It was also a face transparent to emotion. When Jim Bix smiled, you wanted to smile along with him. When he grinned, you wanted to laugh. He was conscious of his own guilelessness, Matt knew, and oddly ashamed of it. He avoided poker games. He told lies seldom and never successfully. Matt had once witnessed Jim Bix attempting a lie: He told Lillian he had broken one of her Hummel figurines, protecting the guilty party, the family dog, whom Lillian despised. The lie had been so incoherent, so patently manufactured, and so blindingly obvious that everyone present had laughed—including Lillian but excepting Jim himself, who blushed and clenched his teeth.
Jim Bix, in other words, was a nearly unimpeachable witness. Matt kept that in mind as he listened to what his friend had to say. From anyone else, it would have been unbelievable. Absurd. From Jim…
Belief, that cautious juror, withheld a verdict.
Matt opened the door a quarter of an hour before midnight that August evening and welcomed in this ugly and obvious man, his friend, who was also one of the best and most scrupulous pathologists Matt had encountered. Jim accepted Mart’s offer of coffee and settled leadenly into the living room sofa. He was 6’3” from toe to crewcut, and he dominated any room he inhabited, but tonight, Matt thought, he looked smaller—a sag had crept into his shoulders, and his frown hung on his face like a weight. He took the coffee wordlessly and cradled the cup in his hands.
Matt interpreted all this as fatigue. Early in the year, Buchanan General had been certified as a regional trauma center. This was good news for the administration; it meant prestige and more reliable funding. Among staff, the reaction was mixed. They were handed a wish-list of technological goodies—respirators, bronchoscopes, a new pediatric ICU. But they also inherited a number of difficult cases that would ordinarily have been transferred to Portland. For Pathology, it had meant a huge new work load without the prospect of additional staff. Jim had been working evenings for most of two months now. Of course he was tired.
Rachel had gone to bed, and the house, with its curtains drawn against the dark, seemed uneasy in its own silence. Jim cleared his throat. Matt said, “How is Lillian?”—disguising the fact that he’d seen her this afternoon.
“Seems fine,” Jim said. “Kind of quiet.” He ran a large hand through his stubble hair. “We don’t see much of you and Annie lately.”
“Lousy hours. Yours and mine. I hope you can make it on Friday.”
“Friday?”
“Friday night. A little get-together. I called about it last week.”
“Yeah, of course. I’m sorry, Matt. Yeah, we’ll try to be here.” Matt said, “You look punch-drunk.” No argument. “Is it that serious?” A nod.
“Then you better tell me about it. And drink your damn coffee before it gets cold.”
“Something’s fucked up at the hospital,” Jim said, “and nobody wants to listen to me.”
It had all happened, he said, very quickly.
It started earlier in the week. He took a couple of complaints from the staff doctors that hematology results were coming back funny. Standard tests: Smack 24s, red counts, white counts. Patients with borderline anemia were showing radically low hemoglobin totals, for instance.
New blood was drawn, new tests ordered, and he promised to oversee the results personally.
“Everything was kosher. I made sure of it. But the results… were worse. 7’
Matt said, “Significantly worse?”
“I couldn’t go to staff with these numbers. What was I supposed to say? I’m sorry, Doctor, but according to the lab your patient is dead. When the patient is actually sitting in the dayroom watching Days of Our Lives. And the bad thing is, it’s not just a few samples now—now everything is coming up fucked. Hematology, hemostasis, immune response, blood typing. Suddenly we can’t run any kind of blood assay without getting completely Martian numbers out of it.”
“A lab problem,” Matt said.
“Can you think of any kind of problem that would screw up all these results? Neither could I. But I thought about it. I talked to the chief resident, and he agreed we should farm out the most urgent tests to other labs until we track down the problem. Okay, we do that. This was a couple of days ago. We start looking at everything. Some weird contamination coming through the air ducts. Bad sterilization. Voltage spikes on the A.C. lines. We clean it all up. We try some basic tests on a sample of whole blood from the freezer. And everything comes out within reasonable limits.”
“So far so good.”
“Exactly. But I’m not entirely convinced. So we draw some fresh blood from a healthy donor, and we put it through the cell counts, hemoglobin counts, reticulocyte counts—plasma fibrinogen, platelet counts, one-stage assays—”
“And it comes up fucked,” Matt guessed.
“It not only comes up fucked,” Jim said, “it comes up so completely fucked that we might as well have been running tests on a glass of tepid well water.”
Matt felt a touch of fear, as tentative as a cold hand stroking the back of his neck.
If there was some new pathology out there, and if it was common enough to be manifesting in all of Jim’s blood samples… but why hadn’t anyone else seen it? “What about the tests you farmed out?”
“They’re not back. We phone the private labs. They’re sorry, but the results don’t seem quite… plausible. They want to know if the samples were damaged in some way, maybe contaminated in transit. Meanwhile, the chief resident gets a call from the hospital in Astoria. Are we having blood-count problems? Because they are. And so is Portland.”
“Jesus,” Matt said.
“That’s the situation this morning. Everybody’s going crazy, of course. Phone lines to the CDC are jammed. This afternoon, I take some fresh blood and I put it under a microscope. Has anything changed? Well, yeah. Suddenly there’s foreign bodies there. Like nothing I’ve ever seen before.”
Matt put aside his coffee cup, which had grown cold in his hands. “Foreign bodies? What—viral bodies? Bacteria?”
“On a slide they look kind of like platelets. Roughly that dimension.”
“You’re sure you’re not looking at platelets? Maybe deformed in some way?”
“I’m not that stupid. They don’t aggregate. They stain differently—”
“I’m not questioning your competence.”
“Fuck, go ahead. I would, in your place. The weird thing is that these organisms weren’t there the day before. I mean, do they reproduce that fast? Or what, were they hiding?”
“It’s just so bizarre. If you were looking at blood from patients with a common pathology, okay, but—the patients are healthy?”
“Far as I can tell, the condition is not making anyone particularly sick.”
“How could it not? White counts are low?”
“White counts are missing.”
“This is ludicrous.”
“Obviously! I know that! I’ve been reminded of it at great length. If you want me to make sense of it for you, I can’t.”
“But it’s harmless?”
“I’m not saying that. I’m not saying that at all. It’s an ongoing situation. It scares the shit out of me, actually. You know what I notice? Everybody I run into seems to have a case of the sniffles. You see that in your work, Matt? Nothing serious. But everybody, every individual. Walk into a crowded room and count the Kleenex. Check out a drugstore. Big run on OTC decongestants. My pharmacist says he can’t keep aspirin in stock. Is this a coincidence?”