Resistance
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Resistance

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by Daniel Kalla
     
 

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No treatment. No cure. No hope

Once it seemed as though penicillin and other antibiotics had won humanity a lasting victory over harmful bacteria. But now hardier bugs, resistant to most common classes of antibiotics, are emerging–with potentially catastrophic consequences.

When Dr. Catalina Lopez of the Center for Disease Control first receives a report

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Overview

No treatment. No cure. No hope

Once it seemed as though penicillin and other antibiotics had won humanity a lasting victory over harmful bacteria. But now hardier bugs, resistant to most common classes of antibiotics, are emerging–with potentially catastrophic consequences.

When Dr. Catalina Lopez of the Center for Disease Control first receives a report of a lethal new "superbug" immune to all known antibiotics, she realizes that she has a major health crisis on her hands. An ultra-resistant form of group A strep is spreading like wildfire throughout hospitals and emergency rooms in Seattle and the Pacific Northwest. Doctors, lacking any effective way to combat the infection, can do nothing but stand by and watch their patients die, one after another.

Dr. Graham Kilburn, an infectious disease specialist in Vancouver, is one such doctor. Desperate to contain the spread of the new superbug, he joins forces with Lina Lopez as they try to find some way to halt the growing epidemic.

What they don't realize is that shadowy forces are conspiring to spread the disease on purpose–and they will stop at nothing to avoid exposure.

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Editorial Reviews

From the Publisher

“Daniel Kalla joins a select list of doctors who know how to keep you up all night with their writing.” —Nelson DeMille, New York Times bestselling author on Pandemic

“Dan Kalla expertly weaves real science and medicine into a fast-paced nightmarish thriller–a thriller all the more frightening because it could really happen.” —Tess Gerritsen on Pandemic

“Very much in the Michael Crichton school of cutting-edge scientifically rooted thrillers. Pandemic is an absorbing, compulsive thriller, the sort of book you could stay up too late reading. I'd advise against that, however. With all the bugs going around, you're going to need your immune system functioning at full strength . . . .” —The Vancouver Sun

“A totally compelling novel, one of those rare thrillers that lays out a scenario that is not only possible, but terrifyingly probable.” —Douglas Preston, author of The Codex on Pandemic

“Kalla's ripped-from-the-headlines plot and confident command of both language and medicine make this sobering book a pleasure” —Publishers Weekly on Pandemic

Pandemic starts fast and never lets up on the suspense . . . Kalla juggles the many narrative balls easily, manages to insert a little romance, puts his protagonists in plenty of danger and drives his complex plot to a rousing climax.” —The Edmonton Journal

bn.com
The Barnes & Noble Review
Emergency room physician-turned-novelist Daniel Kalla's newest medical thriller should come with a dispenser of antibacterial liquid soap. After readers finish Resistance, the terrifying story of a "superbug" intentionally unleashed on an unsuspecting public, the first thing they will want to do is thoroughly wash their hands!

When a new, deadly superbug (a form of antibiotics-resistant bacteria that lives, breeds, and spreads within hospitals) begins to kill people in major Pacific Northwest cities, Catalina Lopez of the Centers for Disease Control realizes quickly that she has a potential epidemic on her hands. With the help of people like infectious disease specialist Graham Kilburn and detective Seth Cohen, the outbreak is tracked to a drug user in Vancouver who injected what she believed to be cocaine and heroin given to her by an anonymous dealer. Further investigation reveals a connection between the bug and a groundbreaking new antibiotic being tested in hospitals in the area. Would a pharmaceutical company that has invested millions of dollars in a drug create and unleash killer bacteria that only their drug could treat?

