Locked In:
A Medical Mystery

by Stephen D. Dighton

Xlibris Corporation, 1996/2000

Click here to order this book direct from the publisher.

Blink twice for help... Something strange has gripped the residents of Douglas County, Oregon. One by one several people and even whole families have literally fallen down in what looks like a coma. It's horrifying for those untouched by the disease to see their loved ones fall beside them mid-word without any warning and without any discernible reason,. It's much more terrifying for the victims, however, than anyone realizes because the victims aren't in a coma. They are fully conscious, aware of their surroundings, and able to do only two things on their own--breathe and blink. They have Locked In Syndrome, a kind of living death in which they can see, hear, taste and feel, but cannot even twitch their nose. Senior Public Health Nurse Nancy Brandauer has the task of finding out what happened to these people and what will bring them out of it before their condition becomes irreversible. Her quest is motivated by something much deeper than her commitment to her profession, great though that is. Her motivation springs from the very core of her soul because her only daughter is one of the victims.

To learn more about the author, click on his picture.

Into the midst of this emotional whirl, the Centers for Disease Control drops someone to "help." Her first love, Zachary Keller, a man from whom the parting was not sweet, but bitter, unresolved, and for which Nancy feels a certain guilt. A Bahá'í now and happily married for many years, she draws strength from her husband Ed, even as he draws strength from her. Their bond is as unassailable as any couple's can be, but it faces a rapid succession of challenges that will test its temper as nothing has before.

"Locked In" twists and turns, going where you least expect it. Just when you think you've rounded the last turn and worked everything out, it tosses you another surprise--right up to the very last page.

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Table of Contents

1. I'm Here! 2. Duck Swoop 3. Falling Down 4. Help 5. Do You Feel Lucky? 6. Cloudy, Then Sunny 7. Productivity 8. The Eyes Have It 9. Good News of a Sort 10. All the Comforts of Home 11. Wake Up Call 12. Mind Blast 13. Another Fantasy Bites the Dust 14. Getting an Earful 15. What a Lovely, Fair Day 16. Rumpled of the CDC 17. White Shoes 18. Give and Take 19. By the Evening's Early Light 20. Good New, Bad News

21. Recriminations 22. Into the Zone 23. A Little Healing 24. Going Exploring 25. Speak to Me Only With Thine Eyes 26. Eureka! 27. Know It All 28. A Dog's Life 29. Another Long Day 30. Home, Home on the Ranch 31. No Show 32. Home Alone 33. Lancing a Boil 34. Line of Sight 35. Local News 36. Revelations 37. Failings 38. Sharing 39. Faith & Healing 40. Well Laid Plans

41. The Going Rate for Miracles 42. Murphy's Notable Absence 43. Don't Touch 44. Murphy Shows Up 45. Miracles Do Happen 46. A Quiet Evening at Home 47. A Long Walk 48. What Do We Do Now? 49. Mr. & Mrs. Murphy 50. No News 51. Two Out of Three 52. Opening Up and Closing Down 53. Uh, Oh 54. Strange Bedfellows 55. Stalked 56. Recovery 57. Distractions 58. Friends Epilogue

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Chapter 1

I'm Here!

 

He awakened, with a sofa staring at him across a green carpet.

I'm on the floor. What am I doing on the floor?

Yellow plaid, soiled to a dirty mustard, and the sofa's scarred pine baseboard, filled his field of vision.

I must have fainted. But why?

A strand of the ancient shag carpet's yarn tickled his nose. He twitched involuntarily in response.

Nothing happened.

His nose still itched. The carpet still tickled it.

He twitched again. Nothing. Again.

He'd felt the urge to twitch, even sensed the signal his brain had sent to his nose to twitch; but his nose had remained as immobile as Washington's on Mt. Rushmore. The itch became increasingly insistent.

He attempted to rotate his head away from the irritating fibers.

It remained as motionless as his nose. The fiber's tickle was rapidly becoming painful, more like needling than tickling.

What's holding me down. Why can't I move?

He heard Fear tap softly at the door in his mind.

He tried to raise his right hand to his face.

It remained frozen.

No, not frozen. Limp. Lifeless.

No, not lifeless. He could feel it. He could feel the long tufts of the dingy-shag-carpet yarn wrapped around his fingers, pressing against his palm, and thrusting up through the hairs of his bare arm.

If his arm had been frozen or lifeless, he would not have been able to feel those things, he reasoned. And he definitely could feel them. It wasn't just his imagination.

He knew exactly where his arm lay in relation to his body even though he couldn't see it. He knew exactly where his left hand was, too, when he shifted his attention to it. In fact, he knew the exact position into which his body had fallen: face down; head turned right; left arm about thirty degrees out from his body and bent outward at the elbow about ninety degrees; right arm straight down and close to his body; left leg straight with toes turned out; and right leg slightly bent, about ten or fifteen degrees from his left with toes turned out.

As he reviewed his body's position, Fear pried the door open a crack. He slammed it shut, but not before a malodorous wisp had entered.

