Malicious Intent (27 page)

‘Organic or manmade?’ Anya asked.

‘Manmade, it seems. Whatever the fiber, it is the same in both cases.’

Anya sat back. ‘So, they
are
identical. Whatever we saw on Clare Matthews’ slide was the same as Alison Blakehurst’s.’

‘Your judgment was sound. Nice bit of pathology work.’

‘She’s been trained by the best,’ Elaine added.

Peter stuttered for a moment, something Anya had never KATHRYN FOX

213

before witnessed. Seeing her mentor vulnerable in the presence of her secretary didn’t feel right.

‘We have the chemical composition,’ Peter added, ‘but it doesn’t match any of the controls. I checked with the Dust Diseases Board but they don’t have records prior to 1967. It must be something that was in use before that.’

Elaine listened, then said, ‘What about building suppliers?

If you know what it’s made of, can you find out where it was made?’

‘Unfortunately, it isn’t that simple,’ Peter said. ‘Asbestos and similar materials are found in a plethora of products. For example, asbestos can be found in roofing, sheeting for sheds, linoleum, brake linings. The list is almost endless.’

‘What I don’t understand,’ Anya said, ‘is if this fiber is old, why it is turning up now in young women?’

‘That bothers me, too. The time lag for developing disease from these things is twenty to forty years and, of course, cigarettes exacerbate the condition. As far as I can tell, neither of these women smoked or had obvious exposure.’

‘Clare Matthews was orphaned and grew up in foster homes, and Alison Blakehurst grew up around a clothes shop business.’

‘We don’t know if the fiber itself causes disease, but if the body coats it in protein, it has already induced an inflammatory response, even in young people. That is a genuine concern.’

‘Maybe someone is recycling the material without knowing what it contains,’ Elaine suggested.

‘We still need to identify the fiber to find out where the women came into contact with it. Did they do X-ray diffraction?’

Peter nodded. ‘In addition to electron microscopy.’ He pulled a page from the file. It included a graph of a continuous black line with a series of vertical peaks and troughs. ‘There are several prominent peaks that correlate with those found in amosite asbestos, but the central ones’ – he pointed with his pen, – ‘don’t match any of the controls on record. We know the substance has a chrysotile core made of hydrated magne-sium silicate, but the percentage of elements is unique.’

214

MALICIOUS INTENT

Elaine stopped writing. ‘There must be other ways of finding out what it is.’

Anya tapped her desk. ‘For that, you have to send it to Western Australia.’

The area of analysis had become so subspecialized, only one lab, located in Perth, was capable of performing the detailed molecular analysis.

‘It’s the only lab with the facilities to test it further.’ Peter again turned to Elaine. ‘They determine the molecular structure of the substance. That’s the equivalent of a fingerprint, if you like, which can be matched to a larger database. It is, unfortunately, very expensive to do.’

‘Why don’t you pass it on to the public health unit? Surely they’ll want to know about this fiber so they can warn people about it.’

‘It’s not that straightforward, Elaine. We’re in a bit of a catch-22. The public health unit doesn’t want to know about it unless it’s a notifiable disease. And until we can confirm what it is and that is causes disease, they’re not interested.’

‘So by the time you find out what it is, it’s already a public health problem. What is wrong with these bureaucrats?’

Anya pulled out some notes she’d taken. ‘Could we talk about what we know about the dead women who inhaled the fibers? In terms of backgrounds, the women, including the overdose in Merrylands and the murder-suicide from the coast, have absolutely nothing in common. They didn’t even grow up in the same place. What we do know is that they are all recorded as deaths by suicide, or in Fatima Deab’s case, accidental overdose. All have the fibers and all went missing. Two had herpes and two that we know of had shaved pubic regions.’

‘Make that four,’ Peter said. ‘I checked. Neither Clare Matthews nor Alison Blakehurst had any pubic hair.’

Anya leaned forward. ‘Are you sure?’

‘Alf Carney’s registrar started the PM and he was keen to do all the right things, exactly by the book. He documented a complete absence of body hair. Seems he’d never seen completely KATHRYN FOX

215

hairless genitalia before. And sorry it took so long, but I had to track down the junior registrar who did Clare Matthews’s PM.

