Kate sat in the passenger seat of the Yukon, pulling her sleeves down over her hands to keep them warm. A cold front had settled over the mountains while they slept, reminding them of the winter to come. Kate stifled a yawn, taking a sip of her Judy blend coffee and catching Andy’s eye. They smiled at each other but didn’t say anything. Having stayed up late last night talking, they didn’t feel the need to fill the morning air with random chatter.
Last night had been hard for Kate. She knew it was wrong to keep things from Andy. Not just the latest incident with Mona Kellar, but the growing sense of unease, the questions she had about herself, the all-too-familiar feeling of being lost. But right now, in the face of the growing bioterrorism threat in Hidden Valley, answering or even acknowledging those questions seemed indulgent. So Kate had kept Andy talking. Curled up in her pyjamas and Andy’s sweatshirt on the bed, she’d watched Andy pace the room, the frustration of inaction evident in each step she took across the small space.
While Kate had been managing patients the day before, Jack, working through the data he’d been given over the last two days, had given Andy and Constable Ferris the most highly probable infection site as the James Ranch. It linked Tessa James, of course, as well as Chase Noonan and Keith Grange, who had both worked there. Mary Johnston had taken her granddaughter there for riding lessons. But it did not include Roberta Sedlak, who they were having a hard time definitively linking to any of the other patients.
The James Ranch was the best guess, so Andy, Constable Ferris, and Dr. Salinger had gathered their protective gear and headed out. But Richard James had refused to even allow them on the property, threatening them through the intercom attached to the front gate. Apparently he assumed this was all a set-up by Michael Cardiff to discredit him in the community. Constable Ferris had attempted to be persuasive, holding back a severely pissed-off Andy. Richard James told them to come back with a warrant before he’d let them on his property.
Andy wasn’t ready to give up that easily. She and Ferris knew that without a more firmly established link between all the initial incidences of the HV1A virus, getting a warrant would be difficult. Going to Superintendent Heath was a possibility, but Andy knew that would be more trouble than it was worth. It would only confirm Richard James’s paranoia. So Andy wanted to bring in Kate, thinking her neutral medical stance and her visibility in the community would bring him around.
“Why were you down in the lab yesterday?” Andy said as they drove to the James Ranch. “I never got around to asking you last night.”
“Dr. Doyle submitted twenty-eight samples to the lab yesterday on top of what the ER was sending down. I don’t know for sure, but I’m guessing most of Valley General’s hospital board and their families jumped the queue for getting tested.”
“Christ. And here I was thinking Dr. Doyle was starting to stand up to them, when really she was just being underhanded.”
Kate took a sip of her coffee. It was nice to have Andy on her side, to share in the frustration.
“Some team leader,” Andy grumbled, turning onto a neatly paved side road as the sun began to peek its way through the clouds. “What do you want to do?”
“Confront her,” Kate said decisively. “Privately, of course. Make sure she knows how backed up the lab is getting without doubling the samples for no reason other than to make her life easier.”
Andy nodded approvingly. “Let me know if I can help.”
Kate smiled. “How about another vacation at the end of this? I bet you could find us another cabin in the mountains somewhere,” she said, teasing.
Instead of returning the smile, Andy gave her a long, searching look, and Kate’s hand trembled lightly. What had she just given away? “I take it you’re not anxious to return to Van East?” Andy said, pulling down the visor to block the sun that had erupted from behind the clouds.
Kate blinked, utterly unprepared for this conversation. She sipped her coffee, wondering what her chances were at avoiding this. Pretty slim, she thought, as Andy pulled onto the shoulder of the road, a tall black fence separating the road from neat green paddocks.
“I was making a joke, Andy,” Kate said sharply, wondering if Andy would back off if she got annoyed.
“I know. But that doesn’t answer my question,” Andy said, not backing off even a little. Kate hadn’t really expected her to. “I know you’re struggling, Kate. I know Winnipeg was hard.” Andy’s voice was soft and Kate swallowed convulsively. Winnipeg had been hard, but not in the way Andy thought. The last time she’d landed in that city, it had been about finding her lost sister. This time, it was not her sister who was lost. “Kate…” Andy waited until Kate looked up. “I know you’re avoiding something.”
