Bob."
"She was in quarantine when she got sick." The nurse began to stroke Craig's hair, trying to get him to relax. "We started treatment immediately..."
"Good supportive care, Brice," she corrected. "It makes a difference."
Beth! Tears welled up behind Craig's closed eyelids. He brushed away the humiliation he felt at his own weakness.
"Dixie," called Brice.
"Anybody else sick?"
Reluctantly she nodded. "Carlos Hernadez, Erik Ross..."
Brice bit his lip as she named his colleagues from 16's.
"...Kel Clarke, Karen Wolfe, Carl Darcy, Martin Wu and seventeen civilians."
Craig closed his eyes wondering how many deaths for which he would bear ultimate responsibility. He whispered, "Dixie, I want to be alone."
"Ok." She looked back at the young firefighter. "Craig, the best thing you can do for her -- for them -- is to get well yourself."
Roy looked away from the red-streaked horizon and down at Captain Smit. The stocky brown-haired woman sat on the running boards of Engine 51, holding the oxygen mask against her mouth. Her face was blackened with soot and thin tracks trailed down sides of her cheeks, tracing back to her red, watery eyes. She was no longer gasping for air; her respiratory distress was easing. "How ya doin', Cap?" asked DeSoto, placing his hand on her shoulder.
"Ok," she rasped, pulling the mask from her face. "Got to get back out there. Hank needs me."
Roy pushed her back down, startled by the force he had to apply to get her seated again. The woman was a department legend. First female firefighter in Perth, Australia, she had arrived in LA on the heels of a court order requiring the county begin hiring women. She had promptly applied and become one of the few females in the department. Smit had been the first woman DeSoto had ever seen haul hose. His budding feminist of a daughter gave him endless grief over his professed surprise upon seeing Smit set down a victim and push back her SCBA mask to reveal a woman's face. He met Smit's determined eyes, " 'fraid you're gonna have to sit the rest of this one out, Cap. Department policy."
"Bloody," sighed the woman.
DeSoto looked up to see Kelly staggering toward him half supporting, half carrying Gage. Roy ran toward the two men. He pulled his partner's other arm over his shoulder and helped him toward the triage area. John's mask was dangling around his neck, his face was pale and damp, and he kept squinting confusedly at his surroundings.
"I just got a little dizzy. I'm ok," protested Johnny, weakly.
"What happened?" demanded Roy, looking at Chet while easing John down on the yellow plastic blanket, covering a patch of the parking lot. He turned his attention to Gage, "Lie down."
"I'm ok," Johnny protested. Nevertheless he let himself be seated on the ground, hoping the hovering DeSoto would stop spinning. He closed his eyes.
"We were doin' a sweep. I looked back and my able assistant is on his butt on the floor." Chet pointed over his shoulder to the burning structure. "It's pretty hot in there."
"Kelly!" yelled Stanley.
"You need me anymore, Roy?"
"No, thanks. I think I got it," he answered, unfastening the straps on his partner's SCBA, removing the heavy tank.
"Hang in there, Gage." Chet adjusted the harness on his airpack, reseating the load on his shoulders. He ran toward the engine.
John opened his eyes and waved to Chet.
DeSoto turned back to his reluctant patient and gestured toward Johnny's turnout. "Let's get that off. What happened?" Roy watched John's face carefully while helping him remove his coat. The white undershirt beneath was soaked with sweat. "T-shirt too." He pointedly ignored Johnny's glare.
Stiffly, John stripped off his shirt. Roy's face swum in front of him. Stupid, Gage! A damn, dumb rookie mistake! His head throbbed. "I just need some water," he pleaded, stomach heaving at the thought of drinking anything. DeSoto's fingers wrapped around his wrist.
Looking at his watch, DeSoto moved his hand onto his friend's diaphragm. The skin beneath his palm was hot and damp. Too fast. "You take any smoke?"
"A little. Roy, I'm fine. Just got a bit dizzy." Johnny gave a wry smile. "Like Chet said, it's kinda hot in there." He scowled at the fair paramedic as Roy fastened the bp cuff around his arm and checked his blood pressure. "Roy, you're overreacting. I'm OK!" Johnny struggled to his feet.
DeSoto caught Gage as he pitched forward, getting his boots covered as John threw up. "Yeah, Johnny," he muttered, lowering the firefighter's limp body to the tarp. Gage's head rolled back. "You're just fine." Roy checked John's airway, positioned him on his side, and put a spare blanket pack beneath his head. Possible heat exhaustion.
"DeSoto, you need a hand?" asked Captain Smit, removing the O2 mask and standing up.
"No thanks, Cap." Roy gazed imploringly at Smit. "Please, sit down."
Mike stepped over, placing his hands on the woman's shoulders, assisting her in reseating herself.
Roy knelt beside Johnny, who was already stirring. "Lay still," he ordered, touching Gage's shoulder. DeSoto opened the long green case containing the engine's tank of O2, unrolled the tubing and, inserted the nasal cannula. With a smooth grace born of long practice, Roy caught the half-conscious man's hand as he tried to brush away the tubing and subtly altered the position of John's arm to prevent another attempt.
"Roy, I'm..." began Johnny, starting to roll over. DeSoto's knee against the middle of his back stopped him.
"You just decorated my boots. So I'm not really in the mood to argue with you. Just lie still and indulge me." He shook his head. Sometimes Johnny's stubborn refusal to admit he was mortal drove DeSoto crazy.
Roy slid the thermometer beneath John's tongue. "Be good and let me take your temperature."
"Umm, Roy," mumbled Gage.
"Shh!" Placing the stethoscope in his ears, DeSoto inflated the blood pressure cuff around Gage's arm and took another reading. Johnny's b.p. was higher now that he was lying down. He pulled the thermometer from John's mouth.
"Roy," called Stoker. "ETA on the ambulance is two minutes."
"Thanks Mike," he answered, scuttling to the other side of the tarp and checking his partner's pupils.
Grimacing, Gage jerked away. "Roy!"
Ignoring Johnny's protests, Roy picked up the biophone. "Rampart, this is County 51. How do you read me?"
John closed his eyes in exhaustion and defeat.
"We read you loud and clear, 51," crackled Morton's voice. "Go ahead."
"Rampart, we have a 31 year-old male firefighter. Collapsed during a sweep of a burning building. Victim is pale and diaphoretic. Pulse 108 and weak; respirations 24; bp 90/50; temp. 103.6." Roy paused, licking his lips. "Pupils equal and reactive. Patient is nauseated and has vomited. Evidence of orthostatic hypotension and dehydration." He clicked the ballpoint pen, touching each item as he read. "We have begun O2, six liters."
"10-4, 51. Start cooling measures. Begin IV D5W, continue O2, and transport."
DeSoto transcribed the instructions onto the MICU form. "10-4, Rampart," he replied, reading back the orders.
As Roy began swabbing his arm, Johnny shifted. "I hope your technique is good."
DeSoto's head jerked up in surprise and he studied Gage's face for a moment. The corners of John's lips were slightly curled. "You never -- uh -- mentioned any concerns about my technique before."
"Was never my arm before." Johnny gritted his teeth, trying to forget how much he hated needles. The b.p. cuff hissed and Roy's hand tightened on his arm. From behind the rig, he could hear the gravel crunching as the ambulance crew approached.
"...10-4, 51." Morton turned to face McCall. "Dix, please get a treatment room set up."
"Ok," she nodded.
Mike sat on the stool behind the nurses' station and wearily scrubbed his hands across his face. When he looked up, Brackett was standing at the counter, wearing a grim frown. "Kel, what's wrong?" asked Mike, his eyes narrowing.
"Karen Wolfe, just died."
Sighing, Morton slumped.
Brackett looked down the corridors. "Where's Dixie?"
"Getting treatment 2 ready." The young doctor hesitated. "Tell her if there's anything I can do..."
Dixie stood in the corner of the exam room, watching the student nurse, Carol Hayes. Forcing herself to concentrate, McCall evaluated her performance. The head nurse clung to her professional role, refusing to allow herself to think. If she stopped, she knew she would have to mourn, a luxury she could ill afford.
Hayes stepped up to the head of the litter, preparing to assist DeSoto and the attendants as they transferred Gage to the exam table. McCall took the IV bag from Roy and hung it on the stand. The young woman was good except for a tendency to become flustered; she had yet to develop sufficient experience and, most importantly, confidence. And wolves in paramedics' uniforms, don't help, thought McCall, recalling certain dark-haired paramedic reducing the young nurse to a helpless puddle with one look from his brown eyes. Even now Carol blushed when Johnny looked up at her.
Two plastic bags lay on the foot of the stretcher and Gage's bunker pants spilled from the top of one bag. Roy stripped him as per protocol. I would love to have seen that fight. As they lifted the sick firefighter, she saw John cling to the damp sheet covering his body as though holding on to life itself.
"Careful," Johnny protested.
"...He vomited two more times on the way in, an additional approximately 400 cc's," recounted Roy, finishing his report to Dr. Morton. He tore the carbon of the patient care form off the clipboard and handed it to Dixie. His blue eyes were clouded with concern.
John's struggles made for a less than graceful transfer, trapping oxygen tubing beneath his head. Carol hesitated a second, debating how to disentangle the line. She awkwardly lifted Gage's head to free the tube. As she moved his neck, he involuntarily flexed his hips, bending his knees slightly.
Dixie shuddered. The chilling, bug-like motion was the stigmata of a CNS infection. "Doctor."
"I saw it Dixie," replied Mike. Frowning, he peered at Johnny but did not move any closer. "John, are your neck or shoulders stiff?"
Roy abruptly turned his head, staring at Morton.
"Not really." Experimentally, Gage moved his head. "Yeah, kinda...."
"Yes. I took a little smoke, always gives me a headache..."
Morton pursed his lips. "Dixie take Nurse Hayes and Roy to exam 4. Call Kel or Joe down here and get me another nurse."
Johnny pushed up onto his elbows. His expression was a mix of alarm and anger. He recalled the symptoms from the briefing given by the Health Department about the new, virulent form meningitis. "Doc, I just gotta little dizzy from the heat. I don't have meningitis," his voice was touched with fear. "I'm not that sick."
"Maybe John. But with the current situation we are required to take precautions." Mike turned and left the room.
"Roy" begged Gage.
DeSoto looked at his boots still spattered with Gage's vomit. Taking a deep breath, he touched the tip of his tongue to the back of his teeth.
"Roy, Carol," said Dixie, "come with me."
"We're putting the lid on this now," announced Swenson, staring into Brackett's dark eyes.
"We can't quarantine everybody. You'll really start a panic."
Dana pointed to the jammed waiting room. "You already have that. I want everyone he treated in isolation, now. And the firefighters he works with."
Kel pursed his lips and sighed angrily. "We don't have enough beds. Besides, Doctor..."
Dana started down the hall toward the nurse's station and phone. "Then they can stay at home -- alone."
He shook his head, following Swenson through the halls. "I can see confining DeSoto -- Gage did vomit on him -- even the patients Gage and DeSoto treated."
Dana picked up the phone. "Erik Ross." She named the engineer infected by one of the paramedics at his station.
Kel grabbed the woman's arm. "Dana, let's think this through. At least wait for the labs..."
Swenson glared at the tall doctor, until he let go. "By that time they will have exposed how many other people?" She dialed. "Chief McConnikee, please," said Dana into the receiver.
Frowning, Brackett shook his head and stalked to his office.
Dixie watched the CDC's epidemiologist leave the exam room. Roy sat on the table with his back to the door, unmoving. His contaminated turnouts were gone, he instead wore a hospital gown. His shoulders were slumped and his head bowed.
"Roy," began McCall. The paramedic turned toward her, his face the mask of fear and despair she had so come to dread. "Let's get you ready to go upstairs."
He nodded, numbly. "How's Johnny?"
"Not too happy, spinal taps are no fun." Dixie unrolled the blood pressure cuff.
"Does he have it?" he asked, quietly.
She looked up, meeting his pale eyes. "We won't know for sure until the lab work is done." McCall patted his arm. "We're going to take good care of him. So don't worry."
Roy pressed his tongue against his upper lip and exhaled slowly. "How's everyone else?"
"Brice is getting better." She slipped the stethoscope into her ears and inflated the cuff.
He waited for her to finish. "What about the paramedics from 110's and 43's?"
"Martin is doing a little bit better." Dixie shook down the thermometer and slipped it beneath DeSoto's tongue. "It looks like Kel Clarke might have gone deaf, but it is hard to tell, she's still too sick to be sure."
"Karen and Carl?" inquired Roy, around the thermometer.
The nurse bowed her head.
McCall gestured for DeSoto to be quiet. "Karen just died. Carl died last night." She removed the thermometer from his mouth.
Roy swallowed. "Dix, would you call Joanne for me. Tell her..." His words trailed off.
"I already called Joanne." At the mention of his wife's name, DeSoto's eyes closed.
"How is she?" he asked, his voice hollow.
"Scared," admitted Dixie. "She wanted to come down here, I..."
Roy's eyes sprang open. "No," he interrupted, "I don't want her coming anywhere near here. I want her to stay home, away from people, where she'll be safe."
"I told her coming here was pointless. She wouldn't be allowed to see you." Dixie opened one of the supply cabinets and gathered the equipment she needed to draw a blood sample. Spreading the supplies on a tray beside the bed, she took hold Roy's arm. "As soon we get you settled in, you can call her," McCall said, securing the tourniquet and tapping the firefighter's forearm.
Roy's jaw tightened, at the thought that this might be the last conversation he ever had with Joanne. He stared as the needle slipped beneath the skin, angling into the vein. The tube filled with blood, the ruby liquid surging inside the glass, coating the walls, drawn by the vacuum in the tube. A sudden rush of nausea overcame him as he thought about just how dangerous his blood and other bodily fluids could be. Did I infect Joanne when we made love? Jen when I bandaged her bleeding knee? He gagged.
Dixie pulled the needle from his arm and fumbled for a basin. She steadied the paramedic as he vomited.
He lifted his gray, strained face. He sniffled. "What if...." he asked unable to finish.
Gently, McCall handed DeSoto a Kleenex and eased him into a reclining position onto the table. "Roy, even if Johnny just infected you, you wouldn't be contagious this soon."
He stared at her bleakly, his eyes suddenly red and moist. "That's why you're wearing that." He pointed with his chin to her mask.
She looked away.
Hank watched traffic as Mike maneuvered "Big Red" in the apparatus bay. The sight of the squad parked in the room, with Reese and Kurt, the B-shift paramedics standing next to the vehicle talking with a young man Stanley recognized as one of the Chief's drivers, increased the anxiety he had been battling ever since squad 43 had arrived at the fireground to replace 51's squad.
"...Figures Gage would find a way to get outta having to overhaul that mess," complained Kelly, from the back of the rig.
Stanley stared at the shifting images in the sideview mirror and picked up the radio handset. "Engine 51, in quarters." The rear door of the bay was open, in the parking lot he could see the Chief's buggy and white car bearing the County seal and the inscription 'L.A. County Health Department.' Chief McConnikee leaned against the fender of the county car talking to a middle-aged black woman wearing a dark skirt and suit coat. Hank's throat tightened.
