Jan coffey, p.28
Jan Coffey, page 28
"Does she know I'm coming?" Fahimah asked.
The physician nodded. "I told her this morning." Behind the thick glasses, his eyes were welling with tears. "I have known and worked with your sister on many different occasions over the past few years. Frequently, she has contacted me to accept patients that she felt needed to be hospitalized from the refugee camps. I do not know if you have heard the nickname the people have for her."
Fahimah nodded. "Firishte... the angel."
"And she truly is an angel." Dr. Mansori smiled. "I must tell you, though, that I have never seen your sister as happy as today, when I told her you were coming."
Fahimah's eyes burned with unshed tears. "Will you take me to her?"
The doctor stretched a hand in the direction that they should go. He led them up a set of stairs. Austyn and Dr. Mansori talked, but Fahimah didn't hear a word of their exchange. She was lost in a different time.
Two girls, holding each other in their mother's kitchen, staring out over the body of their father at the sea of dead friends and neighbors on their street.
She and Rahaf were two lonely souls who only had each other left. This had been the story of their life. Only fifteen months apart, they were each other's shadow, each other's soul. There were two hearts in their bodies but they pulsed as one.
'This is it, khanoom."
Rahaf's door was open. Two people and a nurse who were inside saw Fahimah and quickly came out. They each said something kind to her as they passed, but again she couldn't hear.
Fahimah stepped through the doorway. She looked at the bed, and her tears began to fall.
Rahaf lay on the high hospital bed. She, who had once been so young and vibrant and full of health, was now a mere skeleton. The missing leg created a void that was visible under the smooth white blanket. Her green eyes tried to focus as she lifted her hand.
"Fahimah?"
She didn't remember taking the steps, but she was there, next to her sister, holding her in her arms.
They'd spent a lifetime apart, but they were one again.
Chapter Forty-Five
VA Medical Center, Maryland
Cell phone lines were jammed. Some of the regular telephone exchanges seemed to be working, but it was hit and miss.
Finally, David got through on an 800-number for Homeland Security in Washington. Could he speak to Faas Hanlon? He was unavailable. Was the next person in charge of the NFI investigation available? No, no one else in charge of that investigation was available, either.
"There's got to be someone there to talk to. I have critical information about the situation."
"Mr. Link, we have no one available to talk to you right now, but if I could take a number where you can be reached, an agent connected with the investigation will get back to you."
"I've been doing just that at a number of places over the past two hours, and no one has called me back yet."
David was disgusted. 'Tine, let me leave a message for Faas Hanlon."
He had been right about the e-mail, at least. Both of his daughters e-mailed him back within an hour. They wanted to know what the heck was going on… and yes, they still had the Strep-Testers.
The company-wide e-mail he'd sent out was creating some questions. But no one was jumping in and offering anything useful. Both Bill and Ned Reynolds had their "I am away" messages on, and the VP of Sales hadn't opened his e-mail yet, either.
His secretary had e-mailed him that she was making the calls to the sales force, but that she wasn't able to get through to a lot of them because of clogged phone lines.
He decided that leaving a message for Faas Hanlon wasn't enough.
David e-mailed and then phoned the White House. He couldn't get through. He e-mailed the FBI. He was getting to be a master at it. The same text was copied and pasted in each e-mail. Name, phone number where he could be reached, the company he worked for, identifying himself as a survivor, so far, of the NFI research boat incident, indicating that he has information that might tie the source of the infection to new sample Strep-Testers that his company had released.
One of the residents came out in the hallway, and David pounced on him.
"The nurses are becoming very concerned about your behavior, Mr. Link," the young man told him.
"Good," David said, frustrated. "Call Security. Call the police. Call the FBI."
"We can't do any of those things right now." He started into a long speech about the procedures for the quarantining of the patients.
David cut him off. "I'm trying to give you information that could save thousands of lives. I work for the company that makes a new product, over-the-counter home Strep-Testers."
"Oh, I've heard of them. That's an interesting idea. But they haven't hit the market yet, have they?"
"Five hundred of them are in circulation. And there are ten thousand that are going to be distributed this morning. . .unless we can stop it," David said, trying to keep any hint of fanaticism out of his voice. "I believe the Strep-Testers are causing the infections."
"And why do you think that?" he asked too casually, sending David's blood pressure a notch or two higher.
"Four of our sales people who had these samples had a death in the family from NFI," David told him, exaggerating a little. He wasn't certain for two of the cases, but he decided it was a safe assumption. "They might have used these testers."
"They might have," the resident repeated doubtfully. "Are you sure they used them?"
"I'm pretty sure they did. I know that Philip Carver, the program director on our ship, used one, because I gave it to him."
"You know, sir, every investigator in this country is working on this disease. Don't you think they would have found that information, if it were a common link? And that's only four or five cases out of how many? I've lost count of the total number of fatalities. What about the rest?"
"Yes, you're right-" David looked at the resident's badge " - Dr. Niles. You're right to be dubious. But don't you think this information needs to be brought to someone's attention?"