Kate had to look away again, away from those grey eyes that saw to the very centre of her, past any hastily shut doors, past every sad attempt at distraction. Andy could see, she always had. What does she see that I can’t? Another convulsive swallow. The question was close, too close.
“You don’t have to talk to me, you know.” Andy was still trying, her voice carrying that sweet, understanding softness that had always tugged at Kate’s heart. “Just know that you can. And that you don’t have to waste any more energy trying to hide from me.”
From me, Andy. I’m hiding from me.
Those were the words Kate knew she should say out loud. She didn’t. Instead, she took three slow breaths, counting the spires of the long black fence framed in the side window until those words in her head disappeared. As if the thought had never existed in the first place. Finally she looked at Andy, who waited patiently, quietly, like they had all the time in the world to work this out.
“Thanks,” was all Kate said into the silence.
Andy looked at her for a long time and Kate, her defenses terrifyingly low, let her. She didn’t know what Andy saw, but whatever it was, it was enough.
“Are you ready for this?” Andy said, indicating the large, black gate in front of them.
More than ready. Anxious to get at something she had some hope of solving.
“Yes. Maybe you should let me do most of the talking?” Kate asked, giving a tentative smile. Andy returned it, put the truck in gear, and eased forwards into the driveway. She then lowered the window, pushed a button on the intercom, and waited until a subdued voice at the other end answered.
“James residence.”
“This is Sergeant Wyles with the RCMP. Could you let Mr. James know that Dr. Morrison is with me and would like to speak with him.”
“One moment.”
The speaker clicked off, and Kate and Andy waited in silence. A moment later Richard James spoke through the intercom. He was angry.
“Sergeant Wyles, I thought I made myself clear yesterday—”
Kate leaned across Andy, raising her voice to be heard through the speaker.
“Mr. James? This is Dr. Kate Morrison, I’m one of the doctors working with the team at Hidden Valley General regarding the community virus. The one linked to your daughter’s recent illness.”
A brief pause. “Dr. Morrison, are you here to discuss my daughter? Is something wrong?”
Kate could hear the anxiety in his voice, remembered Dr. Doyle describing how overprotective he was of his only child.
“Tessa’s fine, Mr. James,” Kate reassured him. She was unwilling to play on a worried father’s fears to get them in the door.
“Then I fail to see—”
“It’s the rest of Hidden Valley I’m worried about,” Kate interrupted.
“I don’t understand.”
“If you would please meet with us, Mr. James. Give us twenty minutes of your time.”
Another pause. “All right.”
The intercom buzzed, and the huge black gates swung slowly, mechanically on their oversized hinges. Andy followed the long, winding driveway, edged in an assortment of evergreens, the house coming into view as she took the last turn. Even on this cold, grey day, the house set back against the trees was absolutely stunning. Kate’s first thought was of the bow of a ship, its most prominent peak coming out from the house at an angle, giving the impression of movement, of moving forwards. The house was a perfect assortment of wood and glass, the expanse of the roof betraying its monstrous size.
“Nice,” Andy noted neutrally. “A little on the small side maybe.”
Kate smiled. “Any advice before we go in?”
“This is your show, Dr. Morrison. I’m just along for the ride.”
“All right, then. Just try not to glower too much, okay?”
Andy scowled playfully, then pushed the driver’s side door open. As Kate got out too, her heart suddenly lurched in her chest and she froze. I love her. God, I love her. Kate knew she had to get this under control. She couldn’t let Andy keep worrying about her, not on top of everything else. Another thought occurred to her, and Kate felt sick at its implications. What if Andy grew tired of always carrying the weight of Kate’s worries? What if…
“Kate?”
Andy was at the passenger side door, looking in at Kate, concern in her grey eyes.
Kate looked down at her hand, still clenched around the door handle. She pulled at it, felt the metal give way, and a gust of cold air swept in through the open door.
“Are you all right?” Andy said. “You’re so pale.”
