Of Flesh and Blood (10 page)

“Good to see you, too, Normie.”

Chow pointed to the building behind him and then tapped his own chest with two thumbs. “Sadly, Bill, you’re staring at the prettiest thing you’re going to see once we get inside this joint.”

William’s mood clouded. “The infection has spread, I take it.”

“You take it right, amigo. We had to close two medical short-stay units this morning because of three new infections. This
C. diff
is becoming one major pain in the butt.. . .” He patted his backside. “Specifically, for this cute Asian derriere.”

William had already heard about the closures. “Is there something else, Normie? You made it sound urgent in your message.”

Chow nodded, suddenly grave. “The superbug has hit the dialysis unit.”

William’s stomach knotted. In the past week, the antibiotic-resistant bacteria, or superbug,
Clostridium difficile
—known more commonly as
C. diff
—had spread rapidly through the Tower. William had always thought of
C. diff
, and its characteristic severe diarrhea and flulike symptoms, as a relatively benign infection. Up until recent years, simple outpatient antibiotics fought off all
C. diff
infections. But the Alfredson’s new superbug strain had developed multiresistance to antibiotics, and doctors were running out of treatment options. From his years working as a nephrologist, William realized that the consequences of the superbug reaching the kidney-failure patients—all of whom were already immunocompromised to one degree or another—would be grave.

“How many patients?” William asked.

“Only three so far.”

The small number brought little relief. Once the microorganism established a toehold at a site, it inevitably spread. Though William had not practiced clinically in over twenty years, as a kidney specialist the dialysis unit was near to his heart. He hated the idea of it being overrun by rogue bacteria.
Moreover, he worried over the health of one specific patient—a reclusive VIP who almost no one even knew had been admitted to the hospital.

“I want to see the renal floor,” William announced.

“Yeah, I figured as much.” Chow sighed exaggeratedly and turned for the door.

They rode the elevator to the Tower’s third floor. The doors opened to a sight that chilled William. It looked like a scene from some postapocalyptic sci-fi movie. The staff all wore full head-to-toe body precautions, including gowns, gloves, face masks, hoods, and booties. A large sign posted above the closed double doors to the renal dialysis unit stated that no visitors were allowed on the floor.

A gowned and masked security guard hurried over to them. He glanced at their hospital identification badges and then said, “I’m afraid, Doctors, everyone has to wear protective gear on this floor.”

Chow flashed the guard a thumbs-up and then turned to William. “My orders, Bill. Normie’s done being Mr. Nice Guy. We’re not screwing around with this superbug no more.”

Chow led William into the makeshift changing room that was formerly a patient lounge. A bank of portable lockers had been installed along one side of the room. Piles of clean gowns overflowed from a large hamper while boxes of booties, gloves, and masks rested along the windowsills.

They changed into the full protective garb and then headed out to the ward. A tall African-American woman waited for them outside the door. William recognized the reedy woman behind the mask and cap as Dr. Roselle Garland, a world authority on kidney disease and head of the Alfredson’s renal program. Her usually calm gray eyes shone with uncharacteristic alarm.

“What’s going on, Roselle?” William asked.

“You’ve heard about our three cases of
C. diff?
” Garland said.

He nodded. “What’s their status?”

“Two of them are very ill. One is verging on critical.” Garland paused. “William . . . it’s Annelise Nygaard.”

William’s heart leapt into his throat. “Oh, no.”

Chow viewed Garland with a grimace. “Who the heck is Annelise Nygaard?”

She turned to William and searched his eyes for permission.

“That’s not her real name,” William said.

“Figures.” Chow shrugged. “Sounds more like one of the characters from those romance novels that the wife is addicted to.”

William glanced around to ensure no one was within earshot, and then said in a low voice, “Normie, Annelise is the alias Princess Catherina goes by.”

“Princess Catherina?” Chow did a double take. “Holy crap! That Swedish royal who used to party naked with the rappers and rock stars?”

“She’s Danish.” William viewed Chow sternly. “Normie, only a handful of people know the princess is here. And she is desperate to keep it that way.”

