Read an Excerpt
"Okay, beautiful, what you got for me?" Sawyer leaned across the reception desk as the clerk glared at him.
Miriam cracked her chewing gum. "You've been here too longyou're getting smart-mouthed."
"I've always been smart-mouthed."
"And get a haircut."
He pushed his shaggy light brown hair from his eyes then tossed his head. "The longhaired look is in. BesidesI'm worth it."
The clerk rolled her eyes and picked up three charts. "You can have two sick kids with chicken pox in room six or a forty-three-year-old female with D&V behind curtain two." They lifted their heads in unison as the noise of someone retching behind curtain two filled the air.
He shuddered. "Give me the kids." He grabbed the charts and walked down the corridor. His eyes skimmed the information on the charts. Ben and Jack Keating, aged six and seven, just returned from abroad with chicken pox.
He pushed open the door. Unusually, the lights were dimmed in the room. The two kidsbrotherslay on the beds with a parent at each bedside. Alison, one of the nurses, was taking a temperature. She walked over to him, her pregnancy bump just starting to emerge from her scrub trousers. "Sickest kids I've seen in a while," she murmured.
He gave her a smile, his natural instinct kicking in. "You safe to be in here?"
She sighed. "After three kids of my own it's safe to say I'm immune."
Sawyer crossed the room quickly, leaving the charts at the bottom of the beds. Alison was right. These kids didn't look good. Chicken pox could be a lot more serious than a few itchy spots.
"Hi, I'm Matt Sawyer, one of the docs. I'm going to take a look at Ben and Jack." He extended his hand towards the mother then the father, taking in their exhausted expressions before turning to the sink, washing his hands and donning some gloves.
He walked over to Ben. In the dim light it was difficult to see his face, but it looked as if it was covered in red, bumpy spots. "Hi, Ben, I'm just going to have a little look at you."
The six-year-old barely acknowledged that he'd spoken. He glanced at the cardiac and BP monitor, noting the increased heart rate and low blood pressure. At first touch he could feel the temperature through his gloves. He pressed gently at the sides of Ben's neck. Unsurprisingly his glands were swollen. There were a number of spots visible on Ben's face so he peeled back the cover to reveal only a few angry spots across his chest but a whole host across his forearms.
The first thing that struck him was that all of the spots were at the same stage of development. Not like chicken pox at allwhere spots emerged and erupted at different times.
Alarm bells started ringing in his head. Be methodical. He heard the old mantra of his mentor echoing around him.
He moved to the bottom of the bed and lifted Ben's foot.
There. The same uniform spots on the soles of his feet. He stretched over, reaching Ben's hand and turning his palm over. Red vesicular spots.
He tasted bile in the back of his throat and glanced across the room to where Alison had switched on her telepathic abilities and had already hung some bags of saline and was running through the IV lines.
"Where were you on vacation?"
The boys' father shook his head. "We weren't on vacation. I was working. We've just come back from three months in Somalia. I work for a commercial water-piping company."
Somalia. The last known place for a natural outbreak of this disease.
"Were any of the locals you came into contact with sick?" There were a million different questions flying around his head but he didn't want to bombard the parents.
Mrs Keating nodded. "We were in the highlands. A lot of them were sick. But we didn't think it was anything too serious. We actually wondered if we'd taken a bug to themwe were the first people they'd come into contact with in years."
His reaction was instinctive. "Step outside, please, Alison."
"What?" The nurse wrinkled her brow.
He raised his voice, lifting his eyes and fixing them on her, praying she would understand. "Wait outside for me, please, Alison."
The atmosphere was electric. She was an experienced nurse and could read the expression on his face. She dropped the IV lines and headed for the door.
"Is something wrong?" Mr. Keating started to stand.
Sawyer crossed to the other bed. Jack was lying with his back to him. He wasted no time by pulling the white sheet from across Jack's chest and tugging gently on his shoulder to pull him round.
Identical. His face was covered. Red, deep-seated round vesicles. All at the same stage of development, a few covering his chest but mainly on his forearms. He opened Jack's mouth. Inside, his oral mucosa and palate were covered. He checked the soles of his feet and the palms of his hands. More identically formed red spots.
He could feel chills sweeping his body. It couldn't be. It couldn't be. This disease had been eradicated in the seventies. No one had seen this disease since then.
Then a little light bulb went off in his head. Hadn't there been a suspected outbreak a few years ago that had turned out to be chicken pox? The very thing that this was presumed to be? He ran the list of other possibilities in his head. He knew them off by heart. Anyone who'd ever worked in the DPA did.
