Switching to a higher power of magnification, Jack immediately appreciated the primary pathology. The cells lining the blood vessels that coursed through the heart were severely damaged. As a result, many of these blood vessels had become occluded with blood clots, causing multiple tiny heart attacks!
With a shot of adrenaline coursing through his own circulation from the excitement of discovery, Jack quickly switched back to the section of lung. Using the same high power he saw identical pathology in the walls of the tiny blood vessels, a finding he hadn’t noticed on his first examination.
Jack exchanged the lung section with one from the spleen. Adjusting the focus, he saw the same pathology. Obviously it was a significant finding, one that immediately suggested a possible diagnosis.
Jack pushed back from his desk and made a quick trip back to the micro lab and sought out Agnes. He found her at one of the lab’s many incubators.
“Hold up on the tissue cultures on Lagenthorpe,” he said breathlessly. “I got some new information you’re going to love.”
Agnes regarded him curiously through her thick glasses.
“It’s an endothelial disease,” Jack said excitedly. “The patient had an acute infectious disease without bacteria seen or cultured. That should have given it away. He also had the faintest beginnings of a rash that included his palms and soles. Plus he’d been suspected of having appendicitis. Guess why?”
“Muscle tenderness,” Agnes said.
“Exactly,” Jack said. “So what does that make you think of?”
“Rickettsia,” Agnes said.
“Bingo,” Jack said, and he punched the air for emphasis. “Good old Rocky Mountain spotted fever. Now, can you confirm it?”
“It’s as difficult as tularemia,” Agnes said. “We’ll have to send it out again. There is a direct immunofluorescent technique, but we don’t have the reagent. But I know the city reference lab has it, because there’d been an outbreak of Rocky Mountain spotted fever in the Bronx in eighty-seven.”
“Get it over there right away,” Jack said. “Tell them we want a reading as soon as they can get it to us.”
“Will do,” Agnes said.
“You’re a doll,” Jack said.
He started for the door. Before he got there Agnes called out to him: “I appreciate you letting me know about this as soon as you did,” she said. “Rickettsias are extremely dangerous for us lab workers. In an aerosol form it is highly contagious. It’s as bad or worse than tularemia.”
“Needless to say, be careful,” Jack told her.
17
Helen Robinson brushed her hair with quick strokes. She was excited. Having just hung up the phone with her main contact at National Health’s home office, she wanted to get in to see Robert Barker as soon as possible. She knew he was going to love what she had to tell him.
Stepping back from the mirror, Helen surveyed herself from both the right and the left. Satisfied, she closed the closet door and headed out of her office.
Her usual method of contacting Robert was merely to drop in on him. But she thought the information she now had justified a more formal approach; she’d asked one of the secretaries to call ahead. The secretary had reported back that Robert was available at that very moment, not that Helen was surprised.
Helen had been cultivating Robert for the last year. She started when it became apparent to her that Robert could ascend to the presidency. Sensing the man had a salacious streak, she’d deliberately fanned the fires of his imagination. It was easy, although she knew she treaded a fine line. She wanted to encourage him, but not to the point where she would have to openly deny him. In reality, she found him physically unpleasant at best.
Helen’s goal was Robert’s position. She wanted to be executive director of accounts and could see no reason why she shouldn’t be. Her only problem was that she was younger than the others in the department. She felt that was the handicap that her “cultivation” of Robert could overcome.
“Ah, Helen, my dear,” Robert said as Helen demurely stepped into his office. He leaped to his feet and closed the door behind her.
Helen perched on the arm of the chair as was her custom. She crossed her legs and her skirt hiked up well above her knee. She noticed the photo of Robert’s wife was lying facedown as usual.
“How about some coffee?” Robert offered, taking his seat and assuming his customary hypnotic stare.
“I’ve just spoken with Gertrude Wilson over at National Health,” Helen began. “I’m sure you know her.”
“Of course,” Robert said. “She’s one of the more senior vice presidents.”
“She’s also one of my most trusted contacts,” Helen said. “And she is a fan of Willow and Heath.”
“Uh-huh,” Robert said.
“She told me two very interesting things,” Helen said. “First of all, National Health’s main hospital here in the city compares very favorably with other similar hospitals when it comes to hospital-based infections, or what they like to call nosocomial infections.”
“Uh-huh,” Robert repeated.
“National Health has followed all the recommendations of the CDC and the Joint Commission on Accreditation,” Helen said.
Robert shook his head slightly, as if waking up. It had taken a moment for Helen’s comments to penetrate his preoccupied brain. “Wait a second,” he said. He looked away to organize his thoughts. “This doesn’t sound like good news to me. I thought my secretary told me you had good news.”
“Hear me out,” Helen said. “Although they have an overall good nosocomial record, they’ve had some recent troubles in their New York facility that they’re very sensitive about and would hate to be made public. There were three episodes in particular. One involved an extended outbreak of staph in the intensive-care units. That gave them a real problem until it was discovered a number of the nursing staff were carriers and had to be given courses of antibiotics. I tell you, this stuff is frightening when you hear about it.”
“What were the other problems?” Robert asked. For the moment he tried to avoid looking at Helen.
“They had another kind of bacterial problem originate in their kitchen,” Helen said. “A lot of patients got serious diarrhea. A few even died. And the last problem was an outbreak of hospital-based hepatitis. That killed several as well.”
“That doesn’t sound like such a good record to me,” Robert said.
“It is when you compare it with some of the other hospitals,” Helen said. “I tell you, it’s scary. But the point is that National Health is sensitive about this nosocomial infection issue. Gertrude specifically told me that National Health would never in a million years consider running an ad campaign based on it.”
“Perfect!” Robert exclaimed. “That is good news. What have you told Terese Hagen?”
“Nothing, of course,” Helen said. “You told me to brief you first.”
“Excellent job!” Robert said. He pushed himself up onto his long, thin legs and paced. “This couldn’t be better. I’ve got Terese just where I want her.”
“What do you want me to tell her?” Helen asked.
“Just tell her that you have confirmed National Health has an excellent record vis-à-vis nosocomial infection,” Robert said. “I want to encourage her to go ahead with her campaign, because it will surely bomb.”
“But we’ll lose the account,” Helen said.
“Not necessarily,” Robert said. “You’ve found out in the past that they are interested in ‘talking heads’ spots with celebrities. We’ve communicated that to Terese time and time again and she has ignored it. I’m going to go behind her back and line up a few of the stars from some of the current hospital-based TV dramas. They’d be perfect for testimonials. Terese Hagen will bomb and we’ll be able to step in with our own campaign.”