In the Land of Milk and Honey (7 page)

“Have you seen Amber today?”

“No, but my wife and I both work. What's this about?” Nick looked uneasy.

“You have a key to that apartment, bro?” Hernandez asked him with a voice like velvet over a sledgehammer.

“Um . . . yeah. Sure. We swapped in case . . . you know. Fire or whatever.”

“Get it,” I said.

—

I instructed Nick to stay in his own apartment while Hernandez and I headed up. Knocking got no response, so I unlocked the door and cracked it open. “Amber? This is the Lancaster Police.”

Nothing, not a sound. The air in the apartment felt stifling, suffocatingly hot, as if the occupant had turned up the heat hours ago and never turned it down. The heat made the cloying smell of the sickroom worse. I started breathing through my mouth, and Hernandez wrinkled his nose. It wasn't pleasant, but it didn't smell like death, thank God. I knew exactly what
that
smelled like.

“Amber?” I stepped farther into the apartment and nodded at Hernandez to go check out the kitchen. I headed for the hall and the bedroom.

I found Amber Kruger in bed. She was on her side in baby blue pajamas, covers cast off, knees curled up protectively into her chest. Her skin shone yellow-white, like the moon, and there
was a sheen of sweat cast over her features. She looked young and petite with frizzy red-brown hair and freckles. And she lay so heavily on the bed she looked partially sunk through it.

“Amber?” I knelt by the bed and put my fingers to Amber's throat, dreading to find the flesh stiff and cold. But it was soft and there was a pulse, faint and slow like the final notes of a slow orchestral march. Thank God! As if to confirm the diagnosis of life, a tremor racked through Amber's body. I had the strangest thought—that Amber was in the crack between life and death and her body was trying to shake her loose one way or the other. She didn't waken.

“Shit.” I pulled out my cell phone and called dispatch. “I need an ambulance right away. And call Lancaster General and have them ready for a critical patient with tremetol poisoning.” I gave Amber's address. Thankfully, the hospital wasn't far. As I put the phone in a pocket, Hernandez touched my shoulder.

“She gone?” he asked quietly.

“No, but she's going.” I stood up, ignoring the hand he offered. As a female police officer, I'd learned to never accept any gesture that underlined my femininity, no matter how innocent the intention.

And now what? I felt useless. If this had been a heart attack or hypothermia, a broken leg or car accident, my training would tell me what to do. But I had no idea what might help tremetol poisoning. I wished I'd asked Glen Turner that question.

“Can you get a warm, wet cloth from the bathroom,” I asked Hernandez. I sat on the bed. “Amber? Amber can you hear me?” I
picked up her left hand—it was damp and chilled—and rubbed it briskly.

Hernandez brought the cloth. “Should you be that close?” he asked worriedly. “I mean, is she—”

“It's not contagious. Not like that.”
At least, I hope not
.

Amber's eyelids flickered briefly.

“Amber? Can you stay with me? The ambulance is on its way. Hang in there.”
Please don't die. You don't deserve this, and I have to know where you got that milk, and where you sold it.

From the distance came the blessed sound of sirens.

—

By the time Hernandez and I reached the hospital, Amber was already in the ER.

“You gonna wait?” Hernandez asked when it was clear there wouldn't be news anytime soon.

“Yeah, I'll stay. But you should go home. There's nothing you can do, and we can't both fall asleep at our desks tomorrow.”

“If you say so, boss. Promise you'll call me if you need me?”

“Pinky swear.” I smiled.

Hernandez gave a jaunty salute and left me to my solitary vigil in the waiting room.

I texted Ezra to let him know I wouldn't be home. Then I phoned Glen Turner and told him about Amber's condition. “I did a quick search of her bag and her truck, but I didn't find anything like a list of suppliers. I'm going to wait here to see if she wakes up.”

Glen sounded tired. “If you could, that would be helpful. I'll be in Philly all night. Text me if her condition changes.”

“Will do.”

There was nothing else I could do, so I closed my eyes, hoping for a few hours of uncomfortable sleep in the waiting room chair. I must have drifted off, because a voice woke me up.

“Detective?”

“Yes?” Blinking awake, I stood up, still half-asleep.

I swayed, and the doctor, a thirtysomething Indian, steadied me with a hand. “Sorry if I startled you.”

“No. It's fine.” I shook my head, trying to dislodge the fuzz that coated my brain. “Amber Kruger?”