Always a strong boy, Toby Miller had prided himself on being like his father. Fearless. He had always been able to keep that door closed. Even when Fear had managed to ooze under the door like a poisonous gas, spreading its choking miasma, he had been able to defeat it--usually by doing what it told him not to do.

But now he couldn't do that. He couldn't do anything. He couldn't move. He was paralyzed!

The word reverberated in his head. The door flew back and admitted the black, suffocating cloud, choking him, making him gasp for air. His heart raced. He felt as if he were drowning, like that time when he was six and had fallen in the river. His vision blacked out.

Fighting for his life, Toby squeezed his eyes shut and held his breath, not realizing at first that he had done either. Suddenly he became aware that he had.

He had closed his eyes!

He popped them open.

He had control of his eyes!

He had held his breath. He could control his breathing. He wasn't choking. He wasn't drowning.

Fear had done that. Fear had made him think he was dying.

Taking in a deep breath, holding it a few seconds, and letting it out slowly, Toby consciously controlled his respiration. He changed the rate. He changed the pattern. Yeah, he had complete control of his breathing.

While he'd experimented, his heart had slowed to its normal, steady rhythm. The choking fog in his mind withdrew and dissipated like mist in the hot sun.

Okay, I've got some control. Not much, but some. And I'm not paralyzed, because I can feel things. Paralyzed people can't feel. But I can't move either. What's happened to me?

Toby felt Fear push on the door again. He pushed back. He wasn't going to let it take him. He was like his dad. No fear.

Toby didn't know how long he'd been out before coming to, face to face with the sofa; but he doubted it was more than a few minutes, probably less than a minute. He didn't know how he knew this; he just knew that he did. He couldn't see his watch or the timer on the VCR behind him, but he knew.

Actually seeing them wouldn't have been much help because he had no more than a general idea as to when he had walked into the living room. Sometime around ten to three in the afternoon, he thought. Dad had said he'd be back around three so they could go to the fair. He was rarely ever late. They had an agreement about that. If either said they were going to be somewhere at a certain time, they were. They'd made that pact the day Opal had left them. And they'd kept it.

He listened for the truck. Fear still pressed against the door in his mind...waiting. He could feel its pressure. The door had no knob, no lock, no bolt. Nothing to keep it from opening except his own pressure against it.

Fear pushed. He pushed back. It was that simple.

In his mind he still had all his physical strength and all his physical powers. They were concentrated on keeping that door shut. In reality he couldn't do anything except move his eyes and breathe. Listening for the truck distracted him and kept him from thinking about how long he might be like this, about whether he'd ever recover, about whether he'd ever be able to play football again. Or tell his dumb jokes. Or kiss Janet--if he could ever get her to notice him.

At thirteen he had an entire life before him. He didn't know what direction it would take. He wasn't even sure what he wanted to do with it. But he did know he didn't want to be like this: helpless, locked inside his body, staring out at the world, watching people feel sorry for him and being unable to tell them what he thought or felt or cared about. He tensed every muscle, swung his arms, kicked with his legs and wiggled his toes.

He remained inert.

Frustrated and angry, he screamed at his useless body and flailed away at it with limbs that remained utterly still. So what if his father came home. He couldn't tell him anything. He had no way to communicate!

Yes, I do. I can use my eyes.

He thrust Fear's door back into its jamb and banished the insidious, stifling cloud that had wormed its way back into his mind during his self-pitying outrage.

He felt ashamed. His father would never have allowed himself to feel like that. Self-pity was shameful. Worse, it was dangerous. It let Fear enter.

Toby listened to the cars drive by. Some pulled up and parked. He listened to their doors open and close, and to the happy chatter with the occasional, odd grumble. He could only catch a word or two, and once, a phrase. People going to the fair were having to park on the side streets of the town and walk down to Madrone's two block "business district" of store fronts built in the 1870's and '80's.

Tonight a great bluegrass band from Eugene was playing. That's why he and Dad were going tonight instead of tomorrow. Sunday's entertainment was some local kids who called themselves the City Kickers. He'd heard them at school, and they weren't very good. They said they did country rock, but it was mostly just bad rock imitations played really loud.

Toby and his father lived close enough so they didn't have to go to the fair and pay the two dollar admission. They could hear the entertainment from their front porch, but not anywhere near as well as being there. Besides, they would miss the food. And the food was the best part about the fair. They had all kinds of it: barbecue, Mexican, Thai, Chinese, even Greek and Middle Eastern stuff like falafel, dolma, and gyros, which Toby had already sampled for lunch. And the desserts: homemade cakes, pies, cookies, and every kind of fudge you could think of. And none of it restaurant food. These were all homemade goodies from family recipes. That was a fair requirement.

He knew Mrs. Schuyler, next door, had spent the last couple of days baking cookies. This and a dozen other events in Douglas County provided a lot of her income. And she always sold out.

Of course, there were other things at the fair, too. The Oregon wineries set up tasting booths, which he was too young to visit--legally anyway. Last year Harry had managed to get them a glass. What a waste. He couldn't see why anyone would want to drink sour cow piss. That was something he could definitely live without.

