Nita prepared the bed while Sam waited impatiently for the inner door to open. The indicator light blinked off signaling that the outer door was closed, then the hidden motors hummed and air hissed by the seals before him and, as soon as the inner door had opened wide enough, he squeezed through. The policeman on the wheeled stretcher — still in uniform — was sitting up on his elbows. “I don’t know what I’m doing here, Doc, I’m not that sick, a touch of fever, a summer cold, you know, this time of year,” he said it calmly, quietly, as though trying to reassure himself. There were red, suffused patches on his face that could be developing boils. Sam took up the record holder. Francis Miles, age thirty-eight, occupation, police officer, all typed in very neatly, but scrawled across the lower half of the page in large letters was RAND’S DISEASE VIRUS: POSITIVE.
“Well, that’s what you’re here for, Frank, so we can find out,” Sam said, putting the records back without changing his expression. “Now lie back so you don’t roll off and we’ll see about getting you to bed.” He pushed the stretcher into the tight quarantine ward and the massive door swung behind them.
Nita was cheerful and fluffed the policeman’s pillow, produced a menu for him to study, saying that he looked hungry, and even found a bottle of beer that had been tucked away in the back of the refrigerator. Sam worked swiftly attaching the telltales to the patient’s dry, hot skin and it took him almost fifteen minutes to get them all accurately placed and recording to his satisfaction. In that time the patient’s fever went up a full degree. The first boils were already beginning to form when he closed the door of the office and dialed Dr. McKay’s number, touching in sequence the dimpled numbers of the induction dial.
“We’ve been monitoring your pickups,” McKay said.
“Are there any recommendations for treatment?”
“They are under discussion—”
“But you must have some suggestions?” Sam clenched his fists, keeping his temper under control.
“There is some difference of opinion. Supportive treatment appeared to have been ineffective with the last case, but it has been suggested that in combination with interferon it might be more effective and a supply is on the way to you now. However hyperbaric oxygen therapy has been successful with related…”
“Dr. McKay,” Sam broke in, “there is no hyperbaric chamber here, so treatment would mean moving the patient again. You must understand— the instruments can’t tell you everything — this man is dying before my eyes. I’ve never seen a disease progress with the speed of this one. Have you?”
McKay shook his head with a weary no and Sam leaned closer to the phone.
“Do I have your permission to begin supportive treatment with interferon and antibiotics to stop any secondary infections? I must do something.‘”
“Yes, of course, Dr. Bertolli, after all he is your patient and I quite agree with your decision. I’ll notify the committee of what has been done.”
When Sam hung up he found that Nita was standing behind him.
“Did you hear that?” he asked.
“Yes, you did the only thing. They can’t possibly understand without seeing the patient. I had to give him some Surital, six cc’s, he was getting excited, almost hysterical, is that all right?”
“It has to be correct because anything we do now is dictated by the patient’s needs. Let’s see if the interferon has come yet.”
The capsule was waiting in the receiving basket and Sam quickly prepared the injection while Nita swabbed the patient’s arm. He was lying on his back, his eyes were closed and he was breathing heavily through his mouth. His skin was spotted with the angry red swellings of the boils. Sam gave him a large intravenous injection, the blood stream would carry the interferon to every part of the body, then injected one of the furnucles with a smaller dose.
“We can use that for a control,” he said, ringing the injection site with an iodine marking. “Interferon applied locally is always more effective. In combination with the antipyretic we may get some positive results.”
There was no dramatic improvement after this, though the policeman’s temperature did drop two degrees. McKay and his group monitored everything and suggested variations in treatment. The burly policeman was Sam’s patient and he resented their attitude, that the man was a sort of giant guinea pig, though he made no protests. The policeman was a guinea pig; if he could be cured the treatment would be available for others.
And there were other cases. They were being routed to New York Hospital, where a special sealed ward, far bigger than this experimental one, had been evacuated and staffed with volunteers. It was difficult to learn how many there were, even the official medical reports were reticent with the facts, while the TV and radio bulletins were obviously stopgap morale builders. Sam had his patient to care for or he would have seethed with frustration at being trapped in the ward while a plague might be growing in the city outside.
“What is that for?” he asked when he saw Nita removing a wire basket of pigeons from the tube capsule. He had been aware of her working in the lab during the past hours, though he hadn’t talked to her. She brushed a strand of russet hair away from her eyes and pointed to the desk.
“I have been reading reports all day from the laboratories that are working on the Rand virus and there is one experiment that they haven’t performed yet, that would be safest to do here in tight quarantine where we have a patient ill with Rand’s disease.”
“What experiment is that?”
She shuffled through the papers and pulled one out. “Here is the first report from pathology. It has been found impossible to infect human tissue in vitro with infected cells from Commander Rand. They tried this before he died last night. They also found out that they couldn’t pass the virus on to any of the lab animals, monkeys, guinea pigs, rabbits…”
“Then — if it can’t be passed on you and I can leave quarantine! But how could this policeman have been infected?”
