(Originally published under my David Best pseudonym.)
THIS SHOULDN’T BE happening, TR thought as the truck hit a big pothole in the ruined highway. I’m not supposed to be here.
The truck dropped into another hole, throwing him against a crate. He struggled to his feet and banged on the cab window with his fist. “Watch where the hell you’re going.”
He could hear the two members of the French team in the cab laugh at him. Then the truck hit another hole, probably on purpose.
Laugh it up boys, TR thought. Soon, things won’t be so funny.
How he hated those two. They called him Le Boucher, the butcher, because they thought his mouse dissection technique was too aggressive and careless—their way of diminishing him. As though they were so damned superior. Well, it wouldn’t be long now, and it’d be their turn.
But this was not the plan. By now, TR should have been in Tselinograd with Bill Lansden, his leader. TR wasn’t there because Lansden’s wife had been in a bad car wreck back in the States, and Lansden had to depart early, leaving TR to finish packing the equipment and take it and himself out with the French.
And after nine weeks, was he ever glad to be going. He looked out the back of the truck at the endless prairie, unbroken by any living thing except green wheat, stretching endlessly to the horizon. It was a hellhole even without the epidemic they’d all come to fight.
What a fiasco. Fly eight thousand miles, bring in a ton of medical equipment and supplies, only to discover that a French team had arrived for the same purpose the day before.
The damn Kazakhstanis had sent out pleas to the US and France and didn’t tell either country about the other.
The two teams had combined forces and traced the strange illness that had killed fourteen of the villagers to a microbe carried by the local mice, which had overrun the place after a big snowstorm had buried a bumper wheat crop the previous year. The snow hadn’t melted until spring, giving the furry little monsters more food than they could consume. So they’d done what all animals do under those circumstances; they’d created a population explosion, which had led to infestation of even the wheat thatch on the village roofs.
The two teams had determined that the disease organism was expelled from infected animals in their urine. Invariably, some of this urine made its way through the thatch into the villagers’ homes, and when the floors were swept, microbe-laden dust was inhaled by the home’s occupants. That much the medical teams had established for sure. But they didn’t have the equipment to determine much about the bug, except that it was completely destroyed in infected individuals within an hour after death, and it was a virus belonging to the hanta genus. To learn more would require sophisticated equipment neither team had brought.
The truck banged into another pothole, bouncing TR into the air and jarring his spine so hard when he came down that his teeth clicked.
Jesus, doesn’t this thing have any springs on it?
The two teams had agreed to publish the results of their work together. And when the French had proposed that they take all the blood samples and do the molecular biology work, that dope Lansden had agreed. He’d paid no attention when TR suggested dividing the samples and giving each team a set—too much trouble, Lansden had said. His position on this was crazy. So TR had taken charge. And for all their insulting behavior and attempts to dominate the study, he’d decided that the French should go home empty-handed.
The truck suddenly slammed to a stop. Three men dressed in camouflage fatigues, all of them armed with machine guns, materialized out of the wheat twenty yards back.
TR turned and looked over the cab, where he saw a Jeep containing more armed men blocking the road. They’d apparently been hiding in the ravine to the right.
The ones behind the truck began screaming at TR in Russian and motioning for him to get out. He jumped to the pavement and was spun around so he was facing the field flanking the road. A foot in his back sent him sprawling onto the shoulder. He tried to get up, but was held on his knees by a gun behind his ear. As he realized that this was the traditional Russian method of execution, the contents of his stomach turned rancid.
The men from the Jeep pulled the Frenchmen out of the truck and forced them to their knees beside TR.
“You don’t understand,” TR whined. “I’m not with these other men. I’m—”
The guy with the gun at TR’s head shouted at him and pressed the pistol harder against his skull. To his right there was a gunshot, and the Frenchman who’d been driving the truck let out a faint grunt as though he’d been hit in the gut. In his peripheral vision, TR saw the man fall face forward into the wheat.
Then, beside him, not three feet away, another shot sent a bloody aerosol and pieces of the remaining Frenchman’s skull flying before he, too, crumpled onto his face.
An instant from his own death, TR rolled onto his back and yelled, “Nicolai Butuzov! Nicolai Butuzov! Amerikanski! Amerikanski!” Expecting to be shot in the face, TR raised his arms as if they could protect him.
A burly guy dressed like the others, but wearing a military beret, had been inspecting the contents of the truck. He turned now and barked an order in Russian. He left the truck and walked over to TR. In heavily accented English, he said, “How do you know Nicolai Butuzov?”