“She's in ICU but stable for the moment. I'm Dr. Ambati. Can we talk?”

“Yes, of course.”

I checked the time. It was just after four
A.M.
The doctor led me out of the waiting room and into a corridor. Poking his head in a small examining room to verify it was empty, he gestured me inside. He half sat, his hip on the exam table, and clasped his hands in his lap. There was a frown of concern on his otherwise smooth face. “I heard they have this tremetol poisoning in Philadelphia right now as well. And the CDC is working on this?”

“Yes. We believe Amber is connected with the Philadelphia outbreak. It's vital that I speak with her.”

The doctor nodded. “She isn't conscious yet. But I'm hoping in the next few hours . . . Her blood work shows severe metabolic
acidosis, certainly enough to kill her. But I spoke to the CDC, and they confirmed a treatment of intravenous bicarbonate. That should reduce the acid in her blood that's caused by the tremetol and, hopefully, enable her to recover. I suspect it will take a few days or even weeks for it to pass through her system though. And from what I've read, she may have permanent weakness in some of her muscles.”

“So there is a cure for this?” It was hard to believe. I'd begun to think of tremetol like strychnine—a one-way pass to certain death.

“Yes, it's pretty straightforward. We need to counteract the acid in the patient's blood using an IV solution until the body has flushed the toxin enough to rebalance itself. Unfortunately, the toxin works fast. The CDC says it can kill within twenty-four hours. If patients don't know to seek treatment—”

Or won't. Like the Amish.

“Have you seen any other cases at this hospital?” I asked. “Amber had to have gotten the milk that made her sick from a local farmer.”

The doctor shook his head. “I've been on since eleven, and I checked with the nurses. We haven't had any cases in the past twenty-four hours at least. Or if we did, we didn't know what we were looking at. That's what scares me, Detective Harris. Because it would be easy to diagnose this as flu if a GP didn't do the blood work. Sending a patient home with the advice to rest is the worst thing they could do.”

“I understand.” By now, sleep had fled and I was already
organizing in my mind. I had to speak to Glen Turner and Grady. They needed to make some kind of public statement and soon. And it was bad news that no other patients had appeared at Lancaster General. Someone else local had to have gotten sick from the milk Amber was selling, if only the farmer's own family. If they weren't coming into the hospital, they could die.

“Well, I'll send out an e-mail to all our doctors and staff so we can be looking out for it,” Dr. Ambati said.

“Thank you. As soon as I get a chance to speak with the CDC liaison, I'll let him know what you said. Would it be possible to see Amber now?”

“You may. Though I'm not sure when she'll wake up, or how cognizant she'll be when she does.”

I looked at my watch. “I've got nothing better to do until at least six
A.M.
”

“Very well. This way.”

—

I dozed off again in the chair next to Amber's bed. A crick in my neck woke me. The light of sunrise was just appearing outside the window. I looked at the figure in the hospital bed. In the dim light of the room, Amber's eyes were open. They were a deep brown, and they glistened with tears.

“Hey.” I leaned closer. “Do you need me to call a nurse?”

“Where am I?” Amber whispered.

“Lancaster General. You've been very sick. We found you in your apartment and called an ambulance to bring you here.”

Amber snuffled a breath, as if she would normally get upset about that but she was just too damn tired. She started to close her eyes.

“
Amber.
I'm Detective Harris with the Lancaster Police. It's very important that I speak to you.”

Amber's eyes opened again, but they were hazy and unfocused. “Me?”

“Yes. You got sick from raw milk. And so did a number of people in Philadelphia who bought milk from you at Tuesday's farmers' market.”
And some of them died.
I didn't think that would be helpful information at the moment.

Amber's eyes widened. “No. That's not possible.” There was disbelief in those eyes, and pain. In Grady's rundown he'd mentioned that Amber was twenty-nine, only three years younger than I was myself. But right now she looked childlike and completely adrift.

It might not be protocol, but I took Amber's hand anyway. It felt clammy and limp, completely lacking in strength. “I'm afraid it is. It's very important that you tell me where you got the raw milk you sold on Tuesday. Others may get sick if we don't find the source.”