Besides which, Dad would tan his hide if he ever caught him drinking, even a little taste. He didn't hold with alcohol at all. He called it a mortal sin.

A bunch of artists, some from as far away as Medford, were there, too. They showed their paintings and pottery and such, but they weren't nearly as interesting as the food.

Their truck's familiar rumble brought Toby back to his immediate situation. He listened to it pull into the drive and heard its door creak open and slam shut with that hollow sound he'd always known. He could even hear his father's boots click-clack on the concrete walk. They pounded up the steps and across the wooden porch to the door. The knob rattled and the door swung open.

"Toby, I'm ho--. Toby! Oh, my God! Toby, what's happened?"

Toby couldn't see his father until he bent over him. Their eyes made contact briefly, but his father didn't seem to notice.

"Toby, can you hear me?"

He grabbed Toby's shoulder and started to roll him over, and then stopped.

"Better not move him till help gets here," he said softly to himself, not realizing he'd spoken aloud. "Help. Got to get help."

Toby felt his father's boots pound away from him across the carpeted wooden floor and then heard them slap the kitchen's linoleum behind him. He heard his father snatch the phone from the wall, spin the dial three times--one long, two short--and talk to someone. Then he ran back, bent over him again, and prayed to the Lord to take care of his boy. Out of the corner of his eye, Toby could just make out his father's hair above the white knuckles of his intertwined hands.

Frustrated and helpless, Toby screamed in his mind at his father and tried to tell him what had happened. But even if he'd been able to talk, he wouldn't have been able to explain anything. Worse, he couldn't tell him he didn't hurt anywhere, that he could breathe and feel and hear and see just fine. He just couldn't move anything but his eyes. If his father would just look at him, he would be able to show him that he wasn't unconscious; but that he was here, locked inside his body, but here.

He closed his eyes and faced Fear's door. In his anger and frustration, it had opened. He had to concentrate on keeping it closed. He couldn't worry about his father or the future right now. He just had to keep that door closed.

He became aware of the siren's crescendoing banshee wail just before it choked off. Doors slammed and booted feet pounded up the same path his father had taken a few minutes ago. Voices surrounded him and produced a jumble of mostly incomprehensible words. He felt rubber-gloved hands squeezing, pressing and moving over his legs and arms. They felt his fingers, curled them, and let them go. Pressing gently, they worked up his back to his neck and his head. Other gloved fingers pulled his eyelids back and a bright light flared, blinding him. He felt himself try to flinch without success. The fingers let go and he closed his eyes. He tried to close them tight, but couldn't.

He felt a band which had been wrapped around his right arm immediately begin to constrict and squeeze his biceps. He recognized the feeling of having his blood pressure taken. The constriction eased, but the cuff stayed in place. He felt fingers press against the pulse in his wrist. Different voices shouted numbers as the hands left him.

Behind him a radio squawked and a voice ran through a rapid routine like an auctioneer. He picked out a few words.

Flaccid.

That means limp, doesn't it? Wasn't that what they said about the kid that got paralyzed in the ball game on the rescue show on TV?

PERL.

What pearl? Where? Did he say my eyes were pearl? What's he talking about? They're blue. No one has pearl colored eyes except Geordi, and he's blind.

Unconscious.

I am not unconscious! Look at me again! Look at me!

He opened his eyes and tried to look up, but couldn't see anyone. The effort made his eyes ache. He closed them again and tried to calm himself. This wasn't getting him anywhere. Somewhere on the periphery of his consciousness, Toby noticed that Fear hadn't been able to open the door even though he hadn't kept the pressure up.

A bulky, soft, but stiff roll was wrapped around his neck. Something narrow and hard was pushed up against his left side. He could feel it press against his arm and leg. Then hands grabbed him all over, pulled his limbs straight, and held his head while they rolled him over onto his back on a hard board.

Thank God.

Toby opened his eyes and tried to make contact with someone. No one looked at his face. Two men in dark blue shirts bent over him. One had a stethoscope in his ears, and he pulled Toby's shirt open. The other peeled large sticky dots off a strip of paper and stuck them to his chest. The first guy put the cold disk of his stethoscope on Toby's chest and listened. Then he moved it down to his stomach. At the same time Toby felt something wrapped tightly around his left arm. This was followed by a sharp jab. He tried to jerk his arm back, but couldn't, of course.

Must be an IV. Amazing what you can learn from TV. I just wish they'd look at me.

Straps were placed across his chest, arms, and legs and cinched tight. Then they picked him up, put him on a stretcher, and rolled him out to the ambulance.

All during the ride to the hospital, Toby continued to try to catch the attendant's eye without success. The medic looked above Toby's head at the wall from which Toby heard a steady beeping sound which he figured must be his heart beat. The attendant looked at the IV bag and drip chamber and fiddled with it now and then. He pumped up the blood pressure cuff and watched it. The only time he looked at Toby's face was when he flashed his light in Toby's eyes.