"...He has gotten lazy as a paramedic, always bailing out, leavin' us to do the real work," continued Chet.
Swiveling in his seat, Hank glared at Chet as Mike brought the engine to a stop. "Shut up Kelly."
Marco started to climb down from the jump seat but abruptly stopped, one sturdy leg dangling in the air. "Cap, it's Chief McConnikee."
"Yeah, I saw him."
"I wonder what we did wrong," whispered Kelly.
"What you did wrong," remarked Stoker, stepping from the cab.
Stanley closed the door. "Straighten up, the lot of you," he warned, half-heartedly, feeling a dark and formless dread gathering.
"Hank," called the Chief, "Can I talk to you and your men?" Beside McConnikee, the woman smoothed her suit and lifted a clipboard, examining the firemen curiously.
"Sure, Chief," replied Stanley, gesturing for the rest of the crew to join him in the parking lot. The men arrayed themselves in a loose row.
"This is Dr. Jefferies of the County Health Department," began McConnikee.
Suddenly Hank's fears took shape. "Gage?" he interrupted, involuntarily. He could sense his men tensing, trading nervous glances. They were all thinking about the mounting numbers of fire service personnel stricken -- killed -- by the new illness. "That new virus?"
The officer nodded solemnly. "I am afraid so. Dr. Jefferies has the details."
The doctor took a step forward. In quiet tones, she began to outline the symptoms, explain the precautions the Health Department wanted to take and discuss the blood samples that were going to be drawn. Numbly Hank listened, studying the faces of his men as she talked. He could see Kelly's jaw tighten, beneath a thick layer of soot, as the firefighter remembered slinging Gage's arm over his shoulder. Chet stared down at his bunker pants, coated with the black grimy ooze of ash and water through which he had crawled. Over Kelly's head Stoker and Lopez locked eyes. Marco gave his friend a supportive sidewise glance.
"...We believe the risk of contracting the infection is extremely low, however we would like you men to remain at home -- alone -- for the next seven days. Go nowhere; see no one." Jefferies handed xeroxed sheets to each man. "If you experience any of the symptoms listed below, call that number. A doctor will be able to help you."
Stanley stared at the paper. The list of symptoms swam before his eyes and his head started pounding. "How is Johnny?" he asked.
"We are doing everything we can for him," replied the woman.
Like you did for Bellingham, thought Hank bitterly.
"Here," replied Chet, shifting uneasily.
"I'd like you to come with me to Rampart."
The fireman looked desperately at Hank. "Go on, Pal. I'll call your sister, tell her what's going on," reassured Stanley.
Kelly nodded grimly and climbed slowly into the car.
The darkness closed in around Dana, her breath inside the respirator sounded unnaturally loud. The improvised dark room inside the lab trailer was barely big enough for one person and an ultraviolet microscope. With two people crammed into the narrow blackness, it was positively claustrophobic. Every move caused Swenson to brush against the lab technician.
"Your eyes adjusted?" asked the young man.
Dana nodded before she remembered he could not see her in the dark. "Yes."
"The control." Two tiny clicks of glass hitting metal sounded in the dark.
Swenson placed her hand on the barrel of microscope, guiding her face into place. A faint glow floated before her eyes, the normal fluorescence of certain biological molecules in the blood of an uninfected person. The antibodies extracted from Alex Sharp's blood with their attached chemical marker did not recognize and bond to anything in this blood sample. "Nothing." Dana sensed the body of the technician shift as he nodded his agreement.
A brilliant green light came into focus. Startled by the brightness, Dana jerked back. The lurid orange lettering placed on the edge of the slide in the glow-in-dark marker jumped out at her -- Brice. "This is really hot," she commented, reverting to the biologist slang for a sample teaming with infective agent. "This isn't a current sample, is it?"
"No, it's from a sample drawn on the second day of his illness," he replied.
"DeSoto." The slide clicked home.
Swenson bent again. "Negative. He's not infected -- yet."
The bright green glow again filled the microscope's field of view. Screaming hot. Dana straightened. The antibodies from Sharp's blood knew this virus, a descendant of the original lethal attacker. Now she just had to figure out how Gage had caught it and how many people he had infected.
"Positive," she mumbled.
Dixie donned a fresh mask and gloves, sliding them securely over the cuffs of her gown. The warm dampness of her breath folded back on her face and every inhalation was heavy with the woody, faintly chemical smell of the filter. She firmly clamped down on the first tickling of claustrophobia -- a moment of panic could be fatal. McCall didn't want to enter the exam room and see another of her nurses or paramedics lying ill. My paramedics, she sighed. Ever since I helped DeSoto fight for his -- our -- precious program, I have become mother hen for another gaggle of young men and women. Now they are dying and there is nothing I can do. NO! You will not think of that right now. Picking up the paper cup she had brought with her, she passed the bright yellow sign on the door and entered the treatment room.
Gage was lying on the exam table, arm across his eyes. A blue plastic basin lay on the bed beside him. Even asleep he looked tired, sick -- and a little frightened. Dixie set down the cup and picked up the thermometer. "Johnny," she said quietly, touching his arm. Through the latex of her gloves she could feel the feverish heat of his skin.
John opened his eyes, squinting at the brightness. "Dixie." He smiled weakly at her. "The Dilantin must be hitting me pretty hard," he said, naming the anticonvulsant medication Dr. Morton had ordered. "I can't seem to stay awake." The tickle in his chest had grown into a crushing pain and he couldn't shake the feeling of lightheadedness. Johnny felt horrible.
"As soon as I'm done, you can go back to sleep."
"Okay." The vicious headache that gripped Gage's skull drained him of the desire to move, talk or even think too much. Lying immobile with my eyes closed for a month sounds just about right. The beam from the overhead light felt like it was drilling right through his head. He slid his arm lower, deepening the shadows over his face.
McCall reached up and adjusted the lamp. "Is the light bothering your eyes?"
He started to nod but the pain in his neck stopped him. "Yeah," he concluded, wearily. Johnny studied Dixie's face, trying to read his diagnosis from her expression.
She looked away, shaking down the thermometer.
"Have they finished the lab work?"
"Not yet. Soon," she replied, gesturing for him to open his mouth, then slipping the slender glass tube beneath his tongue. While she waited, Dixie measured his vital signs and checked the IV line. Johnny, you have more bad luck than anyone I know. Placing the stethoscope in her ears, she listened to his lungs, and then took the thermometer from his mouth, committing the reading to memory since the strict quarantine regulations imposed by the CDC forbade bringing the patient records into the room.
Gage gazed expectantly at McCall.
"104." She leaned slightly forward, making sure the basin was empty. "Stomach feeling better?"
"Want to try and drink a little something?"
John lay still, feeling the dryness of his mouth and trying to decide whether his stomach would tolerate anything. Despite having thrown up, he could still taste the smoke from the fire. "Yeah," he answered, attempting to push into a sitting position, but his arms wouldn't support his weight. He repositioned his hands and tried again. Trembling, his arms buckled. Once more he fell back against the mattress, a shiver of fear passing through him.
Placing her hand on Johnny's shoulder to stop another attempt and shaking her head, Dixie raised the end of the gurney at little more. The speed at which the virus was striking down Gage, frightened her. John's hand shook as he took the cup, spilling a small amount of the pale beige liquid. McCall steadied his hand, while he drank thirstily. The door opened and Drs. Morton and Swenson entered the treatment room.
The cool soda soothed Johnny's aching throat, but after a dozen swallows his stomach twisted. With a very slight shake of the head, he pushed the cup away from his lips. Over the exam table, Dixie and Mike exchanged glances.
McCall took the soda from his hand.
"Ginger ale, my favorite." He sighed, letting his eyes close. John listened as Dixie recited his vitals to Morton. Not so good. The results of the lab tests were implicit in the presence of the CDC's epidemiologist. "I have it," he said, flatly, opening his eyes in time to see Morton nod.
"Yes, John," he replied.
Dixie patted his hand. "We'll get you settled in a bed in a couple of minutes."
"I need to ask you a few questions," said Dr Swenson. She began to question Gage about his contacts over the past few days.
Quietly, Johnny answered the doctor's questions. Refusing to think, he floated on the sound of her voice, sinking beneath the waves of sound, slumbering. Suddenly, the doctor lifted his arm, rousing him.
"What are these?" Dana asked, touching the fading red welts on his arm with a gloved finger.
"Humm?" mumbled John, blinking. He tried to focus on his forearm. "Bug bites." Closing his eyes, he let himself drop back to into oblivion.
"Where did you get them?"
"On a rescue... truck... ditch..." The paramedic fell asleep.
"Something important?" asked Morton.
"Probably not..." murmured Swenson, lost in thought.
Dana walked back into the conference room. Stacks of interview transcripts covered the table, mingled with lab reports and the latest data from the CDC. Some kind soul had cleaned away the litter of dirty coffee cups and sandwich wrappers. She dropped a small brown paper bag on the table.
Picking up the yellow pad filled with her scribbled notes, Dana turned up the lights and looked at the wall where Mike Morton had taped up the micrographs and electronmicrographs of their yet unnamed member of the paramyxoviridae family. Swenson stared at the black and white photographs. In the harsh artificial light, the prints resembled a collection of mug shots of a new and deadly kin to measles, mumps, and equine distemper. One picture showed a huge infected cell formed by dozens of Alex Sharp's kidney cells, which had been fused together by the action of the virus. The giant cell was dotted with dark spots, the nuclei of the doomed constituent cells. Another photo was an image of the virus viewed with a transmission electron microscope. A fuzzy coat of protein protected the few hundred thousand codons of RNA that was the virus's deadly cargo. Looking at the picture, she remembered the thrill of sitting in the darkened graduate lab at Hopkins, watching the shadowy image of coxsackie A24 on the microscope screen, seeing the lovely symmetry of the viron resolve as she adjusted the electron optics. "You have to admit it is beautiful," she whispered.
Dana jumped. "Mike, I didn't hear you come in."
The handsome black doctor looked at the epidemiologist. The woman had changed out of her suit and was wearing a well-worn pair of jeans and a loose peasant blouse.
"Any changes I should know about?" she asked.
Morton rubbed his burning, tired eyes. "Gage is sinking fast." He sighed and dropped into a chair. "Shaw is worse. And, I'm beginning to feel like a witch doctor with nothing more than effective than bag full of spells and few leeches."
Raising her head, Swenson met Morton eyes. "Mike..."
"There isn't a damn thing I can do for them. I've signed six death certificates in the past two days. So, I have a little trouble sharing your assessment of this bug's beauty." His voice shook.
Dana turned away and studied one of the photographs. To give the doctor time to collect himself, she talked. "From a strictly evolutionary stand point, viruses are excellent adaptations. Why bother with the biological machinery for reproducing yourself, if you can highjack some other organism's. All this fellow needs to do, is attach to the cell membrane, inject some stands of nucleic acids, and then the cell will make copies until it consumes itself. The ultimate expression of the Darwinian imperative -- reproduce as many times as possible...."
"And to hell with the host," interrupted Morton.
"Doesn't even enter the equation. As long as the host survives long enough to infect someone else, then the virus is a success." Swenson stopped and glanced back at Morton. The doctor's shoulders were slumped and his eyes reddened. "Not that any of this," she waved at the pictures, "makes it easier..."
Morton shook his head. "I've got to get back." Wearily, he pushed himself upright.
Dana gazed at the conference room door for several minutes after Morton left. With a quick shake to clear her head, she plopped onto a chair, swiveled around, and put her feet up on an adjacent seat. The scrawl on the sheaf of notes in her lap refused to yield the answer to her question -- how Cindi Mallory and John Gage had become infected.
With a frustrated hiss, she tossed the pad aside and grabbed the sack. Opening it, she pulled out a bag of M&M's and poured a handful onto the table. The brightly colored candies glittered against the dark formica table top. Dana popped a couple into her mouth and let them melt, savoring the silky sweetness. Settling back in the chair, she studied the chalkboards lining one wall, covered with lists of names and interlacing arrows, which indicated chains of transmission. Alone in one corner was written Gage. Every line pointing to his name was crossed out. The only contact he had had with any victims, occurred at least forty-eight hours before they were contagious. Idly, Swenson began arranging the candies, reproducing the diagram on the chalkboard in a color-coded, edible form. She was unable to shake the feeling that Gage was the link to the source of the infection.
A red welt on the back of her hand caught her attention. Dana stared at the swelling, remembering the many similar spots on the paramedic's arms and legs. Spots that she and the rest of the medical staff had dismissed because of the lack of similar bites on other victims. She remembered the confrontation.
"Bugs?" asked Brackett incredulously. "I would expect to see a much larger outbreak if that were the case."
"So would I, unless it is a very isolated reservoir," replied Dana.
"We already thought of that and ruled it out. This is Los Angles not Africa. It is hard to have a population of mosquitoes so isolated that only a few people get bitten." Kel shook his head. "I wish it was this simple."
Swenson frowned. As much as she hated to admit it, the doctor was correct; there simply were not enough common denominators. "You're right. The victims are too different.... No one place in common."
Abruptly Dana swept aside the candies. "I've been an idiot," she snapped angrily, at the empty room. Swenson walked over to the map of the county, tacked to a bulletin board and studded with colored pins, marking the homes and places of work of all the victims. Tracing her finger along the map she read, '2049 E. 223rd St.'
Tsinhnajinnie stood in the door to the dayroom, watching the CDC doctor cross the darkened parking lot.
"Hello, I'm Dr. Dana Swenson, from the CDC," greeted Dana, walking past the paramedic into the station. "I'm looking for Captain Hookrader."
"The Engine is out on a run," Aline replied, hooking her thumb behind the holster holding her bandage scissors. "Maybe I can help you. Dr. Morton said you are looking for the location of a car accident." Her voice conveyed her puzzlement.
"Yes, an accident Gage and DeSoto responded to -- maybe seven or eight days ago. It's possible Gage was exposed to the source of the infection on that rescue." Even as she said it, Dana realized how foolish she sounded.
Tsinhnajinnie's lips formed a silent 'oh' as she led the doctor to the captain's office. Pulling out the chair, Aline set the logbook on the desk. Quickly, she leafed through the pages. "How is Johnny?" Tsinhnajinnie asked, tracing her fingers down the columns.
"Critical." Dana glanced at Aline. The firefighter's face was lined with concern. "I'm sorry. A friend of yours?"
"The department is close. We've already lost three of our brothers and sisters. One more would be..." Aline's voice trailed off. "Here you go; they had two."
Swenson followed Tsinhnajinnie's pointing finger. "Which would have involved a truck and a ditch?"
"This one." Aline transcribed the address onto a slip of paper. "SR 314 at mile marker 26." Turning on her heel, she headed for the map board in the apparatus bay. "Around here," she said, pointing.
For a long moment, Dana stared at the spot on the map. The hair on the back of her neck stood on end. "May I use your phone?"