"Have you called the FBI… or the police department?"
David told him about all the phone calls and e-mails he'd sent.
The young doctor shrugged. "Sounds like you've done everything you should be doing. I don't know what else to tell you. But I still think it's highly unlikely that your theory is correct, since your company had to go through all kinds of testing with the FDA to get the product approved. If there was any question about the tester's safety, don't you think it would have shown up then?"
"Does the name Vioxx mean anything to you?"
"Well, that's not exactly the same thing, but I believe they're still fighting that out in court."
"Who wins in court is not the issue. People could be dying because of this product."
The resident shrugged again.
"Even if the product that was tested is viable, it may very well be that this product lot was infected. Who knows, maybe some terrorist planted something in our lab."
"I still don't know what to tell you. You've done everything you can. Now wait and see. I'm sure they'll get back to you." He glanced at his watch. "Sorry, I have to go."
David rubbed the back of his neck. The muscles were knotted. He wasn't overreacting. What happened if he was right?
He couldn't believe how close he'd come to making Josh use the strip.
A cold sweat washed down his back. Anyone could be using one right now.
He made up his mind. He dialed the number for the White House again and got through. He punched numbers until he was speaking to a living human.
"Yes. This is David Link. I am the terrorist behind the NFI outbreak.... Yes, you heard me correctly. The NFI outbreak... No, I don't want you to put me on hold. I've just been taken off the research vessel that had all the kids on it, and I'm being held in the VA Medical Center.... That's right, the VA Medical Center in Maryland. Yes, I am behind every single one of the outbreaks. Yes, David Link. I work for Reynolds Pharmaceuticals. Okay... now listen to me, because I'm only going to say this to you once. Are you ready?"
David definitely had the White House operator's attention.
"As we speak, ten thousand infected products are being shipped all over the country. Ten thousand. That means the number of NFI deaths so far is nothing compared to what will happen tomorrow if you don't get someone over to this hospital now."
Chapter Forty-Six
Taleghani Hospital
Kerrnanshah, Iran
Austyn couldn't have felt more welcome.
After asking him a couple of questions about his background and realizing their visitor's interest in science and research, the physician gave him a complete tour of the hospital. He talked about the staff and their publications. Dr. Mansori had been here since before the Iranian revolution, and his thirty-year tenure gave him the air of a proud parent.
Austyn didn't want to stray too far and for too long away from Fahimah, though, so after a couple of hours they made their way back toward the wing where Rahaf was staying.
There was a nurse outside the door, and she told Austyn that Fahimah was looking for him.
He knocked on the door and Fahimah opened it.
Austyn had to keep from putting his arms immediately around her. She had a look on her face that he could only describe as one of gain and loss. She had found something that she knew she was about to have torn from her.
"I told Rahaf about you," Fahimah said softly. She drew him into the room.
Austyn looked at the bed where Rahaf lay. The absurdity of imagining she could be responsible for the terror in the U.S. would have been comical if it were not for her condition. She was beyond frail. The years and her illnesses had been very hard on her. She looked so much older than her age. Her intelligent green eyes, though, were very much alive.
"Mr. Newman," she said hoarsely.
"Please, call me Austyn," he said, approaching her. The head of the hospital bed had been raised and a couple of pillows were propped up beside her. There were no IVs or any other monitoring devices hooked up to her. His gaze went over the place where her leg should have been.
He saw, pinned to her hospital gown, a gold charm. He recognized it as the one the woman at the clothing store in Erbil had given Fahimah.
"My sister tells me that she owes her freedom to you."
Now he was embarrassed. He looked at Fahimah and shook his head. "All I can say is that I'm sorry, though I know that will never be enough."
"Let's not discuss politics," Rahaf said, wincing. She was sounding very tired and short of breath. "We all are victims… every one of us."
It was obvious that she was in a great deal of pain. Dr. Mansori had mentioned that, other than shots of morphine to ease her suffering, she wouldn't allow treatment that would needlessly prolong her life. She moved slightly and motioned to a chair near the bed.
"Please sit down," Fahimah said, repeating her sister's gesture.
Austyn did as he was told but not before Fahimah brought another chair that was by the window closer to the bed, too, where she could sit.
"Fahimah tells me you are facing an epidemic in America."
Austyn summarized the situation, focusing first on the strain of bacteria they'd never seen before - with the exception of what had been discovered in Rahaf's laboratory. He gave her as much background information as he had on the cases discovered since that first outbreak. He also mentioned the latest suspicion that some kind of cold medication might be infecting the victims.
Rahaf listened to everything he said. Despite her pain and obvious discomfort, Austyn could see she comprehended every word.
"My study initially started on a family of Panton-Valentine leukocidin," she began softly, "which, as you know, is toxic to cells. They can cause leukocyte, or white blood cell destruction, pneumonia and necrotizing fasciitis...."
