and got the same replies, except when she asked if he was one of Dr. Zabriski’s patients.
“No,” said Dr. Cester after a spasm of abdominal pain subsided. “I’ve never been to an ophthalmologist.”
“Do you work with him?” asked Marissa.
“I occasionally give anesthesia for him,” said Dr. Cester. His face contorted again in pain. When he recovered, he said, “I play tennis with him more often than I work with him. In fact I played with him just four days ago.”
After obtaining her samples, Marissa left the man, more confused than ever. She had begun to think that fairly close contact—particularly with a mucous membrane—was needed to communicate the disease. Playing tennis with someone did not seem to fit that mold.
After sending off the second set of viral samples, Marissa went back to Dr. Zabriski’s chart. She read over the history in minute detail and began the same type of diary she’d drawn up for Dr. Richter. She added what material she’d learned from Mrs. Zabriski and the secretary, knowing that she would have to go back to both of them. Although such work had not resulted in determining the reservoir of the virus in the L.A. outbreak, Marissa had hopes that by following the same procedure with Dr. Zabriski she might find some common element in addition to both doctors having been to the same eye conference in San Diego.
It was after twelve when Dubchek, Vreeland and Layne arrived. Marissa was relieved to see them, particularly because Dr. Zabriski’s clinical condition had continued to deteriorate. The doctor taking care of him had demanded some routine blood work be done to determine the state of the patient’s hydration, and Marissa had been caught between the conflicting demands of treating the patient and protecting the hospital. She finally allowed those tests that could be done in the patient’s room.
After a cursory greeting, the CDC doctors all but ignored Marissa as they struggled to get the mobile isolation laboratory functioning and improve the isolation of the patients. Dr. Layne had some large exhaust fans brought in, while Dr. Vreeland immediately went down to the administration area to discuss improving the quarantine.
Marissa went back to her charts but soon exhausted the information they could supply. Getting up, she wandered to the isolation lab. Dubchek had removed his jacket and had rolled up his sleeves while he labored with the two CDC technicians. Some kind of electrical bug had developed in the automatic chemistry portion of the apparatus.
“Anything I can do?” called Marissa.
“Not that I can think of,” said Dubchek without looking up. He immediately began conversing with one of the technicians, suggesting they change the sensing electrodes.
“I would like a minute to go over my findings with you,” called Marissa, eager to discuss the fact that Dr. Zabriski had attended the same San Diego medical meeting as Dr. Richter had.
“It will have to wait,” said Dubchek coolly. “Getting this lab functioning takes precedence over epidemiologic theories.”
Going back to the nurses’ station, Marissa seethed. She did not expect or deserve Dubchek’s sarcasm. If he’d wanted to minimize her contribution, he had succeeded. Sitting down at the desk, Marissa considered her options. She could stay, hoping he might allow her ten minutes, at his convenience, or she could go and get some sleep. Sleep won out. She put her papers in her briefcase and went down to the first floor to rescue her suitcase.
The operator woke Marissa at seven o’clock. As she showered and dressed, she realized that her anger toward Dubchek had dissipated. After all, he was under a lot of stress. If Ebola raged out of control, it was his neck on the line, not hers.
When she arrived back at the isolation ward, one of the CDC lab techs told her that Dubchek had gone back to the hotel at 5:00 A.M. He didn’t know where either Vreeland or Layne was.
At the nurses’ station things were a bit chaotic. Five more patients had been admitted during the night with a presumptive diagnosis of Ebola Hemorrhagic Fever. Marissa collected the charts, but as she stacked them in order, she realized that Zabriski’s was missing. She asked the day nurse where it was.
“Dr. Zabriski died just after four this morning.”
Although she’d expected it, Marissa was still upset. Unconsciously, she had been hoping for a miracle. She sat down and put her face in her hands. After a moment she forced herself to go over the new charts. It was easier to keep busy. Without meaning to, she caught herself touching her neck for swelling. There was an area of tenderness. Could it be a swollen lymph node?
She was pleased to be interrupted by Dr. Layne, the Director of the CDC’s Hospital Infectious Disease Program. It was obvious from the dark circles under his eyes, his drawn face and the stubble on his chin that he had pulled an “all-nighter.” She smiled, liking his slightly heavyset, rumpled looks. He reminded her of a retired football player. He sat down wearily, massaging his temples.
“Looks like this is going to be just as bad as L.A.,” he said. “We have another patient on the way up and another in the ER.”
“I’ve just started looking at the new charts,” said Marissa, suddenly feeling guilty for having left the night before.
“Well, I can tell you one thing,” said Dr. Layne. “All the new patients seem to have gotten their disease from the hospital. That’s what bothers me so much.”
“Are they all patients of Dr. Zabriski’s?” asked Marissa.
“Those are,” said Dr. Layne, pointing at the charts in front of Marissa. “They all saw Zabriski recently. He apparently inoculated them during his examinations. The new cases are both Dr. Cester’s patients. He’d been the anesthesiologist when they had surgery during the last ten days.”
“What about Dr. Cester?” asked Marissa. “Do you think that he contracted the disease the same way that Dr. Zabriski did?”
Dr. Layne shook his head. “Nope. I talked at length with the man, and I found out that he and Zabriski were tennis partners.”
Marissa nodded. “But would such contact count?”
“About three days before Dr. Zabriski became ill, Dr. Cester borrowed his towel between sets. I think that’s what did it. Transmission seems to depend on actual contact with body fluids. I think Zabriski is another index case, just like Dr. Richter.”
Marissa felt stupid. She had stopped questioning Dr. Cester just one question short of learning a crucial fact. She hoped that she wouldn’t make the same mistake again.
“If we only knew how the Ebola got into the hospital in the first place,” said Dr. Layne rhetorically.
Dubchek, looking tired but clean-shaven and as carefully dressed as always, arrived at the nurses’ station. Marissa was surprised to see him. If he’d left at five, he’d hardly had time to shower and change, much less get any sleep.
Before Dubchek could get involved in a conversation with Layne, Marissa quickly told both doctors that Zabriski had attended the same San Diego medical conference as Richter had and that they had stayed in the same hotel.
“It’s too long ago to be significant,” Dubchek said dogmatically. “That conference was over six weeks ago.”
“But it appears to be the only association between the two doctors,” protested Marissa. “I think I should follow up on it.”
“Suit yourself,” said Dubchek. “Meanwhile, I’d like you to go down to pathology and make sure they take every precaution when they post Zabriski this morning. And tell them that we want quick-frozen samples of liver, heart, brain and spleen for viral isolation.”
“What about kidney?” interjected Layne.
“Yeah, kidney, too,” said Dubchek.
Marissa went off feeling like an errand girl. She wondered if she would ever regain Dubchek’s respect, then remembering why she’d lost it, her depression was wiped out by a surge of anger.
In pathology, a busy place at that time of day, Marissa was directed to the autopsy rooms, where she knew she’d find Dr. Rand. Remembering his pompous, overbearing manner, she was not looking forward to talking with him.
The autopsy rooms were constructed of white tile and gleaming stainless steel. There was a pervading aroma of formalin that made Marissa’s eyes water. One of the technicians told her that Zabriski’s post was scheduled for room three. “If you intend to go, you have to suit up. It’s a dirty case.”