William remembered the news coverage. In the early 1990s, when still in her late teens, the young Danish princess had gone through a rebellious phase when she partied with famous musicians and movie stars and was rumored to be sexually involved with several of them. Because of her striking good looks and royal title, she quickly became the target of gossip columnists and the paparazzi. Thirty-five now, Catherina had since dropped out of the limelight. But a notorious photograph from the time—picturing her dancing topless on the deck of a yacht outside Nice with a rapper (who was gunned down in a drive-by shooting two weeks later)—had immortalized her reputation as the Party Princess.

Catherina had since tried to maintain a low profile. After her childhood-onset diabetes destroyed her kidneys and almost claimed her eyesight, she had become a recluse. That only fueled the paparazzi’s interest. And the more they hounded her, the more obsessed the princess had become with her privacy. She had not been seen in public in nearly ten years but the rumors still swirled, placing her anywhere from dead and buried in an unmarked grave in Wales to living in the commune of a South American cult.

Catherina had first come to the Alfredson for treatment of her damaged eyes. Several years later, after her immune system rejected her first kidney transplant, she had chosen to return to the Alfredson for a combined kidney and pancreas (islet cell) transplant. But, like many celebrities before her, the princess had registered under an alias. Only William and a few of Catherina’s doctors, like Roselle Garland, knew the woman’s true identity.

“I want to see her,” William said.

Garland nodded and headed toward another set of closed double doors that normally would have been kept shut only during fire alarms. William and Normie followed Garland onto the renal ward, stopping at the last
private room at the far end of the main hallway. She rapped on the door with a gloved hand.

The door opened a crack. A petite middle-aged woman slid out through the small opening and then quickly shut the door behind her. Despite the woman’s mask, William recognized Jutta Lind as the princess’s executive assistant. On their previous encounters, the unsmiling Lind had always struck William as being as officious as she was blindly loyal to her princess.

“Ms. Lind, may I introduce Dr. Chow, our hospital’s chief of infection control,” he said.

She nodded, but eyed him with suspicion. “Dr. Chow,” she said coolly.

“Dr. Chow is aware of the . . . situation,” William said, which only deepened the woman’s frown lines. “We would like to speak to the patient.”

“She is exhausted, Dr. McGrath,” Lind said without budging from the door.

“It’s important, Ms. Lind.”

Lind viewed them for another long moment before she slid her hand behind her back and opened the door. She stepped inside and held the door partly open for them. The three doctors filed into the room. William had barely passed through when he heard the whoosh of the door closing behind him.

The blackout curtains were drawn tight and the room was illuminated by only one fluorescent light above the bed where Princess Catherina lay propped up with a blanket drawn up to just below her neck. Despite the room’s dimness, she wore chunky opaque sunglasses that covered a third of her face but did not hide her drawn cheeks or bony jaw. Even in the weak light, her complexion was ghostly pale and starkly contrasted with her short jet-black hair. William saw little likeness between the prematurely aged and emaciated woman in front of him and the lovely vibrant princess he remembered from the magazine and TV images.

Catherina’s head moved slightly in his direction. Through her dark lenses, William could not tell if she was looking at him, or even if her eyes were open. As he neared the bed, he heard her heavy breathing and saw that her translucent lips were cracked and fissured. Up close, her skin was tinged with a worrisome greenish hue.

William bowed his head slightly. “How are you feeling, Your Highness?”

Catherina’s head bobbed slightly. “I have been better, thank you, Dr. McGrath.” Her raspy voice was much weaker than last time they had spoken.

William introduced the princess to Chow. In an exaggerated attempt at etiquette, Normie bowed forward at the waist. “Your Majesty.”

“ ‘Your Highness,’ ” Lind corrected with a note of sharpness.

“I prefer simply Annelise,” Catherina croaked. She covered her mouth with a slender hand and her shoulders bucked in a gagging gesture. After a moment, she pulled her hand from her lips. Breathing even heavier, she gasped, “Jutta, my basin, please!”

Her assistant rushed to offer the princess a bean-shaped bowl. Catherina rested it on her chest as though she had trouble holding the weight of the empty plastic container.