Roy sat beside John's bed. The ventilator forced Gage's chest into artificial movement. His partner's face was an unnatural gray and John's eyelids, fingers and feet were puffed with the fluid retained by his failing kidneys. The cardiac monitor showed a frantic pattern of alternating strong and weak beats, the normal shape and spacing of the trace distorted. DeSoto turned away, not wanting to see anymore harbingers of his friend's impending death.
Slumping forward and staring at the grid of lines between the floor tiles, DeSoto sat thinking. This isn't happening. This kind of thing doesn't happen in America; this isn't the third world. He stretched out his gloved hand, examining the thin film of latex, which protected him. Diseases don't just appear in the middle of a city and start killing the people you work with.... The people you love.... He imagined Joanne's face, serene and calm as she sat at the kitchen table paying the bills, the light from the overhead lamp caressing her checks and sliding down her shoulders.
The alarm on the monitor sounded. An erratic wiggle bisected the screen. "V-fib," he yelled. Locating the correct spot, Roy positioned his hands on Johnny chest beginning chest compressions. One -- two -- three... Roy's lips moved soundlessly. "Where the hell is everyone!" Eight -- nine -- ten... Under DeSoto's palms the surface of Gage's chest shifted. Abruptly Roy realized he was no longer working on his partner. Horrified he looked up.
Joanne lay in the bed, her soft brown hair melted to her head, perspiration soaking the bed linens. The monitor continued to shriek; the rise and fall of its cry wailing his name.
"Somebody help me!" Roy searched the room for a crash cart. But the room was nearly bare, save for rows of beds filled with the sick. Don't look. Don't stop! DeSoto closed his eyes and continued CPR, his arms rapidly turning leaden and numb. Seconds stretched into minutes and still the room remained empty.
Helpless, Roy looked at his wife, willing her heart to start beating again. Joanne's normally flawless complexion was a mottled blue. Beneath partially open lids the hazel circles of her irises were nearly invisible; she stared past DeSoto, her pupils blown.
"Joanne!" screamed DeSoto, still struggling to force the blood to circulate through her body. Beads of sweat ran through his hair, rolling down his face, mingling with tears and soaking his mask. His shoulders ached and he panted for air.
Suddenly, Brackett grabbed his arms. "Stop!"
DeSoto yanked away, resuming CPR.
Kel forced the paramedic away from the bed. "Roy, stop! She gone." He shut off the ventilator. Joanne's chest fell a final time.
DeSoto gaped at his wife. Spinning, he grabbed the doctor's shoulders, throwing him against the wall. "Where the hell were you?" he demanded.
"Roy, there was nothing we could do. It was cruel to prolong her suffering." Slowly Kel climbed to his feet. Gently, he placed his hand on DeSoto's shoulder, squeezing.
"You bastard," said Roy coldly. He drew back his fist, a gazed into the physician's dark eyes. After a long moment he lowered his arm, pushing Brackett away. Reeling with grief and exhaustion he stumbled and fell against one of the beds. A soft moan rose from between the thick cooling blankets.
"Daddy," groaned a familiar voice.
DeSoto looked down. "Jen," he moaned, collapsing to his knees.
"Jen!" DeSoto sat up, sweat streaming down his sides and heart pounding beneath his breastbone.
Mercury blue light from the street lamps in the parking lot poured through the window, falling across the bed. The second gown, Roy wore backwards to cover the embarrassing gap in the back of the other, was hopelessly tangled, cutting into his armpits. The whole mass was soaked with sweat and he desperately needed to urinate but was still frozen in between nightmares.
Sighing with disgust, Roy staggered to the bathroom. As he stood, the air turned the damp fabric into the clinging embodiment of icy terror. When he returned the small light over the bed was on and one of the night nurses stood inside the door, carefully attired from head to toe in isolation garments. She held a tiny paper cup. He could hear the faint click of pills.
"Mr. DeSoto, Dr. Morton ordered something if you had trouble sleeping." She set the medication cup on the overbed table and poured a glass of water.
Wordlessly, Roy reached for the pills, craving dreamless oblivion. He swallowed.
"Good," sighed the nurse, her voice weary and a little frightened. "Get some sleep, Mr. DeSoto."
After the woman left, Roy stared out window. Following the yellow lines of the streetlamps, he traced the route from the station to the Torrence neighborhood where his house was. He pretended he could see the light in front of the vacant lot next to his house and the bushy darkness of the arroyo running behind his street. Joanne, DeSoto thought. He imagined Joanne sitting on the edge of their bed, wearing her pale lavender gown. In his mind's eye, she touched his pillow. "Be careful," he whispered into the ominous night.
Dr. Swenson drove through the flat plain of cultivated fields. Green blocks of alfalfa, bounded by the narrow dark green lines of weed rimmed irrigation ditches, rolled past her windows. A small white sign, emblazoned with a black 314, confirmed that this was the road described in the station 51 logs and the police accident report. Set far back from the road were a couple of small ranch houses, holdouts against suburban sprawl. Numerous white fenced paddocks surrounded one low brown building at the far end of a dirt lane.
A wide, water filled ditch meandered along side the road. Native vegetation stimulated by the abundance of moisture grew to an unusual height. Thick clusters of some kind of yellow flower bloomed around the bases of utility poles. Amid the growth sprouted the occasional tall thin metal pole, supporting a slender white cloth cylinder dangling from a conical sheet metal hood. With approval, Dana noted the presence of the mosquito traps. At the edge of the road about a half a mile ahead, she saw a cluster of men and vehicles. "This must be it," she whispered, slowing the car.
Dana parked on the opposite side of the highway from the white van of the Los Angles County West, Vector Control District. She reached over, pulled a small can of mosquito repellent from her purse and sprayed her hands, ankles and face. The pungent odor of OFF filled the vehicle. Although the chances of an encounter with an infected insect -- if the mosquitoes were even the viral reservoir -- were low, she felt irrationally reassured. She grabbed a clipboard from the seat beside her. Thus prepared, she slipped from the rental car.
"Hello," hailed a tall, heavy-set man in white coveralls. "You from the CDC?"
"Yes." Swenson glanced quickly in either direction before running across the road. "Dr. Dana Swenson," she replied when she reached the van.
"Bill Santos, entomologist, California Department of Health."
Dana shook his hand. "Pleased to meet you."
Bill nodded. He turned and began digging in a box in the back of the van, talking as he rummaged. "We got traps every 1000 ft for 3 miles down the ditch." His voice grew muffled as he reached deeper into the truck. "The one I looked at had four different species -- about normal for this area." Santos emerged holding a pair of white disposable Tyvek coveralls, gloves and a roll of duct tape. "Mosquitoes aren't attracted to light colors and with this virus I don't want to take any chances," he said by way of explanation.
"Absolutely." Awkwardly, Swenson pulled on the overalls and gloves. She held out her wrists and watched the entomologist wrap strips of tape around the seam between the sleeve and glove.
Bill caught sight of the tops of her thick socks rolled over the cuffs of the pants; he smiled his approval. "You've done this before," he observed, handing her a veiled beekeeper's helmet.
"In Sierra Leone and Zaire," she said, slipping the veil over her head.
With satisfaction she listened to the surprise in his voice. Often her male colleagues seemed to think she was little more than a glorified actuary, completely lacking in any field experience or common sense. "Let's see what you got," she instructed, trudging through the thick grass toward the trap.
Bill and Dana stood watching a white swathed technician kneel next to a trap. A metal hood supported and protected a small battery powered lamp and a tiny thermos bottle of dry ice connected to a slender tube. The light and carbon dioxide served as bait. Beneath the attractant hung the mosquito equivalent of a lobster trap. The technician unclipped a white mesh cylindrical bag full of mosquitoes and dropped it into a glass jar holding a cotton ball soaked in ether. Swenson stared in disgusted fascination as the tiny insects dropped to the bottom of the container. They looked like glorified lint particles not the source of centuries of human misery and death that they were.
Santos took the bag from the tech and poured the deceased insects into a test tube. He shoved a stopper into the neck, lift the tube to the light and shook it. Wings and legs tangled and untangled as the mosquitoes slid over one another. "Three different kinds here. We'll sort 'em and get 'em packaged." He lowered the tube. "Five more traps to go. Be done in twenty to thirty minutes." With that, the entomologist turned and headed back to the van.
Swenson nodded. She looked down the road, about a quarter mile to the east was a dark strip of bare dirt, cutting into the lush greenery. It was the spot where 51's automobile accident had occurred. She started walking.
Dana stood on the bank of the ditch. A path of torn earth and crushed vegetation led to the stagnant waters. A few yards away was the concrete lined path of a new irrigation channel, but water still seeped into the old dirt lined aseca creating a mosquito nursery. Sheets of green algae floated in the still water.
Swenson stepped closer. If her theory was correct, this was where John Gage had been infected by a mosquito hungry for blood, with which to nourish the next generation of little bloodsuckers. Bits of glass and metal littered the ground. Flies swarmed over something on the ground. Dana looked more closely. A shattered Vacutianer sample tube lay on the ground, the faintest traces of culture media still clinging to the glass, attracting the hungry insects. Abruptly, the glass and metal fragments resolved themselves into familiar forms, the shattered remains of medical equipment. The driver had been a veterinarian according the accident report, she recalled. One huge black fly launched itself from the surface of the tube and flew straight at her. Startled Swenson jumped back.
A voice whispered in Johnny's ear in the rich cadences of Lakhota rather than the breathy hissing of English, calling to him, coaxing and questioning. Licking his lips, he tried to answer, to tell the voice he did not understand, but the words became trapped in the stickiness coating his throat. His lips moved silently. John fought his way through the poisonous fog, which drowned his thoughts, snatched names from his tongue and dragged him inexorably toward sleep --and death. Dark shapes and a vague presence hovered at the edge of his consciousness. It felt as though a great malevolent beast sat on his chest with its muzzle pressed against his mouth, sucking away his breath, leaving him panting. Gage lifted his arm to push away the thing on his face, but his wrist was caught in a padded embrace. His heart raced in terror. He was defenseless, no longer knowing if he was awake, asleep, dreaming or just plain insane.
Johnny sat up in his parent's bed. He stared out the window. Beyond the frost-patterned glass, Dwayne raced through the yard to the fence to greet their cousins. His boots scattered powdery snow into the icy blue sky. Ruby and Matt sat heavily bundled on top of a toboggan that their father pulled over the drifts. His auntie, Kate Gage-Red Owl, walked behind her husband following in the track he had broken through the ice crusted snow. She had her herb bundle tied securely over her back, folded in a shawl just like the old women carried their grandbabies.
John climbed out of the bed and stood at the window, pressing his feverish forehead against the freezing glass. He looked at the smooth yellow wood of his cousin's glorious new sled -- the sled they had found in the dump by the BIA housing compound behind the Manderson Day School. Thin red stripes stretched the length of the toboggan. Dwayne grabbed the rope and helped his cousins drag the sled up the rise across the road from the house. Laughing, the children threw themselves onto the toy. It flew down the hill, much faster than the scraps of cardboard Johnny and Dwayne used. Halfway down, Dwayne tumbled from the wooden platform.
Sullenly, Johnny tugged at his infected, aching ear. His breath froze on the windowpane. He scraped away the ice with his fingernails. The loaded sled had overturned in the drifts beside the road. John could see why it had been in the trash in the first place. The delicate wooden curve at the front was cracked and a boot-sized piece of the platform was missing. "It's just some old piece of wasicu garbage," he mumbled, turning away from the window and climbing back into bed.
He buried his face in the pillow, tears soaking into the feathers. In the kitchen he could hear the sound of his aunt, who knew the old herbal cures, boiling-up one of her remedies. Johnny choked at the thought of the bitter draught. If it hadn't been winter they would have gone to the clinic, but the weather was too uncertain to risk a hundred-mile trip to the doctor. So his father had sent for John's auntie and her Indian medicines.
"Yaceye sni yo," instructed Howard Red Owl, Johnny's favorite uncle, towering over the bed. He reached down with his huge hand and wiped away his nephew's tears. He was a tall Mnikowozu from Red Scaffold. Howard's warm gentle manner contrasted sharply with John's father's cold distant nature. "Tuktel niyazan hwo?"
Johnny pointed to his throbbing right ear.
"Old man, English," commanded Kate. She set two coffee cups on the dresser next to the bed. The watery winter sunlight threw shadows across her face.
Even with his stuffed up nose, John could smell the strong odors of bergamot and wild licorice. He slid deeper beneath the covers.
Howard scooped up his nephew, blankets and all. "Cutting off his tongue won't make him a whiteman." He held his nephew on his side with Johnny's head resting on his arm.
Kate picked up the cup of bergamot tea and leaned over John. "Not our place," commented his aunt, dipping the spoon handle into the cup. She dripped the warm decoction into her nephew's ear and pressed a cotton ball into his ear canal. Reaching behind her, she picked up the other cup, the licorice root tea. "Drink."
Johnny twisted looking up at his aunt's firm expression and he knew he was not going to be granted a reprieve. Beneath his head he could feel the hard, migrant farm worker's muscles of his uncle's arm. Howard winked at him. Reluctantly he took the cup. Grimacing, John swallowed the earthy, bitter tea.
Howard pointed with his chin toward the mudroom. He spoke in rapid Lakhota to his wife. Kate returned with a bottle of ginger ale, contents still icy from the long walk to her brother's house.
Johnny lay cradled in Howard's arms, sipping the sweet, cold soda.
Poor guy, decided Brice, watching his roommate's lips move behind the oxygen mask as he soundlessly talked to the ghosts inhabiting his hallucinations. The only noise Gage made was a tortuous wheezing as he breathed. The sound reminded Brice of his own still achy and congested chest, sending a tickling down his throat, causing him to cough. Pain shot through his head with each hack.
When they had brought in 51's sick paramedic, he had briefly considered telling Dixie not to put Gage in the bed where Bellingham had died, worrying that his late partner might persuade Johnny to come work with him. But Craig had dismissed the whole irrational notion as a result of the remnants of his fever and lingering effects of the anticonvulsant medications. Over the past few hours, he had watched John rapidly deteriorate, falling into a restless delirium and developing ever-worsening respiratory difficulties. Gage pulled against the restraints, panic spreading across his flushed, damp face. Brice blushed, remembering the humiliating weakness that earlier this morning had kept him from being able to get to his feet and help. A fever-induced claustrophobia had overcome John causing him to tear at the oxygen mask covering his face, pulling out his IV. Brice had headed for Gage's bed but the floor had tilted beneath his feet, smacking him on the hip. Instead of helping, he found himself being lifted and eased back into bed by Gina's supportive arms, while another nurse re-started Gage's IV. 'A weak man is a disgrace.' Craig heard his father's voice echoing in his head, shaming him.
Brice coughed again. The guilt and grief came crowding back, beating down the dull throbbing in his temples and destroying his fledgling appetite. His eyes burned. Craig pulled off his glasses, rubbing the bridge of his nose. Beth, Kel, Karen, Carlos, Erik and who knew whom else, all sick - maybe dying -- because of me. And, Bob dead because of me. Sighing, he decided to impose the order of language on his thoughts. He began to speak. Gage would keep his secrets.
