The bewildering thing was that the early suspicion of influenza had been ruled out, as had its most serious complication, viral pneumonia. A rapid-culture nasal swatch test to detect A and B type flu antigens — molecular components of the viral strains that stimulated defensive reactions by the body — had shown the specimens to be negative. A second type of quick diagnostic on a mucus sample from Gordian’s throat produced identical results within twenty minutes. Both methods were considered 99 percent reliable, an analytical certainty for all intents and purposes.
Sighing with frustration, Lieberman sat leafing through the papers on his desk for the third time, seeking any clues he might have missed. His grandmother, rest her soul, could have catalogued Gordian’s symptoms with a touch to his forehead and a look down his inflamed, blistered throat with a flashlight, instructing him to open wide in Yiddish. And despite the framed sheepskins and certificates on his office wall, Lieberman’s present insight into his condition went little deeper than that. Examination of Gordian’s blood under a microscope had eliminated the common bacterial pneumonias — primarily pneumococcal, but also staphylococcal, and the even rarer Legionella strains responsible for Legionnaires’ disease. There was no sign of related chlamydial and mycoplasmal organisms. The serological workup had shown a raised level of lymphocytes, the white helper cells in the bloodstream that responded to an attack by foreign microbes. This was basically confirmation of Grandma’s home diagnostic method — clinical evidence that infection was present and the immune system was sending out scent hounds to scout for antigens, just as the swab tests had done. But while the lymphocytes were evidence that a virus was breeding inside Gordian, they would do nothing to establish its identity.
Lieberman had checked San Jose Mercy’s databases for similar undiagnosed cases reported within the last forty-eight hours and found none. An expansion of his computer search to include the past week, then the past month, also drew blanks. He had next contacted associates at nearby hospitals by phone to see whether they might have recently encountered anything that resembled Gordian’s illness. Again, nothing. However, something had to be done to find out what Gordian was up against. His body was at war with a stealth invader and clearly flagging in its battle. Unless and until its identity was specified, an effective course of medical treatment to aid him would be impossible.
Lieberman inhaled, exhaled. He ought to know what he was confronting here, and he did not. That alarmed him tremendously. He needed to consult with someone who could provide some guidance and specialized expertise.
Lieberman lifted the receiver off his phone to get the chair of the virology department on the line but then decided that call could wait a bit and hung up without punching in his extension. There was another person he wanted to speak to first. One of his oldest friends and colleagues, Eric Oh was an epidemiologist with the California health department who had performed some of the principal research on molecular methods for the identification of unrecognized and emerging pathogens and been a celebrated virus hunter for the Centers for Disease Control in Atlanta before marrying a hometown girl who’d insisted he stop fiddling with BL4 pathogens, and move back West to settle down. It was a downright breach of protocol to involve Eric before consulting with a senior departmental head in this hospital. And the criteria that would normally warrant contacting government officials — a cluster of reported cases distinguished by symptoms akin to Gordian’s or data suggesting a full-scale outbreak of an infectious disease in the community — were absent. A single patient with an ailment that had stumped his humble general practitioner for less than forty-eight hours did not constitute a public health hazard, even if that patient was somebody of Roger Gordian’s prominence.
But Lieberman was getting gut radar signals. The kind you grew to credit more and more with age and experience. And insofar as he was concerned, an informal meeting of the minds with Eric could hardly be considered reproachful professional conduct.
His lips compressed to a barely visible stitch on his long, careworn face, Lieberman retrieved Eric’s phone number from his pocket organizer and once again reached for the telephone.
“… can’t believe I was so thoughtless… so stupid… spent three Sundays in a row building a pen for my dogs… all I did… give Dad a hard time…”
Julia’s voice penetrating his sleep, Gordian stirred, opened his eyes. She was sitting with Ashley near the foot of his hospital bed, back out of the way of the tubes and electronic monitors connected to him.
He lifted his arm from his side and weakly pulled the loose-fitting oxygen mask down below his chin. The women noticed he’d awakened and turned to face him, starting to their feet.
“Get me a drink of water, everything’s forgiven,” he managed. The inside of his mouth felt dry and clotted. “Deal?”
Julia was at his bedside in a snap, her mother behind her. “Dad, I don’t know if you should be taking off the mask—”
He moved his hand.
“Breathing’s fine right now.” The words scraped out of him. “Just thirsty.”
Ashley was already lifting the pitcher from his rolling tray. She filled a paper cup halfway, passed it to Julia, and then pressed the button to raise the upper part of the bed.
Gordian reached for the water as Ash straightened the pillows underneath him, but Julia shook her head.
“Let me hold it for you,” she said. “Better take it slow. Little sips, okay?”
Gordian nodded. He wet his lips, rinsed the water over the sticky film on his tongue. Then swallowed. The coolness going down the hot, reddened lining of his throat was indescribably welcome.
“Thought you two were going out to grab a bite,” he said.
“We did,” Ashley said. She stepped closer and touched his cheek. “You were asleep when we got back.”
He looked at her.
“How long was I out?”
“A while… I’m not sure…”
Gordian shifted, checked his beside clock. Almost two in the afternoon. He’d been sure he had drifted off for fifteen, twenty minutes at the longest. Make that a couple of hours.
He shifted his gaze back to his wife. Ash had put on her face, as she liked to say. Not that she needed to wear much makeup. So many years of marriage, she looked like the photos taken of her when they were newlyweds. But he could see dark crescents under her eyes. Small lines at their corners that hadn’t been there before.
“Do you feel like having lunch?” she said, gesturing toward his tray. “The nurse left some lunch. There’s a turkey sandwich. Jell-O, naturally—”
He shook his head.
“A little later, maybe,” he said. “My legs are cold. Air-conditioning’s turned up kind of high, don’t you think?”
He saw Ashley give Julia the briefest of glances. Maybe not so high, he thought.
“I’ll go ask for another blanket at the nurse’s station,” she said.
“Count on me waiting right here.”
She gave him a wan smile and went out into the hallway.
Gordian took down some more water, thanked Julia, then eased back against his pillows. The window shades were drawn, but the daylight seeping in around them seemed too bright. He let his eyes close for a second.
When he opened them, Julia was watching him on the bed.
“You aren’t at work,” he said.
“No kidding.”
“It’s a new job,” he said. “I’d hate for you to have any trouble.”
She sat gently on the edge of the mattress.
“It’s okay,” she said. “I used the old parent-in-the-hospital scam.”
“Good one,” he said. “Let’s play it to the hilt.”