Critical by Robin Cook Page A

was bouncing from one topic to another. She looked down at the turgid, nearly solid slice of lung she was holding. She knew pathological bacteria were making a comeback, but what she was facing in terms of pathogenicity seemed beyond the pale.
    â€œSo the cases you mentioned earlier were necrotizing pneumonia?” she asked. “Just like this case appears to be.”
    â€œThat would be my guess, but I’d be even more certain if I looked at the microscope section of your case. I’d be glad to take a peek.”
    Laurie nodded. “And Kevin’s cases were the same as yours?”
    â€œVery much so.”
    â€œWere his nosocomial also?”
    â€œOf course. They were nosocomial but also involved the community-acquired strain, the same as mine.”
    â€œWhy didn’t you bring this up at Thursday conference?”
    â€œWell, frankly, it was not that many cases, and everyone is aware of the burgeoning problem of staph, particularly antibiotic-resistant staph.”
    â€œWere the involved hospitals fairly evenly distributed around the city?”
    â€œNo, they were all here in midtown Manhattan. I mean, there could have been cases in Queens or Brooklyn, since they would be sent to their respective borough morgues.”
    â€œWhat hospitals here in Manhattan?”
    â€œI can’t remember the exact breakdown from individual institutions, but all six came from three specialty hospitals: Angels Heart Hospital, Angels Cosmetic Surgery and Eye Hospital, and Angels Orthopedic Hospital.”
    Laurie stiffened. It was as if Arnold had slapped her. “None from Manhattan General or University or any of the other big city hospitals?”
    â€œNope. Does that surprise you?”
    â€œYes and no,” Laurie said, taken aback by such a coincidence. There were a lot of hospitals in New York City. It begged the question: Why just three?
    â€œDid you contact the hospitals, or look into the situation at all? I mean, why just those three hospitals?”
    â€œKevin and I thought it coincidental, so yes, we looked into it to a degree. I also asked for Cheryl Myers’s help as well. I called the Angels Orthopedic Hospital and spoke to a very nice woman whose name escapes me at the moment. I’d gotten the name from the hospital administrator. The individual I spoke with chaired the interdepartmental infection-control committee.”
    â€œWas she helpful?”
    â€œAbsolutely. She said the hospital was well aware of the problem and had hired an infection-control professional, or at least the company that owned the hospital did. So I called this individual whose name I can’t forget was Dr. Cynthia Sarpoulus.”
    â€œWas she helpful?”
    â€œWell, I suppose, at least to an extent.”
    â€œWhat do you mean?”
    â€œShe wasn’t terribly cooperative, although I suppose she was stressed and defensive under the circumstances. My assumption was that her employer, Angels Healthcare, which is the name of the company, had put the burden on her. Anyway, she essentially told me to butt out, and that the situation was well under control, thank you very much. You know the attitude, I’m sure. To her credit, it sounded to me that she was on top of the problem. Against management’s objections, according to her, she had insisted all the ORs in all three hospitals be closed, which also according to her had everybody on her back. She then had all the ORs fumigated by an alcohol-based agent, which is what is recommended. She’d also instigated a rigorous hand-washing regimen. On top of that, she’d had the entire staff tested as potential carriers, and those who tested positive treated. I have to say I was impressed. They surely weren’t sitting around, wringing their hands.”
    â€œThanks for the information. Sorry to take so much of your time,” Laurie said.
    â€œMy pleasure,” Arnold said.
    â€œWould you mind if I came up to your