“I’m fine…I’m good,” Kate said as she got out of the truck. She couldn’t meet Andy’s eyes. “You have Dr. Din on standby for collecting samples, right?”
“Yes, he’s with Ferris at the RCMP office,” Andy said, frowning. “That is, if Richard James allows it.”
“Let’s see what we can do,” Kate said.
As they approached the massive front door, it opened. A man in a long-sleeved pink polo shirt and neatly pressed khaki pants held the door open and smiled politely. “Sergeant Wyles and Dr. Morrison, Mr. James said he will receive you in his study.”
Kate and Andy followed the man down the hall. The house was magazine perfect, the wood and glass and stone of the exterior brought inside to reflect warmth and opulence and a distinct tone of grand comfort. Kate barely noticed the details, only that the house made her feel small. She had never been in such a grand house, had never been received anywhere, and was feeling more than a little intimidated at the thought of trying to persuade the owner of this house to do anything he didn’t want to. Kate felt her lack of confidence acutely, a hard, immovable line down her chest.
As the man led them through an open door, Kate felt Andy touch her wrist, then trace her thumb in a quick, light pattern across Kate’s palm. It reminded Kate of the first day they’d met, the first time Andy had touched her and the amazing, confusing, instantaneous connection between them. Kate remembered also why Andy had touched her. Against Andy’s explicit orders, Kate had slammed her fist into a patient’s chest, restarting his heart. She remembered being so sure of her actions, so confident it was the right thing to do. Now Kate caught Andy’s eye, silently thanking her for her absolute confidence.
Richard James sat behind an expansive wooden desk in front of a large window that threw him into dark relief. He was an average-sized man, generically good looking, almost nicely forgettable. As Kate and Andy were shown into the room, Richard stood immediately, came around the desk to shake their hands, and then invited them to sit in one of the chairs set casually around a small coffee table. Kate was surprised and more than a little relieved by the gesture. She wasn’t exactly sure how the conversation would go with Richard behind his giant desk. As she sat in the chair, surveying the man in front of her, Kate thought this was the exact opposite gesture to what Michael Cardiff would have made.
“Sergeant Wyles, I see you found another way in,” Richard said as a greeting. Kate noticed he didn’t seem angry, just very, very cautious.
“Dr. Morrison can be persuasive,” Andy said, matching his tone.
“Well then, Dr. Morrison, perhaps you’d like to tell me why you’re here. What does my house have to do with the virus circulating through Hidden Valley?”
He was direct. Kate appreciated directness.
“The Public Health Emergency Management team, of which Sergeant Wyles and I are both members, is trying to track down the source of the original viral outbreak. Given the data that has been collected, four of the original five cases can be traced to your property.”
This was obviously news to the man. He sat up in his chair. “Who? Tessa, obviously, but who are the others?”
Kate shook her head. “That’s information I can’t share with you, Mr. James. I am bound to keep their confidentiality just as stringently as I keep Tessa’s.” It was a not-too-subtle reminder, if he needed it, of her absolute neutrality.
“Yes, of course. I shouldn’t even have asked,” he said. “I’m just shocked to hear it, that’s all.” He took a moment to digest the news. “But isn’t this thing like any other flu bug? Doesn’t it just, I don’t know, sweep into a community and then out again?” He waved his hand vaguely in the air to show how easily it could descend and retreat. Kate wished with everything in her soul it could possibly be that easy.
“No, it’s not like any other seasonal influenza. It’s more like salmonella. There’s a point of contamination that can be tracked and then isolated. We’re hoping to do the same for the virus.”
It was a lie. The HV1A virus was nothing like salmonella, but the PHEM team was trying to isolate the point of infection. Kate knew she had left out the most unique and alarming feature of HV1A virus, but it needed to remain with as few people as possible.
“And you think you might find it here? In my home?” Richard asked, a perfect wrinkle of worry across his forehead.
“On your property, yes.” Again, Kate wanted to try to give the most accurate information without revealing too much.
Richard leaned forwards in his chair again, running his hand over his mouth. “What do you need from me?” he finally asked.
