CHAPTER TWENTY-ONE
C
HARLI
RAISED
HER
HEAD
from the crook of her arm and scrubbed at her eyes. She sniffed and wished desperately for a tissue to blow her nose.
“It doesn’t matter. I
know.
” She cut short his protest with a wave of her hand. “I have to deal with it—with Lige, with all of it—sooner rather than later. I have to deal with my mom. But right now?” She turned and dared a look at Neil. “Right now, illegal or not, those poor guys need to be checked on.”
“Well, I’m not letting you go alone. You can use at least some moral support.”
Charli’s heart lifted. He still wanted to be near her, despite her having a crazy shopaholic for a mom and doing Lige’s bidding, not to mention being the Secret Santa.
Of course, she still hadn’t told him about her dad covering up outbreaks and deaths for Lige. Or that she hadn’t told the whole truth about where the money for the clinic had come from.
But for now, she wanted to feel Neil’s strength. “Okay. All right.”
“I speak Spanish. Would that help you out?” he asked.
Part of the weight she’d been carrying moved from her shoulders. It would be a relief not to rely on a game of charades to glean medical history. “Yeah. Yeah, it would. Last night I was relying on Lige to do the translating...and, well, I figure he’s not the most trustworthy translator. I decided I was better off without him.”
Neil rolled his eyes. “Tell me about it.” He turned and headed back for his car. “I’ll follow you.”
About a half mile farther on, the dirt road emptied out into a shantytown of trailers at the edge of the onion field. Charli parked the car and got out, taking in the scene before her.
The newest trailer had to be thirty years old, with cardboard blocking off a broken window. The oldest? It was a remnant of a trailer frame, with blue tarp covering the roof and a stovepipe stuck out the front window. Aluminum foil and towels seemed to be the insulation material of choice to stuff in windows.
An old school bus with its paint peeling and the school system’s name blacked out rested at an angle on two flat tires. Here and there clothes flapped on clotheslines, but for the most part, there was no sign of life.
At least not human. A skinny dog skulked away from Charli’s approach, darting behind the trailers. No grass grew here, only sprigs of frostbitten dog fennel that had sprung up in the narrow spaces between the trailers. The sturdiest, most carefully maintained structure was a hoop greenhouse. Charli could see lush green plants through the translucent plastic and marveled that these people would house their plants better than themselves—or was that Lige’s greenhouse?
The whole settlement resembled something Charli had seen on the disaster relief trip she’d taken to Haiti while she was in med school.
The sound of a car door slamming made her turn around. Neil strode up to where she stood, his mouth drawn in contempt. “Well, this explains why he wants illegals. If he had them on legit work visas, he’d have to provide better housing for them.”
“It’s awful, isn’t it? Do they even have running water?” Visions of typhoid came charging through Charli’s imagination. She’d known migrant workers lived in subpar conditions, but she wouldn’t even call this primitive. She shook her head. “Let’s find Hector and Luis.”
Neil trailed after her as she took off for the nearest trailer. “I take it that was the pair you treated last night?”
Charli just nodded. She didn’t have time to offer color commentary. She was due at the office, and she’d already taken way too much time trying to explain her situation to Neil. She climbed a set of rickety steps and knocked on the trailer’s dented door.
It opened a crack. Suspicious brown eyes stared out at her.
“Hola,”
Charli greeted the person.
“Soy la doctora Prescott.”
The eyes blinked, no less suspicious than they had been thirty seconds previous. But then, somewhere deep in the trailer, came a groan and the all-too-familiar retching sound from the night before.
“Hector?” Charli asked. “Luis?”
The door opened a sliver wider.
“La médica?”
The eyes turned out to belong to a short round woman in a tight pair of jeans and a faded sweatshirt, with worry and fatigue marring her features.
“Sí.”
Charli held up her medical bag.
“La doctora.”
The woman threw open the door and let loose a torrent of Spanish. Helplessly, Charli looked over her shoulder at Neil. “Did you get any of that?” she asked.
Neil said something in Spanish, and the woman spoke more slowly. He turned to Charli. “She says for you to come in, that her teenage daughter is very ill. She says Hector and Luis are a couple of trailers down.”