TR had suspected from the start that the name his contact had used was probably an alias, but shouting it had done the trick. “I’m the one who hired you, for Christ’s sake.”
The burly Russian gave another order, and the assassin looming over TR stepped back. The Russian extended a hand to help him up. “Why didn’t you say so earlier?”
ATLANTA, 12 YEARS LATER
CHRIS COLLINS CAUGHT Jamie Mallon, one of the hospital’s circulating nurses, just leaving the OR.
“Jamie, do you have a minute?”
“Sure. What’s up?”
“Last week you worked with Dr. Blake on a laminectomy. Did Dr. Doyle, the cardiovascular guy, come into the OR at any time during the procedure?”
Chris was working a hunch. In the last two weeks, three patients in the hospital had developed strep A infections in their surgical wounds. One case would have raised her eyebrows, three was an epidemic. As the hospital’s medical director of infection control, it was her job to contain this thing. Since strep was an organism carried by people and not by contaminated water or instruments, and was most often transmitted into wounds during surgery, she had concentrated her attention on the OR personnel in each case.
Dr. Tom Doyle had been the surgeon of record on two of the three cases, but not the third. Interestingly, the OR log sheets had shown that the laminectomy case Chris had asked Mallon about had been done in OR #4, which was right next to the room where Doyle had performed a triple bypass that had become infected. And the two surgeries had been done on the same day at the same time, a fact too intriguing to ignore.
“Dr. Doyle…” Mallon said, thinking back. “Was he listed in the log?”
One of Mallon’s responsibilities as circulating nurse was to keep a list of everyone who entered the OR during a procedure.
Mallon’s brow furrowed, and her eyes flashed. “Are you suggesting I didn’t do my job properly?”
“Not at all. It’s just that I know sometimes things get hectic in there, and you’re trying to do three things at once, and sometimes, very rarely, a little thing like keeping the personnel log gets neglected.”
Seeing that Chris was so understanding, Mallon let her defenses down. “The laminectomy,” she said, once again examining her memory. Then she hit on something. “He was there… for just a minute. Stopped in to tell Dr. Blake that he had to drop out of the fishing trip they had planned.”
In Chris’s mind, this pretty much sealed the deal. Doyle was the carrier. The pager in her pocket began to vibrate. She touched Mallon’s shoulder in a show of appreciation, thanked her, then looked at the number on the pager: her office. In keeping with the hospital’s rule against cell phone use on the wards and most other parts of the hospital, she headed for the nearest house phone.
“Paula, this is Dr. Collins.”
“Your father’s here to see you.”
She hadn’t heard from him in twenty-nine years, not since he’d left her mother for another woman.
My father, here? “I’ll be there shortly.”
She hung up and stood for a moment, her mind grappling with what she’d just heard. It couldn’t be. Paula must have misunderstood. Then she began to remember what it had been like for her and her mother struggling financially without her father. And how she’d felt growing up: inadequate and somehow at fault for making him leave. How even now, with her mother dead, she faced life alone, unable to trust any man enough to let them get too close, unwilling to ever put herself in a position to be left again. Even knowing where these feelings came from, she hadn’t been able to shed them. The truth will set you free? Not always, brother.
No, that wasn’t him waiting for her. He’d ignored her for nearly three decades. Why would he crawl out of hiding now? And after what he’d done, he wouldn’t dare show himself.
In addition to her duties as medical director of infection control for Good Samaritan, Chris was part of a three-member private infectious disease practice housed in the physician’s office building next door. The call she’d just taken had come from there. So, even with the new crossover between the two buildings on the third floor, she faced a fairly long walk.
Though she would have bet that the man waiting for her was not her father, the anger she’d resurrected in thinking about him was a wind at her back, propelling her through the halls even more briskly than usual. Upon reaching the entrance to the main office, she took a moment to gather herself, then went in.
Almost all their practice came from being called in by other physicians to manage infections acquired by patients already in the hospital. So they seldom had a full waiting room, which is why they only had a couple of chairs, mostly for drug reps who dropped in. Thus, when Chris walked through the door, there was only one man there. He stood expectantly, and they stared awkwardly at each other.
He was wearing black slacks and an eggshell-colored sport coat over a black turtleneck. His brown hair, receding in front, hung to his shoulders in back. Round wire-rimmed glasses and a neatly trimmed salt-and-pepper mustache and goatee completed the impression that he was either a creative-type guy or wished to look like one. Chris had only two pictures of her father: a fuzzy full-length snapshot taken when he was twenty, and a better head shot made around fifteen years ago. This man bore some resemblance to her father, but she still found it hard to accept that this was him. Beyond her general disbelief, she remembered him as being a lot bigger. But of course, everything seems bigger to a six-year-old than to an adult. And she clearly wasn’t seeing him at his best, for there was no doubt in her mind that he was seriously ill. His skin had a distinctive yellow-green hue, and the waistband of his turtleneck rested on a potbelly probably caused by fluid accumulating in his peritoneal cavity. A classic case of liver failure.
