“Hold the clichés,” Vinnie said. He took the folder and let it fall open in his hands. “Frankly, I’m not in the mood for any of your sappy sayings. What bugs me is that you can’t come in here when everybody else does.”
“Laurie’s here,” Jack reminded him.
“Yeah, but this is her week for scheduling. You don’t have any excuse.” He briefly read portions of the folder. “Wonderful! Another infectious case! My favorite! I should have stayed in bed.”
“I’ll be down in a few minutes,” Jack said.
Vinnie irritably snapped up his newspaper and headed downstairs.
Laurie reappeared with an armful of folders and dumped them on her desk. “My, my, but we do have a lot of work to do today,” she said.
“I’ve already sent Vinnie down to get prepared for one of these infectious cases,” Jack said. “I hope I’m not overstepping my authority. I know you haven’t looked at them yet, but all of them are suspected plague but tested negative. At a minimum I think we have to make a diagnosis.”
“No question,” Laurie said. “But I should still go downstairs and do my external. Come on, I’ll do it right away, and you can get started.” She grabbed the master list of all the previous night’s deaths.
“What’s the story on this first case you want to do?” Laurie asked as they walked.
Jack gave her a quick synopsis of what he knew about Maria Lopez. He emphasized the coincidence of her being employed in central supply at the General. He reminded her that the plague victim from the day before had also worked in that department. They boarded the elevator.
“That’s kinda strange, isn’t it?” Laurie asked.
“It is to me,” Jack agreed.
“Do you think it’s significant?” Laurie asked. The elevator bumped to a stop, and they got off.
“My intuition tells me it is,” Jack said. “That’s why I’m eager to do the post. For the life of me, I can’t figure out what the association could be.”
As they passed the mortuary office Laurie beckoned to Sal. He caught up to them, and she handed him her master list. “Let’s see the Lopez body first,” she said.
Sal took the list, referred to his own, then stopped at compartment 67, opened the door, and slid out the tray.
Maria Lopez, like her late co-worker, Katherine Mueller, was an overweight female. Her hair was stringy and dyed a peculiar reddish orange. Several IVs were still in place. One was taped to the right side of her neck, the other to her left arm.
“A fairly young woman,” Laurie commented.
Jack nodded. “She was only forty-two.”
Laurie held Maria Lopez’s full-body X ray up to the ceiling light. Its only abnormality was patchy infiltration in her lungs.
“Go to it,” Laurie said.
Jack turned on his heels and headed toward the room where his moon-suit ventilator was charging.
“Of the other two cases you had upstairs, which one would you want to do if you only do one?” Laurie called after him.
“Lagenthorpe,” Jack said.
Laurie gave him a thumbs-up.
Despite his hangover, Vinnie had been his usual efficient self in setting up the autopsy on Maria Lopez. By the time Jack read over the material in Maria’s folder for the second time and had climbed into his moon suit, all was ready.
With no distractions from anyone in the pit besides himself and Vinnie, Jack was able to concentrate. He spent an inordinate amount of time on the external exam. He was determined to find an insect bite if there had been one. He was not successful. As with Mueller, there were a few questionable blemishes, which he photographed, but none he felt were bites.
Jack’s concentration was inadvertently aided by Vinnie’s hangover. Preferring to nurse his headache, Vinnie remained silent, sparing Jack his usual quips and running commentary on sports trivia. Jack reveled in the thought-provoking silence.
Jack handled the internal exam the same way he’d handled those of the previous infectious cases. He was extraordinarily careful to avoid unnecessary movement of the organs to keep bacterial aerosolization to a minimum.
As the autopsy progressed, Jack’s overall impression was that Lopez’s case mirrored that of Susanne Hard, not Katherine Mueller. Hence, his preliminary diagnosis remained tularemia, not plague. This only highlighted his confusion of how two women from central supply had managed to catch these illnesses while other, more exposed hospital workers had avoided them.
When he finished with the internal exam and had taken the samples he wanted, he put aside a special sample of lung to take up to Agnes Finn. Once he had similar samples from Joy Hester and Donald Lagenthorpe, he planned to have them all sent immediately to the reference lab to be tested for tularemia.
By the time Jack and Vinnie had commenced stitching up Maria Lopez, they began to hear voices in the washroom and out in the hall.
“Here come the normal, civilized people,” Vinnie commented.
Jack didn’t respond.
Presently the door to the washroom opened. Two figures entered in their moon suits and ambled over to Jack’s table. It was Laurie and Chet.
“Are you guys finished already?” Chet said.
“It’s not my doing,” Vinnie said. “The mad biker has to start before the sun is up.”
“What do you think?” Laurie asked. “Plague or tularemia?”
“My guess is tularemia,” Jack said.
“That will be four cases if these other two are tularemia as well,” Laurie said.
“I know,” Jack said. “It’s weird. Person-to-person spread is supposed to be rare. It doesn’t make a lot of sense, but that seems par for the course with these recent cases.”
“How is tularemia spread?” Chet asked. “I’ve never seen a case.”
“It’s spread by ticks or direct contact with an infected animal, like a rabbit,” Jack said.
“I’ve got you scheduled for Lagenthorpe next,” Laurie told Jack. “I’m going to do Hester myself.”
“I’m happy to do Hester as well,” Jack said.
“No need,” Laurie said. “There aren’t that many autopsies today. A lot of last night’s deaths didn’t need to be posted. I can’t let you have all the fun.”
Bodies began arriving. They were being pushed into the autopsy room by other mortuary techs and lifted onto their designated tables. Laurie and Chet moved off to do their own cases.
Jack and Vinnie returned to their suturing. When they were finished, Jack helped Vinnie move the body onto a gurney. Then Jack asked how quickly Vinnie could have Lagenthorpe ready to go.
“What a slave driver,” Vinnie complained. “Aren’t we going to have coffee like everybody else?”
“I’d rather get it over with,” Jack said. “Then you can have coffee for the rest of the day.”
“Bull,” Vinnie said. “I’ll be reassigned back in here helping someone else.”
Still complaining, Vinnie pushed Maria Lopez out of the autopsy room. Jack wandered over to Laurie’s table. Laurie was engrossed in the external exam but straightened up when she caught sight of Jack.
“This poor woman was thirty-six,” Laurie said wistfully. “What a waste.”
“What have you found? Any insect bites or cat scratches?”
“Nothing except a shaving nick on her lower leg,” Laurie said. “But it’s not inflamed, so I’m convinced it’s incidental. There is something interesting. She has definite eye infections.”
Laurie carefully lifted the woman’s eyelids. Both eyes were deeply inflamed, although the corneas were clear.
“I can also feel enlarged preauricular lymph nodes,” Laurie said. She pointed to visible lumps in front of the patient’s ears.
“Interesting,” Jack commented. “That’s consistent with tularemia, but I didn’t see it on the other cases. Give a yell if you come across anything else unusual.”
Jack stepped over to Chet’s table. He was happily engrossed in a multiple gunshot wound case. At the moment he was busy photographing the entrance and exit wounds. When he saw Jack he handed the camera to Sal, who was helping him, and pulled Jack aside.