Alan E. Nourse - The Bladerunner (15 page)

"You could train more surgeons," Doc said.

"That's no answer. You know how hard it is to recruit new medical students, and it's getting worse every year. Health Control knows that too. We have to find some way that fewer doctors can supervise more work.

It's the only possible solution, and the robot-training program is absolutely essential to it."

"But you can't make robots do research. Health Control's research programs are all going down the tube too. There hasn't been a really major medical breakthrough in the last twenty years. Thousands of incompleted research programs have just stopped dead. That's another thing that's wrong with Health Control's program."

"Well, I can't touch that part," Katie said bitterly. "That's got to be someone else's headache. I've got trouble enough with the robot-training program here at Hospital Number Seven. And the Health Control people have been crowding me. Every week I have a Health Control supervisor down here checking progress, and they're getting very tense; the program isn't moving fast enough. Last week I spent a whole day on the carpet with the Secretary of Health Control himself. He wanted to know why we were six months behind our projected goals, and I couldn't tell him—without landing Dr. John Long in a pile of trouble. As it is, I can't bluff for you much longer. I'm going to have to pinpoint my trouble areas in so many words, and that could mean you'd be facing a full-blown Health Control investigation."

Doc shrugged. "So what can they do? I haven't broken any laws in your program. The worst they could do would be to give me a bad mark on my promotion record."

"John, you just don't know what they could do! With this data they could prove malpractice, criminal negligence, grossly unethical medical practices. They could revoke your license, strip you of all your medical credentials, block you from working in any hospital or clinic anywhere in the country." She hesitated, looking up at him. "And that might not be all. When Health Control decides to go after somebody, they dig in deep. They might not stop with your hospital work, they might look at everything you do—where you spend your time, who

you associate with, where your phone calls come from, what taxi trips you take, everything. If a man should happen to have something to hide, he could find himself in real trouble."

Doc looked up sharply. "Just what do you mean, something to hide?"

Katie spread her hands. "All I know is the rumors I hear," she said. "If nothing else, you're a dissident, and Health Control wants dissidents under control. In particular they want control over the key men, the professional leaders, the top experts in their fields—like you, for instance. If they catch men like that moonlighting, they're inclined to make public examples of them."

"So now I'm moonlighting?"

"I don't know. Are you?"

"If I were I sure wouldn't tell
you
about it."

"I might be the safest person you could tell," Katie said quietly. "I can tell you one thing, though. If you are, you're leaving a trail. And if Health Control wants to pick it up, sooner or later they will. There's no way to cover your tracks completely, they can always find
something."

There was a long silence in the room. After a moment Katie joined Doc at the window. The sky was almost dark now and the city lights, normally dazzling, were muted by a light powdering of snow that had been falling. "You've got a great view here," Doc said softly.

"One of the perquisites of my job," Katie said. "With your wits and skill you could have one too. You could be Chief of Surgery in this place in another few years. And then, if you still hated the system so much, you'd be in a position to get things changed legally, from the top down."

"I don't know," Doc said. "In a few more years there may not be much left to salvage."

"You don't really believe that, John."

"Maybe not—but then maybe I do. The thing that started out a stream has turned into a flood. The Heinz-Lafferty formula could have been modified to be workable, if they'd only taken enough time to approach it slowly. But they didn't, and now it's going more and more wrong every year. Your robot-training program won't save it; that's just a drop in a leaky bucket. And you can't see the flood coming because you're so solidly on the government's side."

"Could you believe that I might also be on your side?" Katie said. "I don't want to fight you. More than anything, I'm afraid for you. There's been too much interest in you and your work here. Health Control has been asking too many questions about you. And there are far too many rumors. I'm afraid you're walking into grave trouble and don't even know you're being watched."

Doc gazed at the woman for a long moment. Then he took a deep breath. "Okay, maybe you
are
on my side. And maybe you're right that I'm walking into trouble without knowing it. I appreciate the warning. But that's nothing compared to the kind of trouble you and your Health Control bosses could be walking into right here in this hospital."

Katie looked up. "What kind of trouble?"

"Perfectly legitimate, necessary medical work that gets out of hand. You're barely able to limp along and handle the patients that you've got coming in here during normal times. What would you do if a real medical disaster struck?"

For a moment a shadow crossed Katie Durham's face. Then she said, "Aren't you maybe borrowing trouble, John?"

"Not exactly. How many cases of meningitis has the hospital admitted in the course of the last week?"

"Far too many, I admit. We've had to convert three whole wards for isolation care. But that's not what you could call a disaster."

"Then why does the computer have a security lid on the meningitis data?"

Katie gave him an odd look. "That's just temporary until we can establish a baseline for analysis. Right now our people are breaking down the data we have, plotting incidence curves, comparing case histories to find common denominators—the works. Until that's finished we try to cut off any extraneous data searches. Look, I won't say we're not worried. This is a new strain of meningitis, we aren't even sure what's causing it, and cases have been increasing sharply. We don't know yet whether it's really an epidemic pattern, or just a chance clustering of cases that we're seeing. But whatever it is, Viricidin seems to stop it if we get treatment started early, and the lab has an immune globulin to protect people who've been exposed. It certainly isn't out of control. In fact, it wouldn't be any strain at all except that it's turning up right on the heels of this Shanghai flu epidemic."