Garland stepped closer to the princess. “Annelise, because of your . . .” The nephrologist searched for the right term. “Gastrointestinal symptoms, your blood sugars are very volatile and your electrolytes are even more brittle. We need to perform more frequent dialysis. Daily.”

The princess’s shoulders heaved again as she brought the basin closer to her lips. After the spell passed, she reached up and pulled off her sunglasses. Her eyes were deeply sunken in their sockets, and the skin tented and crinkled around them. But her large pale blue irises were as captivating as ever. William now saw the resemblance to the Party Princess.

Catherina looked from Garland to William. “Am I too . . . unwell to proceed with the transplant operation?”

Garland nodded. “Until you’ve recovered from the infection. Yes.”

For a moment, the princess viewed them with unconcealed anguish, but then she hurriedly fumbled to put her sunglasses back on. “I see,” she breathed.

“Your Highness—Annelise,” William said. “On behalf of the entire staff of the Alfredson, I wanted to tell you how very sorry we are—”

Catherina raised a shaky hand to interrupt. “Pardon me, Dr. McGrath, but I just need a few moments alone,” she rasped as she clutched the basin nearer to her chin.

“Of course.” William recognized that Catherina was embarrassed by her display of nausea.

“Thank you.” The princess tried a smile but her lips pursed and she gulped back a gag, before jerking her head away from them.

The others headed to the door, but Lind stopped them from leaving. “Doctors,” she said in a conspiratorial whisper. “I know you are aware of the importance of the princess’s privacy to her. It is absolutely paramount.
We
hope that we can rely on you to protect her identity from any prying eyes or ears. No one can know the . . . condition Princess Catherina is in.”

You have no idea how important it is for the Alfredson, as well
, William thought, but before he could reply a low mournful groan came from the direction of the princess. It was followed by a series of sickening retching noises and then the splashing sound of vomit hitting the floor.

A moment of silence was broken by the crash of the bowl hitting the floor and then Catherina’s plaintive cry. “
Jutta!
”

Driving through the breaking dawn light, edgy and brittle with exhaustion, Jill Laidlaw fought off a twinge of guilt for having left Tyler alone and demoralized on his birthday. It soon turned to irritation. Her husband was bringing work home too often recently. It was sad about the kid, but Tyler didn’t have a monopoly on heartbreak. As a specialist in neurodegenerative disorders, Jill faced her own share of tragic cases. But she trusted that, rather than pity, what patients needed from their doctors was the best medical care possible. She had learned early in her career that too much emotional attachment only clouded a physician’s clinical judgment, which never benefited the patient.

Jill realized that their careers were now driving a wedge between them, whereas before their professional ambitions had once deepened their bond—each of them the cheerleader for the other. If work kept them apart for stretches, they used to compensate with romantic weekend getaways, often spent almost entirely in bed. Lately, the passion and the laughter had petered out. The move back to the Alfredson, which Tyler had resisted at every step, had strained their relationship. And their repeated and futile attempts at pregnancy had worn them down. No matter how hard Jill tried to bury her mixed feelings about motherhood, she suspected Tyler must have known. Though he was too decent to ever raise the subject, she wondered if he blamed her ambivalence, at least in part, for their failure to conceive.

At times, she ached for their previous intimacy. Some nights, she would wake with a start and pat the bed beside her to ensure Tyler was still there. Lately Jill could not escape the sense that she would rise one morning to find him gone. The irrational insecurity was so unlike her that it embarrassed her. But she sensed he was slipping away, and hated the thought of losing
him. Despite their current troubles, she still loved him more fully than she would have once thought possible.

Jill’s thoughts drifted back to her looming career crisis. Her current research grants supported her lab with its staff of more than twenty, including several postdoctoral students who were full of promise. But like all academic physicians, Jill had to apply to renew those grants every three to five years. She had never felt more vulnerable. The federal government, her major sponsor, provided the lifeblood for her potentially groundbreaking multiple sclerosis study. But with the federal deficit soaring, funding was being cut at every level. The competition for grants was fiercer than ever, and the chance of rejection higher. Jill knew there were no guarantees, especially since she did not have enough data to publish yet.