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Chapter Ten

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“Pfizer man’s here.”

Allison marked her place in the Atlas of Dermatology. Coretha stood in her door. “Skip the Viagra samples but get as much of the Lipitor as you can.”

“You told him last time you’d eat lunch with him.”

Allison groaned. Drug company sales people made a practice of providing lunch to busy physicians and their office staffs just to get a few moments to talk with them about the latest wonder drug and to leave samples. In many offices, it was a tradition—the Pfizer man on Mondays, the Merck woman on Wednesdays and so on. The Winston Medical Clinic had few pharma callers and Allison couldn’t have cared less about the ones who did show up. But samples allowed her to provide medicines to her many patients who could not afford them. Lunch with the drug rep came with the territory.

At the moment, however, she couldn’t even think about eating. She’d almost vomited when she removed the sock of fifty-eight-year-old Wanda Faggart, her first patient Monday morning. The putrid smell of the black, oozing, gangrenous fourth toe on her right foot still clung to her nostrils. On top of that, the call from Josh in Columbus had left her stomach churning.

“Apologize to him for me. And don’t forget to get the Lipitor.” Allison returned to the medical text and found a section dealing with what she had observed in Faggart: a large necrotic ulcer with overlying exudate and surrounding erythema, edema, and eschar formation.

But what had caused the death of the tissue? She turned to her computer and searched her medical sites for causes. There were plenty, from vasculitis to streptococcal infections to a dozen different syndromes and phenomena. But occurrences were extremely rare. In all her prior practice, she’d never seen a single case where the cause wasn’t immediately apparent. Now, within days, she’d seen three cases of tissue death in otherwise healthy people. Scruggs’s nipple ring involved a piercing. He had done it himself. Streptococcal bacteria on the instrument was the presumed cause. In the case of Faggart’s toe and the woman with the infected ear—Audrey Pringle, according to the file she’d retrieved—dirty instruments could not be blamed. Still, she couldn’t shake the feeling that the incidents were related. But how?

She remembered another patient, the woman with the tongue piercing. She buzzed Coretha. “Bring me the file of that that woman whose boyfriend beat her up last week. Sugar something.”

“Candi. Candi Cloninger.”

“Right. The one with the black hole on the x-rays.”

Allison reread her notes. Cloninger had shown swelling and blood near the tongue piercing. Allison had attributed it to the beating. Maybe it was something else. An early stage of what she was seeing in her other patients? She withdrew an x-ray of Cloninger’s skull with the black void in the middle as if there were no bone in the way. “What’s the word from the company about checking the machine?” she asked.

“They can’t get a tech here until Wednesday.”

“Wednesday? We need to know before then.”

“Is there a way we could do our own test?”

Allison thought about it. “Can’t hurt, I guess.”

“Start with a fresh box of film in case there was something wrong with the last one.”

A new box was lying on the counter. Allison opened it and took three views of Coretha’s wrist and hand.

The x-rays showed just a touch of arthritis in Coretha’s fingers—and a very unexpected dark black ring about the diameter of a nickel that cut into Coretha’s wrist in two of the films. The area inside and immediately around the ring was almost as dark. The ring wasn’t visible on the third.

“That’s weird.” Coretha rubbed her wrist. “What the heck is going on?”

“Something’s wrong somewhere, that’s for sure,” Allison agreed. She reviewed the variables—machine, film, Coretha—and concluded she could rule out Coretha because the black ring wasn’t always there.

In terms of the machine, she couldn’t think of a problem that would produce two unexpected and very different anomalies—a tennis ball-sized void in Cloninger’s mouth and the ring-like void in Coretha’s wrist.

Coretha anticipated her next thought. “I’ll call our film supplier. Maybe someone else has reported problems.”

“Good idea. And let’s hope no one comes in with a broken leg.”

Coretha laughed. “At least until Wednesday.”

Still brooding at the end of the day over the unexplained occurrences of tissue death, Allison packed the stack of medical journals she had set aside for the evening—even though she knew they likely would go no further than the pile on her bedside table—and went home.

She knew something was amiss as soon as she cracked the front door. Invariably, Hippocrates sauntered up the greet her. Not today. She checked his usual napping places—under the bed, in the towel bin, on top of her winter boots in the closet—and found no sign of her beloved cat.

“Hippocrates!” she called. She waited for the sharp cry of acknowledgement that always came. Silence.

She tried to reconstruct the morning. Was it possible she mistakenly left the cat outside when she’d gone to work? She slid open her patio door and called into the evening. Quiet, except for the muted engines of a passenger jet throttling back overhead and the whoosh of tires on a nearby road.

Panic swelled within her as she imagined the worst. Hippocrates was her truest companion—unquestioningly loyal, unconditionally loving, consistently comforting. Plenty of research showed that pets could enhance their owners’ mental health and sense of well-being but she believed Hippocrates actually had the power to heal. Strange, she knew full well, that a doctor would believe such a thing about her cat. But she had evidence. Just as she had rescued the malnourished black and white shelter kitten during the meltdown stage of her marriage, Hippocrates had rescued her.

Now, the only friend she could count on was missing. Worse, it was her fault.

Her search of nearby roads turned up no sign of the cat. She felt sick. An innocent life had been entrusted to her and she had fallen short. She returned to her condo and cried. When she was done, she took a deep breath, curled up on the couch with a throw and resolved to wait up for him. She couldn’t think of anything else to do.

To pass the time, she tried to think about the other mystery of the day—the cases of unexplained tissue death among her patients. At least that mystery offered her leads to pursue. She dialed the clinic. Coretha wouldn’t be there until the morning but Allison wanted her to get the message first thing. “Find Audrey Pringle, Ricky Scruggs, Candi Cloninger and Wanda Faggart. Get them to come to the clinic. I need to give them another look.”

She sank bank into the cushions, readjusted the throw and resumed torturing herself.

Fallout

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