“We’d like to bring in a team to take samples,” Kate said, without elaborating.
“What does that look like?”
“They’ll come in biohazard suits and collect dirt and dust, mainly, and take swabs from common surfaces,” Andy added, better than Kate at evasive responses.
“In the house,” he clarified.
Andy kept her eyes on Richard, her expression unreadable. “And the outlying buildings.”
Richard held the look, obviously thinking about the virus in his home and on his property. And how it had gotten there.
“How many staff do you have, Mr. James?” Andy jumped in.
Kate mentally shook her head. Why had she even bothered using these diversionary tactics on Andy? Andy had them perfected.
“In the house? Six regular staff. If you want to include the whole property, closer to twenty.”
Kate made a mental picture of that number of staff, working and interacting on this massive farm. She thought about Chase Noonan and Keith Grange, working on more than one farm. It didn’t make sense. Out of a possible thirty people potentially exposed to a virulent bug, only three were sick? She considered her conversation with John at the NML, how different it could look if the target was a few people as opposed to an entire community.
Kate tuned back into the conversation.
“You have my permission, of course you do,” Richard was saying. “But why didn’t you share this with me yesterday?”
“It wasn’t information I really wanted to share over an intercom, Mr. James,” Andy said.
“You must think I’m a fool, acting the way I did yesterday. I will admit that Michael Cardiff’s bid for MP has me more than a little paranoid.”
Kate felt Andy shift, very slightly, almost casually in her chair. Kate noticed because Andy didn’t fidget, certainly not in front of someone she was questioning. Going with her gut, Kate pressed him on the subject.
“May I ask why?”
“A long history. You’d have to be a resident of Hidden Valley to truly understand how interconnected everything is out here.” He looked back and forth between them. “It’s not a very interesting story, I assure you. Michael and I disagree on a great number of things, and at the end of the day, I just don’t trust him to do right by me, my family, or this community.” He paused, like he was considering saying more. Then he turned to Andy. “Will you be getting started on the samples today? I’d like this done before my wife and daughter get home this afternoon.”
“Right now, if possible,” Andy said, pulling out her phone. Kate assumed she was texting Ferris and Dr. Din the go-ahead.
“I’ll have my property manager show you around.” He stood up and picked up the phone on his desk, speaking into it quickly before setting it down again. “His name is Tony, he’ll meet you out front.” Richard reached forwards to shake their hands again. “Let me know what else I can do to help.”
Ferris pulled up outside the massive James house less than fifteen minutes later. Dr. Din began pulling on biohazard gear, a puffy, thin white suit with a built-in face shield and a rubber mask which looked shockingly uncomfortable. Dr. Din didn’t seem to care as he moved efficiently, preparing his tool kit full of swabs and bottles and clear evidence bags. Ferris also began the process of putting on the suit. A second pair of eyes, Kate assumed, as well as a measure of protection.
After seeing Dr. Din and Ferris off with a clearly suspicious Tony, Kate and Andy got back in the Yukon and began their trip back to town. Just down the road from the James Ranch, they pulled up to a flashing red light strung across the road, announcing to nobody else that it was a four-way stop. Andy leaned over suddenly and kissed Kate on the cheek.
“What was that for?” Kate asked, laughing, grateful Andy knew how to pull her out of her own head, as usual.
“I like working with you. It’s very helpful to have you there reading my mind when I’m questioning someone.”
“Well, it’s probably good you didn’t decide to make out with me at the James residence.”
Andy leaned in again and kissed Kate on the lips this time, lingering just long enough for Kate’s heart to begin racing in her chest before she pulled away again.
“Too many cameras,” Andy said, eyes shining.
“I didn’t see any cameras.”
“That’s why you’re the doctor and I’m the cop.” Andy put the car in gear again, surging through the empty intersection.
They were quiet as Andy wound their way back towards Valley General. A few fat drops of rain splattered against the windshield before the sun made a brief, bright appearance.
“How long until the samples are back?” Kate asked.
“Two to three days minimum, I’ve been told.”
