David Swanson looked out the window of his 7th floor New York apartment. The yellow morning horizon of just a few minutes ago was rapidly turning into a sunny day and the outside temperature reading was already 66 F. Not bad for October in New York City. This will be a good day. But he was soon to be proven wrong. Going to the desk in his small study, he smelled a peculiar but familiar odor coming from his body. It was there every time, after the attacks of drenching sweats and shaking chills. He attempted a few simple exercises and felt the usual soreness in the muscles of his shoulders, abdomen, and thighs. It had happened again .Another malaria attack and I don’t remember a thing.
He tried to think back to last evening when he had taken his latest medication. Usually he remembered the aura preceding his attack. He had gone out. What happened? Usually when he got the ringing in his ears, along with the throbbing temporal headaches, he had at least two-hours to get back to his apartment before the sweats and shaking chills began. The proof would be in the bathroom. He lifted the toilet seat lid, emptied his bladder, and there it was. His urine was dark red. His army doctor in Iraq described it as port wine. In dim light it looked almost black.
“Lieutenant Swanson, you have the type of malaria caused by a strain of the plasmodium parasite of the falciparum variety.”
“That means nothing to me, Major.” Swanson sat up in his frame bed at the field hospital. He was built like a cage fighter but with a college refinement–all the more deadly with the expertise of Special Forces training.
“The parasite lives and grows inside the red blood cells–your red blood cells. When it gets too big for where it lives, the red cell bursts releasing hemoglobin, the substance making red blood cells red. Then your kidneys get rid of it. You pee out the hemoglobin. It’s dark red because there’s no oxygen attached to it anymore.”
Major Robert Gordon held a chart showing the lifecycle of the plasmodium falciparum organism. “This little sucker started out in the salivary gland of a mosquito.”
“A friggin mosquito bit me and spit that thing into my body? For almost a year I’ve been dodging bullets, landmines, and RPG’s, and I get downed by a microscopic creature that lived in the spit of a bug?” Swanson steadied himself by hanging onto the bed rail.
“Lieutenant, you may feel a little dizzy because the net result of the whole process is that you tend to lose almost a whole unit of blood when your red cells burst. We have several medications we’re now using here in the Middle East which should prevent future attacks. However, it is possible this type of falciparum can remain dormant waiting for your system to get run down at which time its life cycle could start up again. Unless you take the medication when you have a cold or feel ill you could get another attack.”
“What happens to me now? I’m part of a special operations unit here in Baghdad. We’re ready to launch an important mission against a concentrated Al-Qaeda group and I have to get out of here.” Swanson fell back onto his pillow from the dizziness.
“We have a standard protocol for treating malaria and a few other serious infectious diseases in this place. You’re to be transferred to Ramstein Air Force Base and recuperate in Landstuhl Army General Hospital...” Major Gordon held up his hand to stop Swanson from interrupting. “…for at least two weeks Lieutenant. And there can be no discussion on this.”
Swanson remembered that first attack vividly. There were no blackouts in his memory at that time. He also remembered everything at the end of his two-weeks in the Landstuhl Army hospital when he had his second attack.
“Lieutenant Swanson, your strain of falciparum is not responding to the chloroquine or the primaquine antimilarials. We have to get your disease under control or it could kill you. But there’s good news.” The infectious disease Army specialist smiled. “You’re being shipped home to the states…to Walter Reed Army General Hospital.”
Swanson tried to re-think his steps from last night. The headache and ringing in his ears started at dinner. He took two of his new antimalarial tablets and excused himself in the middle of a conversation with his date–the broker from Dallas. Yes. I remember her. After he took the medication, things became blurry. The sounds of other diners became loud and merged to incomprehensibility and he nearly fell over when he tried to stand up.
“David. David. Are you all right?” The lithe but strong woman steadied him onto his feet.
“It’s malaria. I just took my medication and have to lie down somewhere.”
“Let’s get you up to my hotel room. It’s only four floors up. Do you want me to call a doctor?”
“Yes. The number is on my medic alert bracelet. Get me upstairs first.”
Swanson put his hand to his forehead and looked at the mirror on his bedroom dresser. He tried to recall everything happening in her room but events going from the restaurant to her hotel room were not there. The most he could remember about her was her name, Lisa Feldman. Yes. He had her card. Swanson dialed the handwritten phone number on the back of her business card. He had met her at the exhibit hall of the Stock Brokers Eastern Regional meeting three-days ago. She specialized in computer software markets.
“Hello, Talbert Hotel. Manager’s office.” It was a melodious female voice. It wasn’t Lisa Feldman.
“I’m calling for Lisa Feldman. She gave me this telephone number which is supposed to be her hotel room.”
“Just a moment. The manager is taking all calls to this number.”
“This is Mr. Cory, Talbert Hotel management and security.”
Swanson repeated his attempt to contact his colleague from the previous night.
“I’m afraid Miss Feldman met with a serious accident last night. She was found on the third floor staircase landing. She apparently fell and was taken to New York University Hospital.”
Swanson felt his pulse quicken and his chest tighten. “Is she going to be all right?”
“You’ll have to call the hospital. I’ll give you the number.”
Swanson paced the floor of his tiny study with the cordless phone attached to his ear as he maneuvered through layers of hospital operators until he was connected to her room.
“Intensive care unit? I’m calling about a patient named Lisa Feldman.”
David Swanson didn’t have many close friends in New York City. It wasn’t that he was antisocial; he just didn’t have many friends or acquaintances. He had to make three phone calls. The first phone call was to his boss, Coleman Dandy, who was familiar with Swanson’s occasional recurrent malaria episodes. He had plenty of sick days left on the books.
“David, take care of you first. I’ll get someone to cover for you on the market floor servers. Do what you have to do and get back here soon.” Dandy hung up without asking about the results of his dinner with Feldman.
He dialed the next number and let the phone ring. He could picture the corner office of the laboratory at the VA hospital where Barbara Winn worked. She was both head nurse for infectious diseases and coordinator for malaria research studies with the chief of medicine.
“Barbara Winn speaking.”
Swanson told her of his latest falciparum attack but not about Lisa Feldman.
“Did you call Dr. Binelli?” she asked.
“I must have. I was discharged from the ER just like last time with a note to be followed up by Dr. Binelli and Dr. Krantz.”
“David I don’t understand why you have to keep seeing Krantz. He’s a psychiatrist.”
“Binelli tells me I need to have sequential mental status exams, because of my cerebral malaria. It’s in my records.”
“Why are you calling me David? My role in your treatment at the VA is purely from the research aspect of your peculiar strain of falciparum.”
“I consider you a friend and mentor with all that’s happened to me. Can we meet in private somewhere tonight?”
“You’re such a klutz when it comes to asking me for a date. I’ll tell you what. Let me prepare something at my place tonight around eight. You remember where it is? You’ve picked me up at my apartment twice before.”
“I’ll be there.”
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