<div><div> <h2>CHAPTER 1</h2> <p>The storm that battered the <i>Grand Atlantic</i> and caused so many of its passengers to become seasick was finally subsiding. But occasional, large swells were still slamming into its steel hull with enough force to make glassware and the other unfixed objects vibrate and move about. These sounds and motions made all but the most experienced travelers ill at ease, despite the repeated reassurances by the ship's captain, whose gravelly voice was now coming over the public address system.</p> <p>"We are currently passing through the outer edge of the storm and will shortly reach calm waters. The remainder of our voyage should be smooth and uneventful."</p> <p>In a posh portside cabin, Carolyn Ross growled her annoyance as a small bottle of Joy perfume rattled noisily on the dressing table before her. Quickly she grabbed the expensive vial to prevent it from slipping away.</p> <p>"Damn it, David!" she grumbled aloud. "How long will it be until things really calm down?"</p> <p>"Not long," he answered. "The swells are coming farther and farther apart."</p> <p>"You said that ten minutes ago."</p> <p>"It was true then too." He grinned and came up behind her to rub her neck. "I thought you nurses were supposed to be so patient."</p> <p>Carolyn smiled at David Ballineau's reflection in the mirror and wondered why he had been so unaffected by the rough seas. He hadn't taken any medicines or used any skin patches to prevent seasickness. It just didn't seem to bother him, like it did most of the other passengers. "Maybe the poor ship's doctor will be able to get some rest now."</p> <p>"He wasn't that overworked," David remarked. "All he had to do was pass out Antivert and Dramamine pills."</p> <p>"He was overworked enough to beg you to come back and help him."</p> <p>"It wasn't a big deal," David said with a shrug.</p> <p>"More than a hundred sick patients would say otherwise," Carolyn argued mildly, as she reached back to fasten the latch on her pearl necklace. "It was really unfortunate that the other ship's doctor wasn't available."</p> <p>"He and his nurse-wife were down with a double dose of seasickness," David said. "Make that a triple dose."</p> <p>"That bad, eh?"</p> <p>"So bad they had to crawl to the bathroom just to throw up," David went on. "They both plan to get off the ship in Bermuda and fly home."</p> <p>Carolyn gave David a long look. "Are you telling me they'll leave the <i>Grand Atlantic</i> with only one doctor and one nurse?"</p> <p>"Only temporarily," David told her. "The ship will arrange to pick up replacements in Montego Bay."</p> <p>"And until then, suppose another hundred passengers show up with seasickness?"</p> <p>"If they ask me, I'll lend a hand again," David said with another shrug, thinking that another hundred straightforward cases of seasickness would be a relatively simple matter to treat. Pass out pills, tell patients to lie down with a damp washcloth over their forehead, and sip liquids sparingly. And all would soon be well. Easy enough, David thought to himself. Far easier than dealing with a handful of critically injured patients at University Hospital in Los Angeles where he was director of the emergency room. That was life and death. Seasickness was a transient inconvenience.</p> <p>"Would you help me with my necklace?" Carolyn asked, fumbling with its latch.</p> <p>"Sure."</p> <p>They were standing in the dressing area of their opulent suite near the bow of the luxury liner. All of the suites aboard the <i>Grand Atlantic</i> were oversized, with rich fixtures and furniture, plush carpeting, and hanging tapestries on the wall. In addition to the dressing area next to the bedroom, there was a separate parlor and a marble tiled bathroom that was large enough to have a bathtub and walk-in shower. The ship was considered the most elegant passenger liner in the world, built to accommodate the tastes of the wealthy, particularly those who enjoyed old-world splendor. But it was special in other ways too. To ensure the comfort of the passengers and to minimize the intrusive and disturbing instruments of modern-day life, the use of cell phones was prohibited in public gathering places, particularly in the dining areas, theaters, and libraries. To encourage passengers to follow these regulations, all calls made from the individual suites went through a central phone bank and were free of charge, regardless of destination or length of conversation. At a cost of $8,000 to $12,000 per passenger, depending on the location of their suite, everyone expected and was given the best of all worlds on a ten-day cruise that went from New York to Bermuda to Montego Bay to San Juan and back.</p> <p>"There," David said as he secured the latch on Carolyn's string of Mikimoto pearls. "Now you're perfect."</p> <p>She nestled the back of her head against his chest and smiled. "I feel like we're in another world."</p> <p>"We are," David agreed. "It's as if someone turned the clock back a hundred years."</p> <p>"I heard one of the passengers comment that the suites on this ship were modeled after those on the <i>Titanic</i>."</p> <p>David nodded and kissed the nape of her neck. "Not only the suites, but a lot of other things too. According to some naval historians, this liner is remarkably similar to the <i>Titanic</i>. It has the same structure, style, and dress codes. Even the ship's officers are all British, just like on the <i>Titanic</i>."