Tampered (5 page)

They wrapped up their inspection with a look at the hot-water tank and a careful assessment of the staff toilet, then returned to the front lobby and asked the receptionist to locate the manager, Gloria Oliveira.

The woman at the desk looked no more confident at her station than she had forty-five minutes earlier. She picked up the phone as though it were a hand grenade, then mumbled something into it. “Mrs. Gloria say she down in a few minutes.” The woman hesitated and stared at the closed-to-visitors sign beside her desk. Clearly, she had no idea what to do with visitors when none were allowed. She studied her fingernails, as if drawing inspiration from them, then pointed to a pair of wingback chairs in front of a coffee table in the common room. “Please, sit. Like a coffee?”

Zol stifled a shudder and turned to Natasha. There was no mistaking the look on her face. He shook his head for both of them. “Thank you. No.”

They settled in the chairs, not for comfort but for the chance to talk out of earshot of the reception desk.

“Gloria Oliveira's got some cheek,” Zol said, “keeping us sitting on our hands down here. Doesn't she know her licence is on the line?” He'd expected the manager to storm into the kitchen as soon as they arrived. He'd braced for her bravado and solemn assertions that
we take food safety extremely seriously here at Camelot Lodge
. What was she doing all this time?

Natasha tapped her checklist with her slender forefinger. “Nick isn't among her greatest fans, but he does run a tight kitchen.” Natasha's parade of brightly coloured shoes had been the talk of the office ever since her arrival, fresh with her Master's. It seemed her latest indulgence was her fingernails. Today they were varnished the deep red, near purple, of a rich Shiraz. “A couple of minor deviations,” she continued, “but no violations.”

“I'm worried about the soup. We'll see what the lab has to tell us about it.” He pointed to Natasha's case. “How many samples did you get in total?”

“About a dozen. The usual suspects — the ketchup bottle, mayonnaise jar, some slimy lettuce and broccoli from the crisper, a big thing of gravy from the back of the fridge, the drains from the three sinks.”

“Unless things have changed since your last inspection, none of those cultures are going to show any pathogens.”

“Won't even show any mould. We've been through every crumb in that kitchen before. Ever since their first gastro cases.” She thumbed through her sheets, found what she was looking for, then added, “This whole thing started with four gastros on January eleventh. Total number reported now stands at thirty-one.” She pulled at the curls beside her ear. “And five deaths.”

Only three people had died at Camelot in the previous calendar year. It was a wonder the papers hadn't got hold of the story and done the math. They were bound to soon and shout from the headlines:
Cozy Camelot Turns Death Trap
.

“How many active cases at the moment?” he asked.

“It changes every day. But among the independent seniors on the Belvedere Wing, we know about four.” She looked skeptically at her notepad.

Zol shared her skepticism. Unreported cases of flu, gastro, and other contagious infections were the bugbears of public health. Getting to the bottom of outbreaks in residential institutions — bringing epidemics under control by isolating their cases and pinpointing their sources — was close to impossible if many of the cases were not reported to the health unit. Even the most conscientious managers fudged the numbers. There was strong incentive for under-reporting: if cases weren't reported to the authorities, the outbreak didn't seem so bad, there was little for families to get upset about, life could go on as usual, and the problem might go away on its own.

“Did you notice that rash on Nick's arm?” Zol asked.

“That tattoo was gross.”

“Dermatitis of some sort. And infected, by the look of it.” He pulled two loonies from his pocket and juggled them. “You know, this could be toxigenic food poisoning — staph aureus from Nick's rash contaminating everything in that kitchen.”

“He let me take a culture of his rash. But I don't think our problem is staphylococcus aureus. It never showed up in our previous samples. And doesn't staph food poisoning start with violent vomiting?”

“Hurling your guts out is the dominant feature. That hasn't been the pattern here, eh?”

“Abdominal cramps, diarrhea, and fever.”

“Staph food poisoning doesn't cause fever,” Zol said. “But we'll check it out.” If the swab from Nick's arm did grow staph aureus, he'd have to ban the chef from the kitchen until the infection was controlled. “Until the results come back, he'll have to keep that arm covered.”

Two minutes later Gloria Oliveira shuffled toward the side exit behind two men in black suits pushing a stretcher. A heavy sheet covered the unmistakable shape of a corpse. Zol watched Gloria's shoulders heave as she patted the body and watched it disappear into a waiting black van. Camelot's sixth death since January.

Dark circles ringed the woman's bloodshot eyes as she approached. She wiped the tears from her face, let out a few shuddering breaths, then smoothed her blouse. Zol's impatience melted at the sight of her distress.

“My mother,” she said, blowing her nose. She turned and stared at the side exit.

“Your mother?” said Natasha, her eyes wide in disbelief. “Oh my goodness. How awful for you.”

