up on her. The young doctor who first admitted the patient had worked hard to fit the symptoms into anything in the literature, but had come up empty. Lauren worried that she would come up against the same brick wall.
When she was first told of the case, the litany of past terrors ticked off in her head: Ebola, cerebral encephalitis, anthrax, hemorrhagic fever. The sores, especially, raised a concern. They were dark purple, like bruises, and drained yellow pus when ruptured. But the interview with Felicia’s father reduced Lauren’s initial fear that some strange contagion was at work. None of the high risk behavior was present in the patient nor her family. No travel out of the country. No interaction with livestock. No intravenous drug use. The backwoods of western Maryland hardly seemed a likely site for a terrorist attack. The only high-value target was the presidential retreat of Camp David, but that was more than fifty miles away.
Lauren knew these factors only reduced and didn’t eliminate the possibility of a highly contagious virus. Her work at Johns Hopkins on West Nile Virus taught her that mosquitoes were nature’s most efficient disease transmitter, better than any man-made device for germ warfare. As were ticks, fruit flies, bad water, mold, tainted meat. The list was endless and frightening in its banality. The most important fact she learned from the interview was that the Rodriguez’s had six other children and all had had close contact with Felicia since she became sick. None of them showed any symptoms.
Her father, Raoul, had lowered his head in shame when Lauren asked how long Felicia had been ill.
“Three weeks. She sick bad for three weeks.”
Frustrated, Lauren asked why it took him so long to bring her to the hospital.
He had turned red and stammered, “I bring in. Downstairs give me pills. Tell me make her sleep and give water. No money, you know?”
Lauren had patted him on the arm and assured him that she would take care of his little girl and that ‘no money’ wasn’t a problem. Downstairs meant that he had brought the girl to the emergency room. Lauren had seen it a hundred times, especially in California. Migrant workers with no insurance using the emergency room for general care and getting the blow-off by over-worked doctors.
She’d argued the case on more than one blue-ribbon panel of medical experts, for all the good it did. The system was broken. The best care went to the highest bidder, to those who could afford a lawyer if something went wrong. The directors of the hospital could afford benefit dinners at the Ritz Carlton, but pro bono services to the neediest were targeted for cuts at every budget review. She knew that emergency room doctors were good and they did their best, but limited time, resources and sleep made for snap judgments, and snap judgments led to mistakes. Someone made a mistake with Felicia Rodriguez and hadn’t taken the time to properly diagnose her. Now the little girl sleeping in front of her was paying the price.
“What do you think?”
She jumped from the edge of the bed with a start, holding the chart against her chest like a shield.
Dr. Stanley Mansfield stood in front of her. He was the chief of staff at Midland General and had been so for as long as anyone could remember. Tall and lean, with salt and pepper hair, he didn’t look older than mid-fifties though the older nurses assured Lauren that he had to be well into his sixties by now, maybe even early seventies. The doctor knew the staff liked to speculate about his age so he kept it a closely guarded secret, saying that it would be revealed only at his funeral. His way of making sure people showed up, he liked to joke.
“Stanley, you scared me to death.” Lauren laughed. She had not only learned to respect Dr. Mansfield’s judgment in the short time they’d been colleagues, but they’d developed a friendship as well. He ran a tight ship at the hospital but the medicine always
When she was first told of the case, the litany of past terrors ticked off in her head: Ebola, cerebral encephalitis, anthrax, hemorrhagic fever. The sores, especially, raised a concern. They were dark purple, like bruises, and drained yellow pus when ruptured. But the interview with Felicia’s father reduced Lauren’s initial fear that some strange contagion was at work. None of the high risk behavior was present in the patient nor her family. No travel out of the country. No interaction with livestock. No intravenous drug use. The backwoods of western Maryland hardly seemed a likely site for a terrorist attack. The only high-value target was the presidential retreat of Camp David, but that was more than fifty miles away.
Lauren knew these factors only reduced and didn’t eliminate the possibility of a highly contagious virus. Her work at Johns Hopkins on West Nile Virus taught her that mosquitoes were nature’s most efficient disease transmitter, better than any man-made device for germ warfare. As were ticks, fruit flies, bad water, mold, tainted meat. The list was endless and frightening in its banality. The most important fact she learned from the interview was that the Rodriguez’s had six other children and all had had close contact with Felicia since she became sick. None of them showed any symptoms.
Her father, Raoul, had lowered his head in shame when Lauren asked how long Felicia had been ill.
“Three weeks. She sick bad for three weeks.”
Frustrated, Lauren asked why it took him so long to bring her to the hospital.
He had turned red and stammered, “I bring in. Downstairs give me pills. Tell me make her sleep and give water. No money, you know?”
Lauren had patted him on the arm and assured him that she would take care of his little girl and that ‘no money’ wasn’t a problem. Downstairs meant that he had brought the girl to the emergency room. Lauren had seen it a hundred times, especially in California. Migrant workers with no insurance using the emergency room for general care and getting the blow-off by over-worked doctors.
She’d argued the case on more than one blue-ribbon panel of medical experts, for all the good it did. The system was broken. The best care went to the highest bidder, to those who could afford a lawyer if something went wrong. The directors of the hospital could afford benefit dinners at the Ritz Carlton, but pro bono services to the neediest were targeted for cuts at every budget review. She knew that emergency room doctors were good and they did their best, but limited time, resources and sleep made for snap judgments, and snap judgments led to mistakes. Someone made a mistake with Felicia Rodriguez and hadn’t taken the time to properly diagnose her. Now the little girl sleeping in front of her was paying the price.
“What do you think?”
She jumped from the edge of the bed with a start, holding the chart against her chest like a shield.
Dr. Stanley Mansfield stood in front of her. He was the chief of staff at Midland General and had been so for as long as anyone could remember. Tall and lean, with salt and pepper hair, he didn’t look older than mid-fifties though the older nurses assured Lauren that he had to be well into his sixties by now, maybe even early seventies. The doctor knew the staff liked to speculate about his age so he kept it a closely guarded secret, saying that it would be revealed only at his funeral. His way of making sure people showed up, he liked to joke.
“Stanley, you scared me to death.” Lauren laughed. She had not only learned to respect Dr. Mansfield’s judgment in the short time they’d been colleagues, but they’d developed a friendship as well. He ran a tight ship at the hospital but the medicine always
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