“Certainly,” Aretha said. “That’s what we’re here for. Have them sent over. We’ll take care of them.”
“Thank you,” Jack said. “Actually, I’d like to bring them over myself and deal with you directly. Would you mind? You see, the sooner I get an answer, the better. I’m concerned it might be a new strain and I don’t want these samples to disappear down a bureaucratic rabbit hole.”
“No problem,” Aretha said. “When would you like to do this?”
“Would now be okay?” Jack said. He knew he was being overly pushy, but he thought the situation demanded it. It seemed particularly opportune that he could potentially do her a favor as well. Between city agencies things always worked better when there was a personal relationship and a give-and-take.
“Why not,” Aretha said. “It will give me a chance to meet you in person. Are you familiar with the Public Health Laboratory building?”
“I’m not,” Jack admitted.
“The easiest way would be for you to come in the back entrance off Twenty-sixth Street and take the service elevator directly up to the third floor. That’s where our level-three lab is located, where the testing will be done. I can meet you there.”
“Perfect,” Jack said. “I’m on my way.”
Initially Jack debated using his bike again for the quick high itinvariably gave him, but decided against it. He worried there wouldn’t be a safe place for it when he went into the Public Health Laboratory unless he brought along his ponderous collection of chains and locks. Instead he merely ducked directly out of 520 onto First Avenue with a shoulder bag full of specimens and jogged the four blocks down to 26th Street. Although there was ancient-appearing scaffolding erected around the massive Public Health Laboratory building, Jack was able to find the service entrance with comparative ease. As he rode up in the battered service elevator, he guessed the building was from approximately the same era as the old OCME structure.
As the elevator doors opened, Jack was greeted by a tall, youthful, and athletic-appearing African American woman with bright eyes and an equally bright smile. Her hair was meticulously done in cornrows with colorful beads. She introduced herself with infectious alacrity and pumped Jack’s hand. Without hesitation she took the samples Jack had taken out of his shoulder bag and handed over her business card.
“I put my mobile number on the back,” Aretha said. “How about you give me yours?”
Jack took out one of his business cards and added the number. He handed it to Aretha.
“I’ll run rapid tests for the usual culprits,” she told him. “That will certainly include the standard influenza strains, SARS, MERS, and even the new bird flu, plus the usual run-of-the-mill respiratory villains. I should have some results in a few hours.”
“I’ll appreciate a call as soon as you have the results,” Jack said. He couldn’t have been more encouraged and pleased. “Could you test for hantavirus, too? I know the chances are probably zero, but there was some inflammation in the gallbladder, spleen, and kidneys, like what is seen with hantavirus.”
“I’ll run all the rapid tests,” Aretha promised. “It’s actually automated. If there’s a known virus present with a decent titer, meaning there’s enough of it, it will pop up. And if it killed the woman, it’s got tobe a decent titer, especially since you got it directly from the lungs. Now, with that decided, is there any chance you’ll be playing basketball tonight?”
“I’m not sure,” Jack said. He was impressed with Aretha’s tenacity. “Sorry, but my daughter is having some health issues. I’ll have to see. But I could call some of the other guys and set it up for you, whether I come out or not.”
“I think I’ll wait until you are available,” Aretha said. “I’m an old hand at street b-ball and know the politics can be dicey.”
“You’re right in general,” Jack said. “But our court is neighborly and everyone is pretty laid-back. And there is no gender issue, if that’s your concern. There was a few years ago, but that’s not the case now. Skill is the determining factor for both sexes, which shouldn’t be a problem if you played college ball for UConn. But if you’re reluctant to show up on your own, I’ll give you a call if I can get out there tonight. I could definitely use a run.”
“I’ll keep my fingers crossed,” Aretha said. “Meanwhile, I’ll get to work on your samples. I’ll also inoculate some cell cultures just to let you know over the next couple days if any viruses are present. That might be helpful if the rapid tests are negative.”
“I appreciate your help,” Jack said. “This could be important, especially if it is a new influenza strain.”
After promising to get together at some point at the playground across from Jack’s house, Jack returned to the street. From the Public Health Laboratory, he merely had to cross First Avenue and skirt a small park to get to 421. In less than five minutes he was back on the fifth floor, sitting across from Bart Arnold.
“This case you turned me on to is getting progressively more interesting,” Jack said. “I just finished the autopsy. Thanks for cluing me in.”
“What did you find?” Bart asked. He leaned forward, all ears.
“First of all, the woman had had a recent heart transplant,” Jack said.
“No!” Bart said. He laughed briefly in disbelief and shook his head.“There’s always surprises in this job. Who would have guessed to look at her. And is that what you think killed her: something going haywire with the transplant?”
“No, the transplant couldn’t have looked any better than it did. It appeared like the heart of an athlete, with absolutely no signs of inflammation or rejection whatsoever. All the pathology was in the lungs, which showed a huge amount of inflammation from what I’m guessing was a cytokine storm secondary to a viral pneumonia, possibly influenza.”
“Having had a recent heart transplant, she must have been on high-dose immunotherapy,” Bart said.
“No doubt,” Jack said. “I’m sure Toxicology will confirm that.”
“But if she were on high-dose immunotherapy, wouldn’t that preclude her having a cytokine storm? Wouldn’t immunotherapy block a cytokine storm or at least keep it in check?”
As soon as Bart said the words, Jack knew he was absolutely right. All heart transplant patients took high doses of immunotherapy to block rejection, which probably would have blocked the immune response that triggered a cytokine storm. Jack had let his excitement get the better of him. All at once he was back to square one.