“I am
so
sorry,” said Zol. “Here, you better have a seat.”

Gloria sat down and the three of them stared at the carpet in awkward silence.

“She refuse to go back to hospital,” Gloria said, finally. “Said she rather die.”

“Was she ill for a long time?” asked Zol. It would be easier if the woman's death was one of those blessings, a release from a drawn-out, painful affliction.

“No. Until Christmas, she was perfect. Just a little arthritis and only seventy-six years old. Then, sick three times in one month. And two days ago, sick again. Refuse any doctor see her. Headache last night. High fever this morning. And then . . .” She covered her face.

Zol hated to rub salt into the woman's grief, but he had to ask. “Did your mother have diarrhea?”

Too choked up to speak, the poor woman just nodded.

Zol knew that Gloria had sponsored her widowed mother's emigration from Portugal a few years back. Raimunda Ferreira lived with Gus and Gloria in the manager's apartment. Zol had often seen her dusting the windows, even vacuuming the carpets. Natasha reminded him that Hamish Wakefield had looked after her at Caledonian University Medical Centre in February. She hadn't had gastro, but septic shock caused by listeria monocytogenes.

Zol thought back to a year ago when listeria had turned the country upside down. Two dozen seniors, mostly around Toronto, died after eating deli meats contaminated with listeria monocytogenes bacteria. The source turned out to be cold cuts prepared by a prestigious Canadian meat packer. Under the media spotlight, the provincial Ministry of Health and the federal Food Inspection Agency forced the company into acting swiftly. But it took weeks, and a growing string of deaths, to discover that the listeria was lurking deep inside the factory's meat-slicing machines. No one could promise that such contamination wouldn't happen again; it seemed that listeria in deli meat was almost an essential ingredient, like table salt and nitrites. Warnings went out that anyone with a compromised immune system — especially seniors and cancer patients — should never consume ready-to-eat deli meats. But the damn bug was ubiquitous and impossible to avoid completely.

Gloria fixed Zol with her gaze. “Doctor — you must tell me where it comes from, my mother's infection. This fever. The doctors treat her and she get it again.”

With Gloria following ministry guidelines about never serving deli meats, had her mother made clandestine trips for salami subs at a franchise sandwich shop? It looked like her final illness was either epidemic gastro that spun out of control, or a relapse of the listeria that had landed her in intensive care back in February. He'd ask the coroner to perform a post-mortem blood culture. If listeria had invaded her bloodstream again, it would show up there. It would be hopeless to ask for a full autopsy. Families never wanted them, and old people's deaths were never deemed suspicious without undeniable evidence such as neck bruises or gunshot wounds.

A few moments later they followed Gloria up the stairs and stood in silence while she unlocked the door to the Mountain Wing.

The place looked orderly enough, but the stench was horrendous. The air, thick with the smell of flatus and feces, hit Zol like a punch in the gut. The smell evoked a loathing he knew was bordering on pathological. One of the final torpedoes that sank his doomed marriage to the ever-flaky Francine had been her complete lack of sense of smell. Day after day he'd come home from work to the smell of Max's dirty diapers rotting in a pail, the house filled with that unbearable stench. And here it was again. He watched Natasha wince at the moaning coming from a room down the hall. The sound was almost as noxious as the smell. The cries told of loneliness and terror, unanswered except by tearful echoes from across the hall. Where were the staff?

A compact woman, no more than five feet tall, slipped out of a room. Her pastel top and matching pants had lost all semblance of crispness, and her sweaty brow was framed by strands of straight black hair escaping from barrettes askew on her head.

Gloria pocketed her Kleenex and straightened her shoulders. “Amelia,” she called as the nurse dashed toward another room. “Dr. Szabo is here from health department. I want you to show him around.” Gloria caught Zol's eye and continued, “Show him what a good job you girls do with isolation and hand washing.” She flicked her gaze to the bottle of hand sanitizer on the wall.

The nurse turned and quickly pumped a measure into her palm.

Zol smiled at the diminutive woman staring at her shoes, clearly tired and apprehensive, yet rubbing her hands extra vigorously. He turned to Gloria and asked, “How many nurses do you have on this ward?”

“Staff of ten.”

Zol looked up and down the hallway. This was a small ward with a pair of two-bed rooms on either side of the corridor, a nursing station at the far end, an alcove packed with supplies, a tub room, a staff toilet, and a couple of utility rooms. Where was the bustle? A staff of ten should make a lot more commotion than was evident here.

Natasha's eyes swept the bleak cinderblock landscape. “And how many are on duty at the moment?”

Gloria bit her lip. “Two. Amelia is the RN and we have Cora, fully qualified PSW.”

Just one nurse and a personal support worker to feed and bathe and medicate and clean up after eight incontinent, elderly patients with the runs? It was absurd. And impossible.