Kalla has been compared to medical thriller icon Robin Cook for good reason: Resistance (as well as his debut novel, Pandemic) is powered by years of real-world experience in hospital emergency rooms and a comibination of expert insight and speculation. It also features a cast of impeccably crafted characters, pedal-to-the-metal pacing, and enough jaw-dropping plot twists to satisfy the most demanding reader. Ready or not, welcome to the post-antibiotic era… Paul Goat Allen

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Product Details

ISBN-13:
9780765354396
Publisher:
Tom Doherty Associates
Publication date:
05/02/2006
Pages:
400
Product dimensions:
4.17(w) x 6.71(h) x 1.09(d)

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Read an Excerpt

Resistance


By Daniel Kalla

Tom Doherty Associates

Copyright © 2006 Daniel Kalla
All rights reserved.
ISBN: 978-1-4299-1261-7



CHAPTER 1

Portland, Oregon


He eased the stolen black Ford Explorer to a stop behind the Dumpster in the dismal alley. When he switched off the ignition, the interior lights brightened and he caught a glimpse of his own reflection in the rearview mirror. There was nothing familiar about the face staring back. With three days' worth of stubble, spiked black hair and frosted tips, and the thick chain and heavy cross dangling from his neck, he could have been eyeing a total stranger. Someone he would have despised at first sight.

Dennis Lyndon Tyler — or at least that was who his out-of-state driver's license purported him to be — appreciated order in his life. Normally fastidiously clean-cut, he favored a dark jacket and tie for his assignments. Simple. Dignified. Nondescript. But now he dressed like a walking neon sign in a shiny blue track suit with reflective white Nikes and the gaudiest Rolex knockoff he could find.

And he couldn't shake his low-grade nausea from the stench of his own cheap cologne.

Tyler peeled his eyes from the mirror. A job is a job, he repeated the familiar mantra in his head. The money is right. Focus.

He stepped out of the car. As he instinctively smoothed out the creases in his jacket, his hand brushed over the hard metal strapped under his right sleeve. The gun's contact brought a welcome sense of familiarity.

Walking the alleyway, he deliberately infused his normally crisp stride with the cocky spring he had noticed in the others he'd studied. After three weeks of posing, the gait had nearly become second nature. He could maintain it without trying.

This was the fifth alley he had covered tonight. Yet another of the many gathering spots for the lowest of Portland's lowlifes he'd visited in the past few days. They congregated here, huddling in the doorways and other nooks and crannies among and between the rundown buildings, preoccupied with their sole reason for existence. Drugs.

He'd chosen well this time. This alley writhed with junkies. Male. Female. Some alone, others clustered in groups. A number of them looked young enough to be in junior high school. A few lay on their sides or sat propped up by a wall, their glassy eyes open and pinpoint pupils staring out at nothing. Several fumbled at the tourniquets on their elbows or at their partners' necks, searching for that elusive vein to inject whatever chemicals they could force into their bloodstreams. Though Tyler had become accustomed to the activity, his guts still churned from the stench of the Dumpsters and the smothering sense of desperation and need.

As he passed by, he caught the eye of a number of junkies who recognized his unofficial uniform. A tall thin man with a ravaged face and matted hair swaggered up to him. He stopped directly in Tyler's path and, without a word, nodded to him.

Tyler eyeballed the addict up and down. His cheeks were hollow, and his scraggly pale arms bore telltale scabs crusted over. Still, Tyler decided that the man didn't quite fit his need. He shook his head. When that didn't budge the junkie, he narrowed his gaze and curled his lip into a slight sneer. That sent the man scuttling like a beetle back into the shadows of the nearby building.

He repeated the same silent dance with four or five other alley dwellers. He recognized a few potential candidates but passed them over too, remembering that he had been instructed to choose only the absolutely sickest-looking of the junkies.

Near the end of the alley, where the light of the main street glowed like the opening at the end of a tunnel, movement caught Tyler's eye. He turned to see an emaciated woman leaning against a Dumpster. She struggled to push herself upright before staggering out to meet him.

