A week after the incident with Nicholas at the cafeteria, Matt and Shari entered Presidio Med's waiting area. They had shared a nice breakfast together and now it was time for the two of them to get down to some serious work. As he accompanied her to the laboratory, they ran into Drs. Jules Keating and Jackie Collete.
The two women greeted them and continued to walk, but a few barely concealed laughs made Shari's brows arch.
" You know? Half of them think we're sleeping together," was Matt's casual comment.
Inwardly, he thought that the two full-grown women should have showed a bit more maturity.
" Yeah, the half that doesn't think I'm sleeping with David," she replied and had the reward of watching his eyes reach the size of plates.
" You know about that?" He asked.
" Now I do." Matt puzzled look made Shari burst into laughter. " It's OK, really. I understand their reaction. I just hope that one day I will be able to prove I'm here because I really deserve it."
" You already are. Don't you think I don't know how much time you spend in the lab?"
" Yeah, but what's your friend Nicholas' problem? I mean, what did I do to deserve all that 'you're not ready' crap?" Was her question. They had never discussed what had happened that day at the cafeteria.
" I have absolutely no idea. But he's under a lot of stress, you know. Yesterday, he lost a little girl on the table," explained Matt. He wasn't trying to justify Nick's actions, he didn't think the man deserved it, but he didn't want Shari to believe Nicholas was such a hardass either.
" God..."
" He's angry for the loss and, I hate to admit it, his injured pride. He's been wonderboy at the OR and that's made him a bit big-headed; but he's not a bad man."
" Oh, really?" She asked mockingly.
" He's as stubborn as hell, I'll give you that. But just let him get used to the idea of being surpassed by a woman your age and then you'll see he's quite a nice person," was Matt's prediction.
Shari didn't fully believe it, but she smiled and nodded, not wanting to contradict her friend.
The morning went by slowly and a bit monotonously for Shari, who preferred working at the hospital. She only had to Gram dye a couple of microscopic spreads and then examine them; she had taken her time at doing that, since she enjoyed studying bacteria in all its profundity. But by noon she was happily leaving Usher Medical Tower. Suddenly, a voice from behind her stopped her in her tracks.
" Miss Hayes, may I have a consult with you?"
She turned and faced Dr. Kokoris, a questioning look on her face. " Sure, what is it?"
" We've received this patient in the morning and, quite frankly, we are disconcerted," he said swiftly and without looking straightly at her.
Shari was surprised by the sight of a confused Nicholas Kokoris, the oh so almighty one. " Why?" She simply asked.
" He has shown contradictory symptoms that don't match his history and no treatment seems to alleviate him."
She nodded. She was trying to remain as aloof as possible, but curiosity took the best of her." Why are you in this? I thought you were a surgeon."
" I am, but Dr. Slingerland consulted me," he replied.
" I see. I've encountered several cases as puzzling as this one," she commented.
Nick realized she had no intention of easing things for him, so he decided to swallow his pride for once. " And since we have both failed, it occurred to me that maybe you could clue us in."
Shari smiled, knowing it had been hard for him to ask for her help. Now it was time to show she didn't have any hard feelings towards him. " Can I see the patient?"
The surgeon visibly relaxed. " I was hoping you would, but I would hate to disrupt..."
" Don't worry, you aren't interrupting anything. I'd really like to collaborate in this, so, let's go."
Nicholas nodded and she followed him back to Presidio Med's offices. Not wanting to waste any time, once they were in the elevator she asked him for the specificities.
" The patient's name is Donald Robertson. Fifty-five years old, no cardiologic history. Symptoms include fever and anorexia. Tests revealed lymphadenopathy and myocarditis, but they don't correspond to his history… he was fine a month ago, when he had his last check-up," he explained.
Shari wasn't surprised; as a virologist, she knew that check-ups were only reliable when it came to 'ordinary' diseases. But a single bacterium could change a patient's entire history in less than a week. Then came the rutinary, " Temperature?"
" 38,5 C. He is not responding to antibiotics."
" Well, then it's not bacterial... or we're dealing with a more specific one that's not attacked by conventional antibiotics," she concluded.
Nicholas stared at her fixedly for a few seconds. " Very well... his room is this way," he said, leading her to a quiet hallway, and then to a door with the number 205 on its door. He knocked on it and a weak voice authorized them to enter.
There were two nurses in the room, which was nice and clean. There were several flower arrangements around the bed, from which a man of graying hair and pale blue eyes looked at them with barely-veiled apprehension. Shari wasted no time and approached him with a smile.
" Good morning Mr. Robertson, I'm Shari Hayes. Do you mind if I ask you some questions?"
The man smiled, relaxing a bit. " You are not a doctor?" Was his question.
" No, I'm a virologist," replied Shari with extreme softness, knowing that her title could probably alarm him.
His reaction was the one she expected. " You think I could be infected by a virus?" He asked, paling.
" That's what I'm here to find out," she stated. Shari took a pair of latex gloves she always kept in her pocket and put them on. " When have you started feeling ill?"