At the hospital Toby entered a roaring tornado of noise. In short order he was removed from the hard board, put on a thinly padded bed, stripped, pinched, poked, stabbed again, and violated by having a tube impersonally run up his penis by a woman in blue scrubs. She left the tube in and taped it to his thigh. He felt his bladder empty, but he continued to have an urge to pee. Then she put a patient gown over him, snapped its sleeves together around his arms, and pulled a sheet over him up to his chest.

Next he was wheeled to another room and put on a hard, cold table. Looking up, he recognized the business end of an x-ray machine. They moved him through several positions as if he was a side of beef, which didn't seem out of place because the room and table were as cold as a meat locker. While they twisted him this way and that, they talked about all kinds of things except what they were doing. Then they put him back on the stretcher and took him to yet another room with a long tunnel. They put him on a rolling frame. A girl ran him into the tunnel and told him to hold still.

"That's silly, Jessie," the girl said to herself. "He's comatose. He can't move."

No, I'm not! Look at me! I'm here! I'm here!

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Chapter 2

Duck Swoop

 

Three great green baize-like mounds, each surmounted by stands of oak, madrone, and fir, cupped the house and barn in the fold between them. Across these mounds hundreds of biscuit colored sheep moved slowly back and forth, cropping the lush grass. From the road they looked like huge slowly rolling stones except that some of the stones rolled uphill. Others traversed the green felt sideways. Very few followed a stone's traditional path.

A straight, graveled drive bisected eighty acres of pasture dotted with more sheep and led to a copse of silver maples which protected the house from the late June sun. Across a graveled yard from the house stood the barn, a weathered, white-painted wooden structure covered by a gray, baked-enamel metal roof that looked new but was actually five years old. This year the owners planned to sheath the sides in the same material.

Nancy Brandauer, one of the owners, knelt on one knee in the barn and looked over the back of a recently shorn lamb she held with her husband, Ed, the other owner. Contented and at peace, she smiled happily at him.

Nancy loved this time of the year. The rains had slowed to a good soaker every week to ten days. The days in between were usually warm, but the westerly breezes kept it cool enough that stepping into the shade sometimes raised goose flesh. Today's breeze, carrying the scent of firs, pasture, and sheep through the barn, made her glad she'd worn a long-sleeved shirt.

She took a tighter grip on the lamb's neck as Ed lifted the ewe's right forefoot and examined the hoof. She'd been favoring it all day. It didn't look infected, but it wouldn't hurt to paint it anyway.

Ed looked at his daughter, standing by expectantly a couple of feet behind Nancy. In her hand was a can and brush. Baxter, their Australian sheepdog, sat attentively beside her.

"You paint it, Janet, while we hold her." The girl sprang eagerly to the task. "Now, it will be your job to watch her," he continued as she daubed a generous portion of the gook on the hoof. "If she's still favoring this foot on Monday, we'll have to get the vet out here. If it gets worse, we'll have to call him sooner. That means we've got to keep her in the holding pen, and you're going to have to feed and water her. I'll put a bale out for you."

"Daddy, I know all this."

Ed looked affectionately at his daughter. Just finished the seventh grade and hasn't been twelve for a full week yet, but she's all grown up. "I know you're going to be a vet, and you've done this before, but just humor your old man and let him feel like he's doing his job."

"Okay," Janet said, resigned to the task of caring and feeding a father's tender ego. They could be such pains about their little girls growing up. She gave it one more try. "Daddy, it's not a problem. I've got it covered."

"I know you do, Sweetheart. I just feel better when I've gone over everything. Helps me to know I haven't forgotten anything."

"Okay, Daddy. But you ought to know by now that it isn't really necessary."

"I do. But just humor me. Now, she'll need to be checked four or five times a day, not just in the morning and in the evening."

"Does this mean I can't go to the fair?"

"No," Ed grinned, "I think you can still take a couple hours out for that. Even vets get a chance once in a while to goof off."

"Great."

Last fall Janet had announced that she wanted to be a veterinarian. They weren't sure how strong this desire was or how long it would last; but they treated it as they had most of her other enthusiasms and provided her with information on what it took academically to be a vet, arranged for her to go on rounds with their vet for a day, and increased her responsibilities for the animals. Janet, in fact, had been the one to notice the ewe's limp and suggest not only the source of the problem but its treatment. Whether she ultimately became a vet or not wasn't what mattered. That she had the opportunity to fully explore the possibility did.

In her practice as a public health nurse, Nancy had seen a lot of children whose horizons had been limited by their parents' own narrow and foreshortened views. They frequently turned out as churlish as their parents who had suffered from the same upbringing themselves. She had always looked upon this as a validation of the old biblical passage about the sins of the father being passed on to the son.

She and Ed had agreed before they were married that their children would not be so burdened. They would be reared with a strong sense of responsibility and the freedom to go in whatever direction their abilities and interests took them. Being able to have only one child had not led them into the folly of forsaking that pledge. Neither had Janet given them cause to question or regret it.

A buzzer blared, startling the ewe. She bolted from Nancy and Ed's relaxed arms, knocked them over, and charged out of the building into the yard. Janet and Baxter ran after it.