“Just a moment and you’ll see. The Rand virus can infect birds, it has taken hold on every species they have tried so far. And then, this is the worst part, the diseased cells from the birds can infect human cells, that’s how poor Frank caught it.”
“Have they tried this on a human volunteer?”
“No, of course not! Just on resected tissue in vitro and HeLa cells.”
Sam was pacing back and forth, unable to stand still.
“It’s like the life cycle in schistosomiasis— from man to snail to man — but that’s a blood fluke, there is no record of a virus propagating this way. Not this one-to-one business with man infecting birds then birds infecting man right back, but no cross infection within the species— wait, can the birds infect one another?”
“Yes, that’s been proven.”
“Then — of course — there’s the next step, that’s why you have the birds here. You want to find out if the human virus will reinfect the birds. If it does, then that means that Frank here and Rand both had the same disease. If they did, once we break the chain of infection it can be wiped out.”
Nita had the hypodermic ready. She reached into the cage and caught one of the birds deftly so that it could not move. It cooed lightly and blinked its pink eyes when the needle slid under its skin: Nita slipped it into another cage and put it into a sealed compartment.
“There’s one thing missing,” Sam said. “Will the virus from the sick policeman infect other human cells; perhaps it has been changed even more by passing through the birds?”
“No, I’ve already checked that. I’m not set up for it here, but I sent samples of biopyoculture from the abscesses down to the sixth floor; they found they didn’t infect human tissue.”
Sam went to inspect his patient, who was sleeping quietly. There was no change, the spread of the disease seemed to have been checked, at least temporarily, though the fever had not gone down. He went back to the lab and sat down across the desk from Nita, who was making notes on a clipboard.
“The lab is beginning to call them Rand-alpha and Rand-beta,” she said. “I suppose that will become the official name.”
“What’s the distinction?”
“Rand-alpha is what Commander Rand had, a deadly virus that cannot be transmitted to man or to any animals other than birds. Rand-beta is the apparently identical virus, it kills the birds and it can be transmitted to man.”
“And it can infect other birds.”
“Yes, very easily, that’s how it spread so quickly.”
“Then the thing to find out now is if Rand-beta when transmitted to man becomes Rand-alpha. If it does our troubles are over. It will mean killing a lot of birds, but we can stop the disease at that stage and stop it from reinfecting human beings.”
“That’s what I’m hoping,” she said, looking at the instruments attached to the bird’s cage. “If the bird gets sick it will have Rand-beta, which means your patient has Rand-alpha — the same as the original case. It will prove that there are only two forms of the disease — and it can only be caught from birds. Once their reservoir of infection is wiped out that will be the end of it.”
They both looked up as the pigeon, stretching out one wing, rolled onto its side.
“It’s body temperature has gone up four degrees,” Nita said.
The first boil formed and they saw that disease was following the now all too familiar course.
“I’ll get a blood specimen down to the lab,” Nita said, “to be checked with the electron microscope. But I don’t think there is any doubt, do you?”
“None at all,” he said as he took a hypodermic needle from the autoclave. “There is only one factor missing from the whole series to prove whether it’s right or wrong.” He turned toward the patient on the bed.
“No! You mustn’t!” Nita shouted, running after him. She grabbed his arm so hard that the hypodermic was jarred from his hand and dropped to the floor. He turned to face her, quietly, without anger.
“Sam, you mustn’t, they were talking about that over at World Health; there were suggestions that they ask for volunteers, but it was decided to wait. It’s too dangerous now, there’s no need…”
“There is a need. Until it is proven that Rand-alpha can’t be transmitted from one person to another we can’t be sure that there won’t be an epidemic. And as long as there is doubt about that I am — both of us are going to be trapped in this isolation ward. Someone will have to be inoculated with the Rand-alpha virus from the policeman here. Since I have already been exposed to Rand-alpha by Rand himself, I’m the logical volunteer. Any arguments?”
“I should—”
He smiled. “In this particular case, my dear Doctor, it is women and children last.”
For a long moment she was silent, then she turned away and opened the drawer. “I can’t argue with you,” she said. “Perhaps you are right, I don’t know. In any case I can’t stop you. But I’m the cytologist here and I’m not going to let any ham-handed intern give himself hepatitis or pyemia or anything like that.” She took out a sealed hypodermic. “I take care of preparing it, right?”
“Right,” he said, and turned back to his patient while she prepared the culture. He knew, without reasoning it out, that she would make no attempt to fool him and prepare an injection of sterile water or neutral plasma. This was too important. She might be a woman, very much of a woman and equipped with all the female feelings and emotions — but she was still a physician.
“All ready,” she said.
He swabbed his arm himself, and when he saw her hesitate he took the hypodermic needle from her fingers, held it vertical for a moment and squeezed out a few drops, then plunged it matter of factly through his skin.