"It's not fair," said Brice softly. "Bob had a wife -- she must be going through hell. She is pregnant. He was going to be a father." He paused, catching his breath and smoothing the sheet over his chest. "It should have been me -- no child to grow up without a father."
Ignoring the white-hot needles of light that stabbed deep into his head, Johnny opened his eyes. The pain behind his temples had long since transcended anything that could be described with a term as mild as headache. It spread in spikes and flares, pressing against the bones of his skull, growing roots down his spine, sinking tendrils of agony into every muscle. The bed kept swaying and dipping, Gage clung gratefully to the bedrail, wishing they would lower his head so he would be less dizzy. He stared at the clock on the blue tiled wall, watching the hands move. Over the roaring in his ears, Gage could hear Brice's voice.
"I should have known. After I got sick, I should have had Dr Morton call and check on Bellingham. He was lying on the floor too ill to get to his phone." Brice fell silent, remembering Bob's dusky, sweat-soaked face.
Johnny clung to Craig's voice like a lifeline in a burning building. He tried to swallow, choking on the cottony dryness of his mouth. The face of the clock wavered, reflecting laser sharp beams of light into his eyes and lancing through his skull. Feebly he turned away from the glare. The other man's words floated around him and he fought to make sense of the sound, to reassure himself that the virus wasn't eating away his gray matter, leaving him brain damaged.
"And I infected Kel, Karen, Carlos, Jimmy and...." Stopping, Craig lifted his arm and studied the IV tubing, wishing he could go back to concentrating on the technical details of being a paramedic on a rescue squad. Sometimes, only Beth anchored him to the human aspects of life. A thousand images of his lover filled his head: her smile as she cheerfully reduced his carefully organized kitchen to chaotic rubble; her eyes when he took her to the mountains just to make snow angels; her lips as she kissed him goodnight... "Beth," Brice moaned. Closing his eyes he could practically taste her mouth and feel her cool skin against him as they made love. Except, he kept seeing her features shrunken by dehydration, long red hair lifeless damp with sweat and ivory skin flushed as the virus burned her alive. Brice's throat tightened. He couldn't bear the thought of Beth slipping away from him, the way Bellingham did, with a death rattle as she struggled futilely to breathe.
Johnny finally gave up. His head hurt too much to allow him to understand Craig's words. Instead, he listened to the other paramedic's tone of voice. "Bri...," he whispered inaudibly. He tried to speak again, but the beast -- still sitting on his chest -- wouldn't allow him enough air.
"And who knows how many people I treated." Brice's voice was leaden with recrimination. "I had my hands all over them. I breathed on them..."
A pair of gowned nurses entered the room.
"Buy you a cup of coffee?"
Roy turned from watching the cars in the parking lot. "Dixie."
The nurse stood in the door, a large take out container of coffee in her hands -- the good stuff from a little place down the road. The smell made his mouth water, despite the depression that enfolded him. "I thought you'd be going through withdrawal by now." Her blue eyes smiled above the mask, but expression did not disturb exhaustion that had settled into fine lines marking her face.
DeSoto accepted the cup and took a huge swallow. "Thanks." He studied her face, not wanting to ask. "I'd have thought you'd have gone home by now."
"Not these days." She shook her head. "We're short handed on night shift."
"Oh." He sipped the steaming beverage, savoring the warmth and flavor. "How's Johnny?"
McCall hesitated. "Not too good." She busied herself adjusting the bedclothes.
Roy opened his mouth and then closed it, remembering the reports he had read, deciding he didn't want to know. He pressed his thumbnail into the styrofoam. "I talked to Joanne."
"How's she holding up."
"She's not the only one." Dixie turned from the paramedic.
Slowly Roy nodded. "Yeah, I know what you mean."
Dixie stood in the front of the cart holding the isolation garb. She caught sight of her reflection in the glass panel of the swinging door; dark blotches marked the skin beneath her eyes and new wrinkles surrounded her mouth. Her hair needed to be brushed and she had abandoned her cap in her locker. She hadn't felt like this since August of 1952 when she had stood in the mud of a bombed-out Korean farm, a ward full of HFRS virus victims at behind her and buses full of wounded Marines arriving from hill 122 in front of her. You never knew whether a sniper or a rat would get you. She had wanted to curl up and cry then as she did now, but she had kept going. And, you'll keep going now.
McCall tied the strings of the cap and pulled on shoe covers. Carefully she slipped on a mask. Sighing she looked into the glass again. You'll do.
Gage had finally lapsed into unconsciousness leaving Brice no further source of distraction from his thoughts. Craig lay, staring at the ceiling reviewing his conduct over the past few days, trying to determine what course of action would have saved his partner and spared Beth her suffering. Behind him the door to the room opened but he did not turn his head.
McCall stopped by Gage's bed and looked at the young firefighter, waxen and motionless atop a cooling blanket. His fine-boned but powerful wrists were held immobile within the canvas restraints. Come on fight back, Johnny.
She turned from John and walked over to the bed where Craig lay. "Sit up and drink this."
Brice turned to see Dixie standing over his bed with a stern expression on her face. She held out a large paper cup. The faintly acrid, cooked odor of a nutritional supplement caused him to gag. "Nurse McCall, I'm not thirsty..."
"Good this isn't for thirst. You need to take some nourishment." She raised the head of the bed and thrust the container closer.
Wrinkling his nose Craig turned his head away. "My stomach is still unsettled. I don't think I can keep it down."
McCall held up a foil wrapped package. "An antiemetic -- Morton's orders..."
He stared at the packet in horror. "Dixie, please. I'm just starting to feel clear-headed. That will make me sleepy."
She gazed at him coolly. "Good, you need to rest."
She lifted the control for the bed. "Roll on your side, please."
"Ok, " he sulked, reaching for the glass. "I'll try a little." He took a sip. The taste was worse than the smell; he pushed away the cup. "That's all I can take right now."
"Craig, do you want to see Beth?"
"Yes." He fought to push himself fully upright. The movement started a violent coughing spasm.
McCall set down the cup and lowered him back onto the pillow, as he gasped for air. She waited for him to catch his breath. When he had relaxed beneath her gloved hands, Dixie continued, "Then drink the rest of this."
"Dixie..." he rasped.
"Roll over." She lifted the edge of the sheet.
"...can I have a straw?"
Craig could just barely see Beth's face between the siderails. Her sweat dampened hair was matted against her head and her freckles looked painted on her ashen cheeks. A non-rebreather hid her lips. She was covered only with a thin gown and sheet. Despite his years of experience, he found himself unnerved by the many tubes and wires attached to his lover.
Brice glanced quickly behind him. Dixie had stepped out into the hall to give them a few precious moments of privacy. He slid his hand between the rails, trying to touch her face. He could not reach her. Wrapping his fingers tightly around the metal frame, he pulled himself upright. Stars swam before his eyes. Gently, he extended his hand and stroked her cheek, caressing her warm, damp skin.
Beth awoke, feeling a light, trembling touch upon her face. She blinked, narrowing her eyes against the painful lights. Brice stood, peering over an isolation mask and hanging on to the bedrails, his knuckles white with strain. To her practiced eye he looked pale and dehydrated. "Craig," she whispered, the name catching in her throat.
"Beth." He touched his fingers to the mask over his lips, kissing the air behind them. Then he rested them briefly on her forehead. The floor beneath his feet shivered and his knees buckled.
Dixie caught the paramedic as he fell, easing him back into the wheelchair.
"I didn't hear you come back in," he mumbled. His skin was glistening with sweat and he was panting.
"You should not be standing," McCall scolded, looking at his face.
"Dixie," called Beth, weakly.
"Yes?" McCall leaned over the edge of the bed and looked down at the other nurse. She listened as Beth whispered.
"He likes cherry popsicles..."
Dixie nodded, her eyes smiling over the top of her mask. "I'd better get Romeo back to his bed." Watching Brice color slightly, she took hold of the handles of the wheelchair.
Dana studied the long strips of silvery duct tape, holding sheets of plastic over the windows. She stepped away from the makeshift airlock in the trailer, which had been converted into a biological hot lab. Most of the viral isolation work was being done inside secure containment labs at the in Atlanta and Fort Derrick, but basic diagnostic work still had to be done for the patients here at Rampart.
On the lab bench was a row of tiny conical tubes with plastic lids each with holding a dead mosquito. Another rack held additional mosquitoes, these ground to a pulp and immersed in an antibiotic laced broth, formulated to suppress competing bacteria. Behind the counter the lab technician was perched on a high stool peering through a microscope, using a tiny scalpel and forceps designed for ultrafine manipulations to tear apart an insect and remove the salivary glands. He placed the fragments on a specially coated sticky slide and used a square of thin glass to spread the material over the surface. "Last one," he commented, dripping a cocktail of chemicals across the tissue.
"Done?" Swenson asked the technician.
"Not quite," he replied. Putting on a thick blue pair of cryogenic gloves, he lifted the top on a large gray cylindrical vacuum bottle full of liquid nitrogen. A thin sheet of white fog spilled from the neck of the bottle, down the sides and across the floor. Long aluminum racks full of tiny vials of blood serum hung suspended in the icy contents. The technician pulled two from the dewar.
In the seconds before thick whiskers of frost covered the vials, Dana read the names on the labels -- Bellingham and Sharp. "How long? If these insects are infected, we are poised for a major outbreak."
"A couple hours, maybe. You can't rush this."
"I know," sighed Swenson. "Sorry, I'm just a little tense."
He looked up from the razor edged slabs of glass, smeared with mosquito and possibly a deadly virus and said, "Believe me, I understand."
The lab technician dipped the sheet of thin plastic covered with grease pencil markings into the vat of disinfectant, in preparation for removal from the lab. He grimaced at the negative results visible through the turbid solution. The mosquitoes were not infected. Dr. Swenson was not going to be pleased.
Brice opened his eyes, to find a blurry cherry popsicle bobbing in front of his face. He blinked in surprise and groped for his glasses. McCall again stood next to his bed, this time holding the desert. "Dixie."
She watched the paramedic turn his head away. "I raided the supply in pediatrics for this. You need the fluids," she said sternly. She put on her most severe frown, calculated to convey to Brice exactly how humiliating she found stealing children's treats. "Cherry."
"I'm not," he began. But after one look at her face, he stopped and reached for the stick. "Thank you."
"That's better," she said, watching Brice bite off a piece.
Craig let the frozen liquid dissolve in his mouth, soothing his still sore throat.
"How long have you and Beth been... together?"
Brice swallowed. "One year, eight days...."
Dixie raised her eyebrows. "How did you two keep people from finding out? Beth is not exactly the quiet type."
Craig grimaced at the intrusion into his personal life. "I asked her not to tell."
Brice hesitated, then looked over at Gage. "How is he?"
John opened his eyes, trying to locate the source of the voices whispering in his ears. He felt as though he was submerged in molasses, unable to move against the viscous liquid.
McCall followed Craig's gaze. Johnny lay very still, the gown hitched up around his ears. His black hair was damp and limp, and his brown eyes were barely visible between swollen lids. Beneath the oxygen mask, his lips were cracked and bleeding. "He is hanging on," she lied. Actually, he looked like Bellingham had the day before he died. She turned away from Gage. "No changing the subject. Why didn't you want us to know?"
Craig sighed. What you really are asking is why wouldn't I admit I love her? "I didn't want to put up with the ribbing." He shook his head, imagining Bellingham's teasing. The sound of John fighting to breathe reminded him that Bob was dead. "Is this any of your business?" he snapped.
Dixie frowned. "Not good enough, half the staff is breaking the rules for you. We at least deserve to know why."
Red liquid dripped unnoticed down Brice's hand.
"Eat your popsicle, Craig," scolded Dixie, her expression softening. She handed him a tissue. "You know, Beth told Karen and Kel she was your wife."
Brice choked. "We're NOT married," he countered, loudly. At the sound of his voice, Gage moaned.
John struggled feebly against his restraints, trying to flee.
Dixie walked the four steps to John's bed. She checked the bedside monitor, not liking what she saw. "Shh, Johnny. Take it easy." She touched his hand.
Cool fingers stroked Gage, comforting him. "Mama," he mouthed. Weakly, John grabbed Dixie's fingers, quieting.
Whispering softly, McCall stood waiting for Gage to sleep and Brice to collect himself.
John's eyes closed and his hand went slack. Disentangling herself, Dixie turned back to Craig.
"How is he, really?" asked Brice, squinting nearsightedly at the monitor.
She hesitated. "Not so good," replied McCall quietly. She looked at Johnny, staring past the ill firefighter, seeing instead wards full of the sick.
"He's dying -- like Bellingham."
"Like Beth...." He swallowed hard.
Dixie touched Craig's shoulder.
"She deserves better. She deserves someone who not afraid to admit he loves her...." Brice closed his eyes, fighting back the tears, which prickled at the back of his throat, shaming reminders of his weakness.
Dixie smoothed the sheet. "I think you just did."
"Keep your mask on, keep your distance and don't touch anything in the room," instructed Gina, watching Roy pull on gloves.
DeSoto nodded. He had pestered the staff into letting him put on an isolation mask, leave his quarantine room, and visit Gage. Roy hesitated. The terror he had grappled with ever since he had attended the health department briefing, again wormed to life in the pit of his stomach. He swallowed hard and pushed open the door.
Johnny lay between a pair of cooling blankets. His skin was ashen, his face puffy, and he twitched restlessly. A black and blue bruise covered his right arm, caused by the seepage from an IV Gage had dislodged in one of his struggles. His fingers were blue tinged and his face was tight with the strain of his struggle to breathe.
"Johnny," said Roy, biting his lip and remembering his nightmare.
Gage stared through DeSoto with the glittering, unfocused look of delirium. He moaned, weakly. "Roy?" Abruptly his eyes rolled back and he began to shake in the throes of a seizure.
"Nurse!" yelled DeSoto, reaching for his partner.
John stood on the uppermost of the cement terraces of the Alameda Diversion Channel. He tightened his fingers on the handle of the throwline bag covering the rope and strained his eyes watching the swirling murky water for the pale blue flash of a fire department uniform. Nervously, he tugged on the line, re-testing the knot that fastened one end of the rope around the guardrail rimming the ditch. Pouring rain soaked him to his skin. He shivered.
"Here he comes," yelled Kelly, leaning over the railing of the overpass upstream from Gage.
John saw Roy desperately fighting to keep his head above the water. His vision narrowed to a tunnel encompassing DeSoto, the rope, and the path the paramedic was traveling. He waited.
"Johnny..." gurgled DeSoto.
John threw the bag. The bright orange sack followed a lazy arc, trailing rope. It glowed in sharp contrast to the sullen gray overcast.
The bag splashed into the water next to Roy. He grabbed the rope, twisting it around his arms. The flood spun the paramedic like a fishing lure on the end of a line.
John pulled. His muscles protested the load. "Give me a hand!" The greenish slime left by previous storm surges was like ice beneath his feet. The torrent sucked greedily at his partner's legs. "Help me!"