He spoke first. “Hello, Chris. You’ve grown into a beautiful woman. And all this…” He gestured to the offices. “You should be very proud of yourself.”
Not wishing to play this scene out in front of the practice’s secretary, Chris said, “Let’s talk in my office.”
He followed her there, and she shut the door. In part because she really did need proof of who he was, but also appreciating the subtext in the comment, she said, “I’m going to need some identification.”
He flashed a shocked expression, then nodding in resignation, he reached for his wallet, from which he produced a driver’s license that he handed to her.
The name on the license was Wayne Collins. It was him. She returned the license, then showed him her back as she crossed the room. She stepped behind her desk and sat down. “Why did you do it?”
“What else would I mean?” she replied, her brows knitted, a chain reaction boiling in her green eyes.
She hadn’t invited him to sit, but moving carefully, like a cat doing something it knows is forbidden, he put himself in the only visitor’s chair. He leaned forward, his hands dangling limply from the armrests, his gaze directed at the mahogany panel on the front of her desk. His tongue snaked out and caressed both corners of his mouth. Then he looked up.
“It’s hard to explain… I don’t really understand it myself. I just felt… smothered. It’s not that I didn’t love you. A part of me did, but another part couldn’t accept all the responsibility. And your mother and I…we just were so different from each other.”
“Did you ever hear of child support?” Chris snapped. “We could have used a hand.”
“I’ve barely been able to support myself. I had a novel published about fifteen years ago. Billy Runyan it was called.” He raised his eyebrows in hope. “Did you know?”
“Afraid I missed it.”
Her father snorted. “You and the rest of the world. I’ve written three others, all unpublished, so I guess I’m a misfit there too. I’ve been able to eke out a living by writing assembly instructions for furniture and toys. Put nut A on bolt B… that’s me. But you… Chrissy, you’ve accomplished so much despite what I did.”
“That’s the way I look at it, too.”
“I’m sure you don’t think I have any right to feel like I’m part of your accomplishment, but I do. I have to, because you’re the only element in my whole miserable life that has amounted to anything. You never knew it, but I was at your medical school graduation, feeling as proud as any of the other fathers.”
“Why didn’t you let me know you were there?”
“I didn’t want to ruin your big day.”
“Maybe if you’d have written or called or come to see me a couple of times while I was growing up, you wouldn’t have had that to worry about.”
“I’ve considered that more times than I can count. It’s hard to think that your tombstone, if you can afford one, should read, ‘Here lies an alcoholic who abandoned his family and pissed his life away.”’
This made Chris even angrier. She was the injured party here. She was the one entitled to throw the spears, but now with his self-pitying whining he was trying to deprive her of even that. Infuriating as this was, his obviously grave condition kept her from retaliating.
“Is that what destroyed your liver—alcoholism?”
“They trained you well.”
“It’s pretty obvious.”
“My doctors tell me I need a transplant. I’ve got medical insurance that’ll pay for it, but only at the program in Kansas City. The waiting list there for my blood type is twenty-eight months. And they say I probably won’t last that long.”
“Won’t they move you up if you suddenly take a bad turn?”
“They would if I didn’t have a history of alcoholism. They’re very strict in their program and require six months of sobriety before I’d be eligible for special placement. And I’ve only been clean for ninety days. I’m doing the twelve steps with AA, but three months doesn’t cut it. To complicate matters, you know how in cirrhotic livers the blood flow backs up and produces varicose veins in your esophagus… Well, mine are huge, and ten weeks ago, one burst. The blood just gushed out. So much that I went into shock. If I hadn’t gone down in a public place, I’d be dead now. But paramedics got to me in time.
“My docs say it could happen again at any moment. If it does, even with prompt medical care, I could die or have brain damage… I mean beyond what you probably think I have already. There are other transplant centers that aren’t quite so rigid about the alcoholism, but I don’t have a hundred and fifty thousand dollars to give them for their services.”
“If you came here to ask me for the money so you could go to a different program, I couldn’t help you if I wanted to. I’m still paying off my student loans and had to hock my soul to buy into this practice.” Even as she spoke, Chris became upset with herself for going into such details with him about her finances.