Nancy hated that buzzer. It was so loud she swore her neighbors could hear it even though they were half a mile away. Every time she suggested that they shut it off, Ed said that he needed to be able to hear the phone when he was in the barn or yard. He hated answering machines, which was her alternative to the klaxon.

He'd finally accepted an answering machine only because it was the best of the three bad choices her boss had given her. They'd tried a beeper, but it always went off at the worst possible moment. A cellular phone, for which the county would reimburse only the cost of their own calls, had not even been a consideration. It was just too expensive.

If one didn't know the Brandauers very well, one might think that Ed resented Nancy's job. Nothing could be farther from the truth. He was very proud of his wife and her accomplishments. He just wished her job didn't intrude on their life as much as it did. So did Nancy. She'd hated that beeper more than Ed had. At least the answerer allowed her to screen calls. Even Ed had come to appreciate that little service after a while. He just hated talking to them. Unfortunately today she couldn't screen calls. This was her weekend on call.

She got up, dusting off her jeans while she went to the telephone on the wall by the door. She picked it up just as the answerer kicked in.

"Thank God you're home, Nancy. This is Tom. We've got a Class One Emergency."

Great, just what I need on a Saturday afternoon, Nancy thought. "What is it, Tom?"

"This one is a real bitch. Four teenagers are in a coma."

"So why is that public health's problem?"

Even here in rural Oregon, drug abuse was a major problem. Crank, methamphetamine, was the most popular choice because it was cheap. Since it was manufactured in crude labs hidden in the thick forests that blanketed most of the area, the opportunities for a toxic batch were innumerable. The surprising thing, Nancy thought, was that there weren't more comatose kids.

It's a sad commentary when the first explanation I think of is drugs, she said to herself.

"I know, it sounds like they got a bad batch of drugs or something," Tom said as though reading her thoughts, "except that these kids aren't druggies and their toxi-screens came back negative. That was the first thing they checked. What's more, all of them have been with their parents today, except one, and his dad swears his boy doesn't do drugs."

Nancy accepted that information with a large dose of salt. She knew all too well how little parents knew about their kid's activities. As a Communicable Disease Investigator, she'd seen only too frequently how surprised parents were to find out their angel had hepatitis from drug use, or was HIV positive. And that didn't even begin to touch on the problem with the more common sexually transmitted diseases. But the fact that most of them had been with their parents all day did make it less likely that they'd scored some bad stuff. Not impossible, but a lot less probable.

"Okay," she said reluctantly. "I'll admit it does sound like it might be our kind of problem. What are you thinking? Biological or chemical?"

"I don't know what to think yet. All I know is that we've got four comatose patients and a flock of terrified parents. You know what I always say, 'If it looks like a duck, and walks like a duck--'"

"--It's probably an Oregon college athlete. I know," Nancy finished his lamest joke. She was so tired of hearing it. But he was right. Health had to investigate. "All right, Tom. I'll leave as quickly as I can. Is the media onto this yet?"

"We haven't gotten any calls from them yet, but they'll be on it soon enough. Just keep a low profile. Once you get some idea of what's involved here, call me. Hopefully they won't show up till you've got a handle on this thing. If they do show up, just refer them to me."

"Don't I always? I hate talking to them. I'll call you after I've talked with the parents and the doctors. Will you be at home?"

"No. I'm in the office. I'll be here till I know what we need to do."

"Okay, I'll call from the hospital as soon I know anything."

"Thanks, Nancy. Sorry to wreck your weekend."

"No," Nancy said with elaborate courtesy. "Thank you. You saved me from checking a thousand sheep for foot rot."

Tom laughed. "Say hello to Ed and Janet for me."

"Will do. Talk to you later."

Nancy looked at her watch. 4:13. She turned around and looked at Ed.

"Big problem?"

Nancy nodded. "Sounds like it could be. Four comatose kids, all at once and no idea what the cause is."

Janet ran back into the barn with Baxter shadowing her, and Ed pushed himself up.

"Don't worry. I've got all the help I need to finish up," Ed said, looking at his daughter.

Nancy looked at Janet as she stood beside her father. She's like a time-warp mirror of myself, Nancy thought. Same plaid cowboy shirt, different color, but the same. Same jeans and boots.

Already nearly as tall as Nancy, but slim and a bit gawky, like most kids her age, Janet had Nancy's thick reddish brown hair, clear complexion, soft brown eyes, and generous mouth.

She's prettier than I was at that age. Still a tomboy, too, despite having become a real woman two months ago. She's going to be a handful when those hormones really hit and she realizes that boys can be a lot more fun than dogs and sheep. Sometimes.

---

Chapter 3

Falling Down

 

During the forty minutes it took her to clean up and drive into Roseburg, Nancy ran down a mental list of things that might cause four youngsters to fall into a comatose state almost simultaneously. The closer she got to Douglas County General Hospital, the more she concurred with Tom's assessment of the situation. If drugs and infectious process had been ruled out, which they seemed to have been already, then the remaining possibilities would not be easy to manage, especially from a public health standpoint. In fact, the only good thing she could say about most of them was that they were self-limiting.