The floors and walls of the conduit rumbled, the vibrations running up Gage's legs, shaking his teeth in their sockets. Hands still battling with the slick line, he risked a glance away from DeSoto's waterlogged form. A wall of yellow-gray water rocketed down the channel. White foam churned on the crest, and boulders and brush whirled like flakes of paper in the surge. John tugged franticly at the rope, struggling to free his partner from the hungry waters. The coarse fibers cut his unprotected flesh. "Roy!"
The deluge washed over Johnny, knocking his feet out from under his body. Gage's last glimpse of his friend was of DeSoto spinning away from the bank, entangled in uprooted shrubbery. The floodwater tumbled John in sodden summersaults. Suspended grit scoured at his eyes. Rocks and tree limbs slammed against the paramedic, filling the water with blossoms of blood.
Gage's head finally broke the surface. He looked for Roy but all he could see was the whirling yellowish, angry tide surrounding him. "Roy!" he screamed above the noise of the flooded river. His bruised and aching limbs were leaden and useless. The cold water froze his skin, leaving the slow feverish burning of the false heat of hypothermia. Gotta get out of here! John choked on a mouthful of the filthy water.
The roar of the flood, turned to a crashing shout. Shit! Just ahead the water plunged over the sharp drop of a flow diverter. Lined with ten foot by ten foot concrete wedges, arranged like rows of broken teeth, the structure was designed to break the force of the rushing deluge. Sprays of gray water erupted from the barriers, glittering against the steel sky. He was swept over the edge.
Gage slammed against the diverter, his fall arrested by the concrete slab. His jaws smashed together and his teeth cut deep into his tongue. The cascade pinned him against the rough surface and the silty water forced itself into his nose, burning as it trickled into his throat. The pressure in his chest was intolerable as he fought to push his head above the floodwaters. Blackness beat against his temples. Involuntarily, Johnny inhaled, his nose and mouth filling with mud as water rushed in, sending the muscles in his larynx into agonizing spasms. Through swirling sheet of water, he could see a mass of tiny rainbows refracted by the spray.
John slowly awoke, becoming aware that his tongue was thick and swollen. The metallic taste of old blood filled his mouth and voices droned incomprehensibly around him. His eyelids remained glued shut. A pair of hands held his knees against his stomach, keeping him trapped on his side. He tried to kick his legs free, but they would not move.
"His temp is up to 105.4, doctor," reported Susan, wiping off the thermometer with disinfectant soaked gauze and returning it to the case on the bedside table. She looked across the bed at Dr. Morton.
Nodding, Morton turned from reading the flowsheets held against the window by a nurse, back to his patient and colleagues. "Joe, he's up half a degree in the past two hours."
Standing beside the bed watching the CDC epidemiologist examine John, Joe shook his head.
Tentatively, Gage stuck out his tongue, forced an eye open a crack and tried to peer at the injured member. The plastic cup of the oxygen mask blocked his view. He was staked out on a slab of ice and cold fingers probed his tender lower back along the spine. Shakily, Johnny raised a hand, trying to push the mask away.
"Easy," said Nurse Pat Chasing Crane, catching the firefighter's arm, as he lifted it a bare inch above the sheets. "You had a seizure and bit your tongue." John gazed uncomprehendingly at her; something in his expression suggested he thought she was just another feverish hallucination. Swenson signaled for Chasing Crane to release Gage's knees. Gently, Pat rolled the naked man onto his back, repositioning him on the cooling blanket.
Swenson leaned over the bedrail and placed the stethoscope on Gage's chest, listening as he breathed. "What's his O2 sat?"
"79%," replied Pat, refastening the wrist restraints that kept John from pulling out his various tubes. She fished ice packs from a basin and placed them against Johnny's skin.
Gage groaned weakly. The pain in his head was excruciating. Gasping, he tried to catch his breath, but ghostly hands were pressed over his mouth, smothering him. Faint tremors, shadows of weak shivers, shook his body. John slid down a dark tunnel.
"His urinary output is still dropping. He hasn't responded to the fluid challenge...." Morton slumped against the wall and summarized the lab report for Early, while Swenson completed her neurological assessment. He turned to Chasing Crane. "Let's begin Mannitol, 12g. Prepare to intubate and get him on a vent." Mike looked questioningly at Dana as she straightened.
"Worse," she answered.
Morton nodded again.
Swenson looked at the doctors, then at John who was falling back into unconsciousness. The paramedic had no history of contact with any known victims during the time that they were contagious. "Where did you contract this, Gage?" she whispered.
"Dana, when will the Ribavirin be here?" asked Morton.
Early inhaled sharply. "Mike, you can't be considering..."
Swenson tipped her head toward Brice. "Gentlemen, we shouldn't be discussing this here." She stepped into the hallway.
Morton stopped next to the trashcan by the double doors leading out of the suite of rooms. He stripped off his gloves and carefully removed the gown, rolling it inside out. "Conservative, supportive care hasn't done anything. The mortality rate for this bug is greater than 80%..."
"Ribavirin is only approved for the treatment of RSV in infants. The evidence for its efficacy with any other illness is insufficient," stated Early, squeezing soap over his hands.
"USAMRIID," said Dana, naming the army's Research Institute for Infectious Disease, "has been using Ribavirin successfully against Bunyavirus hemorrhagic fevers..." She reached for a paper towel.
Joe followed the other doctors out of the isolation ward to the nurses' station. "Those are different beasts."
"Clinical trials in Europe have demonstrated its effectiveness against other paramyxoviruses, including..." she started.
"But against this? Amantadine hasn't touched it."
Swenson choked back her frustration at being continually interrupted. "Amantadine doesn't cross the blood brain barrier, Ribavirin does. And preliminary studies show inhibition of viral replication in cell culture. "
"Yes, in vivo may be different, but nothing else has touched it. The toxicity of Ribavirin is low, lower than Amantadine."
"It wouldn't take much to push him over the edge...."
"He's already over the edge. I think this is the only chance to stop his fall." Dana stared at the Early.
Morton looked up from the chart in which he was making notes. "Gage is my patient and I am going to use it."
"Joe, 48 hours ago he was fighting a fire, now..." He glanced meaningfully at the doors with their yellow quarantine signs. "That spleenectomy he had a few years ago is making him easy prey for this bug. Do you really think he is going to last another day?"
Early bowed his head.
"Parkland in Dallas is conducting Ribavirin trials; they are putting some on a plane. It should be here in a couple of hours." Dana picked up Gage's chart.
Mike perched on the stool behind the counter and scrubbed at his burning eyes. "When it gets here, we will use USAMRIID's dosage protocols."
Scowling, Chet pushed aside the disposable foam tray and the equally plastic dinner. Sighing, he stared out the window into the hospital parking lot. In the background a Mr. Ed rerun droned on the TV set. A local independent, too cash strapped to afford programming from the era of color broadcasting, was the only station not featuring news broadcasts with stories about the virus. I already know more about it than I want, decided Kelly, pacing the confines of the room. A blood test and exam had led to an interview with a CDC doctor, and finally his current incarceration.
A nurse, completely unidentifiable -- save for eye color -- in her isolation attire opened the door. "Are you done, Mr. Kelly?"
"Yeah." Chet nervously tugged his gown downward. "I don't suppose there is any chance of ordering a pizza?"
The young nurse's hand hesitated as she reached for the abandoned tray.
She is scared to death, he realized. And she's not the only one. "That was a joke."
The woman paused, tray in hand. "We are doing everything we can for him."
The door swung shut, leaving him alone. Chet gazed out the window into the gathering darkness, feeling chills of fear prickle up his spine.
The last business man walked down the jetway, tightening his tie and smoothing the wrinkles in his dark suit. Behind him a young stewardess staggered, both hands wrapped around the handle of a heavy blue plastic cooler. The weight made her list dangerously on her high heels. A bold red cross was painted on the side of the box.
She handed the cooler to the waiting gate agent. "This is the medical supplies?" he asked, taking the thin multicolored shipping manifest from the woman's hand. The stewardess nodded.
Dana sat in the ER staff lounge, her head cradled in her hands. The pages of notes and lab reports floated behind her closed eyelids. Graphs and maps blurred and twisted, as incomprehensible as the origin of this virus stalking the citizens of L.A. Buzzing single file lines of mosquitoes followed the thin blue and red lines of highways over test tubes of ruby dark blood. One laughed at her and hissed, "What made you think of us? If it was us, why isn't anyone from the engine crew sick? Brackett was right...." Slowly her hand slipped from beneath her chin. Swenson jerked awake as her head fell forward. She gasped.
"I'm ok!" Startled, Dana turned to see the sturdy, woman paramedic from 51's standing next to her, looking mildly concerned. "Sorry, I dozed off. Didn't mean to snap at you."
Tsinhnajinnie smiled. "That's ok." Humming softly she busied herself at the coffeepot filling a styrofoam cup and stirring in sugar.
Dana listened to the other woman hum and thought about mosquitoes, ditches and paramedics who got sick without exposure to any known cases. Tsinhnajinnie's song rose and fell around her. "What is that? It's pretty."
"Something my mom used to sing." Aline shrugged. "It's suppose to protect you."
"We’ll all need it at the rate things are going."
"No luck locating the source yet?" Tsinhnajinnie asked, sipping at the steaming coffee.
Dana shook her head.
Swenson could see in the woman's eyes the dark awareness of the condition of her colleagues lying the beds of the quarantine ward. Dana averted her eyes. "Not yet," she whispered.
Aline bowed her head.
Her partner, Bert Dwyer, burst through the door. "Ready to go, Aline?" he asked. A flimsy white cardboard box full of medical supplies was awkwardly tucked under his arm. Two red-capped blood draw tubes protruded from the top of the box, scheming to escape. Dana stared at the pair of shiny glass containers, watching Bert shove the Vacutainers deeper into the carton and remembering the crash site at the ditch.
"Bye, Dr. Swenson." Aline crumbled her empty cup and started after Dwyer.
"Wait, Ms Tsinhnajinnie," called Swenson, mangling the pronunciation of the paramedic's name. The woman stopped, her hand on the door, and tilted her head toward the doctor. "You carry tubes for blood samples on your squads, right?"
"Yes," nodded Aline.
"Any with additives?" Dana saw the shattered fragments of glass, lying in the dirt, coated with a yellowish film.
Tsinhnajinnie glanced at Dwyer, who shook his head. "No. Just red-tops."
Swenson frowned. The tube had not come from the squad but instead from the vet's supplies. Zoonotic infections can have their origins among domestic animals as well as wild. She recalled an outbreak of a virulent viral pneumonia in Bangkok -- one Mark's cases -- spread by live chickens sold in a local poultry market.
"Doc?" asked Bert.
Dana waved her hand. "Thanks. You may have really helped us out." The two paramedics exchanged confused looks and shrugged.
"Later," said Dwyer.
Swenson walked over to the phone on the wall. Lifting the receiver, she dialed. "Hello. Dixie, can you tell me the name of the veterinarian 51 brought in?" Listening, she nodded. "Yes, please. If you could have them call me when they find those records, I'd appreciate it. Thanks."
Mike Morton examined at the small piggyback IV bag. He was dimly aware of Early and Swenson discussing other candidates for the experimental treatment. "Shaw, Wu, Adelberg..." listed Joe. The Ribavirin antiviral solution slooshed inside the sack, pooling in the sagging plastic between Mike's fingers. The colorless liquid seemed as impotent as everything else they had tried.
"USAMRIID recommends 1.28g every 6 hours?" Morton asked, glancing up Swenson and Early.
"Yes," confirmed Dana, nodding.
Morton repositioned Gage's arm to reach the port on the IV line. Johnny was motionless, no longer struggling restlessly. The medications and illness had rendered him comatose. The paramedic was dying. Mike slipped the needle into the line and adjusted the drip rate, timing the falling liquid. He lowered his hand. "Now we wait."
In the conference room the phone rang. "Swenson," said Dana, clamping the receiver against her shoulder as she continued to write.
"Dr. Swenson, the patient 51's brought in was Dr. Arthur Eckstein. Room 512."
She clambered to her feet, pushing aside her work and grabbing the pad in which she recorded interviews. "Thank you."
Dana followed the nurse into the room. In the second bed surrounded by a maze of metal frames, ropes and weights, lay a gray haired man, stretched in the therapeutic embrace of traction.
"Dr. Eckstein this is Dr. Swenson from the CDC," introduced the nurse. "She'd like to ask you a few questions."
Eckstein set down the magazine he had been reading, extended his hand and gazed at the epidemiologist curiously. "Arthur," he offered.
Swenson took his hand. The veterinarian's grip was firm and dry, belying the exhaustion and pain she saw etched into the lines on his face. "Dana," she said, sitting down.
Eckstein's eyes clouded. "Is this about that meningitis they are talking about?" He pointed to the TV hanging from the wall.
"Yes." Dana opened her notebook. "I'd like to ask you a few questions."
"I thought they had traced all the cases back to one man. I didn't know him."
Swenson winced at the reminder of the media leak at the County Health Department. "Arthur, it is highly unlikely that you have been infected," she carefully qualified her words. "But one of the paramedics who treated you is..."
"Oh God," breathed Eckstein, paling. "He was sticking needles in me."
Dana patted the man's arm reassuringly. "You're well outside the known incubation time for the virus." She smiled carefully. "However, I do think he was exposed to the source of the virus on the call."
Eckstein slowly relaxed. "What does this have to do with me?"
"We have traced two victims -- victims that had no exposure to any other cases -- to the area where you had your accident."
Arthur raised his eyebrows. "Coincidence."
"Quite possibly," admitted Swenson. "However, there are a few things I want to check out."
"Ok." Eckstein shifted awkwardly.
"Do you use Vacutainer sampling containers?"
Brow crinkling in puzzlement Eckstein spoke, "Me and almost every other vet in the county. Why?"
"I was out at the crash site and there were a couple of broken sample tubes. Were you on a call when you had your accident?"
"Yes, the Elliot's had a sick horse. I was checking up on it."
"Elliot's Stables. Peter Elliot and his wife run a stable in Long Beach -- one of those places where the rich folks from Palos Verdes and Manhattan Beach can board their horses or send their kids for dressage lessons."
"Where is Elliot's?"
"At the end of a little road called Arroyo Lane off 314."
Dana scribbled a notation on her pad. Her palms began to sweat. In her mind's eye, she could see the small dirt roads cutting across the irrigation ditch on their way to the highway. "Did you take any samples?"
"Yes, blood, urine, some nasal swabs... Second sick horse they've had out there."
Swenson's pen moved again. "What was wrong with the horses?"
"I don't know." His eyes grew distant as he remembered. "I thought the first one was some kind of poison -- avocado maybe. Those kids will feed a horse anything. But then a week after the first one died, they had another case."
Dana's head jerked up and she stared at the veterinarian. "Two? What were the symptoms?"
"Anorexia, fever, elevated respiratory rate, a frothy nasal discharge, ataxia, kidney failure...." Eckstein's voice trailed off.
The hairs on the back of Swenson's neck stood up, as she listened to the man describe a combination of respiratory and central nervous system symptoms. Bingo! She struggled not to jump to any conclusions. "Did you do a necropsy?" Dana asked, her voice quiet and calm despite the shiver going up her spine.