“No, I didn’t think you’d be able to do that,”Wayne said. He paused, apparently searching for words.
Suddenly, Chris got an ugly premonition. Surely he wasn’t going to ask her…
“I know I have no right to expect you to help me,” Wayne said. “And I wouldn’t have come, except I don’t want to die with the sorry legacy I’ve built for myself. I need time to balance the scales, to find some way to make up for a lifetime of self-absorption that did nothing for anyone else. So forgive me for what I’m about to say, but I read somewhere that it’s possible for a living person to give a part of their liver to another, and within a few months the part the donor contributed grows back, so they’re as good as new, except for maybe a little scar.”
Oh my God, Chris thought. That is why he came. He wants a piece of my liver. This is just a visit to his parts warehouse. Her anger toward him surged to new levels for putting her in this position.
“Of course the blood type of the donor and the recipient have to be appropriate,” her father said. “I’m type O, and I remember that you are, too.”
“After your history with me, you have the nerve to ask for this?”
“Believe me, I didn’t want to come. But I couldn’t think of any other solution.”
“What about the woman you left us for? What’s her blood type?”
“That only lasted a few years. I don’t even know where she is.”
Chris was so filled with disgust she couldn’t stand to look at him another second. “I’ve got a very busy day scheduled, and I’m already running late. I can’t talk any more just now.” She pulled a sheet of paper from the box on her desk, wrote her address and phone number on it, and got up and handed it to him. “Come to my apartment tonight at seven o’clock. And don’t expect dinner.”
He rose, took the paper, and put it in an inside pocket of his jacket. “I’m sorry for doing this to you.” Then he left.
With him gone, Chris wondered why the hell she’d given him her address and agreed to meet with him again. There was no way she was giving him part of her liver. Undergo major surgery and let somebody hack out a piece of her so a louse of a man could…Live.
Damn it. That’s what we’re talking about here. The man’s life is at stake. How could she just ignore that?
Feeling the needle on her stress gauge creeping into the red zone, she closed her eyes and began the meditation exercise she learned from a Chinese classmate when she was a medical student. Within a few seconds, her pulse and respiration slowed, and her blood pressure edged downward. In just a few minutes she was once again fit for duty.
On the way out she stopped at the secretary’s desk.
“Hope I’m not being out of line,” Paula said, “but your father doesn’t look well.”
“Just one of his many problems. I need to talk with Tom Doyle, the cardiovascular surgeon, ASAP. When you get him on the line, page me, would you please? I’ll be making rounds.”
Ten minutes later, in the ICU, Chris was writing an order for fluconazole to combat a cryptococcal lung infection in a woman who’d caught the bug from the droppings of her newly purchased parrot. Just as Chris scribbled her name on the order and closed the chart, her pager sent her again to a house phone, where she learned that Paula had Doyle on the line.
“I’m at six-eight-two-three,” Chris said. “Ask him to call me here.”
In seconds, he did.
“Tom, thanks for getting back to me so quickly. Would you have a few minutes today to talk about those two patients of yours with strep infections?”
“Are you free now?” Doyle asked.
“Yes. Where are you?”
“Let’s meet in my office in five minutes.”
If Chris had merely wanted to discuss her management of one of Doyle’s patients in her role as a private infectious disease consultant on a case, she would have just met him in the coronary care unit. But implicating him as a strep carrier was not something to do publicly.
Five minutes gave her time to check on one more patient, a retired fireman whose respiratory infection was so extensive his ventilator had blown a hole in one of his weakened lungs. She found his chart in the hands of Charles Hickman, an effusive young pulmonary physician who hadn’t lost enough patients yet to whittle away at his boundless optimism and good humor.
When he saw her, he grinned and showed her the plot of the fireman’s temperature since Chris had added amphotericin B to the antibiotics he was being given.
“You could ski down that slope,” Hickman said, referring to the plot’s precipitous drop to normal. He pointed at Chris. “You da man.”
With more important things on her mind, she let the opportunity pass to remind Hickman that she was actually the other sex sometimes found in the practice of medicine. Instead, she just said, “Keep that up, and I’m going to think you’re surprised. How’s he sound?”
“Better,” Hickman said. “See for yourself.”
She slipped on a gown and mask and donned gloves from the isolation cart outside the fireman’s room. Listening to his lungs with the isolation stethoscope, she noted a distinct improvement in the man’s chest sounds. Returning to the hall, she wrote a short note to that effect in his chart.
“Well, it’s been real,” she said to Hickman.