In the waiting room of the six bed ER, a kind of organized chaos engulfed Nancy in a whirlwind of scurrying people in assorted forms of hospital dress. She wended her way to the clerk at the admissions desk, flashed her ID, and said she was here to talk to whoever was in charge of the comatose children's cases.

"Thank God! He's been asking about you every couple of minutes."

"Who has?"

"Doctor Stevens. Come with me," she said, grabbing Nancy's hand and dragging her into the alcove that served as the nurses' station. "Just wait here. I'll go get him."

Nancy sat on a chair and listened to shouted orders and vital signs. A corridor stretched before her with three curtained portals on each side. People hurried between these rooms, thrust the pale blue curtains aside, and pulled them back again. The clerk poked her head through one curtain after another till a tall, prematurely graying man in beige scrubs stepped out. She pointed at Nancy and he walked quickly across the room.

"You Brandauer? From the Health Department?"

"Yes. Communicable Disease Investigator. What's going on here? Don't tell me you've still got these kids down here."

"No, they're upstairs. Thank God, the ICU wasn't full and they're not in distress."

"You call being in a coma not in distress?"

"I meant medically. That's the part of this thing that's so weird. These kids are all in great health except that they are comatose. No respiratory problems. No cardiac problems. No health problems at all, as far as we can determine, except that they're unconscious and unarousable. That's why we haven't instituted any isolation protocol beyond the usual universal precautions."

"So who are all these other patients here? Did you get some kind of accident?"

"No. These're the parents, plus a three year old and her parents that just came in by ambulance. They all went into coma shortly after they brought their kids in. I was talking to one of them when it happened. Scary to see, let me tell you. Like watching dominoes tumble. First one, then another, then another. In less than fifteen minutes, nearly every parent dropped to the floor."

"That may be scarier than you think," Nancy said, shuddering involuntarily.

"No, Ms. Brandauer. I worked for WHO before I came here. I know what an epidemic is like. This is bad, but not anywhere near as bad as some things I've seen. It's just scary to see them all fall like that."

"And they're the same as the kids?"

"Exactly. No health problems they didn't have before. No recent infections, except one. We've been checking with each of their doctors and getting negative health histories. All the blood work has come back normal so far, not even an elevated white count, and the stat smears are all negative."

"You mentioned one had an infection."

"Yeah, cut his hand a few days ago and it got septic. He's been on penicillin for a couple of days and the infection is already well under control."

"And nothing else?"

"Nothing. If you want my best guess, I'd say it's some kind of toxic exposure. I don't know what or how, but nothing so far points to an infectious agent."

"What's the count now?"

"Eleven, I think."

"How can you take care of that many?"

"We can't. We're sending most of the adults and the one three year old up to Lane Community in Eugene. We're keeping the original four, which still stretches us pretty thin, but we can manage--if we don't get any more cases. We checked with your boss before setting it up," Stevens added when he saw Nancy start to open her mouth in protest. "He agreed that their care was more important than having them conveniently close for follow-up. Lane Community knows the situation and they will be working with their health department."

"You said nearly all the parents collapsed. Does that mean that there are some who didn't?"

"A father, that's all."

"Where is he?"

"In Two. He seems in perfect health, but then so did the others."

"What's his name?"

"Martin or Marler or something. Miller. That's it."

"Thanks."

She walked as quickly as she could to the room, while dodging a lab tech with a tray of tubes and needles, a couple of nurses, and an orderly with a urinal. From the way he handled the urinal, she was sure it was full.

Inside, a man in his late thirties with collar length black hair and a bushy beard stared up at her with wide, frightened eyes. His torn, stained, striped shirt tucked into jeans with frayed cuffs cut off short suggested that he was a logger. His calf high lace-up boots which lay on the floor beside the bed added to that conviction. The triangular leather pad attached to the right shoulder of his broad, brown suspenders cinched it. Thick wool socks encased his feet and they, like the rest of his clothes, needed a long soak in strong detergent. The sawdust in his hair suggested he'd come straight from the cutting site.

"Who're you?" he asked.

"My name is Nancy Brandauer, Mr. Miller. I'm a nurse and Communicable Disease Investigator with the Douglas County Health Department."

"You don't look like any nurse I ever saw."

Nancy looked down at her plaid western blouse, faded jeans and boots. "No, I guess not," she smiled.

At least these're clean. Should've seen me an hour ago.

"You're not gonna take any more blood are you? It seems like they already took a quart at least."

"No. I just need to ask you some questions about your child. Is it a boy or girl. They haven't told me."

"Boy. Why do you need to know?"

"Because several children and their parents have fallen ill. Was your wife one of them?"

"No. Don't have one. Ran off and left me with Toby."

"I'm sorry."

"Don't matter. Was a long time ago."

"How old is Toby?"

"Thirteen."

"And where do you live?"

"In Madrone."

"Tell me what happened with Toby."

"I don't know. I came home from work and found him passed out on the floor. I couldn't wake him up so I called the paramedics and they brought him here. They couldn't wake him up either."

