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Authors: Kathryn Fox

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‘Three steps. First, you map out the genetic makeup of the herpes virus and that of your other suspected contact, which in this case is the two women you described. Then you compare it to a run-of-the-mill herpes virus found in other people in the community, presumably who had no contact with your two women.

‘You look to see whether those viruses resemble each other at a molecular level. In other words, are they related strains? In fact, phylogenetic analysis is the only way you can really see KATHRYN FOX

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whether the viruses are likely to have come from the same source.’

‘Is it difficult to do?’

‘Not really, it’s usually done for HIV, to identify new and unusual strains. We don’t ordinarily do it for herpes viruses, but there’s no reason why we couldn’t.’ He paused and rubbed his chin. ‘It’s an expensive process. I’d need good reason to justify it.’

‘I’m trying to determine whether these women contracted the infection from the same man, which would mean that their deaths, which were both initially ruled as suicides, may need reinvestigation. Apart from that, if we’re sourcing contacts as we are supposed to do, we should know if someone is practicing unsafe sex and infecting partners with a drug-resistant strain of herpes. If he has a number of sexual contacts, we could see an outbreak of a pretty much untreatable condition.’

‘You certainly do present a compelling case.’ He smiled approvingly. ‘Write down the names of the patients and give them to my secretary. I’ll see what we can do.’

His pager beeped again.

‘And please include your contact details so I can let you know the outcome. Might take a couple of weeks. Now, where was I? Oh yes. The clinic.’

Professor Hammond hurried off down the corridor, barely avoiding the cleaner. Only an infectious diseases specialist would scurry like that toward a sexual health clinic.

35

While you were out, a medical student popped in.’ Elaine blew her nose.

‘Something about another case she’d found from four years ago. She was in a hurry to get to a lecture.’

‘Did she say where she’s going to be this afternoon?’

‘Only that she had exams coming up and would be study-ing. She stayed long enough to write you this note.’

Anya put her bag down, kicked off her shoes and sat down to read Zara’s message.

The woman had died aged forty-five years. The autopsy, performed on Lucinda Tait at Western Forensics’s morgue, cited cause of death as pneumonia secondary to chronic airflow limitation. It noted large numbers of fibers in the lung peripheries. An addendum to the histology report said that the fibers remained unidentified. No records of such a fiber at the Dust Diseases Board or through the public health unit. The coroner deemed death by natural causes and released the body for cremation.

The place of death took Anya by surprise. Lucinda Tait had died at the Meadowbank Nursing Home in Pennant Hills.

Zara had phoned the nursing home for the name of any relatives but was told they would not release information unless KATHRYN FOX

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requests went through the appropriate processes. Predictably, the staff couldn’t tell Zara what that actually meant.

‘She’s a funny girl.’ Elaine wiped her nose and replaced the tissue inside her cardigan sleeve. ‘Can’t imagine her as a doctor.

A dentist, perhaps.’

‘Zara’s got a lot to learn, but she’s determined. The intern year will make or break her. Nonstop patient contact is the best test of all.’

‘The counselor from the sexual assault unit phoned, Mary Singer. The woman you examined the other night has refused to make a police statement. She thought you should know.’

Anya quietly sighed. She had learned to accept a victim’s decision regarding police involvement but was always concerned when the evidence taken was disposed of. It could be useful for future or past cases, to compare with specimens taken from other women, or even used to compare with DNA from the state data bank. Mary had been right. Victims weren’t responsible for their assault, or anyone else’s, and had to do what they felt necessary to get on with their lives.

Still, Anya believed that two men who brutally raped a middle-aged woman in a park were bound to attack again.

She turned her thoughts to the nursing home where Lucinda Tait had died. Elaine handed her a note with the address and phone number of Meadowbank, and a printout of the map showing the location, courtesy of the Internet.

‘You’re clear until four-thirty, and you have an appointment out there at two o’clock with the director of nursing. If you need more time, let me know and I’ll reschedule your meeting at Legal Aid.’

People had always told Anya that she needed someone to organize her life. Elaine Morton was like a wife, personal trainer and coach all in one.