The Mountain Wing was officially a nursing home that fell under a litany of regulations from the province's Ministry of Health and Long-Term Care. In contrast, the Belvedere Wing was officially a retirement residence; governments left those places alone, unregulated. It looked like Gloria Oliveira was playing loose with ministry staffing standards in the Mountain Wing.

“How many patients do you have here?” Zol asked.

“The ward holds eight,” she said.

“And the beds are full?”

“One is free.”

Natasha opened her briefcase and pulled out her pen and notepad. “And how many have diarrhea?”

Gloria looked to Amelia for the answer. “Three,” Amelia whispered.

“We don't have reports of any of them,” said Natasha. “Only the four in the Belvedere Wing.”

Gloria bristled. “They just started this morning.”

Zol studied the hallway again. There were no isolation carts outside any of the rooms. No easy access to gowns and gloves for the beleaguered staff rushing from patient to patient. No wonder gastro was flying through the Lodge. If he didn't get this place sorted out in the next few days, Peter Trinnock would see him dispatched to North Overshoe, if only to satisfy the Prime Minister.

“Where are the isolation carts?” he asked.

Gloria pointed to a doorway down the hall. “In the utility room.”

“You need to put them outside every door,” said Zol.

Gloria looked surprised at such a revelation. “We got only one cart.”

“Ideally,” said Natasha, “you should have four. One for each room.”

“But this is small ward. Where we put three carts?”

“You could place the cart in the hallway where it's easy to access,” said Natasha. “And make sure the staff always wear gloves when in contact with patients and their . . .” She paused, searching for a discreet way to phrase it. “Secretions.”

Gloria frowned and crossed her arms. Zol sensed her tallying the cost of purchasing hundreds of vinyl gloves and laundering scores of isolation gowns. Infection control didn't come cheap, but this was a virulent strain. One that may have cost her own mother her life.

When Art Greenwood asked Gloria to unlock the Heintzman's keyboard on Wednesday morning, he could almost feel the scowl in her response. In yet another of her edicts, she replied that a singalong was not appropriate, considering the ongoing
situation
. She was allowing the residents to use the common room this morning, but that was as far as she was willing to go. Eventually, he persuaded her that closing Camelot to visitors didn't mean the residents couldn't enjoy the piano; for heaven's sake, singing didn't spread disease. Of course, she knew damn well that the natives were getting restless and needed a boost in morale. None of them had ever seen such heavy body-bag traffic.

While shaving this morning he'd heard a piece on the radio, a song featuring Josh somebody-or-other. It was the sort of thing that Betty, Phyllis, and the other girls would love — soft and dreamy. Eager to keep the tune in his head so he could pick out the chording, he wrote down the first line of the lyric in his green notebook. Over the years, he'd nearly filled the book with first lines, organized by category. Show tunes, jazz standards, songs from the war, old favourites, and a few hymns and spirituals. All he had to do was read the words of the first line, and the entire melody would pop into his head. After that, his hands knew what to do. And as long as he took his Xanucox arthritis capsules twice a day as prescribed by Dr. Jamieson, the old fingers stayed limber enough.

He was fingering the melody of the new piece with his right hand when the sharp clatter of Phyllis Wedderspoon's footsteps announced her entry through the Lodge's front door. The keys to her Lincoln jingled in her hand as she stomped on the mat.

“Back already?” he called as she approached.

“The library is never busy on a Wednesday morning. The staff are just twiddling their thumbs until the onslaught of toddlers at one o'clock.” She loosened her scarf and held up two books. “I found what I wanted:
The Secret Life of Goya
, and . . .” She shuffled the books and peered at the covers. “And . . . oh yes.
Understanding Dali.
”

Art chuckled. “I didn't know that was possible.”

She paused, her face frozen in a rare look of puzzlement. Then her frown dissolved and she replied, “Oh, you mean Dali. Yes, quite. Our professor says to appreciate the paintings is to understand the artists behind them.” The course in art history she was taking at Caledonian University was her latest preoccupation. Before that it had been conversational Spanish — or was it Italian? And before that, something about architecture. Phyllis did love her courses. And her daily trot inside Lime Ridge Mall, which she called her thirty minutes to strong bones and a sound mind. She told anyone who would listen about her three keys to aging well: academic classes to stretch the mind, regular exercise to tone the body, and friendships with younger folk to broaden the horizons. Of course, when you were eighty-three, ninety-nine percent of the planet's inhabitants qualified as younger folk.

Art pointed to the hand sanitizer on the piano, a reminder of the
new normal
at Camelot Lodge. “Now Phyllis, I didn't see you pump on the way in.”

“I know,” she puffed. She dropped her keys into her handbag and set her books on a side table. “There,” she said as she pumped two dollops of sticky liquid into her palm. “Are you satisfied?”

