Silent Fear, a Medical Mystery (17 page)

After making appropriate rounds, Danny went to Harold’s mother and crouched beside her. “Mrs. Jackowitz, it grieves me every day what happened to Harold. We didn’t see this deadly epidemic coming. I am so sorry.” Her hand rested on the arm rest and Danny clutched over it and squeezed.

“My son was happy working with all of you. I know you helped take care of him in the end. Thank you.”

“You have every reason to be proud of him.”

Sara stood alongside him, grim and weary over the young physician’s demise. There’s nothing worse than a child’s death, she knew. She gave Mrs. Jackowitz a slight hug after Danny got up.

All of Danny’s co-workers knew Sara. He introduced her to other family members and his friends by simply giving her name and not mentioning her as his ex-wife.

After fifteen minutes, Danny, Matthew, and Bruce stood in a partial circle near the dining room buffet.

“Matthew, you didn’t meet him,” Bruce said, “but Danny and I interviewed Jeffrey Foord today. He’s straight out of residency and looking for a neurosurgery position.” Bruce turned to Danny. “What do you think?”

Danny cracked a smile. “He’s a bit unique for the specialty.”

“But … that doesn’t matter, does it?”

“No, not in the least, although he may spice things up a bit.”

“Hire him?”

“Hire him.”

A hand tapped Danny from the side. In a low voice to the three of them, Cheryl said, “This morning’s news conference is on. In there.” She pointed toward the den.

Danny nodded to Sara to follow as they moved to the next room. A TV sat in a shelf opening, broadcasting the nightly news. A middle aged reporter with an English accent spoke from the street in front of the hospital entrance. “The death count and reported new cases in the unusual meningitis outbreak continues to climb. This epidemic claimed one more life here a short time ago, there are three more cases suspected, and two more confirmed in Knoxville. We go now to the medical news conference highlights, which took place here this morning.”

The major network aired the meeting while their names appeared at the bottom of the screen. Sara wringed her hands as she found it difficult to take the next breath. What Dr. Lewis seemed to be saying was that the prognosis for patients and their recovery looked dim if the present course of antibiotics failed. The coverage ended with the last statement from the CDC.

“I assure you,” Dr. Halbrow said, “Dr. Tilson and Dr. Lewis are two of the sharpest knives in the drawer.”

Chapter 14

Sitting at a window table in Downtown Italy, Danny broke apart garlic bread and handed Sara the other half. He took a bite and raised his wine glass for a toast. “To a nice dinner together,” he said as he clinked her glass. “I hope you didn’t feel uncomfortable earlier at the Jackowitz’s. Going there wasn’t something I planned on when I asked you out.”

“I understand. The circumstances are extraordinary. Do you know who died this afternoon?”

“No, I’ll find out tomorrow. It’s too grim to speculate. Perhaps we can talk about the girls and the upcoming wedding, about nice weather and fishing, and even about us.”

Sara hid behind her wine glass, then put it down and brushed her hair behind her ear. Her eyes went to the table, but not for long as she leaned in and spoke softly. “Danny, life comes without guarantees. Things don’t always work the way we plan them. I realized that when Melissa died.” On the brink of crying, she buried her forehead under her hand.

Danny ran his fingertips in the soft hair near her temple. He savored the special moment looking at her and smelling her orange-ginger aroma. The ivory flowered necklace draping her neck - he remembered they’d bought it on a trip - and the peach cotton pullover with a V-neck she wore adorned her complexion. A few intimate seconds seemed like an hour.

“I promise,” Danny said, “to make life run as smoothly as possible for you and the girls from now on. Whether we’re living with each other or not, married or not, if you let me, I’ll look after you three like there’s no tomorrow.”

Their eyes locked. “That’s sweet, Danny. I’ll try and believe you.” She knew it was more complicated than that. He had an infant as well, the result of the extra-marital affair he’d had with Rachel. For the first time, however, she realized the new baby wasn’t insignificant to their two girls, Annabel and Nancy. Their daughters now had a half-sister.

As if reading her mind, Danny placed his hands on his lap. “I know. I have a baby, too. I’ll pull my fatherly responsibility and more, but that situation is separate from my first and foremost family.”

