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ARCHIVING: Only with the permission of the author.
Logistics
By Della Street
November 3, 2005
"Vancomycin?" Natalie peered at the label on a bottle of clear liquid. "I said Rifampicin."
The coordinator shrugged. "I called it in; they said this was indicated."
"You called it in?" she repeated, confused. "What was there to call in? I said Rifampicin. Rifampicin."
"They said Rifampicin isn't first-tier approved for Staph," he replied.
Natalie gaped at him. "Vancomycin-resistant Staphylococcus aureus, Carl," she said. "Take a wild guess what vancomycin-resistant means."
"You don't know that it's resistant," Carl said. "You just think it will be. Rifampicin is ten times the cost."
Natalie closed her eyes, struggling not to blurt out something that she would regret later. After a moment, she said, as calmly as she could, "Okay. We need to shut down this outbreak, right?" She waved a hand toward the isolation rooms. "These patients all have diabetes. Vancomycin doesn't work with diabetics a majority of the time. We know that Rifampicin will."
With a shrug, he said, "HQ says we try Vancomycin first, pending confirmation of resistance."
"Did you call anyone else?"
"Like who?"
"Like WHO! Like the University! Like–"
"Back door it?" he said. "That's not protocol. And we'd still be looking at reimbursement out of our budget."
As Natalie sputtered, unable to formulate a civilized response, the doors to the isolation wing behind them swung open, and Stephen and Miles emerged. They stripped off their gloves and decon suits and dropped them into a secured bin, then joined the pair arguing loudly in the hall.
Natalie held up a bottle to show Stephen. "Vancomycin," she said.
"Look, don't take it out on me," Carl said. "This is what they gave you."
"I'm well aware of what they gave us," Natalie snapped. To Stephen, she said, "If Eva were here, we wouldn't be wasting our breath." She shoved the bottle back inside its packaging.
"Which is why Rossi is in Siberia instead of the NIH," Carl said. "I'm not ending up like her."
Too furious to speak, Natalie whirled around and stormed down the hall.
"She's been on my case from day one," Carl complained. "I don't make the rules, you know."
"One thing you need to learn in this job is that most rules are ambiguous if you try hard enough," Stephen replied. "Your job is to try."
Outside in the sunlight, Natalie paced beside a low brick wall near a mostly empty bike rack, debating her more disciplined self. She had no excuse this time. Eva was probably busy. It wasn't like she could just drop everything for a chat. But she hadn't seemed to mind the other times Natalie had phoned her. And it was always nice when Eva called, so maybe . . . . Summoning her courage, she pressed the speed dial.
"Natalie?" Eva answered happily.
The doctor's frustration eased, and she smiled into the phone. "Hi."
"Wait a sec–hey, guys, I'll be outside for a few." A moment later, her friend's voice returned to the other end of the line. "What's up, Nat? You sound upset."
Natalie nearly laughed. "Based on one word?"
"Reading people is what I do."
"I figured that out the first time we played poker with you," Natalie joked. "At least you had the decency to buy me dinner with my money."
Enjoying the memory with her, Eva said, "Word of advice, Nat? Don't bluff. You're a terrible liar." More seriously, she added, "Speaking of which . . . what's wrong?"
I wish you were here, Natalie wanted to say, but that would be silly, of course. "I just . . . ." She hesitated. "Oh, I don't know." Embarrassed at the obvious lack of purpose for this call, she blurted, "We got Vancomycin when we need Rifampicin. He makes one phone call and just takes no for an answer."
"Griffith?"
"He's just . . . he's not . . . " She sighed. "It doesn't matter, I guess." Wanting to prolong the contact, she leaned back against the wall. "So, where are you?"
"Wellston, Nebraska, population 498," Eva said. "Day three of an investigation into the effects of a power plant on dairy cattle in neighboring counties."
"Sounds interesting."
"It is, actually," Eva said. "It's not the bubonic plague, but it matters."
"Of course it does."
Sounding a bit frustrated, Eva went on, "I'm strictly PR on this one, though. No logistics."
A waste of talent, the doctor thought. Eva had proved quite good at coordination. And research. And just about everything she did. "What's the hot button?" she asked.
That seemed to amuse her friend. "Try this: The power plant is run by Senator Power's brother. One of the dairies is owned by Congressman Taylor's sister."
Natalie winced. "Oh, dear."
She heard some undefinable noise, and then Eva muttered, "Hang on; I'm clearing off a place to sit down."
Mostly for something to say, Natalie asked, "Tired?"
"A little," Eva replied. "Or it could be Wellston's Best-Kept Secret."
"Which is . . . ?"
"Mona's Mystery Meat, courtesy of our local roadside diner."
Natalie chuckled. "Maybe you should stuff some MREs in your bag."