The woman was so gaunt that Tyler couldn't pinpoint her age closer than a range of twenty to forty. She had scruffy jet-black hair and thick chapped lips. Despite the drizzly spring night, she wore a torn black miniskirt and tank top, which exposed a bony sunken abdomen and legs so skinny that they didn't taper from thighs to ankles. The Aztec sun god tattooed on her shoulder appeared asymmetrical like a painting whose canvas had shrunken underneath it. A pink, rhinestone-studded handbag hung off the same shoulder. Studying her large gray eyes and delicate nose, Tyler imagined that once she might have been pretty. Now, with skeletal features and weeping sores on her chin and cheek, he found her repulsive.

Her lips parted into a forced, toothy smile that accentuated the broken incisor on the upper right side of her mouth. "You got anything for me, hon?" she asked in a throaty voice that was meant to sound seductive but struck Tyler as pathetic. He breathed in the scent of her nicotine-rich breath. It mingled with her stale, diseased aroma.

She was the one.

He tilted his head and smiled. "What you looking for, gorgeous?"

"Beggars can't be choosers," she said with a giggle and swayed unsteadily on her feet, like a tree hit by a sudden gust. Then her smile vanished, and resolve hardened into the deep ridges of her face. "If you gotta know, I'm an old-fashioned girl. None of this crystal meth shit. I like eightballs."

An old-fashioned girl. Tyler suppressed a smirk. A month ago, he didn't know what eightballs were, but in the past few weeks he had dispensed several powdery packets of the cocaine and heroin used to concoct the cocktail, which seemed to be a favorite among the most hard-core users. Without a word, he fished in his track suit jacket pocket and pulled out two separate wads of silver foil. They looked as if they had been hastily packaged, but Tyler knew better. He had selected them earlier from the briefcase full of perfectly matching packets that had arrived along with his instructions. Then he had taken the time to grind them with a foot into the hotel bathroom's floor to produce an even more tattered and authentic looking result.

Tyler held the silver foil out in front of him in his open palm. When the woman reached for his hand, he closed it shut around the foil. She jerked her hand back as if it had been slapped. She stared up at Tyler with a look of sudden desperation. Her hand fumbled inside her purse but emerged empty. "I got jack right now for cash, but I got something else ..." Tyler knew where she was heading but he kept his fist closed and watched her expressionlessly.

"We can get a room around the corner." She forced her eyes wider and slowly ran her tongue along her upper lip until it touched the crusting sore at the edge. "And I do everything there. Everything." She pointed to his fist and gyrated her bony hips slightly, causing her to stumble a step. "Know what, baby? I'm going to give you the fuck of the century in trade,'kay?"

The thought intensified Tyler's nausea, but he maintained his poker face. Focus. He opened his fist. "Tonight's your lucky night," he said. "Since I'm new to these parts, I'm offering samplers. This one's on me."

The woman's hand shot out and grabbed the packets with surprising deftness.

Tyler watched as she jammed the foil deep into her handbag. "You got your own rig?" he asked, referring to the syringe and needle she would require.

"Yeah, yeah, in here," she said distractedly, snapping up the purse as if he might revoke his offer at any moment.

"What's your name?"

"Carol," she sniffled. She shuffled on the spot, looking desperate to leave.

"Carol," he repeated, amused by the middle-class blandness of how it sounded under the circumstances. "Next time, you'll know who to see about buying your stuff, right?"

"Oh, absolutely, you're my new man, baby," she said, not bothering to ask his name. Then she swiveled on the spot and lurched on her pumps back to the Dumpster.

Tyler watched until she disappeared into a crack in the building behind the alleyway. He had no idea what was in the packets he had just given her, but he had little doubt that it was more than just heroin and cocaine. And from the substantial deposit to his numbered Grand Cayman account, he inferred that it was going to dramatically shorten what little was left of Carol's pointless life.

Running his hand along the sharp and ridiculous spikes of his highlighted hair, all traces of Carol vanished from his consciousness. He turned and headed back for his car.

A job is a job, he said to himself. The money is right. Focus.