He’s on holidays in Queensland, but remembered the case. He sounded pretty sure she had no pubic hair, even though that wasn’t documented at the time. Unfortunately, I only examined the neck wounds on the body.’

Anya wondered if the police would still dismiss information that could prove so important. Identical fibers, shaved pubic regions, disappearances and suicides. She remembered Detectives Filano and Faulkner arguing about the coroner’s rulings of suicide. They’d still consider the fibers and shavings as coincidence, and they believed the women left of their own choice.

No mystery disappearace, apart from Clare Matthews. Her pregnancy and suicide could easily be explained by believing she screwed up her life and couldn’t cope, as Filano put it. So far nothing connected Mohammed Deab to the other women.

Anya needed more.

Peter continued. ‘You mentioned herpes over the phone. As you know, we don’t ordinarily do swabs, but the registrar for Alison Blakehurst was initially concerned about a streptococcal infection and questioned rare causes of sepsis.’

He addressed Elaine. ‘Don’t worry about writing down any of this. The woman was found in a hotel room. She’d swallowed a cocktail of pills and died after choking on her vomit.

My senior registrar couldn’t exclude overwhelming infection as a precipitant for the vomiting and aspiration, which caused death. Of course, he didn’t have the benefit of a toxicology report at that stage. He diligently conducted the PM as he should have. Mind you,’ Peter added, glancing at Elaine, ‘he once wrote that a deceased gentleman looked like Yoda from
Star Wars
. Turns out the poor chap had a rare syndrome that makes people look exactly like Yoda. Of course, we couldn’t put that on the formal report, but we all had a clear image of exactly what he had seen.’

Elaine giggled.

Peter became serious again. ‘The herpes culture came back 216

MALICIOUS INTENT

drug-resistant. So now you have two of the four with drug-resistance and no obvious immune system suppression.’

Anya shook her head. ‘It’s like playing that game where A and B are the same, and A and C are the same, therefore B

equals C.’

‘Syllogistic logic, I believe it’s called,’ Peter said, stroking his beard.

Elaine drew three circles surrounded by a rectangle. ‘Sounds more like those circles and sets we used to draw with subsets at school.’

Anya drew three large intersecting circles on her notes. In one she wrote ‘lung fibers’, ‘herpes’ in the second, and ‘pubic hair’ in the third. ‘All four women had fibers and shaved pubic hair, but Fatima and Alison were the only ones known to have herpes.’

Elaine offered, ‘Is it too late to check whether the other two had the virus?’

‘Good thought, but unfortunately, the virus would have only survived in any blood samples for a few days, and if there weren’t any obvious blistery lesions, the chances of culturing it at the time were pretty much zero, anyway. Debbie Finch’s report didn’t mention blisters.’

Peter Latham appeared to be deep in thought. ‘Out of context, none of the findings means much. But when you look at the ages of the women, their disappearances and deaths, you can’t help but suspect that they are very closely linked. I have had an uncomfortable feeling about the Matthews case from the start.’

‘I know this is going to sound farfetched,’ Anya ventured,

‘but I can’t help thinking these women might have joined the same cult, religion, or whatever you choose to call it.’

Elaine looked shocked. ‘A cult here in Sydney?’

Peter scratched his beard again. ‘It’s not implausible. Suicide seemed to go against Clare Matthews’ beliefs, for one. Something or someone had a big influence on her.’

Anya began the instructions. ‘Elaine, could you do some KATHRYN FOX

217

chasing up for me? I want to know if there are any cults in this part of the state. You could try searching the Internet, newspaper articles, maybe even consumer complaints, and checking with the police. Peter, could you arrange to have the fibers from the Finch woman and Fatima Deab tested, too? We don’t have much unless we can confirm the fibers from the others are identical to these.’

‘Of course.’

‘Can I ask you both to keep this quiet until we know if there are any more cases? In the meantime, I’ll have a chat with the microbiologist and see if there’s a link between the two herpes infections. I’ll also put another message on the histology forum and see if anyone recognizes the fiber. The sooner we find out what we’re dealing with, the better.’

After Peter had left, Anya wanted to discuss the new information with Kate and dialed her mobile. The call diverted to voicemail.

‘Hi Kate, Anya. I know the other day at the station didn’t go well, but I’ve some more info about those cases. It’s important. Please call me back.’