"I do have some left over from Mission La Roca . . . ."
Laughing, Natalie said, "Sounds like I need to get a real dinner into you. When will you be home?"
"Probably right as you're leaving," Eva said. "Like last time–"
"–and the time before," Natalie finished. She had noticed that little problem, too.
"So, do you want me to make some calls on the, what was it?"
"Rifampicin," Natalie replied. "We'd better not. It wouldn't be 'protocol.'"
"Protocol?" Eva said. "Is that what you're hearing? You know, I could get this guy a shot on CNN . . . ."
Natalie couldn't bring herself to laugh. Not funny yet.
"Damn, I've got to go," Eva said. "Senator Windbag is here to pontificate. First one back to D.C. buys the other dinner, okay?"
"Deal."
Clicking shut the phone, Natalie leaned against the wall for a few more minutes, thinking back to the day her life began to unravel.
August 31, 2005
Striding past Eva's office, the doctor was surprised to see that it was dark. At two in the afternoon? Natalie frowned. She had hoped to do some catching up.
Entering the conference room ahead of Miles, she nodded at the two men seated around the table and dropped into a chair.
"How was Yonkers?" Frank asked.
"Just fine," Miles replied, "cyanide poisoning aside."
Natalie wasn't interested in small talk. "We've been watching the news," she said. "When do we leave?"
Leaning back in his chair, Stephen said, "We don't."
"What do you mean?" Natalie looked from him to Frank. "Bodies are decomposing. Cemeteries are flooding. It's a–"
"–a breeding ground for infectious disease," Stephen agreed.
"So . . . ?"
"So, we're 'coordinating,'" Frank said sarcastically.
"Coordinating what?"
"The insertion of our thumbs up our asses, apparently," Frank replied. "That's all they've told us."
Unbelievable. Stuck in D.C. while a medical emergency descended on the Gulf Coast in front of their eyes. "Where's Eva?" Natalie asked.
Stephen and Frank exchanged glances. What was so hard about that question? "We're not sure," Frank finally said.
"Not sure?" Natalie repeated. "What do you mean?"
This time, Stephen answered. "We haven't heard from her for three days," he said.
"Eva's missing?" Natalie's heart raced. "Why didn't you call me? I've been leaving her messages."
"Not missing," Frank said. "On assignment."
"Where?"
"New Orleans," Stephen said. "Originally, it was supposed to be Mississippi, but–"
"Wait," Natalie said, shaking her head in disbelief. "What is she doing out there?" At the other men's expressions of disgust, it became clear. "No," she said. "They did not send public relations people out there and not doctors. They did not do that."
Neither man responded.
"You haven't heard from her at all?"
"The last time she called in, she was trying to get help for some patients at a nursing home," Stephen said.
"What kind of help?"
"I don't know," he replied. "Her cell was dying."
This was not possible. What had Kate been thinking? Had she become so immersed in politics that she had forgotten about the practice of medicine?
Her thoughts must have been transparent. "It was over Kate's head," Stephen said. "The order came down from Homeland Security. There's been a lot of criticism about the government's response."
"So, instead of–" Too frustrated to continue, Natalie rose and headed back to her office. Plenty of work was piled up for her. There were reports to read and follow-ups to make, but she found herself staring for long minutes at the television screen that sat on the table along her far wall.
Stephen strode into her office a few hours later. "Eva's all right," he announced.
"She called you?" Natalie glanced at the phone on her desk. Why hadn't Eva called her?
With grim humor, Stephen replied, "Not exactly." He reached into a file folder tucked beneath one arm and withdrew a DVD, popping it into the player. A CNN reporter appeared on the screen in front of the Superdome. With him, he said, was Eva Rossi of the National Institutes of Health. Ms. Rossi had nearly drowned in rising waters after the failure of a central levy, he said. How would she describe her experience?
"I was lucky," Eva said. "I swallowed half the Gulf of Mexico, but a wonderful family risked their lives to pull me out of the water. We spent the next two days on the roof of their house."
And how was the federal government responding to the crisis?
"It's not," Eva said bluntly. "Have you seen anyone? This is so (bleeped) up."
Oh, Eva.
FEMA director Mike Brown had indicated at this morning's press conference that the situation was nearly under control, the reporter went on.
"'Under control'? Is he delusional?" Eva exclaimed. "He should cut out the bull(bleep) and get down here to see what's really happening. I've got a great photo op for him – me and the fifteen thousand close friends that I'm sleeping with."
Natalie covered one eye with her fingers, spread just far enough to continue watching the train wreck.
They couldn't fire her; that would have been too public. But not long after she got back to D.C., bitter and exhausted, a position suddenly opened up in the Department of Agriculture that required Eva Rossi's particular skills, the higher ups decided, and for the second time in a month, Dr. Durrant returned from a distant investigation to a darkened office.
