“Having Jack and Chet take a look at this is not a bad idea,” Terese said. “A professional response might be helpful.”

“I’d be happy to make the call,” Colleen offered.

Jack had been on the phone for over an hour, calling the next of kin of that day’s three infectious disease cases. He’d talked with Laurie before calling Joy Hester’s sister and roommate. Jack didn’t want Laurie to think he was trying to take over her case, but she assured him she didn’t mind.

Unfortunately Jack did not learn anything positive. All he was able to do was to confirm a series of negatives, such as that none of the patients had had contact with wild animals in general or wild rabbits in particular. Only Donald Lagenthorpe had had contact with a pet, and that was his girlfriend’s newly acquired cat, which was alive and well.

Hanging up at the end of the final call, Jack slouched down in his chair and stared moodily at the blank wall. The adrenaline rush he’d felt earlier with the tentative diagnosis of Rocky Mountain spotted fever had given way to frustration. He seemed to be making no headway.

The phone startled Jack and pulled him out of his gloom. The caller identified himself as Dr. Gary Eckhart, a microbiologist at the city reference lab.

“Are you Dr. Stapleton?”

“Yes, I am,” Jack said.

“I’m reporting a positive reaction for Rickettsia rickettsii,” Dr. Eckhart said. “Your patient had Rocky Mountain spotted fever. Will you be reporting this to the Board of Health or do you want me to do it?”

“You do it,” Jack said. “I’m not even sure I’d know whom to call.”

“Consider it done,” Dr. Eckhart said. He hung up.

Jack slowly replaced the receiver. That his diagnosis had been confirmed was as much of a shock as it had been when his diagnoses of the plague and tularemia had been confirmed. These developments were incredible. Within three days he’d seen three relatively rare infectious diseases.

Only in New York, he thought. In his mind’s eye he saw all those planes Calvin had made reference to arriving at Kennedy Airport from all over the world.

But Jack’s shock began to metamorphose to disbelief. Even with all the planes and all the people arriving from exotic locales carrying all manner of vermin, bugs, and microbes, it seemed too much of a coincidence to see back-to-back cases of plague, tularemia, and now Rocky Mountain spotted fever. Jack’s analytical mind tried to imagine what the probability of such an occurrence would be.

“I’d say about zero,” he said out loud.

Suddenly Jack pushed back from his desk and stormed out of his office. His disbelief was now changing to something akin to anger. Jack was sure something weird was going on, and for the moment he was taking it personally. Believing that something had to be done, he headed downstairs and presented himself to Mrs. Sanford. He demanded to talk with the chief.

“I’m afraid Dr. Bingham is over at City Hall meeting with the mayor and the chief of police,” Mrs. Sanford said.

“Oh, hell!” Jack exclaimed. “Is he moving in over there or what?”

“There’s a lot of controversy surrounding that gunshot case this morning,” Mrs. Sanford said warily.

“When will he be back?” Jack demanded. Bingham’s being unavailable was adding to his frustration.

“I just don’t know,” Mrs. Sanford said. “But I’ll be sure to tell him you want to speak with him.”

“What about Dr. Washington?”

“He’s at the same meeting,” Mrs. Sanford said.

“Oh, great!”

“Is there something I can help you with?” Mrs. Sanford asked.

Jack thought for a moment. “How about a piece of paper,” he said. “I think I’ll leave a note.”

Mrs. Sanford handed him a sheet of typing paper. In block letters Jack wrote: LAGENTHORPE HAD ROCKY MOUNTAIN SPOTTED FEVER. Then he drew a half dozen large question marks and exclamation points. Beneath that he wrote: THE CITY BOARD OF HEALTH HAS BEEN NOTIFIED BY THE CITY MICROBIOLOGICAL REFERENCE LAB.

Jack handed the sheet to Mrs. Sanford, who promised that she’d personally see to it that Dr. Bingham got it as soon as he came in. Then she asked Jack where he’d be if the chief wanted to speak with him.

“Depends on when he gets back,” Jack said. “I plan to be out of the office for a while. Of course, he might hear about me before he hears from me.”

Mrs. Sanford regarded him quizzically, but Jack didn’t elaborate.

Jack returned to his office and grabbed his jacket. Then he descended to the morgue and unlocked his bike. Bingham’s exhortations notwithstanding, Jack was on his way to the Manhattan General Hospital. For two days he’d had the suspicion that something unusual was going on over there; now he was sure of it.

After a quick ride, Jack locked his bike to the same sign he’d used on his previous visits and entered the hospital. With visiting hours just beginning, the lobby was jammed with people, particularly around the information booth.

Jack wormed his way through the crowd and climbed the stairs to the second floor. He went directly to the lab and waited in line to speak with the receptionist. This time he asked to see the director, even though his impulse was to march right in.

Martin Cheveau made Jack wait for a half hour before seeing him. Jack tried to use the time to calm himself. He recognized that over the last four or five years he’d become less than tactful in the best of circumstances; when he was upset, as he was now, he could be abrasive.

A laboratory tech eventually came out and informed Jack that Dr. Martin Cheveau would see him now.

“Thanks for seeing me so promptly,” Jack said as he entered the office. Despite his best intentions he couldn’t avoid a touch of sarcasm.

“I’m a busy man,” Martin said, not bothering to stand up.

“I can well imagine,” Jack said. “With the string of rare infectious diseases emanating from this hospital on a daily basis, I’d think you’d be putting in overtime.”

“Dr. Stapleton,” Martin said in a controlled voice. “I have to tell you that I find your attitude distinctly disagreeable.”

“I find yours confusing,” Jack said. “On my first visit you were the picture of hospitality. On my second visit, you were just the opposite.”

“Unfortunately I don’t have time for this conversation,” Martin said. “Is there something in particular you wanted to say to me?”

“Obviously,” Jack said. “I didn’t come over here just for abuse. I wanted to ask your professional opinion about how you think three rare, arthropod-borne diseases have mysteriously occurred in this hospital. I’ve been cultivating my own opinion, but as the director of the lab I’m curious about yours.”

“What do you mean three diseases?” Martin asked.

“I just got confirmation that a patient named Lagenthorpe who expired here in the General last night had Rocky Mountain spotted fever.”

“I don’t believe you,” Martin said.

Jack eyed the man and tried to decide if he was a good actor or truly surprised.

“Well then, let me ask you a question,” Jack said. “What would I accomplish by coming over here and telling you something that wasn’t true? Do you think of me as some sort of health-care provocateur?”

Martin didn’t answer. Instead he picked up the phone and paged Dr. Mary Zimmerman.

“Calling in reinforcements?” Jack asked. “Why can’t you and I have a talk?”

“I’m not sure you are capable of normal conversation,” Martin said.

“Good technique,” Jack commented. “When defense doesn’t work, switch to offense. The problem is, strategies won’t change the facts. Rickettsias are extremely dangerous in the laboratory. Maybe we should make sure whoever handled Lagenthorpe’s specimens did so with proper precautions.”