Something clicked in Doc's mind. "My God," he said softly. "Shanghai flu."

"Well, yes. All our outpatient clinics have been loaded down treating that for the last six weeks."

"Treating all the cases that come in, you mean," Doc said. "As for the thousands that didn't come in—" He broke off, pulled a note pad from his pocket and scribbled down a name. "Katie, check something out for me. See if anyone named Hardy was admitted here last night or this morning. An infectious case, isolation ward."

Katie Durham looked at the name, then picked up the telephone and spoke into it for a moment. She waited, impatiently tapping her fingers on the desk. Presently the computer print-out beside the telephone began clicking. She picked up the print-out tape, frowning. "Is that
all
you have on it?" she said into the phone. "Nothing more? And this was at six a.m.? No ... no thanks, that's all I need right now."

She set the phone down very slowly and turned to face Doc. "This Hardy family," she said. "They brought a boy to the hospital, early this morning. But he wasn't admitted. He was dead on arrival."

The fact that he had been half-expecting it all day did not lessen the impact. Doc picked up the computer print-out tape, stared at it for a moment, and shook his head with a sigh. "As fast as that," he said bitterly. "I was afraid of it. What about an autopsy?"

"The father refused permission. Lab did take a throat culture and blood studies, though, and a spinal tap. They supported the history—a viral meningitis. There were traces of Viricidin in his bloodstream, too; he'd been treated by somebody, probably just not soon enough."

"And what about the rest of the family?" Doc asked.

"He was brought in by the father and a younger boy. They were obviously Naturists, and they refused examinations."

Doc winced. "They'll be back," he said, "probably just like the boy. Katie, something's going on here that's very bad, and I don't think you and your Health Control people here are even beginning to grasp it."

"But we know there's a bad infection on the move. We're treating it, and I told you we've got the computers working on the epidemic problems."

"You mean you've started off on a big, sprawling, time-consuming analytic study that's going to take six weeks or more to complete, and I don't think you've
got
six weeks. If what I suspect is true, this hospital and the whole damned city could be buried in bodies in six weeks."

"What do you think is happening?"

Doc sighed. "I'm not sure, but I think you've got to find out in one whale of a rush. Look, I was the one that saw that Hardy boy last night in his home. Never mind what I was doing there, I saw him. He was already mortally ill, the full-blown picture of meningitis, but he'd only had those symptoms for forty-eight hours. Before that he'd been just mildly ill for about two weeks—with the Shanghai flu. Not even a bad case, just a mild sore throat, headache, muscle aches, and those symptoms were all getting better spontaneously. Then whammo! A wildfire meningitis, and he's dead in the course of two days in spite of the treatment I started. Meanwhile, the father and the brother both have had Shanghai flu and have early meningitis symptoms right now, for which they're refusing examination or treatment."

Katie Durham stared at him in confusion. "But John, they're Naturists. It's perfectly consistent that they'd refuse treatment."

"Especially for something mild, right? Like the Shanghai flu. Well, that's exactly the point. Suppose this mild flu isn't just a mild flu. Suppose the virus, once it gets well entrenched, can attack the spine and cause a deadly meningitis. But these people are bypassing early treatment because it just seems like a mild flu. Naturists or whatever, they're trying to 'ride it out,' to use an old Health Control term. And while they ride it out, without knowing there's a bomb waiting to go off later, they're also infecting everybody they come in contact with— and by the time they and the ones they infect decide they can't ride it out any longer, it may be too late to di-fuse the bomb. Oh, your regular clinic patients are all right. The ones that are eligible come in to the clinic for every sniffle, right? When they get the Shanghai flu, in they come and you slap it down with Viricidin and it stops right there. And you've been treating thousands of Shanghai flu cases these past weeks, right?
But what about the ones that aren't eligible?"

Katie sat down at her desk, frowning. "Yes, I'm beginning to see what you mean. You're thinking—"

"I'm thinking that this city is full of people—not just the Naturists, but thousands upon thousands of common, ordinary, everyday people—who are going to try to ride out a mild case of Shanghai flu just the way they'd ride out a common cold, tens of thousands of people like that who can't qualify for Health Control care, people who wouldn't dream of applying for Health Control care for a simple case of flu—considering the eligibility requirements—until it's too late."

"And you're contending that this meningitis could be a late complication of this particular strain of flu."

"Right. And this Shanghai flu epidemic hasn't even begun to crest yet, we haven't begun to see the cases we're going to see when it really gets moving in the population."

Katie shook her head. "But, John, this is all pure guesswork. Sure, there's a flu epidemic moving in, and there's also a nasty viral meningitis that's begun turning up. That doesn't mean the two are related."

"But suppose they were."

"If they were, it could be a disaster. I'm not sure
what
it might mean, but you don't have a shred of evidence."

"That's right, I don't," Doc said. "But maybe you do, in the hospital records, and if the two
are
related, you've got to find it out. You've got to forget this slow, nitpicking computer study you've gotten started and home in on the one critical question you need an answer to right now: how many of your meningitis patients had untreated Shanghai flu to start with, and how many of the flu patients you treated came down with the meningitis anyway. Would that take so long to track down?"