‘Thanks. What would I do without you?’

‘Let’s hope you get enough work so you don’t have to find out.’

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MALICIOUS INTENT

The Meadowbank Nursing Home sat nestled behind a large ivy-covered wall on Pennant Hills Road, one of the city’s busiest thoroughfares. Carefully manicured gardens gave the place a sense of grandeur that belied the state of the residents. The director of nursing, or DON as she liked to be known, greeted Anya with a forced smile and escorted her to a family room.

‘It’s the coziest room in the place,’ she boasted as they entered an open room with glass panels and single vinyl chairs lining three walls.

An elderly lady rocked a plastic baby doll in one of the chairs and sang an unintelligible lullaby.

‘Now Maisie, isn’t it time for activities? Off you go.’

Maisie kept singing, rose, clutched the baby more tightly and shuffled out down the corridor.

‘Diversional therapy does wonders for the residents.’

If Maisie was a testament to therapy, Anya wondered how bad she had been before.

‘I’m looking into a lung disease that afflicted one of your former residents, Lucinda Tait.’

‘Ah, poor Lucy. We all have vivid memories of that woman.

She didn’t really accept living here, I’m afraid. The fact that she was so much younger than most of our residents didn’t help.’

A woman in her mid-forties surrounded by Maisies couldn’t have been easy under any circumstances, Anya thought.

‘Did she have family or friends who visited?’

‘No. Working with the elderly has taught me one thing.

The kind ones always seem to have someone visiting, whereas the others sit alone day after day.’

Anya didn’t hide her surprise. ‘No one ever came?’

‘Not that you could blame them. Lucy was, should I say, somewhat difficult to manage.’

‘In what way?’

‘Her lung disease was very aggressive and her smoking didn’t help. When she came to us, Lucy was unable to walk more than a few steps because of her shortness of breath. She had twenty-four-hour oxygen via a mask and second-hourly nebulizers. Not KATHRYN FOX

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the easiest woman to nurse, either. Lucy constantly argued with the staff about the smoking. Once she set off the emergency exit alarm sneaking out for a cigarette. The staff caught her dragging the oxygen trolley with her. She needed the oxygen more than ever when she smoked, she said.’

The DON clasped both hands on her lap. ‘We were concerned she’d blow herself up and us with her. Toward the end, we discussed transfer with her, due to the risk to other residents. Then she succumbed to pneumonia.’

Anya had seen a number of cases in which chronic smokers were unable or unwilling to break the habit, despite respiratory distress. Many had a terminal illness and, she suspected, wanted to accelerate the process.

‘Was she widowed?’

‘Never married, as far as I know, and no children. She lived at home until her mother died, which is how she came here.

She was no longer independent with her ADLs.’

Anya remembered her mother talking about ‘activities of daily living’ when she assessed her elderly patients to establish whether they could shower, use the toilet, cook, and function independently. For someone so young, being completely dependent on carers must have been difficult. She may have had good reason to be resentful.

‘Do you know if the disease was thought to be occupational?’

‘No. She was just another smoking statistic. I recall the GP

wanted her to have a bronchoscopy, but Lucy refused outright to have anyone probe her lungs from the inside. The local doctor suggested it may be due to some toxin and she may be entitled to compensation, but money meant nothing to Lucy, and she had no one to leave anything to.’

The sounds of a piano playing ‘Pack Up Your Troubles in Your Old Kit Bag’ filtered from somewhere down the corridor.

Male and female voices became louder as the song progressed.

The DON forced another smile. ‘Some of our residents don’t remember their names, but they can all remember the words to songs from the war.’

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MALICIOUS INTENT

‘Could you tell me the name of her treating doctor?’

‘Wilfred Campbell, one of our best GPs. He had a time of it, with Lucy refusing investigation and most of his treatment suggestions. Still, he was with her at the end, when she needed it most.’

The thought of someone with an illness that might have been diagnosed earlier with appropriate investigation must have been frustrating for the doctors and staff. One of the basic tenets of medicine was, at times, the most difficult. You are there to treat patients, not yourself. All you can do is advise them of their options. The rest is up to them. The postmortem was the only alternative to secure a diagnosis.