"Yes. But the lab work isn't back yet. Or at least it wasn't when I was last in my office." He gestured to the canvas slings and ropes. "I've been out of touch...." Falling suddenly silent, Arthur's face darkened as the full implications of Dana's questions became clear. "Oh God... The horses."
"It's a possibility."
"All those people," he whispered. "I didn't know."
Swenson met his horrified gaze. "Dr. Eckstein," she said, deliberately using the man's title, "it's not your fault. We may still be wrong and the two incidents are completely unrelated, but..." She tapped the pen on her notebook. "What's important is what we do now. I'll need to see your records on the case."
He nodded, reaching for the phone. "I'll call my office and the lab, have them hold any tissue samples they still have."
Standing, Dana nodded. "Thank you." At the door she turned. "Oh, do you know a Cindi Mallory?"
"Yes, she works at Elliot's." The vet's eyes narrowed. "Is she...?"
Dana hesitated. "She's dead."
Eckstein bowed his head.
12 am, read Morton through the translucent cuff of his gloves. He let the door fall shut. The hum of the chiller and the hissing of the ventilator masked the noise of his entry. Gage and Brice's room was shadowy and dim. The fluorescent tube mounted above the head of the bed cast a bluish glow across the plastic cooling blankets covering 51's paramedic. The Ribavirin solution glittered as it fell within the drip chamber of the IV.
"...Mr. Gage is sedated. I'm sure it isn't bothering him." The voice of the nurse rose over the clamor of the medical equipment, tinged with desperation. Sickness and fear of sickness had left them understaffed and the strain was extracting its toll. "Please, take your sleeping pill, now."
"Brice, you need to rest," said Morton, studying the monitor over Gage's bed. Over the past twenty hours the medication and the efforts of the nursing staff had reduced the firefighter's temperature from its earlier blast furnace intensity. Mike started to roll John onto his side.
"Thank you," whispered Chasing Crane, walking around the drape and taking hold of Gage's shoulder and hip. "I was about to sedate him the old fashioned way -- skull fracture."
Mike pressed the stethoscope against Johnny's chest and listened. "What was the problem?" he asked, straightening.
"Wrinkled sheets -- on Mr. Gage's bed." With her chin, Pat pointed to the slight fold at the edge of John's bed.
Morton snorted and helped the nurse reposition Gage.
"Better?" asked Pat.
Mike nodded, watching the woman place rolled up washcloths beneath her patient's palms. "When was the last ABG done?"
"Ok...." started Chasing Crane. "Doctor."
Morton followed the nod of Pat's head. Beneath lashes coated with traces of the lubricating ointment that had been applied to protect his corneas, Gage's brown eyes followed the doctor's movements.
"Take it easy," soothed Chasing Crane.
"Go back to sleep, Johnny." Smiling, Morton looked at the nurse.
The paramedic glanced at Mike, his eyes slowly closing.
"I want to start everyone who's been exposed on Ribavirin, follow USAMRIID's recommendations for prophylactic dose," instructed Mike, feeling hopeful for the first time since this nightmare had started.
Peter Elliot stood in the door, wearing a baggy pair of shorts and a Red Sock's shirt, and blinking blearily at the credentials held in front of him by the California Department of Food and Agriculture's Animal Health Officer. The man glanced nervously into the gloom beyond Dana and the Animal Health Officer, squinting at the two vans and Sheriff's Deputy's car parked in the drive. "Yeah, I had some sick horses." Elliot's words were clipped by a thick Boston accent. "Got one now. Vet says it's pneumonia. Why do you wanna talk about my horses in the middle of the night?"
"Sir, we are investigating an outbreak of human illness, which may be related to an equine illness." The CDFA man slipped the slim leather folder back into his pocket.
Dana watched anger and apprehension war for possession of Elliot's face. The wind picked up, carrying the smell of horses to her.
"Peter, what's going on?" called a feminine voice from somewhere deep inside the house. "Who is it?"
"CDFA," replied Peter.
"At 2am?" A middle-aged woman wrapped in a purple corduroy robe appeared behind Elliot. She gazed nervously at assembled crowd on her doorstep. "Peter..."
"Go back to bed Yvonne, I'll take care of it." He looked at Animal Health Officer. "Let me get dressed." Abruptly he disappeared into the house.
Dressed in a pair of disposable Tyvek coveralls and rubber galoshes Swenson stood on the loamy dirt before the corral. Strips of silver-gray tape sealed her gloves and boots to the overalls. In the glow from the security light, she could just make out a horse standing under the cover of an open shed. She pulled on her heavy rubber respirator, tightening the straps. The Animal Health Officer was already opening the gate. Dana watched Peter. The anger had faded from the man's features leaving only fear. "You'd better wait here." Elliot nodded mutely at the suited and masked apparitions that had materialized out of the night.
Swenson walked to the gate. Suddenly, she stopped and turned to Elliot. "Mr. Elliot, do you know a Mr. Alex Sharp?"
"The guy who died?"
"Yeah, he boarded a horse here." In the light, Peter's face was a drawn, sickly yellow.
A jolt of adrenaline shot through Dana's muscles. "Thank you, Mr. Elliot." Swallowing hard, she followed the CDFA veterinarian across the darkened paddock.
The veterinarian murmured soothingly to the animal, which took a few skittish, stumbling steps away from the unusual visitors then, stopped, standing listlessly in the corner. "Poor fellow, you don't feel so good huh?" He took hold of the halter. "Stable froth," he commented, slowly turning the horse toward Swenson.
The horse's nose ran, specks of dark, bloody foam flecking the mucus. The animal's dark eyes stared glassily at Swenson. A prickle of fear ran down her spine as she studied the horse. She felt a strange mix of horror and elation. The puzzle pieces fell into place. A sick horse had infected Sharp and Mallory. The body fluids from an infected horse were in the glass sample tubes that had infected Gage. The pattern of sickness and death that had spread across the city stretched from the animal like a deadly web. "This is it," she whispered. Icy sweat soaked her clothes beneath the cover all. She shivered.
The Animal Health Officer called to his team. "Get blood samples and nasal swabs from all animals on the premises. Be careful to avoid cross contamination."
"Watch yourself with the sharps," added Dana.
The vet nodded his agreement. "We'll quarantine the whole operation, until we get the results back."
Roy stopped just inside the door. The curtain between the two beds was drawn. Past the fabric he could just make out Brice, eyes closed probably asleep, in the other bed. He looked at Johnny, afraid of what he would see. Jones had Gage rolled on his side and was finishing tying the strings on a fresh gown. Only the back of John's head and the corrugated respirator tubing was visible. Under his mask, DeSoto chewed his lip. The other victims being treated with the antiviral had improved dramatically. Johnny, however, was still on the ventilator.
Roy stood staring at his friend's back. Unnoticed, the door behind him opened.
"Excuse me, Roy," said Morton, squeezing past the firefighter.
"Oh sure," stammered DeSoto, startled by the doctor's presence. Mike looked desperately tired.
A rapping on the glass interrupted Roy's thoughts. An unfamiliar nurse pressed a laboratory printout against the window. Mike solemnly studied the numbers. DeSoto squinted at the sheet, but his attempt to read the tiny print in the overly bright room was rewarded with the start of a throbbing headache.
Gina walked around the bed and pulled the draw sheet folded beneath John's hips. DeSoto's heart ached at the sight of his friend rolling bonelessly onto his back. Stillness was not a natural state for Johnny; he looked wasted and vulnerable. "Doc," Roy began, craning his neck painfully to peer past the physician's back.
Mike looked up. Noting DeSoto's worried expression, he pointed to a metal stool beside the Gage's bed. "Roy, he is doing much better."
Even as he sat down, DeSoto could see Morton was right. John looked better. His skin was no longer slick with sweat and the dusky pallor had left his lips. The nails of his slim fingers, lying slack atop the bedding, were pink.
"His last round of bloodwork was pretty good. His kidney function has improved and the latest chest x-ray looks better. He was conscious for a few minutes last night. We'll probably take him off the vent later today, if he wakes up a little more."
DeSoto nodded stiffly. He watched Jones shift Gage's shoulders back onto the center of the bed and smooth the pillow. The nurse carefully repositioned the ventilator tubing and spread a sheet over his partner. Roy smiled slightly, imagining how much Johnny would enjoy the woman's attentions if he were awake.
Mike examined DeSoto's face. It was too pale. "Roy," he called, observing DeSoto closely as he turned. The firefighter seemed to be guarding against moving his neck. DeSoto had been thoroughly exposed when Gage vomited on him. "Do you have a headache?"
Roy hesitated, certain the discomfort caused by trying to read was just a sign of his fatigue. "Not, really."
Mike studied the various expressions crossing Roy's face and decided. "Miss Jones, after Mr. DeSoto has had a few minutes with his partner, please take him back to his room and prepare him for an examination."
Torn between relief and fear, Roy glared at the doctor.
Morton and Jones left, the nurse patting his arm reassuringly. Turning from the door, DeSoto looked at Gage. "Johnny," whispered Roy. The sick firefighter's chest moved evenly and his eyes stayed closed. DeSoto watched and then bowed his head, thinking. After a few minutes, Jones knocked on the window. Standing he looked down and asked softly, "Junior, what did you get us into this time?"
Roy stared at Gina's arm and gritted his teeth. Despite the local anaesthetic the large needle pushing through the cartilage between his vertebra was excruciating. The needle shifted a fraction of a millimeter as Brackett attached the manometer and DeSoto debated screaming, but instead he imagined Joanne.
"180 mm, Mike," reported Kel.
A faint clink of glass accompanied the doctors' movements, Roy felt a flicker of nausea at the thought of what they were doing. He squeezed his eyes shut and reached for memories of his family to fight back the terror and pain.
"Hanging in there, Mr. DeSoto?" asked Jones, her arm behind his knees moving slightly.
"Uh huh," he grunted, visualizing Joanne's thick brown hair. His fingers twitched as he mentally traced the paths of the strands, caressing the warm nape of her neck.
"Almost done" reassured Morton.
DeSoto drifted, letting the pictures change and flow. Warm pride surged in his chest as he remembered Chris in his scout uniform, the spitting image of Joanne's father, or Jen in his workshop, letting him guide her hands as they ran the router over the edges of the bookcases they were building. He had so wanted to see them grow up.
"Done, Roy," said Brackett.
The pressure of a dressing being taped over the puncture brought Roy back. He tried not to struggle as Morton and Jones rolled him over, positioning him to prevent seepage of fluid from the tiny hole in his spine. On a draped stand by the bed sat the four tiny tubes of yellow fluid -- his spinal fluid. DeSoto's stomach did a flip. Licking his lips he turned his head and inspected his IV line, the first he had had since they had practiced sticks on each other in training. The tiny bag of Ribavirin dripped above his head.
"It will be several hours before we get the result back from the lab." Kel gazed down at the paramedic. "Try to drink a little something -- it'll help with the headache -- and get some rest."
"Ok," replied DeSoto, closing his eyes. He knew and the lab report would only be an unnecessary confirmation. By the time they're done, I'll be too sick to care. In memory he touched his wife again, feeling her soft skin and seeing the smile she saved just for him. At least he hadn't infected Joanne.
DeSoto blinked in the gloomy hospital room. Outside the window the remnants of a glorious sunset stretched over the horizon, outlining buildings and trees with purple, scarlet and gold.
"How are you feeling?" Dixie's eyes smiled down at him, in spite the cheerful expression deep lines a fatigue still marked the corners.
Roy lay still for a moment, assessing. His head, chest and muscles ached and he was faintly queasy. Dixie's isolation mask told him the results of the tests -- he had it. "Not as bad as I expected." DeSoto struggled to his elbows, but McCall pushed him back and gave him the pillow fluffing routine he had seen her use with great effect on Gage.
"It's the Ribavirin. It didn't stop the infection, but it is lessening the severity."
DeSoto nodded, stopping abruptly as the muscles in his neck protested.
Dixie filled a glass of water, handed it to Roy, and watched him drink. "Johnny was taken off the vent a couple of hours ago." The nurse chuckled. "He's still out of it, but he did manage to pry one eye open and give Mike a look which should have reduced the good doctor to a puff of green smoke."
Roy smiled for a second, then sobered. "Joanne?"
"Kel talked to her." McCall nodded toward the phone and took the cup from his hand. "But, I think you ought to call her. She needs to hear your voice." She patted DeSoto's leg and winked. "Get some rest. I got to go check on my other favorite paramedics."
After the nurse left, Roy sat in the darkening room staring at the phone, practicing talking to Joanne, hiding his own fears. He picked up the receiver.
In the dark close closet turned darkroom, the technician slipped a last slide covered with horse blood and Alex Sharp's blood serum under the microscope. A pale green glow greeted him. The hair of the back of his neck stood up. Carefully he made a mark in his notebook and turned on the lights. He walked to the airlock, dropped the plastic sheets into a solution of bleach and stripped off the isolation attire.
Outside the California sunlight was blinding, bouncing off the chrome and glass of parked cars. Slowly he walked across the parking lot. These results he would deliver in person.
Johnny stood barefoot in on the damp silt, enjoying the gray mud's coolness -- a sharp contrast to the heat of his sun baked hair. Above the water line, the earth dried and cracked, forming thin curled flakes. Three-toed bird tracks led to the clear flow of Bear-Kills-Woman Creek, a sweet watered rarity among the muddy tributaries of the White River. He stepped ankle deep into the cold waters. Behind him rose a gray bluff, banded with pink sandstone and topped with thick grass. The sheer sides were pock-marked with the pouch-like nests of cliff swallows. A crumbling, fossil turtle shell lay half in the streambed, fragmenting into sharp black bits. He was home.
Gage splashed across the shallow stream and climbed onto the floodplain. Grandpa Baptiste had brought him here as a child, insisting he memorize every detail of this place. Here on the low table, surrounded by the bluffs and screened by the cottonwoods, elms and thick brush, bands of Oglala's had hidden from the Milahanska, the American soldiers. John had heard his grandfather tell his grandfather's stories, gathered the old beads brought to the surface by ants and seen the trees twisted by the many winter burials. Along the base of the cliffs, thickets of buffalo berry bushes awaited the touch of frost to transform the bitter green fruits into sweet bronze globes. Gage sat on the gnarled trunk of a fallen cottonwood and picked up a broken chuck of a limb, looking at the morning star pattern sealed within the heartwood.
A low rumbling echoed up the canyon. Nervously, Johnny stood scanning the western horizon, looking for the darkness of an approaching storm. The wind picked up, blowing the fluffy white seeds of salsify from the prairies above. The canyon filled with a whirling white cloud. Despite the sounds, Gage saw no signs of a storm. Beneath his feet the ground began to tremble.
Around the bend, between two tall spires of clay and sandstone, came horses --paints and bays, led by a single ebony stallion. They burst free of the confining ravine walls, their hooves spraying water into the air and churning the stream to a muddy gray. Calling to one another, they charged up the bank and exploded through the tall grass in front of John.