“And until then?” Kate asked, curious where the investigation led next.
“We’re still looking into how the virus was transported. We’re hoping it will give us some physical evidence to follow. We wanted an RCMP officer with Dr. Din, to be on the lookout for anything that looks like it could have been used to transport the virus into Hidden Valley. We’ve still got very little to go on, no clear targets or motives or patterns in who was infected.”
“And now that it spreads person to person, there’s no way to even guess if anyone was exposed intentionally or accidentally,” Kate added, following Andy’s thought process.
“Exactly, which means a full ER for you and virtually meaningless data for us.”
Kate skipped from an image of the packed ER to the graph she’d shown the team at NML to the boxes of files she’d mined on her first day in Hidden Valley. She thought about the first cases, the tenuous links they’d found between the original four cases. She wanted to trace it backwards, understand the when and where of their exposure to the HV1A virus.
“We need to know how long.” Kate blurted the half-formed thought into the silence.
“What do you mean?”
“How long from exposure to the onset of symptoms. It would give you a timeline, a rough estimate of when the original four were exposed to the virus. From there…”
“It could tell us where they were,” Andy finished the sentence for her.
“Maybe. Hopefully.” Kate cautioned.
“Do they have that information? The NML, can they figure that out?”
“When we get back to the hospital, I’ll call Dr. Levesque.”
“Good, let me know what you find out,” Andy said. The hint of the playfulness in her tone was gone.
As they pulled into the Valley General parking lot and walked quietly beside each other, Kate’s thoughts were already in the building, two floors up with her patients, when she heard Andy mutter under her breath beside her.
“Here we go.”
Kate looked up at Andy’s stony expression, then saw the figure who had detached itself from the shadow of the front entrance. She couldn’t place him for a moment, then she realized it was Paul Sealy from the Squamish Herald.
“Sergeant Wyles, could you comment on the team of scientists who are currently investigating the James Ranch in connection with the viral outbreak?”
Andy kept walking until she was right in front of the reporter. “Did you get your invitation to the press conference this afternoon?”
“Yes, uh, thanks for that,” Paul replied, somewhat awkwardly. Kate kept her face neutral, though she wanted to smile.
“Then we’ll see you this afternoon,” Andy said politely but dismissively as she continued walking into the building.
“The team led by Dr. Ahmed Din, currently on the James farm. Could you comment on what’s happening right now?” he tried again.
Andy stopped and pinned down the man with an unflinching glare. “Let me guess, you followed the van but couldn’t get onto the property.”
Paul didn’t answer, just lifted his chin somewhat defiantly. He was very young, Kate realized, having been fooled by the beard.
“We’ll see you this afternoon,” Andy said again, this time firmly, and kept walking into the hospital. As Kate hurried to keep up, she saw out of the corner of her eye as Paul scribbled something furiously into his notebook.
“Always making friends, aren’t you?” Kate said under her breath.
“You know me,” Andy muttered.
Kate stopped at the main desk to pick up her compulsory mask and gown when she heard Andy for the second time.
“And again…”
A second later and Michael Cardiff was on top of them. “We need to talk,” Cardiff said, his voice an angry hiss.
“Okay,” Andy responded calmly.
“Not here,” he said, leaning in slightly. Kate felt the inherent threat in the gesture, even when it wasn’t directed at her.
“I can speak with you here or in four hours at the RCMP office downtown. Which would you prefer?” Andy said. Either Cardiff hadn’t learned bullying Andy would get him nowhere, or it had never failed him before and he had no backup plan. Kate imagined it was the latter.
Cardiff looked around at the number of people moving around them. They had caught more than one person’s attention, Kate noticed. Cardiff and Andy were difficult people to overlook.
“I imagine this is not information you want out in the general public, Sergeant Wyles. Please be assured that I keep your best interest at heart also when I ask for a private meeting.” His voice had lost the hiss, replaced by the slick politician.
Andy’s eyes grew hard but her tone never changed. “You’re right. Follow me.”