Amber swallowed. Her eyes searched the bedside table. There was a glass and a small pitcher of water there, so I poured some and helped Amber lift her head and shoulders off the bed and take a sip. Even that much effort exhausted her, and I laid her back down when her strength gave out. There was a miasma of heat and stale sweat and something bitter coming off her. God,
she was sick. No one should be this ill, not from eating or drinking something they thought was good for them.

Amber muttered something.

“What?”

“Is it . . . E. coli?”

“No. It's not E. coli. It was caused by a plant the cows ate, and the toxin was passed on in the milk. Please, Amber. I really need those names.”

“So tired.” Amber blinked her eyes open, hard. “Got milk at three farms Tuesday. Levi Fisher, Willow Run Farm, Bird-in-Hand. Amos Bender on Driskell in Paradise. Jacob Keim, Soudersburg Road.”

Oh, thank God.
I drew a notepad from my pocket and quickly wrote the information down. I needed to get this to Glen immediately.

“Am I . . . dying?” Amber asked. Tears rolled down her cheeks. She shifted her hand on the bed, seeking mine. I took it and held it again.

“No, Amber. The doctor said what they're giving you in the IV will take care of the toxin. You're going to be okay.”

Amber took a shaky breath. “Feels like I'm dying.” She closed her eyes.

“No, honey. You're not dying.”

No, Amber would be one of the lucky ones.

I
was still towel-drying my hair as I turned on the TV in the living room to catch the nine
A.M.
press conference.

Ezra came in from the kitchen. “Thought you were gonna get some sleep after your shower.”

“I will, babe, but I want to see this.”

After leaving the hospital, I'd stopped by the police station. Glen had just gotten back from Philly, and he looked even more sleep deprived than I felt. He took the list of names I'd gotten from Amber so his team could contact them. Then Grady insisted I go home and get some sleep. I was tired, but it was hard to ramp down knowing what was about to hit the fan. News on the deaths in Philly was supposed to break this morning, and the brass was scrambling to put together a press conference. Glen had been on a call with the state's agricultural department when I'd left.

I turned to the local news channel and sank down onto the couch. They'd cleaned Glen up and put him in front of the microphone. I wasn't surprised at the choice. Put the CDC man in front. Everyone respects a doctor. But Mitch Franklin, head of the Pennsylvania Department of Agriculture, was standing to Glen's right looking grave and authoritarian.

“I'm Dr. Glen Turner with the CDC. We've been investigating a small outbreak here in Lancaster County for the past week, and we now have word that some cases have shown up in Philadelphia as well. At this briefing we want to fill you in on what we know about this illness, what we're doing about it, and what people at home can do to keep themselves safe.”

The noise of camera shutters and flashes was so loud it sounded like firecrackers. Turner came across well, I had to give him that.

“That's the man who was here last night.” Ezra sat down next to me on the couch. “He's an important person?”

I wasn't sure how to answer that, but I supposed it was true. “He's in charge of the investigation into what's causing the sickness.”

“So far there have been twenty-nine confirmed cases and nineteen fatalities.”

Murmurs were audible in the press audience.

“This is not—I repeat, not—a contagious illness. It's a food-borne sickness, and the only way to get it is by consuming a contaminated food source. We've confirmed that this outbreak is caused by a toxin called tremetol. The confirmed cases have all been linked to raw milk from cows that have ingested a nonindigenous plant that contains the toxin. This makes the cows ill, and the tremetol gets passed on in the milk. The CDC is
currently investigating how and where the sickened cows got access to the plant, but in the meantime, there are some things you can do to keep yourself and your loved ones from getting ill.”

Ezra had his arm around my shoulder on the back of the couch, but he pulled away and leaned forward, looking worried. I felt nothing but relief. Finally, they were telling the public what they needed to know to stay safe. Then again, how many Amish families would see this press conference? None.

“First, as of eight o'clock this morning, the Pennsylvania Department of Agriculture has suspended all raw-milk sales in Pennsylvania until this matter is resolved. Second, we'll be distributing information to the farmers in the county about what symptoms to look for in their animals and what plant they need to check for in their pastures. Third, we recommend that no one consume raw dairy products until we can be sure all affected milk is accounted for. And finally, this illness is treatable if those who are sick report to their local hospital immediately. If you have any of the following symptoms: muscle weakness, trembling, stiff or slow movements, nausea, vomiting, or unexplained exhaustion, please report to your doctor or the closest emergency room and get checked out. We'll be working with the hospitals and physicians in the area to make sure they know what to look for and how to treat it
.
That's all we have to report at this time.”

