Me. I'm part of the Special Pathogens Branch, which is in the Division of Viral and Rickettsial Diseases, which, in turn, is part of the National Center for Infectious Diseases, one of the Centers in the Centers for Disease C & P. My knowledge doesn't go too much deeper than that. Though I could spit out to you molecular biology of the family Arenaviridae, I couldn't sketch the organizational chart of the CDC. I leave that to the brilliant bureaucrats and technocrats in Georgia and Washington. If there was a Nobel for institutional complexity, these guys would lock it up year after year.
I pulled my car into a no-parking zone near the Emergency Department and slapped the Baltimore City Health Department placard on the dashboard. I fished in the glove compartment and found my old CDC placard and put that out, too. Outbreak or no outbreak, the last thing I wanted to deal with was a towed car.
I ran through the automatic doors to the Emergency Department, pulling my ID around my neck as I went. The place was oddly serene; it was, after all, early morning, July, and a weekday. That was a good thing. Although Verlach was on edge, it seemed word hadn't filtered out to the rest of the hospital or, God forbid, the press. The past few years--the anthrax fiasco, SARS--had taught the public health world the finer points of a 24/7 media with an insatiable appetite for the new, new thing.
There was a beige phone on the wall behind the nurses' station. I grabbed it, pounded in the pager number for the hospital epidemiologist, and waited. Two minutes later, the phone rang. I picked it up before the first ring ended.
"Dr. Madison, it's Nathaniel McCormick. I'm in the ED," I said.
The voice that came over the phone was faint, muted. "And I'm up on M-2. What the hell are you doing down there?"
M-2 was a single hallway flanked by double-occupancy rooms. The white
linoleum floor was long ago scuffed to gray, the beige walls streaked
with a grime that never quite vanished, despite the best efforts of
housekeeping. It was the mirror image of M-1, the medicine unit directly
below it, except that the end of M-2 was capped by a set of metal double
A laser-printed sign was taped to the doors: ISOLATION AREA: Contact Precautions MANDATORY. Authorized Personnel ONLY. Questions? Call Bioterror/Outbreak Preparedness at x 2134. Thank you!
Now, no one's ever accused me of being understated, but I thought introducing a loaded word like bioterror might be a wee bit alarmist.
The isolation unit was split into two areas. I was in the first, a small vestibule with two sinks, a big red biohazard trash bag, and trays of gowns, goggles, gloves, and shoe covers. Three opened boxes of half-mask, negative-pressure respirators sat on a rolling cart. The respirators filtered down to five microns, about the size of, say, hantavirus. I was glad to see they were sufficiently worried.
This type of arrangement--a small, cordoned section of the hospital--was a holdover from the bad old days of tuberculosis. Not all hospitals had them anymore; most places just isolated the sick in private hospital rooms. But here was a short hallway flanked by four rooms, two on each side, cut off from the rest of the building, dedicated to keeping the infectious and infirm from the rest of us. A good little quarantine area.
Excerpted from Isolation Ward by Joshua Spanogle Copyright © 2006 by Joshua Spanogle. Excerpted by permission of Delacorte Press, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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