"Has Toby been sick at all in the last week or so?"

"No. Just his usual self. He's a real good kid. Been real good since that slu--, since his mother left. Real good."

"Do you know if any of your neighbors are sick?"

"Not that I know of."

"What did Toby do today? Do you know?"

"Well, we was gonna go to the fair."

"The Madrone Fair?"

"Yeah. We were gonna go tonight to hear the band. He mighta gone down there for some lunch. He loves that food there. It's usually real good."

"I know. Is there anywhere else he might have gone?"

"I can't think of anyplace. He had a buncha chores to do. I didn't check to see if he'd done 'em or not, but he's usually real good about that."

"Where might he have gone besides the fair?"

"Only over to visit Harry; that's his best friend. But he wouldn't a gone today."

"Why not?"

"Harry and his folks're gone. Took off for Disneyland yesterday."

"But he might have gone down to the fair for lunch."

"If I was a bettin' man, I'd put money on it. Is that what you figure it is? Some kinda food poisoning or something?"

"I don't know. I'm just trying to get as much information as I can so we can figure out what's going on. What did you do yesterday? Where did you go and who did you see?"

"No one. We went out to my cutting site and worked all day."

"Isn't he kind of young to be cutting timber?"

"Oh, he don't do no cuttin' or nothing like that. He just helps me with changin' chains and keepin' the saws gassed and oiled. Then I don't have to stop as much. I can get a lot more cut in less time. I get paid by the tree, not the hour."

"I see. So you didn't see anyone else, then? No one else working near you? Stop for gas, anything like that?"

"Nope. Didn't see another living soul the whole time. Place is real remote. Way out past Driver Valley."

"And you didn't eat out last night, or stop somewhere on the way home."

"No Ma'am. Eatin' out is kinda spendy for us. We planned to eat at the fair today, so that kinda took care of any other treats for the month."

"I understand. Now, Mr. Miller, please don't take offense at this, but I have to ask. Has your son ever been involved with drugs?"

"No, Ma'am."

"You're absolutely certain."

"Yes, Ma'am. Absolutely. Toby is a good boy. I don't let him run with those boys."

"I'm sorry, but you must understand, Mr. Miller, that I have to ask. It's sad, but a drug reaction or overdose or some contaminate in a drug is the most likely explanation for this. I've been told that his toxicological screen came back negative, but that doesn't necessarily rule out drugs. They just test for the most common ones."

Miller's voice took on a bit more edge. "I do understand, Ma'am, and my Toby would never touch that stuff. It's a mortal sin. Same's alcohol. He's been raised proper, especially after his momma run off. He's a Christian young man."

"Thank you. I'm sure he is and I'm sorry I had to ask. I'll let you know as soon as we have anything to tell you."

Nancy left in search of Dr. Stevens. She found him leaving a curtained-off bed.

"Are you certain that you've eliminated drugs as a possible source?"

"As certain as we can be. That was our first thought. We not only ran the standard toxi, but had the lab check for any other toxins they could. All negative. And none of these kid's parents look like druggies."

"That doesn't mean much, necessarily, but I know what you mean. Okay, so that means we can probably eliminate that as a source. Did any of the families mention where they'd been today?"

"No, not really. We didn't ask, and most of them went bad so fast we didn't have time to get anything like a decent history."

"None of them mentioned going to the Madrone Fair?"

"Not to me. But I think I did hear one of the nurses say something about it. But I don't know if she was talking about going herself or someone else going. Why?"

"The Miller boy may have gone to it. The father didn't and he says that's the only place his boy's likely to have gone today. Just a hunch. Which nurse mentioned the fair?"

"Sharon, I think. At least it sounded like her."

Nancy found Sharon and she confirmed that one mother had mentioned being at the fair before she collapsed. Checking with the other two nurses produced nothing further. Neither had heard any mention of the fair by a patient.

"But," the male nurse said, "I did notice a receipt in one patient's purse while I was inventorying her things. It was from a potter who is usually there every year. It was dated for today."

"Thanks," Nancy said.

None of them could give any more definite information about where the patients had been the last two days, or what kind of activities they had participated in. It was frustrating. She needed to establish a common link, some point where all their paths crossed.

In the nurses' station, Nancy dialed Tom Cass's office. He picked it up on the first ring.

Nancy didn't even let him identify himself. "Tom, we've got a huge mess here."

"Tell me about it. You find anyone who can still talk?"

"One father, only he doesn't know anything. He came home and found his son in a coma. Nothing to indicate he was sick before. The only lead I got was that his son probably went to the Madrone Fair."

"That's where I was gonna go tomorrow."

"I wouldn't." She made a mental note to tell Janet and Ed to stay away from there, too.

"You thinking food poisoning?"

"Something. At least two other cases were there today as far as we can tell. I don't know that the vector is food, but that's the most likely since we've pretty well eliminated drugs. It's the perfect setup for this kind of outbreak. It does look like some kind of toxin."