" About a week ago or so… "
Smiling soothingly, she went closer to the man, leaned and started running two of her soft fingers across his face. The two nurses looked at her with great interest, while Mr. Robertson seemed surprised; but what really amused her was feeling Nicholas' eyes burning her back. Noticing a small lump near the patient's left eye, she turned to him.
" Dr. Kokoris, have you noticed this?" She asked.
" What is it?" He asked, leaning over to have a closer look.
" A local lesion: palpebral edema can appear at the site of inoculation," she whispered.
" Inoculation?" Nicholas sounded utterly perplexed.
Shari ignored him and turned to the patient, knowing exactly what to ask. " Mr. Robertson, have you traveled anywhere recently?"
" Yes, I've been to Argentina three weeks ago. I have some lands in the North and I went to visit them," he elaborated.
' Then the incubation period was of two weeks. And he was in South America? I'm on the right track,' she thought. " Nice… and what did you do there?"
" Oh, nothing really, just the usual country activities. What I did enjoy was the trip to the northern border; we hiked during the day and at night we stayed in this rustic huts made of mud… it was quite and adventure." His voice was becoming softer.
Euphoric, Shari realized she had hit the nail in the head. But her joy lasted too little, as the diagnosis she would have to give started weighing on her. She noticed her patient had dozed off and Nicholas leaned over to check his vitals. It was her time to act.
" No, don't touch him without globes," she commanded.
" Why?"
" I can't explain now. I want everyone out of the room. And someone please call Dr. Eidenberg." As no one moved, she had no choice but to sharpen her tone. " I said out. NOW." The two nurses left promptly, but Nicholas was still by the patient's side.
" I have to check… " He insisted.
" He's sleeping," she interrupted him.
Nicholas looked at her suspiciously. " How do you know?"
At that point, Shari would have enjoyed slapping him senseless, but managed to control her temper. " They pay me to know this stuff. Now leave me alone with the patient."
" What will you do?"
" I'll get a blood sample and run an ELISA test on him," was Shari's reply, after an exasperated sigh.
Nick was surprised. In all his years of studying, training and practicing, he would have never thought of running an ELISA on a man with myocarditis.
" What for?" He persisted.
OK, that did it. " Dr. Kokoris, step outside please. I'll explain later."
With that, she gently pushed him outside and closed the door right on his face.
***
When she left the room with the small vial of blood in her hand, she faced three men who were waiting for her. Of course, one of them was Dr. Kokoris, and then there were Matt and David Eidenberg. Apparently, the nurses had done what she had told them to.
" David," she greeted him.
He smiled affably at her, but couldn't hide the apprehension in his voice. " Shari, what is your diagnosis?"
" I can't say yet; not until I get the results of the ELISA test and the microscopic examination," she stated.
" Why ELISA?"
' This Nicholas fellow doesn't quit, now does he?' She thought as she hurried to explain. " An ELISA test is similar to that used for AIDS and has been designed to detect the presence of T. cruzi antibodies. Oh, how silly of me… Trypanosoma cruzi are the parasites responsible for Chagas' disease."
The three men looked truly taken aback and could only stare at her for a while. Matt was the first one to come out of the initial state of shock.
" Chagas' disease? Good Lord! When will you be able to tell for sure?" He asked, sounding truly bewildered.
Shari smiled affably. " In about six hours. I'll run the tests myself at the lab. But, David, I believe we should start the treatment on Mr. Robertson and the physicians who took care of him," she suggested her boss.
" Shouldn't we wait for the results?" Asked Nicholas. The Greek surgeon was definitely testing her patience.
" Acute Chagas disease must be treated early. The decision for initiating therapy must not be swayed by negative findings or delayed while waiting for results of isolation attempts, if the clinical and epidemiologic suspicion of the disease is strong. And mine is," she said coldly.
" OK then, I leave everything in your hands," said David, pleasantly surprised by the proofs of her expertise she was giving and by the firmness of her voice as she answered the, sometimes too arrogant, Nicholas Kokoris.
" Thank you, I'll let you know when I have the results," she told him.
As the man left, Shari turned to Matt and Nick. " I want everyone who was in touch with the patient to meet me at the hospital's Epidemics area in half an hour and I want the patient transferred to a private, isolated room there. The T. Cruzi isn't aerobic, but some isolation will help," she commanded.
" Are you sure about this? It seems too extreme," said Nick.
And then, she could no longer keep herself from snapping at him. " Look, Dr. Kokoris, you called me and asked for my opinion. I believe this man is infected with Chagas' disease. Now, whether you like it or not, we have to isolate him until we have a safe diagnosis, is that clear?" Nicholas could only nod. " And since this is my field of expertise, from now on you will do as I say." With that, Shari locked herself in the lab, leaving the two doctors with their mouths hanging open (literally).
Matt, who had been silent the entire time, turned to Nicholas.
" The girl's got guts."
His friend couldn't disagree with that.
***
Hope I haven't been too technical with the symptoms and stuff, but since I'm planning on becoming a virologist myself I kinda got carried away. Please let me know what you thought of this chapter.