</p> <p>"So they copied everything but the name."</p> <p>David nodded again. "They'd be way beyond stupid to ever use that name again."</p> <p>"The <i>Titanic</i>," Carolyn said in a soft voice. "Everyone on the <i>Grand Atlantic</i> was probably thinking about the awful fate of that ship when we were going through the worst part of the storm."</p> <p>"We were never in any real danger," David commented.</p> <p>"I knew that," Carolyn said. "I suspect all the passengers knew that. But the memory of the lifeboat drill we went through just before leaving port still made everybody nervous. Jesus! They just gathered us all together, then had us put on life jackets and stand beneath those huge, hanging lifeboats, while they informed us what to do if the ship began to sink. The memory of that rehearsal was in everybody's mind as the ship bounced around in those rough seas."</p> <p>"The ship's crew was only following regulations," David told her. "The drill had nothing to do with the impending weather."</p> <p>"I wonder if the passengers on the <i>Titanic</i> went through a lifeboat drill."</p> <p>"One had been scheduled," David said, his mind going back to a book about the ship's sinking. "But they canceled it at the last minute for unknown reasons."</p> <p>Carolyn's eyes widened briefly. "And our final lifeboat drill was also canceled at the last moment."</p> <p>"Supposedly because of the bad weather."</p> <p>Carolyn shook her head. "It wasn't that bad."</p> <p>"But the passengers kept bitching and moaning about it until the captain finally gave in."</p> <p>"And I'll bet the passengers on the <i>Titanic</i> bitched and moaned their way out of their lifeboat drill too."</p> <p>"You're probably right," David agreed. "The rich and pampered don't like to be inconvenienced."</p> <p>"Well, let's hope the similarities end there," Carolyn said, then turned to David and smiled. "There aren't any icebergs in the Caribbean, are there?"</p> <p>"None have been spotted recently," David jested.</p> <p>"That's comforting to know," Carolyn said dryly, then reached up to center his black bow tie. "There! Now you're perfect too."</p> <p>They briefly studied their reflections in a large wall mirror. He was wearing a white dinner jacket with a cummerbund, she an Audrey Hepburn–type cocktail dress with thin shoulder straps. That was another requirement aboard the <i>Grand Atlantic</i>. Everyone had to be formally attired at dinner.</p> <p>"You look very distinguished with your graying hair," Carolyn observed.</p> <p>"You think so, eh?"</p> <p>"I know so."</p> <p>David gazed at himself in the full-length mirror. In his mid-forties, he was tall and lean, with an angular face, pale blue eyes, and close-cropped salt-and-pepper hair that turned gray at the temples. His clean-cut good looks were marred by a jagged scar across his chin. According to Carolyn, most women thought the scar made David appear dangerous. He shrugged indifferently at the notion. The only effect the scar had on him was to bring back memories of a time and place he wanted to forget.</p> <p>"Well?" Carolyn asked. "What's your opinion?"</p> <p>"You're right," David said as he turned away from his reflection. "I do look distinguished."</p> <p>"Jesus!" Carolyn chuckled and poked his chest playfully.</p> <p>"How about a drink before—"</p> <p>The phone rang loudly. David picked it up on the second ring and spoke briefly. His face grew more serious as he pressed the receiver to his ear and asked for additional details. "What type of jerky motion?" ... "Is the patient conscious?" ... "Can she talk?" ... "I'll be right down."</p> <p>David replaced the receiver and glanced over to Carolyn. "That was the ship's doctor. It sounds like someone is having a seizure."</p> <p>"Oh Christ!" Carolyn groaned.</p> <p>"I'll run down to the sick bay and get things squared away."</p> <p>"Do you want some help?" Carolyn asked. "I was pretty good with seizures when I was a MedEvac nurse."</p> <p>"Nah," David said. "I can handle it."</p> <p>"You sure?"</p> <p>"Positive," David told her. "Tell you what. If the seas calm down as expected, let's meet on deck near the bar for a drink in thirty minutes or so."</p> <p>"See you then."</p> <p>David dashed out of the suite and down a narrow passageway, rushing by strolling passengers. He hurried through an exit door and took the stairs down, two at a time, all the while going over the differential diagnosis of sudden onset seizures in a middle-aged woman. A brain tumor was at the top of the list, followed by other space-occupying lesions, such as a subdural hematoma or arterio-venous malformation. <i>But a brain tumor would be the most likely diagnosis</i>, he thought miserably. <i>Shit!</i> David moved to the side of the staircase and made room for a pair of joggers who were running the stairs for exercise. The lead jogger, a handsome, well-built man in his early thirties, huffed aloud, "Make way!" and rudely brushed by David. Behind the man was a very pretty young woman with streaked blond hair held in a ponytail. She offered no apology as her elbow caught David in his lower ribs.</p> <p>"Careful!" David called out.</p> <p>The man stopped abruptly and gave David a hard stare. "What did you say to her?"</p> <p>"I said be careful."