Austyn pulled out a pen and paper and scribbled her words as fast as he could. She told him the details of the study that she'd been doing prior to the discovery of something unexpected, the mutation of the bacteria into a super-microbe. Despite her illness and physical frailty, her mind was sharp and clear. She had no trouble remembering anything.
"Although MRSA... methicillin-resistant staphylococcus aureus… has traditionally been seen as a hospital-associated infection, MRS A strains have begun to appear outside of hospitals and clinics in recent years. This specific strain is definitely a community-associated one," Rahaf told him.
"As you know," she continued, "MRSA strains are resistant to the usual antibiotics, but a curious interbreeding with community staph has led to the genetic acquisition of a PVL factor, which in turn has produced a series of changes that make these strains particularly invasive, as well as resistant."
"My understanding," Austyn said to her, "is that staphylococcal infections are an issue only when the individual has suffered a skin break or an open wound, but this isn't always the case with these victims."
Rahaf closed her eyes for a moment, and Austyn looked at Fahimah.
"There is no need to do this now," he said. "I don't want to tire-"
"No, Austyn," Rahaf said. "Just give me a moment."
Fahimah kept her eyes on her sister's face, and Austyn could read the sorrow there. Rahaf drew in a deep breath and looked at him.
"What you say is true." She nodded. "My laboratory experiences were in a controlled environment. But my contention is that, in the real world, this strand can colonize in the mouth and the throat. You see, it is in the genetic combination of these three microbes: staphylococcus, carried by thirty percent of healthy adults in their nose, the strep infection that must be present in the throat, and an outside staphylococcal cassette chromosome, introduced separately that forms the basis for the creation of the deadly new strain… you have a name for it."
"We just call it NFI," he said. "Necrotizing Fasciitis Infection."
As she continued to explain, it became clear that outside of a laboratory environment, the victim had to have a strep infection for the NFI microbe to mutate. Austyn thought of all the cold medications they were testing in the U.S. This narrowed the field down to medications relating to a sore throat where the victim actually has strep throat.
Fahimah gave her sister some water.
"If this is too much for you, we can stop and get back to it later," he told her again.
"No," she said adamantly. "You see... I was so frightened of this NFI... that I destroyed everything. Not only what Fahimah did for me at the lab… but any documentation I had outside, too." She touched her head. "What is left is here."
Austyn understood now the need to remove the bacteria through the amputation. "Can you tell me about the remedy you took to survive?"
Rahaf motioned to Fahimah and sipped some more water first. "Most classes of antibiotics were discovered in the 1940s and '50s. You know that they work by blocking synthesis of the cell wall, DNA, and proteins within the bacteria."
Austyn knew this. "And I know that most of today's antibiotics are simply a variation on that original concept."
"Exactly. The fact that they work in similar ways may be one reason why bacteria are developing resistance," Rahaf told him. "Now, this remedy was not something that I discovered. It is a product presently under testing by one of your pharmaceutical companies. The antibiotic was discovered by isolating a certain microorganism from a sample of soil from southern Africa."
Austyn wrote down the information. She told him the name of the company and how successful the product had been so far on mice. She said she heard it might be a decade before it became available for humans. Rahaf had gone to school with one of the lead scientists working on the project at the time, who had given her a sample of the product.
"If the compound passes clinical trials it will become only the third entirely new antibiotic developed in the past four decades."
"Do you know how this antibiotic works differently from the others?" Austyn asked.
"It acts to block enzymes involved in the synthesis of fatty acids, which bacteria need to construct cell membranes."
She had to stop again. Fahimah gave her sister more water. The burst of energy Rahaf had gathered to give him this information was draining from her body. He hoped she would bounce back. But he could see the pain was too much.
"I need the nurse, my love," she told her sister.
Fahimah ran for the door, and Rahaf beckoned to Austyn.
He went to her and held her thin hands. The green eyes met his. "She has suffered."
He nodded.
"You make good on that suffering. You make sure she is taken care of."
"She will be," he promised her.
Chapter Forty-Seven
Washington Hospital Center,
Washington, D. C.
They were calling it a mild heart attack. At least, this was what the initial ECG and blood tests indicated.
Faas was far from being out of the woods, but he'd made it clear that it was a matter of national security for him to take a call from Agent Newman. Considering everything that was going on around the country, none of the doctors or nurses had a problem with it.
One of the nurses handed him a phone as soon as they rolled his bed into a curtained-off area. They told him he was only between tests. This was a rest stop only.
"Pressure of the job getting to you?" Austyn asked.
"No, I'm faking it. It's a good way to get my ex-wife's sympathy back." Betty had been the one who'd called 911. She was at the hospital by the time the ambulance had brought him in. Now she was talking to the doctor in the hall.
"Great idea. How is it working?"
"So far, so good," he said. "What have you got?"
"Some very good things," Austyn said. "But first of all, you should know that you're the third call I've made. NIH already has this information, and so does our department. So you don't have to leap out of bed and try to do everything yourself."