There were more flashes from cameras, and a dozen reporters called out questions, but the news station cut back to their talking heads. Ezra turned down the volume. He stood up and paced. “This is bad. This is very bad.”

“Surely it's better for them to act quickly and make sure no one else gets sick.”

“You don't understand!” Ezra said vehemently. “Who sells raw milk? The Amish. And they've had to fight the government to do it for years. They want to regulate us. They don't like that anything is outside their control! They'd put us out of business if they could.”

I thought Ezra was being overdramatic. I had a hard time sympathizing with his distrust of government, since I'd always worked for the city in one way or another. “It's only until the CDC is sure they know exactly where that toxin came from. We need to make sure it's not going to affect any other farmers' cows. That's common sense.”

Ezra shook his head. “And what if they never find it? Or just say it's so? And next it is not only raw milk, but any food sold off the farm. And what about baking? The Amish bake with milk. What if customers no longer want to come look at my mules because Amish farms are . . . dirty?”

“Ezra! None of that is going to happen,” I said with a surprised laugh. “You're the one who likes to say ‘Don't borrow trouble.'”

Ezra looked unconvinced, a frown on his brow. On the dining room table, my phone pinged. I got up and answered it. It was Hernandez. “Hey, Harris! Did you see the press conference?”

“I did.”

“Well, it's nuts here. They're gearing up teams to go out and talk to the Amish, ya know, because they don't have TV and all that. Grady said anyone in our office could volunteer to help out today if they didn't have anything else urgent. I'm gonna go. Thought I'd see if you wanna go with me.”

I raised my eyes to find Ezra watching me. “You didn't get any sleep. You should lie down for the morning,” he said.

“I slept some at the hospital,” I countered.

Nevertheless, I wondered if this was the best use of my time today. They would have a lot of men out there passing out information to the Amish. And I could just imagine the warm reception that was going to get. I could probably push off my other tasks at work one more day, but should I?

The thought of focusing on my other cases made me wince. I wasn't ready to let this go. I doubted I could get engaged in another task—or sleep. The press conference should have eased my mind, but it hadn't, not deep down where it counted.

There was an anxiety sunk deep inside me, and it wasn't appeased. Shit. This was my war. I just wished I understood who the enemy was and what the battle was about.

“I'll come,” I told Hernandez. “Meet you at the office in twenty.”

—

Ba
ck at the police station, Grady rolled his eyes as I passed him in the hall as if to say,
Can't stay away, can you?
Hernandez was not at his desk in the Violent Crimes room. His chair was pushed in neatly—military habit.

I was about to text him when Glen Turner walked up. “Morning. Again.” He smiled at me sheepishly.

“No rest for the wicked,” I countered. “Nice job on the press conference. You looked so prime time.”

His mouth fought to rein in a prideful smile. “Well, someone has to be the guy with the bull's-eye on his forehead. So, um, Hernandez mentioned you were coming in to volunteer. You sure you're up for that after last night?”

I tilted up my chin. “I had a shower. I'm fine.”

“That works out for me, then. I was hoping you'd be willing to give me a hand today.”

“Oh?”

“I need to do interviews at the three farms where Amber got her milk. I've already sent agents out to stop them from drinking or selling it, and to see if anyone is sick and needs urgent care. But I need to go myself and do a face-to-face. Since they're Amish, I thought you might be helpful.” He ruffled his hair in frustration. “The DCNR is going to check those farms for white snakeroot, and I hope to God they find it. We still haven't found the source of the tremetol at the Kinderman farm or the Hershbergers', and we've gone over those pastures multiple times. The DCNR guys say white snakeroot is a woodland plant that only grows in shady and damp areas. Both the Hershbergers' and the Kindermans' cows are kept in fenced pastures, and even where the pasture gets shady from nearby trees, there's no sign of the plant. We also haven't found it in anything we sampled from the barn—the water, the feed. . . . We've dismantled and tested over two hundred bales of hay. Hell, we even tested the sparrow and mouse droppings in the barns. But we still haven't found the source of the tremetol.”

“That's not good.” I could feel Glen's frustration, and my own
mirrored it. If they couldn't find the source of the toxin, they couldn't be sure other farms hadn't been exposed. Which meant there'd be no quick lift on the raw milk ban. Farmers would be angry and the public would be scared.