“Oh, no. Is it the same thing Hector and Luis have? If it’s the gastroenteritis, they all must have eaten some bad food.” Charli crossed the threshold and saw an interior more in keeping with a third-world country than any place in the U.S. Naked plywood had been nailed across what had presumably been a sliding glass door on the backside of the trailer. The linoleum under her feet was buckled and cracked, mended in some places with wide strips of duct tape.
Still, in the corner stood a ragged plastic Christmas tree decorated with tinsel and multicolored lights. A motley collection of irregularly shaped presents waited under the tree.
Charli quelled her dismay at the living conditions she saw and fumbled in her medical bag for latex gloves. She handed a pair to Neil. “Here. Put these on. They’re probably going to be tight because they’re mediums, and you have bigger hands than me, but it’s better than nothing.”
“You think it’s contagious?”
“I’m not sure, but safety first,” she said, snapping the latex gloves into place.
The woman directed them with a finger to a mound of covers on a couch with its stuffing spilling out of soiled upholstery. Again she rattled off a quick burst of Spanish.
“She says the place is cursed. That it’s bad luck. They haven’t been here long, but the girl’s gotten sicker the longer they’ve stayed.”
Charli negotiated her way through the narrow path between the Christmas tree and a chunky coffee table loaded with candles featuring religious scenes on them, lit and burning. She squatted down beside the teenager, who was as round and soft as her mother. The girl’s dark hair was matted, her skin pale and damp despite the chill air in the trailer.
It took a long time to manage an exam, what with Neil having to translate. But at least she could trust his translation. Again, the symptoms were intense stomach distress, nausea, vomiting, diarrhea—severe, bloody diarrhea.
“What is it?” Neil asked.
“I’m thinking
E. coli.
That’s three people who are sick. Ask her if they all ate the same things, maybe a cookout where hamburger was served?”
Neil asked, listened to the woman, then volleyed the mom’s answer back. “No. She doesn’t let her daughter hang out with those guys—the younger one has been making eyes at her girl, and so she keeps her away.”
The woman started again, hands on hips, anger lighting her eyes. Neil listened for a moment before telling Charli, “She says that lots of people are sick here, or have been, all with the same sort of thing. Ten, maybe fifteen. They’ve been here a few days, and they got sick when they first arrived. Some became sick, improved and then got sick again.”
Charli frowned. “It has to be some form of
E. coli.
Probably STEC.”
“STEC? What’s that? It sounds bad.”
“Shiga-toxin producing. Basically, you eat or drink something—or touch something and, say, lick your fingers—that’s contaminated and the bacteria produces toxins that inflame the lining of your intestines. So that’s where the bloody diarrhea comes from.”
“Hope you’ve brought along the economy-size packs of Imodium,” Neil joked.
“Tell them not to use that—some Pepto-Bismol is okay, but anything else can prolong the illness.”
“Prolong it! The girl’s been sick for nearly a week. She can’t go without something to—”
Charli shook her head. “It’s
very
important that they stick with something like Pepto and not Imodium—the body needs to be able to clear the infection. Usually this is self-limiting. There’s not a lot we can do besides push fluids and watch for complications.”
The mother interrupted again with what sounded like a question. Neil started in on Charli’s answer.
“She keeps saying the place is cursed,” he told Charli after he’d finished relaying her instructions to the mom.
“It must feel like it.” Charli straightened up. “Let’s go find Hector and Luis...and while I’m here, I might as well look in on some of the sicker ones. Maybe I can figure out the common denominator.”
From trailer to trailer, they worked in tandem. Charli saw the same thing over and over, in varying degrees of severity. Squalid living conditions, horrible stomach ailments. Lige had lied about the scope of the problem—no surprise there, but she was still shocked. By the fifth trailer, Neil had lost any urge to joke.
“This is awful,” he said when they were finished. “Something is making them sick.”
They stood outside, after having stripped off yet another pair of gloves, breathing in fresh clean air. Charli squirted a generous dollop of hand sanitizer into Neil’s cupped palms. “I wouldn’t touch your face,” she advised, “even with this stuff and the gloves.”
“I’ll probably burn these clothes,” he said, a small amount of his humor restored for a moment. “What’s causing this?”
Charli shook her head. She rubbed the alcohol-based cleanser into her skin. The winter air chilled her wet hands. “I don’t know. They were all pretty adamant that they’d not eaten any of the same food.”