Natalie fastened the third button on her maroon blouse, then stepped back and scrutinized her reflection. Her hair could use a few more strokes of the brush, she decided, but everything else seemed in order.
"Hi, Stranger," she greeted Eva an hour later. Her smile faded quickly as she got a closer look at her friend. "You've lost weight." Too much weight.
With one of her trademark smartass grins, Eva replied, "Guess midwest cuisine doesn't agree with me."
"Everything agrees with you," Natalie said. "You'll eat anything."
"Gee, thanks," Eva said wryly. She lowered herself into the seat across from the doctor. "So, how have you–"
"Eva," Natalie interrupted, "how much weight have you lost?"
"It's been two months since we've seen each other, Nat," Eva said. "Don't we have better things to talk about?"
"No." Natalie leaned forward and studied the pretty face looking back at her. Suddenly, she rose and placed the back of her fingers against her friend's forehead as Eva half-heartedly tried to avoid the contact.
"Nat, this is a little embarrassing," Eva said.
"Do you have a fever?"
"You're off the clock, Dr. Durrant," Eva chided her. "It's nothing. I'm on the tail end of the flu."
"For how long?"
A little frustrated at her persistence, Eva said, "I don't know. A month, maybe."
"A month? Have you been to the doctor?"
"Why should I, when I can get a physical from you in the middle of a restaurant?" At Natalie's concerned expression, she said, "You NIH types are paranoid. Not every cold is the black death."
"And not everyone was exposed to highly contagious diseases on a daily basis for almost two years."
"I had a very thorough exam when I left the NIH," Eva reminded her, "including a really great massage."
Had she not been so distracted, Natalie might have been embarrassed by the reference. She hadn't been able to resist manipulating Eva's bare shoulders and back that last day, saying goodbye with the gentle caress of her thumbs.
"Come on, Nat," Eva said. "I never get to see you. Let's not waste it."
Reluctantly, Natalie opened her menu.
The women dawdled over dinner, catching up on the happenings in each other's lives and the men with whom they worked. As always, Eva made Natalie laugh, but . . . . She glanced at a plate that had barely been touched when the waiter swept it up. "You didn't like the eggplant?" she asked casually.
"I've just been talking too much," Eva joked.
"Not possible." Natalie reached over and laid a palm across the back of Eva's hand. "So, do you have to be anywhere?"
"Nope," Eva said. "I'm yours for the night."
Dropping some twenties on the table, Natalie got to her feet. "I know just the thing."
Stephen didn't really mind the pager alert; the documentary he was sort of watching was a little too simplistic for his taste. He dialed the familiar number to check in. "Conner."
"Dr. Conner, this is a containment notification," the voice informed him.
One of his people. "Who?"
"An Eva Rossi. She's at Southwest General."
Eva?
"Admitted by Dr. Durrant," the report concluded.
When he arrived at the hospital an hour later, Natalie was out of uniform but very much in doctor mode as she studied a set of X-rays.
"Nat?" he greeted her.
"Recurring fever, nausea, abdominal cramps, headaches." The recitation of symptoms was clinical, but Stephen knew his co-worker well enough to see that she was upset. "She's lost nine pounds in five weeks. It looks like an infection, but . . . ."
"Bacterial or viral?"
"I don't know." In frustration, Natalie flipped off the display light. "Blood work's inconclusive." She handed him a board to which several loose sheets of paper were clipped.
Leafing through the reports, he said, "Why don't you let me handle this, Nat? Go talk to her."
To his surprise, Natalie seemed to consider his suggestion. "She doesn't have anyone," she said tentatively, talking herself into it.
"Sure she does," Stephen replied. "Go on."
Natalie nodded. "Let me know what you find, okay?"
"As soon as we know."
Hands in pockets, she walked toward the isolation room, peering around the corner as though afraid to enter.
Eva rolled her eyes. "You can come in."
"Are you still mad at me?"
"Well, let's just say that your idea of after-dinner fun and mine aren't even close."
"You never want to try new things," Natalie quipped. She drew a chair up beside the bed. "I want you strong and healthy the next time we go out."
Eva eyed her. "Got anything particular in mind?" she asked mischievously.
There was that look again. Was Eva coming on to her? Natalie sometimes thought so but she was never sure, which made her feel even more like an idiot. She stammered, "Lots of things. Um . . . miniature golf . . . the Library of Congress . . . ."
"You do not get to pick the activity," Eva declared.
"Well, you get back on your feet and we'll do anything you want," Natalie said.
"Anything?"
Okay, this was flirting, wasn't it? A bit nervous under the other woman's scrutiny, Natalie replied, "Sure."
"Skinny dipping in the Potomac?"