CHAPTER 2

Vancouver, Canada


Five more minutes and then I'm gone, Thomas Mallek promised himself for the third time since arriving. Feeling exposed in the flimsy blue hospital gown, the forty-year-old had sat on the same narrow stretcher for almost two hours without anyone paying him an iota of attention. Mallek figured his swollen knee could wait until he saw his family physician Monday morning; no doubt Dr. Ng would squeeze him in sometime. The busy lawyer, father of three, and dedicated marathoner did not have an evening to spare. Especially not at the emergency room of St. Michael's Hospital.

The place was a zoo, complete with sights, sounds, and smells foreign to Mallek. Drunks, street people, and various eccentrics filled the waiting room and paced the hallway; some looking bored, others menacing. The page for "security, stat" to this location or that seemed to crackle over the loudspeaker continuously. The antiseptic smell mingled unpleasantly with urine, vomit, and body odor that permeated the area.

Just as Mallek gingerly eased his leg over the side of the bed to leave, a voice spoke to him. "Mr. Mallek? I'm Dr. Gayle."

Mallek looked up at the young doctor who, with his hair tied back in a ponytail, wore green scrubs and a haggard expression. "Tom," Mallek said, stretching out a hand.

The doctor met Mallek's handshake, then waved a hand at the chaos around them. "Friday night," Gayle said by way of explaining all the problems in this corner of the world.

Mallek chuckled. "Don't know how you do it, Dr. Gayle."

"My fault. I wasn't smart enough to get into an ophthalmology residency" Gayle shrugged. A hint of a grin broke through his exasperated frown. "What's up with your knee?"

"I was out for a ten-K tune-up run earlier," Mallek said. "The toe of my shoe caught a crack in the pavement. About a block later I realized my foot was still stuck in the crack."

Gayle smiled. "Did you feel a pop?"

"Not only felt it, I heard it!" Mallek said. "My knee swelled right away. Now I'm having a hell of a time bending it."

Gayle nodded. "Can you lie back on the bed? I want to have a look."

Lifting his foot back onto the bed hurt Mallek even more than before. He expected Gayle to reach for his knee, but instead the doctor stood back a step and stared from the uninjured knee to the sore one. With a satisfied grunt, he bent over and gently rested the back of his hand on the knee, feeling, Mallek assumed, for warmth. Then the doctor put him through a series of mildly painful manipulations, the worst of which was when he held Mallek's thigh with one hand and tried to pull his calf forward with the other as if opening a drawer.

Gayle straightened up and folded his arms across his chest. "Hate to be the bearer of bad news, Tom, but I'm concerned you might have torn your ACL. That stands for —"

"Anterior cruciate ligament," Mallek finished the sentence with a heavy sigh. "I know. It's a big fear among runners."

"All athletes," Gayle said.

"Now what?"

"We should get an x-ray tonight," Gayle said. "Then we'll set you up with crutches —"

Before Gayle could finish, a series of unintelligible screams erupted from a flailing drunk in the waiting room, followed immediately by the familiar hiss of the loudspeaker; "Security, stat!"

Gayle smiled sympathetically at Mallek. "It won't take too long, Tom. Promise."

Mallek chuckled. "Any chance security could x-ray me? They seem pretty available."

Fifteen minutes later, Mallek had begun to doubt Gayle's word. No one had come to get him for an x-ray. Instead, the action had moved closer to him. In the stretcher beside his, the paramedics had unloaded a skinny teenage girl with dyed blue hair and wearing a tattered T-shirt, tartan skirt, and torn stockings. Though the curtain was drawn between their stretchers, one of the two flaps had peeled back giving Mallek a clear view of the girl. Her eyes were half shut and her words were garbled. Mallek assumed she was stoned, but from the way she moaned and thrashed on her bed, he recognized her agony. And the source of her pain — a a swollen, fiery red thigh with a central bull's-eye-like whitehead about the size of a dollar coin — stared back at him through the curtains' gap.

When the girl tried to bolt off the bed, the call for security broke again over the loudspeaker.