"Tunkashila," prayed Gage, rooted to the ground before the rushing herd. Frozen, he closed his eyes as the animals surged around him. He could feel the heat from their bodies. The horses' wild smell penetrated to the bottom of John's soul, until there was nothing else in the world. The ground shook and the air was filled with the sound of their immense lungs working. Sweat from their foam-covered sides spattered him. The horses neighed and cried as they raced across the floodplain.
Then the herd disappeared up the canyon.
John fell to his knees in relief. Shaking, he traced the outlines of the hoof prints in the broken sod.
Gage awoke, uncertain whether he was on silky silts of Bear-Kills-Woman Creek or the smooth sheets of a hospital bed. He moved his fingers, listening to his nails scratch on the weave of the fabric. Johnny's throat and chest ached, but the terrible pain in his head had abated somewhat. Someone had bathed him, for he was no longer sticky with sweat. He was propped up in a semi-seated position. Sifting through confused memories of delirium and sickness, John tried to figure out how long he had been ill.
A pair of hands started wrapping a b.p. cuff around his arm. Slowly, he opened his eyes and looked up into the face of a short, slender Indian woman. Startled he stared, he had thought the Native woman he had seen while sick was a feverish hallucination.
"Hello," whispered Pat, glancing toward Craig who remained asleep. "How are you feeling?"
"Better," replied John. Or at least he tried to answer, but instead the word emerged as a faint croak. "Water?"
Chasing Crane poured a small amount into a paper cup and held it for him. "Just a little, you're on fluid restrictions." She supported his head as he drank.
Johnny took a sip, exhausted by the movement. "Better. Thank you," he repeated a little more clearly and strongly.
"I need to ask you a couple of questions. What's your name?"
"Johnny Gage.... 1980... Rampart... and Jimmy Carter is pres..." His voice trailed off, as winded, he stopped.
Pat's eyes smiled. Placing the stethoscope in her ears, she inflated the cuff, measuring his blood pressure.
Gage watched her, gathering strength for his next inquiry. "How long?" John asked, when she finished. Speaking left him short of breath.
"Have you been sick?" She watched him nod weakly. "Four days."
It had been long enough for Roy to contract the infection. John struggled ineffectually to sit up as the panicked realization hit him, but Chasing Crane caught his shoulders. "Roy?"
Pat hesitated. "We started Mr. DeSoto on Ribavirin before he showed symptoms. So, he feels pretty miserable but he is responding very well."
Gage closed his eyes in relief, panting from exertion.
"He's been quite -- uh -- explicit about his plans for revenge when you get out of here."
If DeSoto's head hurt half as bad as his did, Roy was entitled to a measure of retribution, Johnny decided, relaxing. He listened to a smile creep into the nurse's voice as she related his colleague's feverish grumblings. Her words bore traces of the speech patterns of the northern plains reservations. John was tired, nearly ready to go back to sleep, but right now each second was as rich as the first breath of fresh air after a good fire. I feel the need for some life affirming activity -- like flirting. Opening his eyes, he watched the attractive woman's hands as she adjusted his IV. "Do..."
Chasing Crane leaned closer to hear the paramedic's weak voice.
"...you know... you have... beautiful eyes?"
Gage watched her checks color, like a dusting of cinnamon on hot chocolate. But, the sight of the nurse's soft brown skin and soothingly dark eyes reminded him of the women back home and caused a rush of homesickness.
"That was quite a dream you were having earlier," she said in an attempt at distraction. She studied the paramedic lying in the bed. He was pale, thin and sick looking now, but she was willing to bet that when well he was heart-breakingly attractive, in an iyeska sort of way. With difficulty, she returned her attention to preparing a new bag of IV solution, aware he was watching her every movement. "What were you dreaming?"
Chasing Crane inserted the end of the infusion set into the bag. "Where's home?"
"You've... never heard... of it." Gage studied the edges of the cup-like mask on the woman's face, trying to imagine the shape of the mouth and nose hidden beneath the barrier.
"Bet I can beat you at the obscure hometown game...."
"Ok. Potato Creek,... South Dakota."
"An Oglala boy?"
"Not exactly... a boy," interrupted Johnny, sulkily. Her protective blue cap was pulled tight over thick rolls of hair. He found himself fantasizing about untying the strings and running his fingers through the heavy tresses. Awkwardly and weakly, he shifted. Smiling John tried to make eye contact, but she was intent on adjusting the drip on the piggybacked Ribivarin solution. "How about you?"
"Upper Cut Meat." She lifted bandage scissors from the bedside table. "I'll take the armboard off, if you'll refrain from pulling out that line."
"Sicangu," he commented, naming the second largest Lakhota band.
She nodded, cutting the tape that held his forearm against the splint.
Johnny flexed his wrist, reached up, and fumbled at the oxygen mask on his face. His hand trembled and the movement left him breathless. "Wanna go... out sometime?" he asked, grinning at the nurse. "Two Sioux... all alone... in the big city...."
Pat disentangled the plastic mask from his fingers and placed it firmly over his nose and mouth. "Mr. Gage, I don't date masked men."
Johnny frowned. "Or contagious ones... either, I suspect..." he muttered, leaning back against the pillows. He felt utterly drained.
She smiled again.
The door opened and a gowned Dr Morton entered. He stopped at John's bed, resting his hands on the rail. The doctor's eyes were bloodshot and his shoulders slumped in exhaustion. "Gage, how are you feeling?" he asked.
"I was... better earlier," Johnny answered, glancing at Pat, his tone colored with disappointment and drowsiness. He fought to keep his eyes open.
Mike looked questioningly at the nurse. She shook her head. He decided to ignore the exchange between the paramedic and nurse.
"Doctor," acknowledged Chasing Crane, as she recited Gage's vital signs.
"..and a positive flirtation sign," she added, concluding her report.
Morton snorted. "Good to see you're recovering, Gage."
John's lips twitched, as he lost his battle and fell asleep.
Craig leaned forward in the wheelchair and reached between the rails, taking Beth's wrist between his fingers. The woman's skin was warm and moist with the last traces of the fever. Brice glanced at her face, but Shaw's eyes remained closed as he touched her, under the oxygen mask she breathed easily and evenly. Counting he watched the second hand of Gage's wristwatch, which he had borrowed from the small table beside paramedic's bed, sweep in an arc. 80 -- Not bad. He checked the color and tone of her skin and rested his hand on her diaphragm, timing her respirations. He barely resisted the urge to lift the blanket and check for pedal edema or count her toes, just to convince himself she was still there. He squeezed her limp fingers, realizing he could no longer endure their relationship of convenience, each free to leave without so much as a backwards glance.
Bracing his hip against the bed rail Brice stood and watched her sleep. Gently he touched her face, tracing the familiar landmarks -- the curve of her ear, the soft hollow beneath her chin, the warm silkiness of her eyebrows...
"Uhmmm," sighed Beth, waking.
"Shh," whispered Brice fingering a lock of her hair. Shaw looked tired; weakness had folded tiny creases into the corners of her eyes, but the light was no longer fading from their green depths. Slowly he leaned forward, brushing his lips against her forehead. "Rest, you still have a bit of a fever."
Licking her lips, she laboriously murmured, "I hope that's not how you check for one in all your patients."
Craig smiled, his heart pounding in terror over what he had to do next. "I'm not exactly the department's most organized paramedic right now. They took all my paramedic toys, I even had to steal Gage's watch."
Brice's heart skipped a beat. "Go back to sleep." He squeezed her fingers.
Johnny gritted his teeth in frustration, the ugly vinyl covered chair kept getting further and further away. His legs started to shake. "Geeze," he hissed.
Pat tightened her grip around her unsteady charge's shoulder and elbow. "Just a little bit further." She nodded toward Gage's other arm, which was twisted behind his back clutching the opening of his grown. "This'd be easier if you'd let go. I've seen men's behinds before."
She chuckled. "You don't want to know what all I've seen."
John feel his checks burn. He looked distrustfully at the floor, which seemed to be wobbling more than his knees. Drawing a deep breath, he pretended he was only two steps from his car after a long Saturday night shift -- during a full moon. He forced his feet to take two more steps and sighed as Pat eased him into the chair. Tipping back his head, Johnny closed his eyes and tried to conceal his shortness of breath. Sweat trickled down the middle of his back.
"Ok?" asked Chasing Crane.
Johnny nodded. "I suppose this is one way to get close to a good looking woman." He fought down a wave of nausea and began to wonder when he was ever going to feel better.
The nurse blushed. "Concentrate on your recovery, Mr. Gage."
From across the room, Gage heard Brice groan softly. He opened one eye and glared at his annoying roommate. Craig was seated on the edge of his bed meticulously cleaning his glasses -- for the dozenth time. The sight of the other man sitting up and easily walking around irritated John. "Is that what you do when you don't have a drug box to alphabetize?"
"There was dust on the lens," replied Craig. He held the spectacles up to the light and squinted at the surface. He always cleaned his glasses when he was worried or nervous; only a supreme act of self-control had kept him from ripping them off his face and scrubbing away the lenses when he had been told he was detailed to 51's to work with the legendary DeSoto.
"I don't know how. You just cleaned them ten minutes ago."
"I wouldn't expect you to understand the importance of clean..."
"Boys," interrupted Pat. She looked down at the paramedic slumped in the chair in front of her. "Let's get you back in bed." Bracing her legs, she positioned herself behind Gage's left shoulder and helped him stand. Slowly she steered him back to the bed. John was leaning heavily on Pat's arm as she eased him down on the mattress.
Gratefully, Johnny lay down and let the nurse untangle the oxygen tubing and pull the blanket over his legs. "Is this our first dance?" he asked, wearing his best 'aren't I the cutest thing you have even seen' grin.
"I know, concentrate on..." The coughing fit that had been tickling at the back of his throat finally got the better of him. He turned away from the young woman.
"...your recovery," finished Chasing Crane, measuring a small amount of water into a paper cup and handing it to Gage. Smiling, she walked to the door. "I'll be back to check on you later."
Johnny nodded, still struggling to catch his breath.
Craig watched at the other firefighter, waiting for John's breathing to slow. His gray eyes were coolly curious. "Why do you do that?"
"Do what?" Johnny asked, hoarsely.
"Harass that poor woman while she is trying to do her job?"
John took a sip of water, enjoying the soothing coolness on his raw throat. "Look at her, Brice. She's beautiful."
"So?" Brice hooked his glasses behind his ears and stared disapprovingly at Gage through the newly cleaned lenses.
Johnny smirked at Craig. "At your age, I shouldn't have to explain why a man would wanna be with an attractive woman. You are in pretty sad shape."
"Grow up Gage," snapped Brice. "Maybe you should try thinking beyond your teenage hormones."
The headache, which had never completely retreated, returned in force, setting John's temples throbbing. "Well, some of us don't have a live in model to take care of that..." Angrily, he pushed himself up on one elbow. The movement started another coughing spasm. Johnny sank back onto the pillow, gasping.
"Maybe if you were more mature," suggested Craig, taking advantage of his roommate's breathlessness. He studied the other man's face. "What I can't figure out is whether it's the women or yourself, for whom you have so little respect."
"What the hell do you mean by that?" demanded Gage, struggling to a sitting position.
"You know what I mean...."
"No I don't," said John, hotly.
"Look at that nurse, there is someone with whom you might have been able develop a relationship -- if you hadn't acted like a pubescent oaf. If you had taken some time to get to know her, as a person not a sex object..."
Johnny felt like he was going to explode. "We talked..."
"Do you even know her name, Gage?" asked Brice, quietly.
Gage flushed and fell silent for a minute. His head and chest were pounding in unison. "At least women know what they're gettin' with me..."
"A one night stand."
"Beats pretend commitment," insisted John. "All the benefits of marriage, none of the obligations. What rule book did'cha find that in Brice?"
"Shut the hell up, Gage," snapped Brice.
Johnny rolled over, pulling the blankets over his neck. He closed his eyes, fighting to calm down and ease the throbbing behind his temples. He lay wishing he was home in his own bed. After a few minutes he spoke. "Brice, what's her name?"
"Pat Chasing Crane," sighed Craig.
"I want to be there," announced Peter Elliot, flatly.
Dana locked eyes with the stable owner. In the back of the house, she could hear the physician taking soothingly to Elliot's wife. The woman had become hysterical earlier in their discussions and had required sedation. Peter sat at his kitchen table gazing defiantly at the masked and suited men and women standing in his home. Sweating, Swenson gripped the sheath of court orders that empowered her to act. "No, out of the question."
"I want to be there," repeated Peter, standing up.
Involuntarily Swenson stepped backwards. The presence of the policemen accompanying her was suddenly comforting. "Mr. Elliot, no one enters the stable without appropriate protective gear."
"I'll wear it."
"It takes special training...."
"Then I'll go without."
"No, you're going into quarantine."
The man turned from Dana and stared out the window, watching a half a dozen men in protective suits unload trucks. "Damn it, you're going to destroy everything I've worked for, I have the right to be there."
Swenson hesitated. Turning to one of the men with her, she said, "Show him how to wear a Racal."
Dana stood under the dark vaulted roof of the stable. The thick plastic suit crinkled every time she moved, echoing in her ears. The CDFA veterinarian pointed toward a bay mare. Behind the mask his face was grim and gray. "Let's get this over with."
Elliot took hold of the halter, stroking the silky face of the horse. The animal's nostrils nervously dilated and it turned white rimmed distrustful eyes on Swenson and vet. "Shhh girl," he crooned. "It going be better soon."
The veterinarian filled a syringe. Carefully, he approached the mare and inserted the needle into a vein. The animal's skin rippled and she stamped. "Ok."
Peter rubbed the mare's neck. "Shhh girl."
The horse's eyes dulled and, stumbling, she sank to the ground, as the overdose of barbiturates overwhelmed her. Elliot dropped his knees. He continued whispering to the animal, until its eyes went cold and glassy. He lifted his tear-streaked face and looked at Dana. "It is finished."
The vet pointed to the next stall. Elliot staggered his feet.
Shaking her head, Swenson closed her eyes; the countenances of the dying, bereaved, frightened and sick, human and animal swam before her. Nature was not kind, and although this skirmish was done, the war between mankind and disease continued. "This time we won," she whispered, turning and walking into the hot sunlight.
Chet stepped into the hospital parking lot. He turned his face toward the sun, and savored the warmth on his skin. Kelly, you are the luckiest man on earth. He took a deep breath.
"Chet!" Marco waved from the cap of his pickup.
Kelly returned his friend's wave. "Marco."
Lopez pulled along side the firefighter. "Need a ride?"
Chet threw the plastic shopping bag containing his turnouts into the bed of the truck. He opened the door. "You bet." Smiling, he rubbed his hands together.
"How're you feeling?" Lopez put the pickup in gear.
"Fine. It's the superior Kelly make-up. No virus would dare."
"No virus would want to."
Glaring, Chet continued. "I owe Gage for this. The Phantom will be avenged for his unjust imprisonment."
Lopez chuckled. "How are Johnny and Roy?"