Carrying two plates, the waiter stopped at their table, and placed the hot entrees they’d ordered in front of them. “Would either of you care for fresh parmesan cheese?”

They both nodded, allowing him to turn the grater over their plates. “I’ll be back to check on you. Enjoy,” he said and left for another table.

“Okay,” Danny said, “let’s eat. And thank you for finally accepting my invitation.”

“You’re welcome. This brings back memories. Your Dad and Mom were the ultimate owners here and I miss Angelo, but this does look pretty good.”

“He was special, wasn’t he? Now for the taste test.” Danny twirled linguini with shrimp around his fork and took a bite. He nodded. “How’s your ravioli?”

She savored and swallowed. “Very nice.”

They sampled each other’s pasta and Sara complimented the waiter on the food when he returned.

“I have big news,” Sara said. “Not as important as what you do or how you’re being heralded on national TV.”

“Sara, I just do my job, but what is it?”

“I’m going back to work,” she beamed. “Same as years ago before I gave it up. First year biology right under the same roof as the girls.”

“That’s fantastic. Good for you. You not only loved to teach, but you’re crazy about biology.”

“Yes, well… anyway, I’m ready.”

“Another toast,” Danny said. “Enjoy the second phase of your beloved career.”

----------

They skipped dessert and Danny drove Sara home. He zipped around the car and opened her door, then walked her to the front entrance.

“I bet your days lately have been extra long,” Sara said.

“Some of them remind me of the hours I pulled during residency.” Danny gently put his hand on her shoulder as they stepped onto the porch. “Sorry we didn’t linger longer over dinner. I’ll be jumping into bed after walking Dakota as soon as I get home.”

“No, this was perfect. The girls and I are having early days, too, before starting school next week.”

“They’re coming over again next weekend, if that’s okay. I’m not on call and I’m picking up Julia late Friday. We’re having a fun dinner at the house Saturday night. You know you’re welcome and invited.”

“I have plans Saturday night,” she said after a moment, in a bemused way.

Danny cocked his head. Maybe she’d explain.

“I have a date,” she said, causing Danny to gulp.

“Anybody I know?” he managed to ask.

“It’s the principal at school.”

Danny racked his brain on the way home, wondering if he’d ever met the man and what he looked like.

----------

Danny waited for Casey to catch up. They’d both left the house the same time, Danny slightly later than normal. Casey trotted upon seeing Danny outside the doctor’s parking zone, and they walked together across the asphalt into the ER back door.

“Are you going to pry about last night?” Danny asked.

“I figured you’d tell me if you wanted to.”

“Things were going well until she dropped the ball. She’s got a date Saturday night with the principal of the girls school.”

“Where she’s going to work?”

“You knew about that?”

Casey shrugged his shoulders. “Danny, Mary and I see her more frequently than you do. She’s been getting ready for it.”

“Oh,” Danny said flatly.

“And she’s a smart, pretty, sexy, and a fun lady. She’s noticeable. The men were going to show up sooner than later.” Casey pointed to the coffee room in the hallway and veered to the left. Danny followed.

“Most of our marriage I was aware of that,” Danny said.

Casey poured two cups of coffee and handed a black brew to Danny.

“Thanks,” he mumbled.

“I could ask you how you think she felt before when …” Casey let the sentence dangle, and then added, “but I won’t.”

“Okay, thanks for not going there.” Danny sipped. He looked at his watch. “Listen, you be careful as far as picking up any PAM patients. You and Mark should be wearing masks and gloves with every passenger you pick up, just in case.”

“That’s a good point. I’ll tell him. So far, however, most of those patients drive in themselves, or friends or relatives are driving them in.”

Both men stepped to the doorway where Casey peeled out the door again to his ambulance and Danny took the stairs up to the OR. He poked his head into the anesthesia office. “Who’s doing my first case?” he asked with a smile.

Dean shut a small middle-locker on the side wall. “I’m staffing two rooms this morning, one of them is yours. Shelly will be in there.” Danny nodded, knowing her long tenure as a nurse anesthetist. “We’re all mortified this morning about Lucy,” Dean added.

Danny leaned into the doorway. “No. I didn’t know. Not yet, anyway.” They gazed at each other in silence, Danny standing there longer than needed.