With a quick glance at Kate, Andy turned and walked towards the office that had become PHEM headquarters. Kate picked up her mask and gown and followed, sure in that moment Andy wanted her there. A witness perhaps, or another set of eyes. Or to read her mind the way she’d done with Richard James just an hour earlier.
Andy took a seat quickly, her back rigid, her eyes not betraying a hint of the contempt she held for the man. Once everyone was seated, Andy spread her hands on the desk, gesturing for him to get started.
“I’m hearing rumours that the virus that’s spreading in Hidden Valley was released intentionally,” Cardiff said, eyeing Andy very closely as he said it. Kate quickly covered her own shock, not nearly as practiced as Andy in the art of neutrality.
“Part of the RCMP’s role in a public health crisis is to manage circulating rumours,” Andy said, almost immediately. “I’d like to know where you heard this.”
“Doesn’t matter,” Cardiff said with brisk wave of his hand, still trying to read Andy’s reaction. She wasn’t giving him anything.
“I’ll let you know if it matters, Mr. Cardiff,” Andy said sharply. “Where did you hear this rumour?”
Cardiff stared at her for a long time, passively attempting to engage Andy in a pissing contest. Andy kept eye contact, pulled out her notepad and a pen, and the sound of them smacking on the table in front of her was loud in the silence.
“A business associate I know whose brother-in-law is on the hospital board said he heard something,” Cardiff finally offered up, watching intently as Andy scribbled in her notebook.
“Is that it?” Andy asked, looking up again.
“Yes.” He seemed taken aback at the casualness of her question.
“I will follow up on it,” Andy said, flipping shut her notebook, making as if to rise out of her seat.
“I’d like a confirmation or a denial, Sergeant Wyles,” Cardiff said, the anger back in his tone.
“I can’t, Mr. Cardiff, as I’m sure you already know. The Public Health Emergency Management team has strict protocols which we are following rigidly in the face of this crisis. Circulating rumours, such as the one you are presenting us with right now, is one way to induce panic in a community already in a heightened state. Rest assured I keep Hidden Valley’s residents’, who I understand you hope to make your constituents, best interests at heart when I refuse to elaborate.”
Kate felt like cheering.
Cardiff clenched his hand into a fist, then almost immediately relaxed it. “I suppose I should thank you for your time,” he finally said, the insult evident in his tone.
Andy said nothing.
He turned suddenly to Kate, leaning back in his chair, aiming for a casualness that fooled nobody. “I don’t suppose you’ll tell me anything either, will you, Dr. Morrison?”
“I’m bound by the same protocols that Sergeant Wyles just spoke about, Mr. Cardiff,” Kate said quietly.
“Closing ranks, I see,” the man said, smirking almost suggestively.
What is it with these people? Kate thought as the anger rose, unbidden, in her chest.
“Are you questioning our motives, Mr. Cardiff?” Kate asked.
Cardiff didn’t say anything, leaning back in his chair with a look on his face Kate was sure he wouldn’t have used on Andy. As it was, Kate could see Andy’s shoulders tense, her jaw lock, the protective instinct triggered. Kate had a brief moment to be thankful she hadn’t told Andy about the incident with Mona Kellar in the stairwell before she focused back on Cardiff.
Kate tried to end it. “The situation in Hidden Valley is far too critical for you or any other resident to not be a hundred percent confident in the team leading them through this crisis. Any concerns you have should go to my supervisor, Staff Sergeant James Finns.” Kate paused. “Or I suppose it could go directly to your father-in-law,” she finished quietly.
It was her own version of a threat, one she knew he would not hesitate to slap back on her or Andy if things were not going well. But right now he had nothing to go on, no complaint other than the fact that he did not like being left out of the loop.
Cardiff stood. “I’ll thank you both for your time. You have given me a great deal to think about.” He left the room, closing the door firmly behind him.
Kate and Andy looked at each other from opposite ends of the long table.
“This is going to get messy, isn’t it?” Kate asked.
“Yes. And quickly,” Andy answered, her eyes still on Kate, though also somehow faraway. Distracted.