‘Is it possible to have her former address?’

‘The house was sold to pay for her place here. I don’t see how that can help you now.’

Anya stood. ‘It’s actually vital to an ongoing investigation into a potential public health problem.’ She smiled wider than normal. ‘I can always arrange a subpena for the information.

Besides, the information is in the public domain. All I’d have to do is search for title deeds but that would be a huge waste of my time.’

The older woman straightened the scarf accessorizing her navy blue blazer. ‘Well, I suppose it wouldn’t hurt to help if we can. I’ll get the address for you if you don’t mind waiting.’

Anya waited outside the office area. Farther along, an elderly gentleman in striped pajamas relieved himself in the middle of the corridor.

‘Arthur, the toilet is in the bathroom, not out here,’ groaned one of the nursing staff as she steered the resident back inside a room.

Anya averted her eyes out of respect for the man, who appeared embarrassed, just like a child who has an accident during toilet training.

The DON reappeared with an address. ‘Lennox Crescent is off the main road. Turn left at the next set of lights and you’ll find it. I’m not sure how far down number seventy-two is.’ She KATHRYN FOX

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noticed the puddle on the floor nearby. ‘If you’ll excuse me, I need to make sure no one slips on that.’

Anya followed the directions to Lennox Crescent, aware there was no mystery disappearance for Lucy Tait and no suicide. She didn’t fit the pattern of the others. This could have been a red herring, but still needed following up. A number of blond and brown brick homes sat back from the street on large blocks. Farther along, developers had knocked down the original houses and replaced them with rows of medium-density, two-story units. It was difficult to believe that councils approved the destruction of suburbs’ characters to line the pockets of developers.

Halfway down the hill on the left, she saw numbers seventy to seventy-six, a series of town houses, extending down each block. She stopped the car by the curb. Number seventy-two no longer existed. With it went the best clue to finding the source of the fibers.

36

Anya stepped out from the lift and saw Professor Jules Hammond sitting at the nurses’ station, absorbed in a patient’s notes. He was startled when she spoke his name.

‘Thought I’d be finished with rounds by the time you got here.’ He closed the file. ‘The clinic’s about to start, but I wanted to discuss this in person, given the sensitive nature of the circumstances.’

‘I appreciate it.’

Anya had hoped to talk somewhere private, but hospitals weren’t designed for that. Most clinical exchanges took place at or around the nurses’ station, the medical version of a central command post.

‘The results of the phylogenetic analysis aren’t yet back, but I have identified a drug-resistant viral infection, in a young woman, again with no obvious reason to develop resistance. I remembered what you said about the women committing suicide. In the context, I felt you should be aware. This one fell from a cliff somewhere up the mountains.’

Anya felt her chest tighten. Another suicide. The police would have to take this seriously. ‘How long ago did this happen?’

‘A couple of weeks. As yet, the woman is unidentified.’

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‘So we have no way of knowing who she was with or how she acquired the infection.’

A young female doctor extracted a number of files from the metal trolley behind the desk, while two older males checked a list. A ward round, with consultant, registrar and resident was about to begin.

Jules Hammond lowered his voice. ‘As yet, she refuses to speak to anyone.’

Anya walked around the desk and knelt beside the professor’s chair.

‘She’s alive? But you said she fell from a cliff.’

‘Seems the trees caused deceleration injuries that she somehow managed to survive.’

‘Where is she now?’

‘I am not at liberty to say.’ He pinched the bridge of his nose. ‘Darned hay fever.’ He sniffed. ‘I can tell you she is safe and undergoing treatment.’

The young doctor nearby dropped some of her files and opted to take the whole trolley around. The senior pair didn’t acknowledge her, or offer to help.

‘Why the secrecy?’ Anya asked. ‘If it’s possible, I’d really like to interview her.’

‘I understand your desire to have her answer some questions but my duty of care is to my patient. If I disclose her where-abouts, I have breached confidentiality. Consider my position.

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