“It's not me who has to be satisfied. They'll take away our in-and-out privileges if any more of us come down with the runs.”

Art didn't mind the lack of visitors. In fact, it made for a welcome change of pace at the Lodge. He would hate, however, to give up their weekly trips to Tim Hortons. It was a struggle to transfer on his gammy legs from his scooter into the backseat of Phyllis's Lincoln, but it was worth it. When four or five of them sat parked in her vehicle, sipping coffees and munching fresh doughnuts from the drive-through, he felt like a youth again. It was sure nice to bite into a soft, warm doughnut that bore no relation to the biblical relics served at the Lodge.

He turned to the piano and started chording with his left hand and refining the melody with his right. Not bad, he decided. Betty would like this. A few minutes later he resolved the final chord, laid his hands in his lap, and was surprised by the clapping behind him. He turned to see an audience of four: Betty and Phyllis together on a loveseat, Maude and Myrtle seated at the card table, hunched over their jigsaw puzzle.

“That was lovely,” said Betty. Her voice didn't sound right. It was weak and trembling.

He backed his scooter away from the piano and rolled to Betty's side. “You don't look too well, my dear,” he said, taking her hand. “Something wrong?”

Betty looked down at their hands in her lap. “It's nothing,” she whispered. “I'll be fine.”

“That's not what Dr. Jamieson said,” Phyllis corrected. “He's putting her on an antibiotic.”

Art couldn't suppress the alarm he knew was lighting up his face. “Not another bout of —”

Betty shook her head. “Don't worry. No fever. And no upset tummy. Just . . . You know, bladder problems. A few days of antibiotics and I'll be fine.” Her face brightened and she pointed to the front door. “Look. My prescription must be arriving this very moment. There's Vik.”

Art watched Viktor Horvat, the owner of Steeltown Apothecary, standing beside the reception desk and rubbing sanitizer onto his hands. Vik arrived once a week with a cartful of medications arranged in those easy-open blister pack things that kept you from forgetting which pills to take at what time. He and the ever-canny Gloria had some sort of exclusive arrangement to provide the prescriptions for everyone at Camelot. Vik was a broad-shouldered fellow with a large Slavic head. He never wore a hat, and Art reckoned that was probably because he couldn't find one to fit. When Vik first started coming to the Lodge three years ago, shortly after Art moved in, he'd been jovial and charming, the steel cap on his front tooth flashing disarmingly when he smiled. Art hadn't seen a smile on that face for months, and the steel-capped tooth now seemed like a crudely fashioned weapon lurking behind his lips.

“He's starting to put weight back on,” said Phyllis. “Lord knows, he needed to.” Vik had spent a few days in intensive care at Caledonian University Medical Centre at Christmastime. He'd had some sort of dangerous infection. But he'd stopped smiling long before taking sick.

“He's been through a lot, poor fellow,” said Betty.

“His English is atrocious,” Phyllis said. “It's a wonder he can read the names of your medicines with any sort of accuracy.”

Phyllis was proud of the fact she didn't need prescription medications and took only a baby aspirin once a day, which she purchased at Wal-Mart whenever she noticed the price was discounted.

“He deserves our compassion,” Betty said. “Imagine losing almost your entire family to a hit-and-run driver and then starting your life over in a new country.”

“It's all very well for us to take in these Balkan refugees, but it's another matter entirely to let them work at exacting jobs where . . .”

Art had become adept at tuning Phyllis out when she got going on her soap box. Betty was right. Vik did deserve compassion. From the recent stories on the front page of the
Hamilton Spectator
, it was clear he'd been having a year filled with misery and irony. His son — the only survivor of the car crash that had killed Vik's wife and daughters back in Yugoslavia — had been locked up for months in a Mexican prison, awaiting trial on drug charges. According to the
Spectator
, the young man claimed he was innocent, caught in the wrong place at the wrong time. But the news stories left one wondering what a young fellow was doing in Juarez, a city known more for drug deals than the tourist trade. No one at Camelot, not even Phyllis, had dared ask Vik for clarification.

No matter where the truth lay, Vik hadn't been himself for a long time. Art hoped that hadn't translated into any cock-ups with their medications. Except for Phyllis, almost everyone at Camelot took close to two dozen tablets a day, in a dizzying array of shapes, colours, and sizes. It was impossible to keep track of them all, especially when your eyesight wasn't what it used to be.

Art glanced around the room at his fellow residents, dozing and reading and chatting, trusting that people like Gus, Gloria, and Vik were taking care of them. He did his best to wave away a terrible thought by thumbing his notebook in search of a morale-rousing tune. But the thought kept coming back to him: if Vik, distracted by his son's tribulations, put the wrong pills into their easy-open blister packs, they'd never know it.