"Yeah, I know. I talked with Stevens while you were on your way in. I gave him approval to transport those people. God knows we can't take care of them all here. I'll scramble a team to check the fair out right now anyway. Maybe we can get lucky and nip this thing in the bud. The townsfolk won't like it, but I'll tell the team to be discreet. No one's died yet have they?"

"Not that I know of. In fact, none of them look sick enough to die. It's baffling. They are perfectly healthy, as far as anyone can tell, except that they're comatose."

"Weird," Tom said, humming the theme from the Twilight Zone. "Watch out for little green men. You know they always land in remote places like Douglas County."

Nancy laughed. "Right. A bunch of little green men ran around the Madrone Fair, snatched whole families at random, and pumped them full of God knows what; and nobody noticed."

"Happens all the time. Don't you read the papers."

"Not those papers. Speaking of which, I haven't seen hide nor hair of the our local press corps yet."

"They'll show. Have no fear, they'll show."

"Well, I'm going to get some names and numbers and see if I can find anyone else who can tell me anything. By the way, Tom, have you called Salem yet?"

"I was waiting for your report. I'll give them what little we've got now and ask them about calling Atlanta."

"Talk to you later."

At the admission clerk's desk, Nancy asked, "Can you put together a list of the families and their addresses and phone numbers for me? I've got to try to find somebody who knows them and can still talk."

"I can give you the admission info sheets. They should have all that. But I'll need them back."

"No problem. And is there someplace private and quiet, with a phone, where I can make some calls?"

"I'll get the nursing supervisor. She can find you someplace."

"Thanks."

Dr. Stevens stuck his head out the door and said, "There you are. We just got another one. Eight years old. Mother is with him now. We've got them in One. You want to talk to her?"

"Yes. Right now."

"I thought you would."

In the room, Nancy established what the woman's name was, where they lived, and that her son had not been sick recently.

"What did you do today?"

"We went to the fair. In fact we were on our way home from there when Teddy said he felt funny. Then he just kinda slumped down in his seat and passed out."

"Did you eat anything there?"

"A little bit of everything I think. Except Teddy didn't have any wine, of course. I had a couple samples. You know, those little taster's cups that hold about a thimbleful. But Teddy had a fajita, and some kind of Greek thing. What do they call it? It's a sandwich made with strips of broiled meat. Oh, I can't think of it. And he had a couple of Cokes. I think he had a couple of cookies, too. I know he hung around the stand playing with the lady's kid and his dog. Cutest little dog; just adorable. And so well behaved and friendly. At first I was surprised that they'd let the dog in, but when I got up close I saw that the boy and dog were standing on the outside of the rope next to the lady's cart. That's funny...I feel kinda faint all of a sudden...my arms. I can't move'em. Why can't I move my arms? Oh, God! Not me, too. I ca--." Her voice expired in a rush of air, and she slid out of the chair like a Slinky.

Nancy yelled for help as she leaped forward to catch the woman's head before it struck the tiled concrete floor. Her left hand provided a bit of a cushion, but did little to slow its descent. Her knuckles paid the price. The woman's eyes held hers, seeming to plead with her in terror, which Nancy knew was just her imagination reading her own anxiety into the comatose woman's stare.

A nurse rushed in. "Just stretch her out in alignment right there," she said and snatched a pillow and placed it under the patient's head while Nancy helped position her. "We don't have a bed free yet, but I'll get us a stretcher or something in a minute." Snapping her stethoscope into her ears, she listened to the mother's heart. Nancy stood up and grabbed the blood pressure cuff mounted on the wall and handed it to the nurse.

Dr. Stevens swept in, took in the scene at a glance, and said, "She passed out right in front of you, right?" Nancy nodded. The nurse looked up and gave him the vital signs she'd just taken. "Just like the others," he said. "Perfectly normal except she's comatose."

---

Mission Journal

Specialist William Nichols recording.

(Translated from the original)

 

Mission Time Reference: 2.032

We have arrived undetected at the observation site. This initial report is delayed because we became ill and unable to carry out the standard setup procedures shortly after insertion. Medical could not identify the specific problem. Best estimate, an unknown infectious agent of local origin. We are progressing rapidly toward recovery.

We may also have suffered some minor physical damage on insertion. The video and audio monitors are functioning poorly. Repair, if it is possible at all, is estimated to take at least until MTR 3.500.

A foray into the population was made at MTR 1.836. We recognize that this does go beyond mission parameters. Failure of the monitors and the uncertainty of their repair forced us to consider alternatives. In the course of a brief exploration of our immediate area, we became aware of a large public gathering and celebration which was taking place nearby. We believed that such a gathering would allow us to mix with the populace in complete anonymity, and we could not let this opportunity to gather direct data pass.

As expected, a great deal of invaluable data was gathered without exposure. Opportunities such as this are rare. A window, extending from MTR 2.714 to 3.218, during a continuation of this celebration, will allow us a second opportunity to observe and collect direct data. In the absence of our ability to use standard monitoring techniques, which we know are of limited reliability in fulfilling the mission objectives, we believe we have no choice but to make use of it, if the mission is to be successful at all.