The fact that he had been half-expecting it all day did not lessen the impact. Doc picked up the computer print-out tape, stared at it for a moment, and shook his head with a sigh. “As fast as that,” he said bitterly. “I was afraid of it. What about an autopsy?”
“The father refused permission. Lab did take a throat culture and blood studies, though, and a spinal tap. They supported the history — a viral meningitis. There were traces of Viricidin in his bloodstream, too; he’d been treated by somebody, probably just not soon enough.”
“And what about the rest of the family?” Doc asked.
“He was brought in by the father and a younger boy. They were obviously Naturists, and they refused examinations.”
Doc winced. “They’ll be back,” he said, “probably just like the boy. Katie, something’s going on here that’s very bad, and I don’t think you and your Health Control people here are even beginning to grasp it.”
“But we know there’s a bad infection on the move. We’re treating it, and I told you we’ve got the computers working on the epidemic problems.”
“You mean you’ve started off on a big, sprawling, time-consuming analytic study that’s going to take six weeks or more to complete, and I don’t think you’ve got six weeks. If what I suspect is true, this hospital and the whole damned city could be buried in bodies in six weeks.”
“What do you think is happening?”
Doc sighed. “I’m not sure, but I think you’ve got to find out in one whale of a rush. Look, I was the one that saw that Hardy boy last night in his home. Never mind what I was doing there, I saw him. He was already mortally ill, the full-blown picture of meningitis, but he’d only had those symptoms for forty-eight hours. Before that he’d been just mildly ill for about two weeks — with the Shanghai flu. Not even a bad case, just a mild sore throat, headache, muscle aches, and those symptoms were all getting better spontaneously. Then whammo! A wildfire meningitis, and he’s dead in the course of two days in spite of the treatment I started. Meanwhile, the father and the brother both have had Shanghai flu and have early meningitis symptoms right now, for which they’re refusing examination or treatment.”
Katie Durham stared at him in confusion. “But John, they’re Naturists. It’s perfectly consistent that they’d refuse treatment.”
“Especially for something mild, right? Like the Shanghai flu. Well, that’s exactly the point. Suppose this mild flu isn’t just a mild flu. Suppose the virus, once it gets well entrenched, can attack the spine and cause a deadly meningitis. But these people are bypassing early treatment because it just seems like a mild flu. Naturists or whatever, they’re trying to ‘ride it out,’ to use an old Health Control term. And while they ride it out, without knowing there’s a bomb waiting to go off later, they’re also infecting everybody they come in contact with — and by the time they and the ones they infect decide they can’t ride it out any longer, it may be too late to difuse the bomb. Oh, your regular clinic patients are all right. The ones that are eligible come in to the clinic for every sniffle, right? When they get the Shanghai flu. in they come and you slap it down with Viricidin and it stops right there. And you’ve been treating thousands of Shanghai flu cases these past weeks, right? But what about the ones that aren’t eligible?”
Katie sat down at her desk, frowning. “Yes, I’m beginning to see what you mean. You’re thinking — ”
“I’m thinking that this city is full of people — not just the Naturists, but thousands upon thousands of common, ordinary, everyday people — who are going to try to ride out a mild case of Shanghai flu just the way they’d ride out a common cold, tens of thousands of people like that who can’t qualify for Health Control care, people who wouldn’t dream of applying for Health Control care for a simple case of flu — considering the eligibility requirements — until it’s too late.”
“And you’re contending that this meningitis could be a late complication of this particular strain of flu.”
“Right. And this Shanghai flu epidemic hasn’t even begun to crest yet, we haven’t begun to see the cases we’re going to see when it really gets moving in the population.”
Katie shook her head. “But, John, this is all pure guesswork. Sure, there’s a flu epidemic moving in, and there’s also a nasty viral meningitis that’s begun turning up. That doesn’t mean the two are related.”
“But suppose they were.”
“If they were, it could be a disaster. I’m not sure what it might mean, but you don’t have a shred of evidence.”
“That’s right, I don’t,” Doc said. “But maybe you do, in the hospital records, and if the two are related, you’ve got to find it out. You’ve got to forget this slow, nitpicking computer study you’ve gotten started and home in on the one critical question you need an answer to right now: how many of your meningitis patients had untreated Shanghai flu to start with, and how many of the flu patients you treated came down with the meningitis anyway. Would that take so long to track down?”
Katie Durham bit her lip thoughtfully. “Twenty-four hours, maybe. Maybe less.” She stared at him for a long moment, then picked up her phone with an air of decision. “Will you see if Tim Lerner in the data bank can come up here, Mary? Right now, if possible, it’s urgent.”
They waited in silence, Doc lost in thought, Katie closing her eyes and rubbing her forehead wearily. Only a few moments later the secretary ushered in a tall, thin young man in a white lab coat and horn-rimmed glasses. “Dr. Durham?”
“Come in, Tim. Dr. Lerner, this is Dr. John Long, surgical staff. You’ve probably never met. John, Tim is our Chief Records Analyst and heads up the Department of Statistics. Now, then. On this meningitis study you’ve got started, Tim, we need some preliminary data very urgently.” Carefully, she began outlining the problem, the question of relationship between flu victims and the meningitis cases admitted to the hospital. Lerner pulled out a pipe, filled it and lit it as he listened. When she finished he said, “When do you need this?”
“The sooner the better. Tomorrow morning at the latest.”
Lerner whistled. “You know that this will all show up anyway when the general study is finished.”
“That’s far too slow. Set the rest of it aside and get this going fast. Commandeer all the computer time you need. I’ll sign the priority. We want a search on every viral meningitis case diagnosed either in the outpatient clinics or in the hospital in the past six weeks, with a tight résumé of follow-up — what happened to each one of them. Even more important, search their records for any history of general influenza symptoms within two weeks prior to onset of meningeal symptoms. Never mind the lab data, we’ll correlate that later. But tabulate old patients and new patients separately — we need hard figures on how many meningitis victims might have delayed clinic or hospital visits on account of ineligibility. Is that clear?”
“You mean you want separate figures for former patients and never-treated patients?” Lerner jotted notes on a pad. “Fine, we can do it. I’m not sure we can vouch for statistical significance on this kind of run, but with any luck we can get you some sort of a picture.”
“That’s what we need right now — a preliminary picture. We can pick up details later. But put this through tonight, Tim. It could be critically important.”
When Dr. Lerner had left, tapping his note pad thoughtfully, Katie turned back to Doc. “Okay, now we’ll see. Personally, I think you’re way out in left field, and this little canter is going to cost the hospital a small fortune in computer time, but we’ll see. Meanwhile, we still haven’t resolved the small problem of Dr. John Long and his part in the robot-training program.”
“I know,” Doc said.
“So what answer can you give me?”
“I just don’t know.”
“Well, obviously I can’t keep you in the program any longer unless you’re willing to cooperate. And if I can’t keep you on it, I’m going to have to explain why to Health Control, and they’re going to start to probe.”
“Can you give me twelve hours to answer?”
“Do you really need twelve hours?”
“I’ve got to think it through. I’m not sure what I can do. Some time would be a help.”
“Then take your twelve hours. Check with me in the morning. I should have data on this other thing by then; you can give me your answer then too. And, John, for God’s sake don’t play games with me anymore. Make it the right answer this time.”
Doc paused at the office door, turned back to her with a smile. “For you, Katie, I’ll try. But if I can’t, it won’t be your fault. I won’t have anybody to blame but myself.”