But the more he stared at the spots the more convinced he became that it was none of the alternatives.
"How long since the spots appeared?"
The mother and father exchanged glances. "A few days? They had a rash at first then the spots developed. They've got much worse in the last day. But the boys had been feeling unwell before thatheadaches, backaches, vomiting. We just thought they'd picked up a bug."
Sawyer felt as if he was in a bad movie. Why him? Why did this have to happen while he was on duty?
Would someone else recognize this? Realize the potential risks? Or would they just chalk it up to a bad dose of chicken pox and discover the consequences later? He'd put all this behind him. He'd walked away and vowed never to be involved in any of this again. He was in the middle of Chicagonot in some far-off country. Things like this didn't happen here. Or they shouldn't happen here.
And right now that was he wanted to do again. To walk out that front door and forget he'd ever seen any of this.
He looked at the long inviting corridor outside. He wasn't a coward. But he didn't want this. He didn't want any of this. The kind of thing that sucked you in until it squeezed all the breath from you.
A shadow moved outside the door.
But there was the killer. A pregnant nurse standing outside that door. A nurse who had been working with him and had contact with these children. Could he walk away from her?
He glanced upwards. It was almost as if someone had put her here so he couldn't walk away. His conscience would never allow him to do that.
If only he didn't know she was pregnant. If only that little bump hadn't just started to emerge above her scrub trousers. That would make this a whole lot easier.
Then he could walk away.
He took a deep breath and steeled himself. He was a doctor. He had a duty of care. Not just to his colleagues but to these kids.
These very sick kids.
He looked back at the parents. "I need you to think very carefullythis is very important. Did you fly home?"
They both nodded.
"When, exactly, did you first notice the rash on the boys? Before or after you were on the plane?"
The parents looked at each other, screwing up their foreheads and trying to work it out.
A detailed history could wait. He knew enough already. He wasn't part of the DPA any more. This was their job, not his. The notification part he could handlesetting the wheels in motion so the processes could take over.
Isolation. Containment. Diagnosis. Lab tests. Media furore.
In the meantime he had two sick kids to take care of and staff members to worry about. Let the DPA do their job and he could do his.
He pulled his smart phone from his pocket and took a picture of Jack's spots and then Ben's. "Wait here."
Alison jumped as he flung the door open. "What on earth's going on?" She matched his steps as he strode down the corridor to Reception. "Don't you think you can get away with speaking to me like that. I want to know what you think is wrong." He watched her as subconsciously her hands went to her stomach. This day was just about to get a whole lot worse.
"Did you touch them?"
"What?" She wrinkled her nose.
"The spots. Did you touch the children's spots?"
She must have read the fear he was trying to hide behind his eyes. "I think I did." She looked as if she might burst into tears. Then realization dawned. "I think I had gloves on." Her voice grew more determined. "No, I'm sure I had gloves on."
"And when you took them off, did you touch any other part of your skin?"
Her face crumpled. "I don't think so. But I can't be sure."
His hands landed on her shoulders and he steered her into the nearest free room. He knocked the water on with his elbows and pulled the hand scrub over, opening up a scrub brush for her. "Scrub as if you were going to Theatre and don't stop until I tell you."
She looked pale, as if she might keel over. But her reactions were automatic, pumping the scrub, covering her hands, wrists and forehands and moving them methodically under the running water.
He watched the clock. One minute. Two minutes. Three minutes. Four.
He nodded. "You can stop now."
"Do you know what it is?" She was drying her hands now.
"I think I do. I'm just praying that I'm wrong. Come with me."
They reached the desk. Miriam had her back to them and was chatting loudly on the phone.
Sawyer leaned across the desk and cut the call.
She spun around. "What are you doing?"
"What?" Several heads in the surrounding area turned.
"You don't have any authority"
"I do. Get me Dr. Simpson, the chief of staff, on the phone." He turned to face the rest of the staff. "Listen up, folks. As of now, we have a public health emergency. The department needs to closeright now." He pointed at Miriam. "Let Dispatch know not to send us any more patients."
He turned to one of the security staff. "Lock the front doors."
The noise level around him rose.
He put his hand on Alison's arm, pulling her to one side. "I'm sorry, honey, but that isn't chicken pox. I think it's smallpox. And we need to contact the DPA."
Callie Turner stowed her bag in her locker and nodded at a few of her colleagues getting changed. She glanced in the mirror and straightened her skirt, taking a deep breath as she gave herself a nervous smile and pulled at her new haircutan asymmetric blonde bob.