"Anything." She raised her eyes to meet Eva's gaze. "Anything at all."
Within seconds after his index finger tore through the seal, Stephen was halfway down the hall. In the doorway of his colleague's office, he held up the envelope. "What is this?"
From behind one of two partially filled packing boxes on her desk, Natalie replied stiffly, "I think it's self-explanatory, don't you?"
"Call me slow."
"I'm through, Stephen."
"Just like that?" he asked. "Isn't this a bit sudden?"
"Actually, I would say that it's overdue."
"What's this about, Nat?"
Natalie tucked her Gray's in beside Pathologic Basis of Disease and a dogeared Medical Microbiology, apparently weighing how much to divulge. "Eva," she finally said.
"Eva's going to be fine," Stephen replied. "She's doing well on the antibiotics."
"She was sick for weeks."
"We didn't send her down there, Nat."
'There' being Louisiana, where a cut on her leg or a panicked gulp of water introduced contaminated bacteria into Eva Rossi's bloodstream, making her the one hundred and sixth person to be diagnosed with a condition as yet unnamed because politicos were afraid to attach the controversial 'Katrina' label to anything.
"She was sick for weeks," Natalie repeated.
Helplessly, he watched his friend and colleague continue to pack. "Nat–"
"Three times," Nat went on. "Three times we were supposed to have dinner last month." She yanked open a drawer and scooped up a handful of stray pens. "We never made it. If we had, I would have known that something was wrong."
"We were home for ten days in October," Stephen pointed out.
"And Eva was away."
"Blame that on the USDA, not the NIH."
Natalie paused in her task. "I'm not blaming anyone," she sighed. "But if I hadn't been away when she got back, I would have seen her sooner. Who knows how long she would have let this go on?"
"Eva knew better," Stephen said. "She should have seen a doctor."
"And she would have, if I'd been here," Natalie said. Pressing down the lid, she went on, "With a private practice, my schedule will be a lot more flexible."
"What's this really about, Nat?"
"It really is about Eva," she said. She closed her eyes. "Everything is about Eva, Stephen."
"I don't–" Conner blinked at her, then abruptly closed his mouth. Eventually, he said, "You and Eva?" Wow.
Scribbling BOOKS across the box lid with a magic marker, Natalie said, "So now you can see that this is not negotiable."
Apparently not. Wow. But Conner did not have time to process this new, rather shocking, information about two close friends. In a few minutes, his job was about to get a lot harder. "At least give me a little time," he pleaded.
"To do what?"
"To figure something out," he said. "Don't give this to Kate yet."
Natalie shrugged. "I won't change my mind."
"I know."
She pointed at a sealed envelope lying on the far edge of her desk. "Tomorrow, then," she said. "I'm going to the hospital."
Staring at the ominous white rectangle, Stephen reached for the cell phone clipped to his belt. "Frank?" he said. "We have a problem . . . ."
The next morning, Natalie was perched on the hospital bed humoring a slightly grumpy patient when Stephen rapped his knuckles on the door frame. "How's it going?" he asked.
"Apparently, Eva is ready to go home," Nat said. "Dr. Rossi has been informing me of her prognosis all morning long."
Grousing a little, Eva said, "You try being stuck in this place 24/7."
Natalie stroked her forearm. "I would have if you wanted," she said.
Eva's sour mood seemed to dissolve. "I know," she said, taking Natalie's hand in hers.
"I'll be with you tonight," Natalie said. "And when you're feeling better . . . ."
"Ahem." The team leader took a few steps into the room. "Before you take off, I need to discuss your employment situation."
Natalie shot to her feet. She hadn't exactly gotten around to mentioning her new status to Eva yet. "No business, Stephen," she said lightly, "I'm off duty." She began looking around for the gym bag that contained the t-shirt and shorts she had retrieved from Eva's apartment.
"I meant with Eva," Stephen said. "The NIH has an immediate opening for a public relations/logistics coordinator. You know anyone who might be interested?"
Both women gaped at him. "What about Carl?" Natalie asked.
"Apparently, four resignations from the NIH's first-response team caught Kate's attention," he replied. "I told her we might reconsider if we had more confidence in the fifth member of our team."
"Well, I don't know," Eva hedged. "Watching people vomit on a daily basis, or sitting in nice air-conditioned press rooms with snack bars and satellite dishes . . . ."
"Seeing each other every day, or seeing each other once a month," Natalie countered.
Eva mulled it over. "I guess you're worth a little vomit," she said.
"How romantic."
"That's one advantage of dating a woman, Dr. Durrant," Eva said flirtatiously. "Life is one long candlelight dinner."
"Right," Natalie said. "Stephen, tell–" But the boss was no longer with them.
Eva grinned at her. "Guess some guys can't handle the mush . . . ."
The End