Kate’s phone buzzed in her pocket, she pulled it out and read the text. Lucy, Ward B. Kate stood. “I have to go. I’ll call the NML when I get a chance, okay?”
“Yes, text me if I don’t answer my phone,” Andy said. “I think I need to talk to Finns, figure out the best way to handle the press conference this afternoon.”
“I’ll be up on Ward B or in the ER if you need me.”
“Okay.”
Kate closed the door quietly behind her and pulled the mask over her face as she ascended the stairs. She wondered how many times she’d been up and down these stairs in the week that they’d been here. They felt familiar already, the time it took to climb them giving her just enough space to clear her head and prepare for the next meeting or crisis or problem.
“Dr. Morrison, I didn’t know you were in the hospital,” Lucy called from down the hall.
“Just got here. What’s up?” Kate asked, wondering what had the nurse so stressed.
“Jim Beckett’s been stable since he checked in. Then about an hour ago, his O2 sats started falling, and he admitted to continued difficulty breathing as well as chest pain.” Lucy handed her the chart as they walked down the hall towards the older man’s room.
“Last films?”
“You saw them this morning,” Lucy answered. Kate hadn’t remembered any change from when he was admitted. She had been cautiously optimistic, but that was gone now. “Send him down for a repeat, ASAP,” she said, quickening her pace.
Lucy started to turn, then stopped. “Wait, you haven’t been checked in, Dr. Morrison. Any elevated temperature, cough, or difficulty breathing?”
“No.”
Lucy pulled out a marker, happy-faced Kate’s shoulder, and then she immediately headed back to the nurse’s station to fill the orders for the patient.
As she walked, Kate scanned the chart quickly, reading the information she already knew. Rebreather mask at one hundred percent oxygen, diuretics and steroids on board. She knew the next step was a ventilator. Kate hadn’t spent too much time with her second Ward B patient, but she had a feeling that the ventilator was going to be a tough sell.
Jim Beckett reclined in an uncomfortable-looking half-sitting position, sucking at the air coming through his mask. Kate took in his pale face, the scared look in his watery blue eyes, and without saying anything, she pulled his mask away. His lips were dusky, a sure sign not enough oxygen was getting in.
“Mr. Beckett, the oxygen therapy isn’t working. We need to put in a tube to help you breathe,” Kate said directly, knowing she didn’t have time for another chest x-ray.
Jim Beckett shook his head. “Don’t want it,” he gasped out.
She’d been up against patients like this before. “What do I need to do to convince you?” she said, hoping to bypass the usual routes.
The man smiled a blue-lipped smile. “Direct…I like that,” he said, his voice barely audible. “Save your breath…no ventilator…unless you can guarantee…that I’ll get off it.”
Kate frowned. “I think you know I can’t. I can guarantee that if your oxygen saturation levels don’t go up soon, then you are going to begin to feel dizzy and the chest pains are going to get worse. Your heart is working too hard to deliver too little oxygen to your body.”
“I know how it works, Doctor…still don’t want it…”
Kate sighed and threw the chart onto the foot of the bed. She found a stool and pulled it up to the railing of the hospital bed and sat down.
“Let’s play a game,” Kate said to the man, surprising him.
“Better not be…a smoking lecture…” he grumbled.
“Nope. I’m guessing I’m about five decades too late for that.”
Another blue-lipped smile. “Six.”
“There you go, then. So, I’m going to try to guess the three words most often used to describe you. And I only get ten words total.”
Kate saw the blue eyes light up. “Seven,” he countered.
“Fine, no problem,” Kate said, shifting in her seat, thinking. “Stubborn,” she guessed.
“Too easy,” he said.
“Doesn’t matter, one down, two to go,” Kate told him. “Smart,” she tried again.
Jim Beckett looked surprised. “I’ll give it to you…though it’s usually…followed by ass.”
Kate had to laugh. She wondered, though, as she caught a glimpse of his monitor, if she had any hope of changing this man’s mind about the ventilator. Kate didn’t want him to know she was frustrated at being unable to talk him into the treatment. As she took the rest of her guesses, mainly variations on stubborn, Kate tried very hard not to picture the tidal wave of fluid and infection that had recently haunted her dreams.
