Vital Signs dmb-2, page 26part #2 of Dr. Marissa Blumenthal Series
Twenty minutes later she pulled into Windorah. She was glad to be there, although the town was hardly a scenic oasis.
At the center of town stood a one-story green, clapboard pub cum hotel with a wooden veranda. A sign proclaimed it as the Western Star Hotel. Across the road from the Western Star was a general store. A little farther down the way was a gas station that looked like it was circa 1930.
Marissa entered the pub and endured the stares of its five male customers. They had paused in their dart game and were looking at her as if she were an apparition. The pub owner came over and asked if he could help her.
"I'd like a room for two nights," Marissa said.
"Do you have a reservation?" the man asked.
Marissa studied the man's broad face. She thought he had to be joking, but he didn't crack a smile. She admitted that she didn't have a reservation.
"There's a boxing troupe in town tonight," the man said.
"We're pretty busy, but let me check."
He went over to his cash register and checked a notebook.
Marissa glanced around the room. All the men were still staring at her. None of them moved or said a word. They didn't touch their bottles of beer.
The man came back.
"I'll give you number four," he said.
"It was reserved, but they were supposed to check in by six."
Marissa paid for a night's lodging, took the key, and asked about food.
"We'll fix you up something here in the pub," the man said.
"As soon as you freshen up, come on back."
"One other question," Marissa asked.
"Is the Wilmington Station close to town?"
"Tis," the man said.
"Quite close. Less than three hours' drive due west."
Marissa wondered how many hours it would take to get to a distant station if it took three to get to a close one. Before she went to her room, Marissa used a public phone to ring the car rental agent to say that she had made it.
She was pleased to discover that her room was reasonably clean. She was surprised to see mosquito netting draped over the bed. Only later would she learn how important it was.
The rest of the evening passed quickly. She wasn't very hungry and barely touched her food. She did enjoy the ice cold beer.
Eventually she found herself in friendly conversation with the men in the bar.
She was even persuaded to join them at the boxing show, which turned out to be an opportunity for the locals to box with professionals. The ranchers would win twenty dollars if they were able to last three one-minute rounds, but none of them ever did.
Marissa left before it was over, appalled by the violence the drunken men subjected themselves to.
The night was terrible. Marissa was again bothered by horrid dreams of sharks and Wendy being eaten. On top of that, she was tormented by drunken shouts and fights outside her door. She also had to do battle with all manner of insects that somehow managed to penetrate the netting around her bed.
By morning, Marissa was even more tired than she'd been the day before. But after a shower and some strong coffee, she thought she could face the day. Armed with directions from the hotel owner, she drove out of Windorah and headed to the Wilmington Station on a dusty dirt road.
The cattle ranch looked just as she imagined it would, consisting of a series of low-slung wooden sheds, white clapboard houses with sheet-metal roofs, and lots of fencing. Many dogs, horses, and cowboys were in evidence. Over the scene hung the unpleasant but not unbearable ripe, musty odor of cow dung.
In contrast to the staring disbelief her arrival caused in the pub in Windorah, Marissa was shown every possible hospitality at the cattle station. The cowboys, referred to as stock men literally fell over each other trying to help her, getting her a beer and offering to take her to the makeshift airstrip for the doctor's scheduled noon arrival. One of the stock men explained their behavior by telling her that an attractive unaccompanied female showed up at a cattle station about once every hundred years.
By eleven-thirty Marissa was out at the airstrip, sitting in her Ford Falcon under a lone gum tree. Out in the sunlight closer to the strip was the Wilmington Station Land-Rover. Just before twelve, she got out of the car and left the tree's shade. Shielding her eyes from the sun, she searched the pale blue sky for a plane.
The day was just as hot as the previous one and just as cloudless.
Nowhere could she see a plane. She listened hard but the only thing she heard was the breeze through the acacia.
After ten minutes Marissa was about to get back into the car when she heard the faint drone of an airplane engine. Raising her eyes to the sky again, she searched for the source of the sound.
She didn't spot it until it was almost on top of her.
The plane banked around the airstrip. The pilot seemed to be deciding whether or not he wished to land. At last, after a second pass, he brought the plane down.
The Beechcraft King Air taxied toward the Land-Rover, then pulled around into the wind. The pilot feathered the engines and prepared to deplane.
Marissa walked briskly toward the plane as the pilot was opening the cabin door. The man who had been sitting in the Land Rover stepped out into the sunlight, flicking a cigarette butt into the dust.
"Dr. Williams!" Marissa called.
The pilot stopped just beside his plane. He looked in Marissa's direction. He was carrying an old-fashioned doctor's bag with brass trim.
"Dr. Williams!" Marissa repeated.
"Yes?" Tristan said warily. He eyed Marissa from head to toe.
"I'm Dr. Marissa Blumenthal," Marissa said. She stuck her hand out. Tristan shook it hesitantly.
"Glad to know you," he said. He didn't sound as if he was sure.