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The group had five lumbar laminectomies which needed to be done so Danny and Matthew Jacob flip-flopped them the whole morning, which meant they had two OR rooms. They ran simultaneously only short periods of time - as one case was closing, the next case was starting. It gave Danny and Matthew a breather – write post op notes, see their next patient, and run up to the floor if time permitted.

The five operations ran exceptionally smooth and swift due to teamwork non-preoccupied with usual concerns. Instead, they remained tentative about PAM, which caused them to only focus on the case at hand, to make it come and go without incident. The pre-op nurses double checked charts, orderlies jumped toward stretchers with patients for transport to the OR, operating room staff had few smiles and typical morning gossip, and patients glanced up and down at anyone who came near them, especially before sedation.

Matthew Jacob kept retying his scrubs tighter as if he’d dropped weight from running before work, and Danny’s brain worked overtime. He concentrated on the open, bloody back in front of him, without the need to have one ear on OR conversation since the room was devoid of talk or music. The only sounds heard were the harmony of machines and suction.

As Danny arched his back to change position, he glanced at each member of the case. The PAM outbreak unnerved them all, even the stoutest caretakers, and why not? What other field could cause a person to knowingly go to work and possibly subject themselves to carrying a deadly malady by the end of the day? Yes, deadly. They all harbored a silent fear.

Danny had scant medical historical knowledge but kept thinking about the Black Death or Bubonic Plague which wiped out a serious portion of Europe’s population in the fourteenth century. The time it took to figure out the source of the infection and treatment had cost lives; many lives. Under his mask, his mouth twisted with disgust thinking that valuable time was being lost. When he saw Peter Brown that morning between cases, apparently their new antibiotic course wasn’t faring well with the current PAM patients.

What recourse did they have now? Would the CDC have any tricks from their vast experience with epidemics? Joelle thought outside the box – could she defy this
Naegleria fowleri
and work magic against it? His own hands were tied. He wished he could surgically remove the buggers but they had worked their DNA or had done what Darwin would have considered survival of the fittest by altering their morphology with appendages to suck the contents right out of human beings’ brain cells.

He put the suction tip back on the drape and picked up the electrocautery like a pencil. Why hadn’t Michael gotten sick like the others? Like other illnesses, it must depend on the patient’s age and their health status, even DNA. And what about the symptom of salivation? He realized it must be a key, timely ingredient needed for its likely transmission. That’s why not everyone contracted it every time they neared a patient who had it at a certain time. He’d have to run his thoughts by Joelle. Yet he realized he must be the exception. He’d been around PAM patients at multiple stages of its development, even the beginning and drying up of their increased saliva.

Danny reflexively stiffened, realizing one more thing. After he had dropped Sara at home the night before, and before he had climbed into bed with Dakota on the floor beside him, he had done a quick computer medical search. Over almost the last seventy years,
Naegleria fowleri
had killed approximately 120 people in the United States. That was bad enough, but what they had now was a salivation-altered form, a Darwinian super monster capable of hopping from patient to patient like fleas on dogs.

If he had the option, he’d vote for the present epidemic and not the full blown pandemic on the way.

----------

Danny passed Matthew in the OR hallway going back with the next spine patient. “Joelle and Ralph Halbrow are waiting for you in the lounge,” Matthew said. “I hope they let you eat.”

“I’ll see to it,” Danny said, but doubted it.

In the lounge, Danny whisked over to the back table swathed in sunshine from the adjacent window where Joelle scooted back her chair and uncrossed her legs.

“Good morning,” she said. “Can you sit a minute so we can talk? Ralph and I decided to see the PAM patients firsthand today after Peter and Tim. We only have Michael Johnson left and we’d like to drag you.” She pushed a head band further back, being careful not to disturb her looped earrings.

“Sure,” Danny said, nodding. “You look nice today, not that you don’t usually look that way.”

Ralph arrived and Danny pulled out a chair for him. “You look less tired today, Ralph,” he said.

“And as opposed to Joelle, spare me a compliment,” Ralph said. “I’m living from a hotel room. When I get this long outa my suitcase, I start looking like a catfish from Mississippi mud.”