Jack worked quickly but with great care. He knew that the less the internal organs were disturbed, the less chance that any of the infecting microbes would be aerosolized.

When Jack had the organs out, he turned his attention first to the lungs. Calvin had drifted over at this point and towered behind Jack as he made his initial cuts into the obviously diseased organ. Jack spread open the lung like a butterfly.

“Lots of bronchopneumonia and early tissue necrosis,” Calvin said. “Looks pretty similar to Nodelman.”

“I don’t know,” Jack said. “Seems to me there is an equal amount of pathology but less consolidation. And look at these nodal areas. They almost look like early granulomas with caseation.”

Clint listened to this pathological jargon with little interest or comprehension. He remembered the terms from medical school, but had long since forgotten their meaning. “Does it look like plague?” he asked.

“Consistent,” Calvin said. “Let’s look at the liver and the spleen.”

Jack carefully pulled these organs from the pan and sliced into them. As he’d done with the lung, he spread open their cut surfaces so everyone could see. Even Laurie had stepped over from her table.

“Lots of necrosis,” Jack said. “Certainly just as virulent a case as with Nodelman or with the case I did earlier.”

“Looks like plague to me,” Calvin said.

“But why was the fluorescein antibody negative?” Jack said. “That’s telling me something, especially combined with the lung appearance.”

“What’s with the lungs?” Laurie asked.

Jack moved the liver and the spleen aside and showed Laurie the cut surface of the lung. He explained what he thought of the pathology.

“I see what you mean now that you mention it,” Laurie said. “It is different from Nodelman. His lungs definitely had more consolidation. This looks more like some sort of horribly aggressive TB.”

“Whoa!” Calvin said. “This isn’t TB. No way.”

“I don’t think Laurie was suggesting it was,” Jack said.

“I wasn’t,” Laurie agreed. “I was just using TB as a way of describing these infected areas.”

“I think it is plague,” Calvin said. “I mean, I wouldn’t if we hadn’t just had a case from the same hospital yesterday. Chances are it is plague regardless of what their lab said.”

“I don’t think it is,” Jack said. “But let’s see what our lab says.”

“How about double or nothing with that ten dollars,” Calvin said. “Are you that sure?”

“No, but I’ll take you up on it. I know how much the money means to you.”

“Are we finished here?” Clint asked. “If so, I think I’ll be going.”

“I’m essentially finished,” Jack said. “I’ll do a little more on the lymphatics, and then I’ll be obtaining samples for the microscopic. You won’t be missing anything if you take off now.”

“I’ll head out with you,” Calvin said.

Calvin and Clint disappeared through the door to the washroom.

“If you don’t think this case is plague, what do you think it is?” Laurie asked, looking back at the woman’s corpse.

“I’m embarrassed to tell you,” Jack said.

“Come on,” Laurie urged. “I won’t tell anybody.”

Jack looked at Vinnie. Vinnie held up his hands. “My lips are sealed.”

“Well, I’d have to fall back on my original differential I had for Nodelman,” Jack said. “To narrow it down more than that, I have to again go out on thin ice. If it isn’t plague, the nearest infectious disease both pathologically and clinically is tularemia.”

Laurie laughed. “Tularemia in a twenty-eight-year-old postpartum female in Manhattan?” she questioned. “That would be pretty rare, although not as rare as your diagnosis yesterday of plague. After all, she could have a hobby of rabbit hunting on weekends.”

“I know it’s not very probable,” Jack said. “Once again I’m relying totally on the pathology and the fact that the test for plague was negative.”

“I’d be willing to bet a quarter,” Laurie said.

“Such a spender!” Jack joked. “Fine! We’ll bet a quarter.”

Laurie returned to her own case. Jack and Vinnie turned their attention back to Susanne Hard. While Vinnie did his tasks, Jack finished the lymphatic dissection he wanted to do, then took the tissue samples he felt appropriate for microscopic study. When the samples were all in the proper preservatives and appropriately labeled, he helped Vinnie suture the corpse.

Leaving the autopsy room, Jack properly dealt with his isolation equipment. After plugging in his rechargeable ventilator battery, he took the elevator up to the third floor to see Agnes Finn. He found her sitting in front of a stack of petri dishes examining bacterial cultures.

“I’ve just finished another infectious case that’s suspected plague,” he told her. “All the samples will be coming up shortly. But there is a problem. The lab over at the Manhattan General claims the patient tested negative. Of course, I want to repeat that, but at the same time I want you to rule out tularemia, and I want it done as quickly as possible.”

“That’s not easy,” she said. “Handling Francisella tularen- sis is hazardous. It’s very contagious to laboratory workers if it gets into the air. There is a fluorescein antibody stain for tularemia, but we don’t have it.”

“How do you make the diagnosis, then?” Jack asked.

“We have to send any samples out,” she said. “Because of the risk of handling the bacteria the reagents are generally kept only at reference labs where the personnel are accustomed to dealing with the microbe. There is such a lab here in the city.”

“Can you send it right away?” Jack asked.

“We’ll messenger it over as soon as it gets here,” she said. “If I call and put a rush on it, we’ll have a preliminary result in less than twenty-four hours.”

“Perfect,” Jack said. “I’ll be waiting. I’ve got ten dollars and twenty-five cents riding on the outcome.”

Agnes gave Jack a look. He considered explaining, but feared he’d sound even more foolish. Instead he fled upstairs to his office.

NEW YORK CITY

“I’m liking it more and more,” Terese said. She straightened up from Colleen’s drawing board. Colleen was showing her tissues that her team had comped up just that morning using the theme they’d discussed the night before.

“The best thing is that the concept is consistent with the Hippocratic oath,” Colleen said. “Particularly the part about never doing harm to anyone. I love it.”

“I don’t know why we didn’t think about it before,” Terese said. “It’s such a natural. It’s almost embarrassing that it took this damn plague epidemic to make us think of it. Did you catch what’s happening on morning TV?”

“Three deaths!” Colleen said. “And several people sick. It’s terrible. In fact, it scares me to death.”

“I had a headache from the wine last night when I woke up this morning,” Terese said. “The first thing that went through my mind was whether I had the plague or not.”

“I thought the same thing,” Colleen said. “I’m glad you admitted it. I was too embarrassed.”

“I hope to hell those guys were right last night,” Terese said. “They seemed pretty damn confident it wasn’t going to be a big problem.”

“Are you worried being around them?” Colleen asked.

“Oh, it’s gone through my mind,” Terese admitted. “But as I said, they were so confident. I can’t imagine their acting that way if there were any risk.”

“Are we still on for dinner tonight?” Colleen asked.

“By all means,” Terese said. “I have a sneaking suspicion that Jack Stapleton will turn out to be an unknowing fountain of ad ideas. He might be bitter about something, but he’s sharp and opinionated, and he certainly knows the business.”