Marissa was mildly surprised at the man's appearance. He didn't look like a pathologist, at least not like any of the pathologists she knew. His face was heavily tanned and he was sporting about a three-day growth of beard. He was wearing a beat-up, classic, wide-brimmed Australian outback hat tacked up on the side.
Instead of a doctor, Tristan Williams looked more an outdoorsman, a stockman perhaps. He had rugged good looks and sandy-colored hair a shade lighter than Robert's. He had an angular jaw like Robert's, but that's where the similarities ended.
Tristan's eyes were deeper set, though Marissa could not tell their color since he was squinting in the glare. And his lips weren't narrow like Robert's. They were full and expressive.
"Would it be possible to talk to you for a moment?" Marissa asked.
"I've been waiting for you to come. I've driven all the way from Charleville."
"My word!" Tristan said.
"It's not very often I get met out here by a good-looking sheila. I'm sure the folks at Wilmington Station can wait for a few minutes. Let me tell the driver."
Tristan walked over to the Land-Rover, storing the doctor's bag in the back seat of the vehicle. Marissa noticed that he was slightly taller than Robert, well over six feet.
When he returned, Marissa suggested they sit in her car in the shade. Tristan agreed.
"I've come all the way from Boston to talk with you," she said once they were in the car.
"You've not been easy to find."
"All of a sudden I'm not sure I'm going to like this," Tristan said, eyeing Marissa.
"Being found hasn't been something I've been interested in."
"I want to talk to you about a paper you wrote," Marissa said.
"It was about tuberculous salpingitis."
"Now I know I'm not going to like this," Tristan said.
"If you'll excuse me, I have patients to see." He put his hand on the door handle.
Marissa reached out and grabbed his arm.
"Please," she said.
"I have to talk to you."
"I knew you were too good to be true," he said. He pulled away from her grip and got out of the car. Without looking back, he walked over to the Land-Rover, got in, and drove away.
By the time Marissa arrived at the Wilmington Station, she was covered with dust. The entire drive she'd been enveloped in the wake of the Land-Rover. Even her mouth felt gritty.
Tristan had already gotten out of the Land-Rover. He was heading up the long walkway toward a small house, medical bag in hand. Marissa ran to catch up to him. Falling in step alongside him, she tried to catch his eye. She had to take five steps to keep up with his every three.
"You have to talk with me," she said when it became clear he intended to ignore her.
"It's very important."
Tristan stopped short, "I'm not interested in talking with you," he said.
"Besides, I'm busy. I've got patients to see, including a very sick little girl, and I hate pediatrics."
Marissa brushed her dusty hair from her forehead and squinted up at Tristan. Even though his eyes were deeply set, she could now see they were blue.
"I'm a pediatrician," she said.
"Maybe I could help."
Tristan studied her face as he chewed on the inside of his cheek.
"A pediatrician, eh?" he said.
"That's mighty convenient." His eyes strayed to the front door of the house. When he looked back at Marissa, he said: "I can't turn that down, not with what I know about pediatrics."
The patient turned out to be an eight-month-old baby girl who was acutely ill. She had a high fever, a cough, and a runny nose.
The child was crying when Marissa and Tristan entered her room.
Marissa examined the infant while Tristan and the anxious mother watched. After a few minutes, Marissa straightened up and said: "It's measles, without doubt."
"How can you tell?" Tristan asked.
Marissa showed him the small white spots inside the infant's mouth, the reddened eyes, and the faint rash just beginning to appear on the forehead.
"What should we do?" he asked.
"Just get the fever down," Marissa said.
"But if complications occur, the child should be hospitalized. Is that possible?"
"Certainly," Tristan said.
"We can airlift her to Charleville, or even Brisbane if necessary."
For the next few minutes Marissa discussed the situation with the mother, describing the telltale signs of trouble. Then they discussed where the child could have picked up the virus. It turned out that two weeks previously, the family had visited relatives in Longreach, where there had been a sick child.
After discussing prophylaxis for the other children at the station,
Marissa and Tristan left the mother and walked toward the next house on Tristan's list.
"Thank you for helping," Tristan said as they mounted the stairs to the second porch.
"I think you could have handled it without me," Marissa said.
She was tempted to say more, but her intuition told her to wait.
Marissa stayed with Tristan and helped see the rest of the patients at the station. All were routine except for an old woman of ninety-three who was dying of cancer but refused to be taken to a hospital. Tristan respected her wishes and simply provided for her pain.
Walking out of the last house, it was Tristan who brought up the paper.
"I guess my curiosity has gotten the best of me," he said.
"What possibly could have motivated you to come all the way out here to ask me about a journal article that was discredited?"
"Because I'm suffering from the syndrome you described," Marissa said, keeping pace with him. They were heading toward the communal food-service area.
"And because the syndrome has been appearing around the United States and even in Europe."
She wanted to ask straight off why he'd made up cases, but she was afraid such a question would end the conversation.
Tristan stopped and studied Marissa.