34

At 1:00 pm Anya arrived at the desk in the outpatients department at Western District Hospital. Toddlers ran around and between rows of plastic chairs occupied by women at various stages of pregnancy and, judging by the amount of crumbs on the carpet, the mothers-to-be had been waiting a while. Across the aisle, men and women with casts, crutches and slings filled the seats. Pretty much like the clinics Anya remembered from her resident years – too many patients and too few medical staff.

‘Dr. Crichton.’ Professor Hammond came out of a side room and placed a file in a basket attached to the outside of the door. ‘Don’t tell me. Um, got it! You were a path registrar when we dealt with that outbreak of meningococcus in the preschool down the road.’

He shoved both hands into the pockets of his knee-length white coat and rocked on his heels.

‘That’s right.’ Anya clearly remembered. ‘Ten or more children were admitted here and we had to examine and interview two hundred contacts in twelve hours. One of our more stressful days.’

‘Even though we warned them about the side effects of the prophylactic antibiotics, the sight of all those toddlers crying KATHRYN FOX

219

orange tears panicked the staff. They closed it down for weeks, despite our reassurances.’ He rocked one more time, as though remembering the episode with fondness.

‘I’m sure you’ve come to discuss something other than old times, and I’m about to start an STD clinic.’ He shrugged his shoulders. ‘Or I should say “sexual health clinic,” to be PC.’

Jules Hammond ran the microbiology department at one of the state’s biggest pathology centers. He came from another time – when nurses trained in hospitals, not universities, his patients suffered from ‘venereal disease’ and doctors all wore white coats. Although he had accommodated most of the changes, the white coat, which he usually buttoned right up, had become the enduring image of a bygone era.

‘I know you don’t have much time so I’ll be brief.’ Anya stepped away from the desk and out of the nurses’ hearing range.

‘A couple of months ago your lab did some sensitivities on a herpes simplex virus detected on the genitals of a young woman who died of a drug overdose. The virus was multidrug-resistant.’

‘We do tend to see it in people who are immunocompromised. Drug addicts’ immune systems are exposed to an awful lot of abuse, not to mention innumerable infectious agents.

Look at the high incidence of bacterial endocarditis and staphy-lococcal sepsis they get. Of course, nutrition is vital to maintaining the immune system so, if an addict is malnour-ished, immunocompromise is more likely.’

One thing about experts in fields of medicine: they never gave succinct answers. Anya listened patiently, careful not to offend him by interrupting a point. She spoke when he allowed.

‘This girl wasn’t an addict. Blood levels and absence of injection sites suggested it was her first time. She could have been undernourished with a body weight of forty-five kilograms, but was otherwise well.’

‘Drug-resistant herpes is moderately rare in healthy people.’

He rocked on his heels again.

‘We’ve identified a second case of drug-resistance in another healthy woman.’

220

MALICIOUS INTENT

The pager in Hammond’s top left pocket beeped and he checked the number.

‘Clinic’s beginning around the other side. Do you mind walking with me?’

‘No problem.’

They hurried along a badly worn blue carpet. Every section in the hospital was color-coded so people could find their way.

Anya felt like Dorothy following a ‘blue brick road.’

‘Now where were we?’ Professor Hammond asked, over-taking a young woman in a wheelchair. ‘We have seen that a bit around here, but you’re more likely to see resistant strains in the inner city, where they treat greater numbers of end-stage HIV

cases. Of course malignancy, and chemotherapy, can cause immunosuppression. You’re sure the women weren’t on treat-ments for autoimmune diseases? Arthritis, for example?’

‘Nothing. What I’m trying to find out is whether both women had relations with the same contact. They are both dead, so they can’t answer that question. Is there any way you can work backward, and confirm the viruses are the same strain?’

They turned into an uncarpeted corridor, Anya’s heels clomped conspicuously on the hard floor.

Jules Hammond slowed his pace. ‘Logically, you’d have to go to the molecular level to prove the viruses are related.’

‘Is that possible?’

‘Theoretically speaking, you could do a phylogenetic analysis.’

Anya stopped short of a yellow ‘wet floor’ sign as a cleaner mopped the floor up ahead. ‘What does that involve?’