“I didn't have a lot of luck questioning Mr. Hershberger,” Glen continued. “Maybe you can get more out of these farmers than I can. Or maybe you'll think of something I didn't, notice something I didn't—knowing the Amish as you do.”

I was flattered by Glen's faith in me, especially after we'd gotten more than one cold shoulder when we did calls the other day. But I wasn't about to remind him of my lack of effectiveness. I wanted to be as close to this case as I could get.

“I'll go with you. I should let Hernandez know. I was going to volunteer with him today.”

“He, um, already left. I told him I'd be needing you today.”

I raised my eyebrows. “That's . . . efficient of you.”

He had the grace to look guilty. “I didn't think you'd mind. If you prefer—”

“Nope, I'm good,” I said briskly. “Let's go.”

—

We
pulled into the driveway of Levi Fisher's farm in Glen's unmarked sedan. The place was already crowded with several SUVs bearing DCNR decals, a CDC van, a police cruiser, and an unmarked white truck with a back cab. Three Amish children, looking perfectly healthy, watched us from the farmhouse's back doorsteps. Their faces were blank, as if they were watching a
flock of birds or some other ordinary occurrence and not the invasion of their family farm by medical and police personnel.

As we walked by the pasture, I noted a number of men in green shirts scouring the area. I assumed they were DCNR agents looking for white snakeroot. Good.

Inside the barn it was quiet, a heavy silence that felt weighted, like at a wake. An Amish man, likely Levi Fisher, was seated on a bale of hay. He held his black hat in his hands, and his head was bowed. He wasn't old, maybe early thirties, and his still boyish face was tight with grief. He looked so miserable I felt sure some member of his family must be very ill or dead. My sympathy went out to him. I was easily able to picture Ezra or perhaps Hannah's husband, Isaac, in his place.

“Dr. Turner?” A young CDC officer approached us. She was dressed in the agency's white coveralls and gloves.

“Hi, Elaine. This is Detective Harris from the Lancaster police. How's the search going?”

Elaine nodded in acknowledgment at me. “Hello. They're checking outside now. We took samples of the feed and hay, but we haven't done anything in the stalls yet. We wanted to give the vet some space.” She tilted her head toward the stalls. “Come see for yourself.”

The barn had a long, open pen for the cows. There was an old wooden half wall on the interior side that came to my chest. A wide door, now closed, led out to the pasture. Inside the stall were six brown cows, all Jerseys, all with milk-engorged udders.
And they were sick. One lay on her side, panting, her eyes rolled back in her head. A man in blue coveralls, who had to be the vet, was kneeling beside her, injecting her with something. The other cows were in various stages of distress. One stood with her head in a corner as if she were trying to hide. The rest milled about, stumbling near the wall. They were trembling, their flanks shaking like they were being stung by an invisible horde of bees. Mucus dripped from one cow's nose. They looked like the Kindermans' cow to me.

I exchanged a dire look with Glen. There was little doubt the Fisher farm had tremetol poisoning.

“Once the vet is done, I want samples of everything in that stall,” Glen ordered. “Straw, feces, urine, their water and any traces of food in the trough or on the floor, birds' nests in the rafters, everything. And get saliva and blood samples from the cows.”

“Right,” agreed Elaine crisply.

“What about the family?” Glen asked her.

She shook her head. “None of them appear to be sick. We checked the milk supply they had in their kitchen—two gallons' worth. The expiration dates written on them were yesterday and today, so that milk is over a week old. According to Mrs. Fisher, they drink the older milk themselves so it won't go bad. The new milk goes into their shop for customers. It's possible they dodged the bullet on this. But we'd still like to run blood work on the whole family, if you agree?”

Glen nodded. “Yeah. Of course.” He looked at me. “Will they have a problem with giving us blood?”

I glanced back at Levi Fisher, who now had his head in both hands. “Shouldn't be a problem. The Amish do get modern health care when they need it.”

“Good. Now what about their customers?”

Elaine gestured toward the door. “Come with me. You need to see their shop.”

She led us out of the barn and across a wide gravel area to a little cement-block building that was coated with white paint. It had a tin roof and looked something like a bunker. An old wooden door faced a parking area big enough for no more than three cars. A sign on the door said “Farm Store. Open 8
A.M.
–6
P.M.
, Mon–Sat.” Another handwritten sign said “Raw Milk!”