The team scrambled around her. The three burly security guards, looking like white-shirted cops, barked at her to stay still. The order struck Mallek as redundant because they pinned each of her arms to the bed while they secured thick black belted restraints around her wrists and ankles. A nurse fumbled with IV tubing at her arm. The girl's moans evolved into screams of indignant outrage.

Someone dressed from head to toe in mask and gown walked up to her bedside. Only when he spoke did Mallek recognize him as the ponytailed doctor. "Angie, we've got to drain your abscess," Gayle explained to the teenager but got only yelps in response.

Gayle instructed a similarly garbed nurse to inject two different drugs, which Mallek assumed were sedatives, because the patient stilled within a minute and only the odd groan emerged from her lips. Then Dr. Gayle prepared a surgical tray by the girl's knee.

None of the staff noticed the gap between the curtains. Mallek was too riveted by the unfolding drama to mention anything. When Gayle pulled a stool up to the girl's knee, Mallek realized he would have a bird's-eye view of the impending procedure on her thigh.

Forgetting all his earlier impatience, Mallek — a devout fan of the Operationshow on The Health Network — watched transfixed as Dr. Gayle swabbed at the swollen thigh. Gently bending his painful knee, Mallek shuffled himself sideways on the stretcher and leaned forward for a better view.

Mallek flinched when Gayle buried the long needle into the top edge of the girl's abscess. The injection provoked a muted cry and a twitch from her before she fell back on the bed. Then the doctor reached for a gray scalpel that looked to Mallek like a box cutter. Holding the scalpel as if it were a pen, Gayle placed it against the skin over the center of the bull's-eye and pressed down.

The moment the blade sliced the skin, the abscess erupted. Yellow pus shot out from the wound and sprayed like a water fountain with a thumb pressed over its nozzle.

Mallek was so stunned by the unexpected jet of pus and the way the doctor jerked back and almost fell off his stool that he didn't immediately notice he'd been sprayed. It wasn't until he felt the wetness at his cheek that he realized a drop of pus was running down his face.

CHAPTER 3

Philadelphia, Pennsylvania


From the forty-sixth floor of the forty-seven-story building, Dr. Ellen Horton stared out the floor-to-ceiling windows. Had she squinted, she might have been able to make out the figures of the rush-hour crowds scurrying along Walnut Street below. But her gaze never shifted from the tinted windows of the matching monstrosity across the street, as she forced herself to think of anything but her impending presentation to SeptoMed's board of directors.

I don't belong here, Horton thought as she smoothed the front of her pinstriped jacket and matching skirt. Fondly, she recalled the casualness of university meetings. At those functions, she would have been far more likely to see T-shirts and track pants than the ties and jackets that were the rule at SeptoMed. The indifference to fashion was only one of many things she missed about the academic world she had left behind.

Nothing felt the same since Horton had "jumped ship to the dark side" as her former colleagues had half joked about her move to the pharmaceutical giant, SeptoMed. Despite their teasing, the exponential rise in her salary had nothing to do with her choice. Even after the six-figure checks began to roll in, Horton maintained the same lifestyle — an obliviousness to material comfort that bordered on the Spartan — with which her parents, both college professors, had raised her. She still showed up to work every day in her '92 brown Ford Taurus sedan, carrying a bag lunch and the same tattered briefcase she'd owned since her postgraduate days.

What Horton needed from SeptoMed was the state-of-the-art lab and the limitless resources that came with their generous offer. Without that support, she might never have had the chance to see her life's work come to fruition. And she had sacrificed too much — childless and single at forty, her closest companion was a temperamental eight-year-old cat — to tolerate failure. But the prize was close. She felt it. In spite of the setbacks of the past two months, her drug would come to market. "Just don't screw this up, Ellen!" she warned herself under her breath.


(Continues...)

Excerpted from Resistance by Daniel Kalla. Copyright © 2006 Daniel Kalla. Excerpted by permission of Tom Doherty Associates.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Meet the Author

Daniel Kalla is the internationally bestselling author of Pandemic and Rage Therapy. He is an emergency room physician in Vancouver, British Columbia.

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