It was meant to signify a new starta new beginning for her. It had looked fabulous in the salon yesterday, expertly teased and styled. Today it just looked as if she was halfway through a haircut. This would take a bit of getting used to.
First day at the DPA.
Well, not really. An internship and then a three-year specialist residency training program completed within the DPA. All to be part of the Disease Prevention Agency. Eleven years in total of blood, sweat and lots of tears.
All to fulfil someone else's dreams. All to pay homage to someone else's destiny. Today was the first day of the rest of her life.
She pushed open the door to the telephone hub. "Hi, Maisey."
The short curly-haired woman looked up. "Woo-hoo! Well, look who picked the lucky bag on her first day on the job." She rolled her eyes at Callie. "Go on, then. Who did you upset?"
Callie laughed and pulled out the chair next to Maisey. "No one that I know of. This was just my first shift on the rota." She looked around. "It's kind of empty in here. Where is everyone?"
Maisey gave her a sympathetic glance. "You should have been here two hours ago. They're assembling a team next door. We've got a suspected outbreak of ebola."
Callie's eyes widened. First day on the job and she was assigned to the phones. The crazy calls. While next door the disease detectives were preparing to investigate an outbreak. She bit her lip. "Who took the call?"
Maisey smiled again. "Donovan."
Callie sighed. Typical. The person who took the call usually got to assemble and lead the team. Donovan had a knack of being in the right place at the right time.
She stared at the wall ahead of her. Someone had stuck a sign up: "Normal People Don't Phone the DPA."
Never a truer word was said. The phone next to her started ringing. She bent forward and automatically picked it up. It would be a long day.
Four hours later she'd spoken to three health officials, crazy bat ladywho phoned every daytwo over-anxious school teachers, five members of the public, and two teenagers who'd obviously been dared by their friends to ring up. Right now all she could think about was a large cappuccino and a banana and toffee muffin.
Her stomach grumbled loudly as she lifted the phone when it rang again. "DPA, Callie Turner, can I help you?"
"This is Matt Sawyer at Chicago General. I've got two kids with suspected smallpox."
She sat up instantly as her brain scrambled to make sense of the words. All thoughts of the muffin vanishing instantly. This had to be a joke. But the voice didn't sound like that of a teenager, it sounded like an adult.
"Well, aren't you going to say anything?" He sounded angry. Patience obviously wasn't his strong point.
She took a deep breath. "Smallpox has been eradicated. It's no longer a naturally occurring disease, Mr. Sawyer."
"Listen, honey, you can call me Doctor. Dr. Matt Sawyer. Ringing any bells yet?"
She frowned. Matt Sawyer? The name seemed familiar. Who was he? And why was he speaking to her like that? She put her hand over the receiver and hissed at Maisey. "Hey, who's Matt Sawyer?"
Maisey's eyes widened instantly, the disbelief on her face obvious. She skidded her wheeled chair across the room next to Callie.
"You're joking, right?"
Callie shook her head and pointed to the phone.
Maisey bent forward and pulled the phone away from her ear, replacing it with her mouth. "Outbreak, dead pregnant wife, disappeared off the map."
The pieces of the puzzle started to fall into place and become vaguely familiar. Of course. She had heard of this guy. In fact, everyone in the DPA had heard of this guy. He was like a dark, looming legend. But it had been way before her time.
Her training and natural instincts kicked in. There was a protocol for this. She pushed her chair under the desk and pulled up a screen on her computer. "Hi, Dr. Sawyer. Let's go through this."
The algorithm had appeared in front of her, telling her exactly what questions to ask, why and when. She started to take some notes.
"You said you're at Chicago General. Whereabouts in the hospital are you?"
She could almost hear him sigh. "The ER."
"What are the symptoms?"
"Two kids, returned from Somalia a few days ago. Ages six and seven. Very sick. Febrile, uniform red spots mainly on their faces, forearms, palms and soles. A few on their trunks. Low blood pressure, tachycardic, swollen glands."
She was typing furiously. Somalia. The last known place to have a natural outbreak of smallpox. It did seem coincidental.
But there were a whole host of other diseases this could be. She started to speak. "Dr. Sawyer, have you considered chicken pox, herpes, scabies, impetigo"
"I know you're reading from the list. I've considered all those things. It's none of them. Check your emails." He sounded exasperated with her.
"What do you mean?"
"Lady, do I have to tell you everything twice? Check your emails. I just sent you some photos. Have you ever seen spots like that?"
She clicked out of the algorithm and into her emails. Sure enough, there it was. Everyone in the DPA had a generic email address starting with their full name. He was obviously familiar enough with the system to know that. There was no message. She opened the attached photos. Wow.