“Could somebody have brought it in? The bacteria, I mean?”
“Sure. Sometimes you don’t even present with symptoms, but you can still be a carrier.” She moved her shoulders to relieve the ache between them and yawned. If she stood still, with the hovel behind her, all she could see was a peaceful countryside. Across a fence, cows drank from a placid watering hole and munched contentedly on winter ryegrass that was an improbable shade of green in a landscape of dun brown.
To be a cow, with nothing to do but stuff your face and loll around all day. No patients to see. No compulsive-shopper mother. No father who died and left you with a hundred thousand problems.
Beside her, Neil stood quietly at first. “Fifteen. That’s a lot. Especially with no common thread,” he said. “You have to call DPH.”
She jerked around to face him. “What?” Call the Department of Public Health? On illegal workers Lige wanted to keep under wraps? That would be
just
what Lige had in mind.
“Yeah. I mean, this could be serious,” Neil told her. “I covered an
E. coli
outbreak from a fast-food restaurant in Macon when I was a reporter for the
Telegraph,
and DPH was all over it.”
Charli’s palms went sweaty, despite the cold. “That’s a little different situation, Neil. That’s a threat to the entire population. This—this is self-contained. And besides, I don’t know yet that it is
E. coli.
It could be viral.”
“But aren’t you supposed to? Report it? An outbreak? And isn’t this an outbreak? With this many cases?”
She closed her eyes, worked her jaw. Yes. Any cluster of cases needed to be reported to health authorities at once. She couldn’t believe she was rationalizing reasons not to do so in this case.
Unable to look him in the eye when she said it, she faced the cows again. One big guy, the color of the rust that was covering almost every piece of metal here, was almost shoulder deep in the water. Apparently, he didn’t mind an ice bath.
Yes. Yes. She should call DPH. It was the right thing to do. These people were sick, and it was complicated, and the easiest solution was to turn it all over to the state and let it be their problem.
Easy if she wanted to get fired and likely never work in medicine again. Easy if she wanted her mother to have a nervous breakdown.
Maybe she could manage this. After all, what could DPH actually do? She could take care of those who were sick—push the fluids, keep them quarantined. These folks didn’t tend to mix with the general population, so it was doable.
It’s not like it’s TB.
She exhaled a shaky breath. How to convince Neil? “Neil...it’s... It—it would just go down in some database of statistics. Fodder for boring PowerPoint presentations. It’s not like they’re going to actually come out here and be able to do anything I haven’t already done,” she replied at last.
“You’re afraid of Lige, aren’t you?” Neil stepped in between her and the pasture. “Charli, you can’t let him blackmail you. You could lose your license.”
“It’s a technicality,” she insisted. “Not everything gets reported right away. I’m doing the care. And if it gets worse...” She hefted her medical bag’s strap on her shoulder.
“Worse? Do you hear what you’re saying? Charli!” Neil waved his cast-covered arm toward the trailers behind her. “These people are sick! They’re depending on you—”
“They’re
depending
on me not getting them deported, too,” she said. “I’m doing exactly what the community clinic would do—treat now, and ask questions later. You think well enough of
them,
so why don’t you cut me some slack?” Charli stalked toward her car.
“I can’t believe you’re doing this. I mean, I know it will be tough for your mom—”
She whirled around. “Look, buddy. You have no idea what tough is. Don’t make me out to be a villain for thinking of my mom first, especially when she’s in such a fragile state. I think I know what’s best for my family.”
“And for them?” Neil jabbed a thumb toward the settlement. “What about them, Charli? Are you thinking about what’s best for
their
families?”
For a long moment, she stared at him, her mouth agape, speechless with fury. “Are you kidding me? Do you
seriously
—” She let out a shuddering breath and glared at him. “I am thinking of their families. I came here, first, with barely an hour of sleep, without calling my mom, without checking on her. I just made a two-hour house call, gratis. While I have paying patients waiting, in my office, getting madder by the minute. I handed out supplies and advice and samples to those folks back there.
And
I took stool samples.
And
I’ll send those samples and pay for them myself, though God knows where I’ll get the money to pay for it. So yeah, I
am
thinking about them. I’m a doctor, Neil. I think I know what I’m doing, thank you very much.”