"Gage is very weak, but better. They're going to let him out end of next week. Roy's goin' home on Friday." Chet held his fingers out the open window and shook his head. "Marco, I'm suffering from chili withdrawal. You won't believe the food in there." He looked at Lopez and slowly grinned. "Let's get some lunch."
"I know a place that makes the best Chicken Tikki Marsala in the entire South Valley...."
Brice parked on the side of the road. Serene green fields stretched among the headstones on either side of the narrow asphalt ribbon. He picked up the bouquet of flowers.
Craig stopped by Bob's grave. The residual effects of his illness left him panting and feeling shamefully weak. Slowly he bent and placed the flowers on the fresh sod covering the grave. He had never before understood the custom of placing useless greenery on a grave, but today it felt right. He imagined the ranks of uniformed firefighters who must have stood here, the rig that had carried Bob for the last time....
The new headstone listed the too short span of his partner's life. A single wilted rose lay against the granite, having escaped the notice of the groundskeeper, who maintained the sterile park-like grounds. "Susan," he whispered. The single blossom evoked Bellingham's wife's quiet grace when he had visited her. He touched the brittle petals.
A wave of dizziness forced him to sit. Brice traced the seams between the sheets of sod, rubbing the faint traces of raw earth over his fingers. Ashes to ashes. Dust to dust, he quoted silently. He had gone to the station for a few minutes this afternoon. People moved with a quiet numbness, no one wishing to disturb the shallowly buried grief and pain. The new members of the house had been silent and circumspect. Martinez of 36's had been detailed to fill Bob's spot temporarily; he worked next to Brice's replacement with uncharacteristic solemnity. The bulletin board had been covered with notices from operations about critical incident stress debriefings and counseling. Bellingham's locker was already empty.
Brice looked up into the cloudless sky, ashamed to find his face wet with tears. He wiped his cheeks. "Bob," he said quietly. The name seemed loud in the stillness of the graveyard. "I took your advice." Craig sniffled. "I finally 'got a woman.' I wish I had been brave enough to admit it before. You'd have liked her. She is -- organizationally challenged -- too."
Smiling weakly, he reached in his pocket and removed a small box he had bought earlier in the day. He opened it. "I was always afraid. I didn't want anyone to grieve for me if something happened. I didn't...." Brice's voice trailed off. He watched a tiny golden finch in a eucalyptus at the edge of the road. "I didn't want anyone to be... to be able to hurt me. I was content to watch life from a safe distance." Craig blinked. "But, I saw what you and Susan had. How alive you were... Even now, she won't trade the life the two of you had -- just to avoid the pain love can cause."
He pulled the engagement ring he had bought for Beth, from the box and held it up. "Today I shall start to live."
"Here you go." Joanne set the mug of hot tea on the nightstand and sat on the edge of the bed.
Roy opened his eyes. Late afternoon sunlight streamed through the window and fell across the bed and table, highlighting the half a dozen pill bottles on the nightstand. His wife was silhouetted by the golden glow. She leaned forward, her face moving out of the glare. DeSoto pushed up onto his elbows. "Thanks." Gingerly, he sipped at the steaming beverage, hiding a grimace of disgust. He hated tea, but it didn't upset his still irritable stomach.
Joanne smoothed the blanket and gently stroked Roy's forehead with the backs of her fingers. Her skin was soft and cool. DeSoto tipped back his head and kissed her hand. Joanne leaned forward.
Downstairs a door slammed and footsteps thudded up the stairs. Joanne smiled. "Either the kids are home or there's a herd of stampeding elephants racing through the house."
Jennifer burst through the half open door.
"Jen, knock!" corrected Roy, leaning back against the pillows, studying his daughter. Bandages covered both knees -- the result of trying to jump her bike over a trash barrel. Wisps of fine blond hair were escaping from her braids and her features were set in an expression that reminded him of his wife.
"It was open." The girl looked at her mother. "Joel and Lois are building a tree house in the canyon. I'm gonna help," she announced, turning and running to her bedroom.
"Change out of your school clothes and be back at 4:30," ordered Joanne. "Where's your brother?"
"Watching Star Trek," yelled Jen, her voice muffled by her sweater.
Joanne rested her head on Roy's shoulder. DeSoto buried his face in her hair. Abruptly, he stiffened with a sudden suspicion.
"Roy?" asked Joanne, alarmed.
"Jen, leave my tools here," called DeSoto.
"Aww Dad!" The dull thud of a stamping foot accompanied Jen's reply.
Joanne chuckled. "And your mother wonders why we don't have more."
Roy closed his eyes and slumped back on the pillows. Rolling on his side, he snuggled against his wife's chest, breathing in her warm familiar smell. Joanne's fingers ran through his hair, gentle and soothing. DeSoto concentrated on her soft skin, the distant sound of the television, Jen's running footsteps, the children at play in the street in front of the house... forgetting the death that had stalked them all. Enfolded in Joanne's arms, Roy fell asleep.
Craig stood in the middle of the kitchen and stared at the bed tray. A neat linen napkin lay across the surface, framing a plate and a cup and saucer. Nervously, he turned a tiny jewelry box in his hands. From the bedroom he could hear the water turn off in the shower and then after a moment the door open. He bowed his head. Suddenly Brice decided. He opened the box and set the sparkling engagement ring on the saucer, covering it with the overturned cup.
"Beth, I'll fix some lunch and bring it to you," he called.
Shaw paused, a bath towel wrapped around her head. "Nothing fancy, there's some Campbell's in the cupboard over the fridge."
Craig wrinkled his nose. "That junk is disgusting." He shuddered at the recollection of the gallons of the stuff the hospital staff had poured down his throat, during his recuperation.
"I'm not asking you to eat it." She smiled at the revulsion in his voice. The canned soup had gotten her through many cash-tight nursing school days and she found the taste comforting.
"I had something better in mind."
"Chicken noodle and a peanut butter sandwich," Beth ordered. "I don't want you overdoing it. You need take it easy too."
Brice sighed, "Ok."
Beth lay atop the blankets, propped up on a stack of pillows, wearing one of Brice's old shirts. On a lap tray, Brice had spread a neat array of apple wedges, triangles of sandwich, a bowl of soup and a steaming pot of tea. "Lie down and rest, Craig," she instructed, leaning back, patting the mattress next to her and picking up a piece of the sandwich. Brice had spread the peanut butter in thin, even layers on each slice to prevent the jelly from soaking into the bread. Turning her head, Beth hid a smile.
Brice kicked off his shoes and stretched out next to Shaw. He watched her eat, too nervous to let himself enjoy the easy rhythms of her movements.
Shaw turned her head, examining his face. The paramedic was extremely quiet and his color was off. Setting down the spoon, she brushed her hand against his forehead. "Craig, you're a bit flushed. Have you been resting, like you are supposed to?
He started to answer but Beth reached for the cup, her fingers wrapping around the bottom, getting ready to turn it over. He choked.
"I'm fine." Brice managed to force the words past his lips in something approaching a normal tone of voice.
Beth lifted the cup...
...and dropped it. The vessel bounced once on the mattress and tumbled to the floor, shattering. She picked up the ring, very slowly and deliberately sliding it onto her finger. Leaning over the edge of the bed, she set the tray amid the fragments of stoneware.
Brice found himself gasping. He hadn't even been aware of holding his breath. Beth rolled over, took his face between her hands and kissed him. The metal ring felt cold on his skin. He shook as her lips touched his.
Shaw settled back on the pillows. "Yes, I'll marry you."
"Good," he whispered beginning to sit up.
"Where are you going?"
"To clean up the broken cup...."
She hooked her hand over the waistband of his jeans, preventing further movement. "No, you're not," she murmured, pulling him back down. Beth rolled over and curled spoon-like against Craig, sighing contentedly, as the warmth from his body soaked into her back.
Brice draped an arm over her side, unbuttoning old flannel shirt she wore and cupping a hand beneath her breast. Closing his eyes, he delighted in the gentle rise and fall of her chest as she breathed. He kissed the back of Beth's neck, immersing his face in her thick red hair, inhaling its clean fragrance and thinking.
Sensing Craig retreating into the morass that had enfolded him since Bob's death, Beth twisted in his arms. Grinning, she tickled his ribs.
"Hey!" he yelped, smoothly rolling her onto her back, straddling her hips and pinning her wrists to the mattress. The oversize shirt fell open revealing her milky white skin. He smiled as she engaged in a token struggle to free herself. The gentle curves of her hipbones brushed against his thighs. Sighing, he enjoyed the rush of heat that flooded over him, sinking into the feeling, letting himself embrace living. What did you tell me Bob? "After the bad ones, you go home, make love to your woman and know that life is a fleeting and precious moment."
"And tickling me was?" he mumbled, bending to bury his face between her breasts. Slowly and precisely he kissed her, working his way up the breastbone to the notch between her collarbones, feeling her warm, soft flesh beneath his mouth. Her skin tasted of salt and honey. Brice released his lover's arms, cradling her face between his hands. He ran his thumbs along the line of Beth's jawbone, caressing her.
Shaw shivered beneath his touch, feeling the calluses and scars on his hands, shadows of his years of firefighting. "Yes! Let me...." Her words were silenced by the pressure of his lips. Lightly, she traced the corded lines of his leg muscles, running her hand from the back of his thigh to the small of his back. She had made love to him many times before but this was somehow different.
"You taste like peanut butter," complained Craig, lifting his head, eyes twinkling.
"And you hate peanut butter," remarked Beth.
"Depends on what you serve it with." He kissed her, yet again cutting off her reply.
Dixie briskly rubbed a towel over her wet hair, enjoying the warm tickle of droplets of water running down her back and long legs. Reaching out she wiped the cold glass of the bathroom mirror clean. She ran her fingers through her new, much shorter haircut, watching the darkened, wet strands fall. McCall had stopped at the saloon after her trip to visit Karen Wolfe's grave. She had wanted to make some gesture separating her from the grief and death of the last two months. 'Makes you look ten years younger,' had commented the youngster as she cut the nurse's hair. "I'd settle for feeling ten years younger," she sighed, picking up the comb.
Wrapping the towel around her breasts, Dixie walked into the bedroom. She skirted the half-packed suitcase on the floor. Sticking out the top of the jewelry box on her dresser were her plane tickets -- first Florida and then to the cerulean blue waters and coral reefs of the island of Eleuthera. On an impulse, she stepped over her neatly folded wetsuit, dug through the plastic shopping bag on the floor and pulled out a bottle of suntan lotion. Slowly, she smeared the liquid over her body, letting the sweet odor of coconut oil wash away the smell of antiseptic and death.
The slick cover of JEMS wiggled slightly, causing the fading sunlight to shift and flash on the shiny picture of a City of Miami rescue squad. Abruptly the journal closed and flew across the room to land on a chair and slide down a pile of Sports Illustrateds and Popular Mechanics before coming to rest atop a battered copy of the AHC Guide to the San Gabriel Mountains. Johnny lay on his couch, wearing worn, comfortable somewhat tattered sweats, and frowning at the discarded magazine. Sighing he scratched his head, further ruffling his already messy hair and kicked off the brightly colored, crocheted afghan.
Sitting up John stared at the bowl of canned vegetable soup sitting on a stack of books by the couch. I'm bored, he decided, looking at the all too familiar walls of his apartment. I hate this place -- time to move. The lingering weakness of his illness had trapped him, forcing him to spend more time in his apartment in the past three weeks than he had in the entire year he had lived there.
Gage walked over to the open window, holding his hand out to the soft breeze rustling the window shades. He looked at the mountain foothills, touched with the last reflected golden light of the sunset, gilt lined shadows against a purple sky. Johnny tasted the air, trying to detect some trace of fall in the balmy winds. Inhaling slowly, he remembered the fall breezes back home, warm until the day the breath of the Arctic blew down from the Canadian plains, pulling down gray snow heavy clouds. He shook his head and turned from the window.
A thin skin of congealed fat covered the surface of the now cold soup, puckering around the spoon handle. For the first time since he had become sick, Gage was hungry and the liquid before him threatened to destroy his recovering appetite. Grimacing with distaste, he padded into the kitchen, and dumped the mess into the sink.
As Johnny left the kitchen, a frayed piece of folded yellow notebook paper lying on the counter caught his attention. Slowly Gage turned over the slip of paper. Neat ranks of letters and numbers spelled out a name and phone number. The scrap had been a parting gift from Brice, handed surreptitiously to Johnny when the other paramedic had finally been allowed to leave quarantine. Reaching a decision, Johnny picked up the phone and dialed.
"Hi, may I speak to Pat Chasing Crane, please. It's Johnny Gage." He listened to the muffled noises for a moment, imagining the unidentified woman gesturing to the beautiful nurse, repeating his name.
"Hello, Mr. Gage. The woman's reply was echoed in the receiver. In the background he could hear the roommate commenting, 'Who is he? His voice is luscious.'
"Not Mr. Gage." John's mouth went dry and his tongue stuck to the roof of his mouth. "Uh, I mean -- Mr. Gage is my father. I'm Johnny."
"Johnny, then," the nurse answered, wryly. "What can I do for you Mr. Johnny?"
Briefly, Gage considered hanging up, reading Chet's book and calling back. "Well... uh..."
"Are you feeling better?" Her tone softened slightly.
"Yes." He took a deep breath. "Gettin' kinda sick of my own cooking."
The line crackled disapprovingly. "I don't cook, Mr. Johnny."
John winced. "I meant..." He felt like he was beginning to repeat himself. "Would you like to go out for dinner?"
"I'm on duty tonight."
"But tomorrow night, I'm off."
John grinned and bounced on his toes. "Seven o'clock, then."
First a few caveats. My field is not virology or biology, so I was in over my head most of the time. Some of the diagnostic techniques and understandings of viral pathogenesis described in this work are anachronistic. Trying to recreate what was state of the art knowledge for the late 70's was extremely difficult. The 80's and 90's saw an enormous increase in our understanding of viruses and in our ability to identify said viruses. PCR, ELISA and other techniques based on gene typing have revolutionized how we identify viruses. What biology and clinical chemistry knowledge I have is all post PCR. Further, significant artistic license was taken with speed and flexibility of immunofluorescence.
My favorite E! episode has always been Virus, but as I have grown up I have felt increasing cheated by the rapid (last 6 min) resolution of the crisis. So I felt I needed to address a few of the scientific and dramatic issues which have left me unsatisfied. This story is the result. It has been a monster lurking in my life for over a year. It would never have moved beyond of few scenes of sweaty sick Gage had it not been for the help and support of a large number of people. First I'd like to thank everyone who loaned their name and/or appearance to create the 'extras' for my story: MA, Carol, Cindi, Mary, Pat, Cap, Kathy Bell, Aline, Lurch, Kel, Karen, Kate, Jeff, Gina, Roo, Chan, DM, Betty, Grey... (I'm just sure I have forgotten someone, sorry). Some of you turned out to be very startling characters :). I'd like to thank my intrepid technical advisers: Pat, Mary, Sandy Park, Dr. DM, Aline, MA. Any errors are my responsibility. A special thanks to Mary, Carol and MA for support when I stood ready to erase the entire damn thing.