“Going so soon? What is it—my breath, my personality, my wife?”
“All of the above,” Chris said, wiggling her fingers over her shoulder at him.
On the way back to her office, a small voice began telling Chris that any woman who would refuse to help her dying father, regardless of what he had done to her, was cold and callous and possibly deserved being abandoned when she was a child. She had always been impressed by the enormity of death. The passing of life from any creature was not a casual event, no matter how many times it had occurred in the history of the earth, for the aggregate passing of billions in the past didn’t lessen the impact on the next one to die. And wouldn’t her refusal to help him be doing the same thing to him he had done to her?
Worse, the voice said. You lived.
And she was a doctor, for God’s sake… Her whole life was dedicated to helping the sick.
WITH ALL THE weight he carried, Tom Doyle looked as though he’d soon be needing a bypass himself. Whenever Chris saw him, she was reminded that every pound of fat needs two hundred miles of blood vessels to support it. It was no wonder he had the flushed complexion of a hypertensive.
“Hello, Tom. Let’s go in the conference room.”
“It’s my understanding that there have been three cases of strep infection. And only two of those are mine,” Doyle said, following her. “So who’s the common denominator?”
“Have a seat. Can I get you some coffee?”
“I’m fine,” Doyle said, sitting at one of the wooden chairs around the mahogany conference table.
Chris sat opposite him. “Tom, how have you been feeling lately?”
“Overworked and fat,” he replied, scratching his head. “You know who I think it is… Bill Gooch, the anesthesiologist. He’s always farting in the OR. And I once heard of a guy who had a rectal strep colonization contaminating his OR by farting them into the air.”
“My question about how you’ve been feeling wasn’t a social inquiry. Have you or anyone in your family had a sore throat lately?”
“Wait a minute,” Doyle said, catching on. “You think it’s me?”
“The strep case that isn’t yours… you went in that OR while the surgery was taking place to speak to Dale Blake about a fishing trip. Do you remember that?”
“Who said so?”
Not wanting to create any trouble for Jamie Mallon, Chris said, “Then you didn’t go in there?”
“I might have.”
“Tom, you’re the common denominator. Have you had a fever lately, or any little skin eruptions?”
Doyle scratched his head. “No, nothing like that.”
It actually wasn’t necessary for a strep carrier to exhibit any symptoms, so Doyle could have harbored a colony in his nose or his rectum without any signs. On the other hand… “Would you wait here for just a sec? I’ll be right back.”
Chris made a quick trip to her office and returned with a pair of rubber gloves and a swab and saline kit. “Would you mind if I took a sample from your scalp?”
“Of course not. But it’s not me. You’re mistaken.”
Chris donned the gloves and swabbed a scaly patch on Doyle’s scalp. “I’ll send this right down to the lab. We should have the results by late tomorrow. In the meantime, you don’t have a case scheduled today or tomorrow, do you?”
“I have one early in the morning.”
It was within Chris’s authority to suspend Doyle’s OR privileges until the strep problem was solved. But without the lab results for confirmation of her hunch, she was reluctant to play that card.
“Under the circumstances, do you feel comfortable operating?’
“It’s not me,” Doyle said. His hand headed for his scalp, but he caught himself and put it back on the table. “You’ll see. It’s somebody else.”
“But what if it is you?”
There was a brief trapped-animal look in his eyes, then the fight went out of him, and he flipped his hand in the air. “All right. I’ll postpone my next case until we hear from the lab.”
When he left, Chris sat at the big table all by herself and wrestled once more with the problem of her father. Finally, needing to get moving, she roused herself and headed back to the hospital to drop off the swab and continue her rounds.
She returned to her office a little after four o’clock, having considered and reconsidered all the arguments in favor of giving her father what he wanted. But she just couldn’t do it. If that meant she was cold and heartless, that’s what she’d have to be.
A few minutes later, while perusing the weekly morbidity and mortality report from the CDC, where, before her infectious disease fellowship, she’d spent two years as an Epidemic Intelligence Service (EIS) officer, she was struck by a sudden thought. Maybe there was something she could do for her father.
She flipped through her Rolodex, found the number for Michael Boyer, and called it.
“This is Dr. Collins at Good Samaritan. Is Dr. Boyer available? No? Would you page him please and have him call me? It’s very important that I speak to him today.”
Boyer quickly returned her call, and they spoke for nearly ten minutes. Hearing her suggestion, he expressed strong interest in the idea and then made a proposal himself that took her by surprise. By the end of the conversation, she had set up an interview for her father which, if it went well, would not only give him a chance to live, but would make him famous.