"You had tuberculous salpingitis yourself?" he asked.
"Confirmed by biopsy," Marissa said.
"I never knew I'd had it. If I hadn't tried to get pregnant, I probably never would have known."
Tristan seemed deep in thought.
"I've been trying to learn something about it," Marissa continued, "but it's been difficult. In fact, it's been a disaster. I've just lost a friend. I'm even wondering if she was killed."
Tristan stared at her.
"What are you talking about?"
"I came to Australia with a friend," Marissa explained.
"A woman suffering from the TB salpingitis just like me. We came because of your article, and inquired about you at FCA in Brisbane.
They were less than helpful there."
Marissa went on to describe what had happened out on the reef, saying that she felt that Wendy's death might not have been accidental.
"And I'm beginning to think that my own life may be in jeopardy," she added.
"But I really can't say I have any evidence of that."
"This all brings back bad memories," he said with a shake of his head. He tilted his hat back and scratched his forehead.
"But maybe I'd better tell you my story so that you have some idea what you are up against. Maybe then you'll go home and live your life. But the telling will take a while. And it's for your ears only. Agreed?"
"Agreed," Marissa said.
"All right," Tristan said.
"Let's go inside and get a couple of stubbies."
Tristan went into the canteen and walked directly into the kitchen. The crew were busy cleaning up from the noonday meal, From the fridge he got two ice cold beers and carried them into the empty dining room. Motioning toward one of the picnic like tables, he popped the tops of the beers and handed one to Marissa.
She sat down facing him.
"I was employed by FCA directly from my specialty training in pathology," he said after a long pull on his beer.
"I was impressed by the organization. It was expanding. Right after I was hired, the chief of the department, that's what he called himself, came down with hepatitis and had to take an extended leave. Since there were only two of us in the department back then, I found myself the chief." Tristan chuckled.
"Almost immediately," he continued, "I started seeing these cases of granulomatous salpingitis, one after another. I knew it was unique, and having just come from training, the possibility of making some kind of academic discovery held great appeal. I have to admit I also liked the idea of getting a paper in one of the journals. So entirely on my own, I decided to write the cases up.
"My first suspicion was tuberculosis, despite TB being rare here in Australia. But since we'd been having a recent increase in immigration from Southeast Asia, where TB is still endemic, I thought it was possible.
"But I had to be sure it was TB. I ruled out fungi through elaborate stains. It definitely wasn't fungi. I looked exhaustively for organisms, but could never find any. But still I was sure it was TB."
"What about sarcoid?" Marissa questioned.
Tristan shook his head.
"It wasn't sarcoid," he said.
"The chest X-rays were all normal and none of the patients had swollen glands or eye problems.
"So I was confident that it was TB although I had no idea how it was spread. But then I made an association with something else that was going on at the clinic. About a year before I began seeing these cases, the clinic had started having Chinese technicians and security people rotate through some sort of fellowship program.
I thought that the clinic was training the technicians in in vitro fertilization to go back to Hong Kong where they'd come from.
But I wasn't sure. They always came in pairs and didn't stay long.
Only for a few months. Many di
"Where did they go after their fellowships?" Marissa asked, recalling the pair of Chinese at the Women's Clinic.
"I had no idea," Tristan admitted.
"I assumed back to Hong Kong. I had never been interested, at least not until I started looking into the TB cases. Then I became curious. So I scheduled a meeting with Charles Lester, the director of the clinic, and I asked him about the Chinese. But he told me it was classified information. All he would say was that it had something to do with the government!"
"What could I do? I asked a few other people, but no one seemed to want to talk about it. But then a pair of Chinese got in a bad car accident. Bad enough to kill one and hospitalize the other. They hospitalized him in the FCA facility. He was the only male patient they'd ever had.
"I made it a point to visit the bloke, just about every day. He was tight-lipped but could speak English. Not a lot, but enough.
His name was Chan Ho. I tested him for TB without anyone else knowing, but was disappointed when he tested negative because it blew holes in my theory. Still in the process of stopping by every day I got to know the fellow a bit. I learned he was some kind of Buddhist monk. He'd learned Chinese martial arts as part of his studies. Now, that caught my attention; martial arts have been my sport since I've been knee-high to a wallaby. When the bloke got out of the hospital, I invited him to come to my gym.
He turned out to be unbelievable at kung fu."
Marissa remembered how the Chinese man in the gray suit had disarmed Paul Abrums with a deft kick.
"Then I learned something else: Chan loved beer. He'd never had any until he'd come to Australia, or so he said. I discovered that after a few good Australian beers he loosened up. That's when he really surprised me. I found out he wasn't from Hong Kong at all, he came from a town near Guangzhou in the People's Republic of China."
"He was from Communist China?" Marissa asked.
"That's what he told me," Tristan said.
"I was surprised too.
Apparently he'd just passed through Hong Kong-illegally, I might add. One night I managed to get him really pissed-" "You got him angry?" Marissa was confused.
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