Outbreak by Robin Cook. Part one

The motel was depressing, but it didn’t matter. Marissa didn’t think she’d be spending much time there. She washed her hands and face, combed her hair and replaced her barrette. With no other plausible reason for delay, she returned to the rent-a-car and set out for the Richter Clinic. The palms of her hands were damp against the steering wheel.

The clinic was conveniently situated on a wide thoroughfare. There were few cars at that time of morning. Marissa pulled into a parking garage, took a ticket and found a spot near the entrance. The entire structure was modern, including the garage, the clinic, and what Marissa guessed was the hospital, which appeared to be seven stories tall. Getting out of the car, she stretched, then lifted out her briefcase. In it were her class notes from the epidemiology portion of the introductory course-as if that would be any help-a note pad, pencils, a small textbook on diagnostic virology, an extra lipstick and a pack of chewing gum. What a joke.

Once inside, Marissa noted the familiar hospital odor of disinfectant-a smell that somehow calmed her and made her feel instantly at home. There was an information booth, but it was empty. She asked a maintenance man mopping the floor how to get to the hospital wing, and he pointed to a red stripe on the floor. Marissa followed it to the emergency room. There was little activity there, with few patients in the waiting room and only two nurses behind the main desk. Marissa sought out the on-call doctor and explained who she was.

“Oh, great!” said the ER doctor enthusiastically. “Are we glad you’re here! Dr. Navarre has been waiting all night for you. Let me get him.”

Marissa absentmindedly played with some paper clips. When she looked up, she realized the two nurses were staring at her. She smiled and they smiled back.

“Can I get you some coffee?” asked the taller of the two.

“That would be nice,” said Marissa. In addition to her basic anxiety, she was feeling the effects of only two hours of fitful sleep on the flight from Atlanta.

Sipping the hot liquid, Marissa recalled the Berton Roueche medical detective stories in The New Yorker. She wished that she could be involved in a case like the one solved by John Snow, the father of modern epidemiology: A London cholera epidemic was aborted when Snow deductively isolated the problem to a particular London water pump. The real beauty of Snow’s work was that he did it before the germ theory of disease was accepted. Wouldn’t it be wonderful to be involved in such a clear-cut situation?

The door to the on-call room opened, and a handsome, black-haired man appeared. Blinking in the bright ER light, he came directly toward Marissa. The corners of his mouth pulled up in a big smile. “Dr. Blumenthal, we are so glad to see you. You have no idea.”

As they shook hands, Dr. Navarre gazed down at Marissa. Standing next to her, he was momentarily taken aback by her diminutive size and youthful appearance. To be polite, he inquired about her flight and asked if she was hungry.

“I think it would be best to get right down to business,” said Marissa.

Dr. Navarre readily agreed. As he led Marissa to the hospital conference room, he introduced himself as chief of the department of medicine. This news didn’t help Marissa’s confidence. She recognized that Dr. Navarre undoubtedly knew a hundred times more than she about infectious disease.

Motioning for Marissa to sit at the round conference table, Dr. Navarre picked up the phone and dialed. While the call was going through, he explained that Dr. Spenser Cox, the State Epidemiologist was extremely eager to talk to Marissa the moment she’d arrived.

Wonderful, thought Marissa, forcing a weak smile.

Dr. Cox sounded equally as happy as Dr. Navarre that Marissa was there. He explained to her that unfortunately he was currently embroiled in a problem in the San Francisco Bay area involving an outbreak of hepatitis B that they thought could be related to AIDS.

“I assume,” continued Dr. Cox, “that Dr. Navarre has told you that the problem at the Richter Clinic currently involves only seven patients.”

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