“I give up,” she told him. “What’s the last one?”
“My wife…when she was alive…always called me sweet,” Jim said, the softness in his voice having little to do with his lung capacity.
Kate put her hand out to the man, feeling his racing pulse on the inside of his arm.
“All right then, Mr. Stubborn, Smart, and Sweet, what’s it going to be?”
He shook his head and Kate’s heart sank. “No ventilator.”
“Do you understand that by refusing the ventilator, you are limiting the measures we can take to save your life in the event that you stop breathing or your heart begins to fail?” Kate asked, her hand still touching the man’s warm arm.
“I understand…I’ll sign to that effect.”
Kate sat with him for a moment longer, not saying anything. “Okay,” she said finally and stood up. Jim reached out for her hand and gave it a squeeze.
“Thanks,” he said.
“For what?”
“No lecture.”
Kate walked quietly out of the room as he lay back, each forced breath barely strong enough to make it to the next one.
Back at the nurse’s station, Kate asked Lucy about his family. He had two kids living in the States, both of whom had been in phone contact already. Kate then checked on Harris Trenholm and was surprised to find him sleeping, his laptop open, his BlackBerry with its blinking message light on the half table. She checked his vitals—unchanged—and then left again quietly.
An hour later, Kate was winding up her phone call with Dr. Levesque at the NML when the code blue was called for Jim Beckett’s room. She slammed down the phone, instinct pushing her forward, itching to wrap her hands around the flexible tracheal tube. But as Kate entered the room again, Lucy calling out his rapidly dropping vitals, she remembered the man’s refusal.
Kate went right up to the rails of the bed, looked Jim straight in the eye. “Mr. Beckett, your heart isn’t getting enough oxygenated blood. Unless it does, soon, your body is going to shut down. Do you want a ventilator?”
A shake of the man’s head.
“In the event that you stop breathing or your heart stops beating, do you want us to take heroic measures to save your life?”
They were words Kate hated to say, an admission of her failure, or at the very least a directive of passivity and impotence. Two things Kate hated. She took a deep breath and watched Jim’s face carefully. This wasn’t about her.
“No…no measures…”
Kate turned to Lucy. “Could you witness, please, Lucy,” Kate said quietly.
Lucy picked up the chart, printed in her neat block lettering and passed it over to Kate. She signed, then closed the chart, giving it back to Lucy to take away. They weren’t going to need it. Kate held his hand. With the drugs in his system to try and make him more comfortable, it wasn’t long until Jim was unable to speak. They sat in silence for longer than Kate could account for.
Jim Beckett’s eyes were closed when he died. His last words had been his own directive to let him pass peacefully. As Kate turned off the monitors, pronouncing his time of death, she couldn’t decide if this was a cause for joy or sadness.
Lucy took over with calm efficiency, handing Kate the chart and the forms she needed to fill out and sending her back to the nurse’s station. Kate sat at the desk and phoned Jim Beckett’s two children, managing the daughter’s instant, unchecked grief. The son’s shock came in the form of continuous questioning, but Kate knew he’d never remember the answers.
Finished with the forms, finished with the phone calls, including one to Dr. Doyle, Kate called up the files on the computer. She clicked through x-rays, autopsy results, oxygen levels, viral loads, white cell counts, steroid dosages, and a hundred other factors for the forty-three people who had now tested positive for the virus. The clicking of the mouse became a steady rhythm as facts and files raced across the screen and raced through her head. Kate knew she should phone Andy, should update her on what she’d learned from Dr. Levesque, but instead she continued her obsessive searching.
The phone ringing on the desk behind her jarred Kate out of her half-conscious daze. Lucy picked it up, then looked over at Kate and spoke quietly before putting the receiver back down again.
“Dr. Morrison, Sergeant Wyles is in the ER.”
Kate looked at the nurse, confused. “Does she want to see me?”
“No, I mean she’s being treated in the ER. That was Dr. MacKay, Sergeant Wyles is in the ER, something about a face lac…”