</p> <p>"Ah-huh," the man snarled, with an expression of disbelief. "It sounded like you said something else."</p> <p>David ignored the man's challenging stare and continued down the stairs. His mind switched back to the patient waiting for him in the sick bay. The first order of business would be to get her seizures under control. He wondered how extensive the ship's pharmacy would be. Surely they would have injectable Dilantin and Ativan on board. <i>Jesus H. Christ! I hope so.</i> From his brief stint helping the ship's doctor with the seasick passengers, David recalled that the sick bay consisted of a small reception area, two examining tables separated by a curtain, and a radiology room capable of taking only the simplest x-rays. It was like a first-aid station when compared to the ER at University Hospital, where the most sophisticated equipment and resources were immediately at hand.</p> <p>"Well, just make do," he muttered to himself as he left the staircase at the G level.</p> <p>David rushed by the ship's spa and entered the sick bay. A plump, heavily bosomed nurse, with dyed black hair, frantically waved him into a nearby room. The middle-aged patient was lying on an examining table, obviously agitated. Her head was tilted to the side and twitching with rapid, jerky motions. But the most disturbing features were bulging eyes that were staring up and back in a fixed position. The woman was making unintelligible sounds because her tongue was protruding far out of her mouth.</p> <p>"It's the strangest seizure I have ever seen," the small, bespectacled, ship's doctor said. Arthur Maggio ran a hand nervously through his thinning gray hair. "Only her head and neck seem to be involved."</p> <p>"What medicines has she received?" David asked at once.</p> <p>"None," Maggio replied. "I wasn't sure of the diagnosis."</p> <p>"No, no," David clarified his question. "I meant, was she given any drugs prior to all this happening?"</p> <p>"Only a shot for her terrible nausea," Maggio answered. "It was given fifteen minutes before the seizure began."</p> <p>Maggio coughed without turning his head away. David immediately detected the smell of alcohol on the elder doctor's breath and hoped it only represented the ingestion of a single cocktail before dinner. "A shot of what?" David asked hurriedly.</p> <p>"Compazine."</p> <p>David nodded to himself. "This isn't a seizure we're seeing. It's a dystonic reaction to Compazine." He quickly turned to the nurse and said, "Draw up five ccs of Benadryl in a syringe for me. Put a 23-gauge needle on the syringe."</p> <p>The nurse looked over to the ship's doctor, who gestured his approval. She dashed over to a medicine cabinet and busied herself following David's instructions.</p> <p>"I've never seen this type of dystonic reaction," Maggio said honestly.</p> <p>"It's called an oculogyric crisis," David elucidated. "It's a very rare reaction to Compazine-like drugs."</p> <p>"And it only involves the head and neck?"</p> <p>"Only the head and neck," David said. "Typically the muscles around the eyes and face go into spasm. And the tongue is frequently involved, which explains why it was protruding from the patient's mouth."</p> <p>The nurse came over and handed David a syringe fitted with a 23-gauge needle and filled with a clear liquid. "Each cc has 25 milligrams of Benadryl."</p> <p>"Good."</p> <p>David used an alcohol swab to clean the patient's antecubital fossa before inserting the needle into a vein. He began to very slowly inject the Benadryl solution. Almost instantly the woman stopped twitching and jerking. Then her eyes returned to their normal gaze, and her tongue withdrew itself back into her mouth. A moment later the patient sat up on the examining table and asked, "What in the world happened to me?"</p> <p>Maggio shook his head in wonderment. "I've never seen anything like that before."</p> <p>"The response is always impressive," David said and turned to the patient. "You had a severe reaction to the drug you received for your nausea. It's called Compazine. You should never take it again."</p> <p>"You needn't worry about that!" Edith Teller had an attractive face now that the spastic contortions had left it. She had prominent cheekbones and dark eyes from her one-quarter Cherokee heritage. "I won't go anywhere near Compazine."</p> <p>"If any of your symptoms return, let us know at once," David advised. "Another shot of Benadryl will stop them in their tracks."</p> <p>"Will they return?" she asked anxiously.</p> <p>"Probably not."</p> <p>"With my luck they will," the woman said sadly. Then tears welled up and began to roll down her cheeks. "This cruise is turning into a disaster for me. Only two and a half days out, and I've experienced rough seas, nausea, dizziness, and a bad reaction to a drug." She looked away and sniffed her tears back. "You save up for the trip of a lifetime and you end up in a sick bay, certain you're about to die."</p> <p>David nodded sympathetically while the woman spoke on and on about being a librarian from Ohio and dreaming of taking an ocean voyage on a great luxury liner and meeting interesting people and visiting exotic places. David appeared to be listening, but he wasn't. He didn't want to hear her sad story, and he didn't want to know about her wishes and hopes and dreams. That's why he was an emergency-room physician. There he didn't have to listen to people complain about life's disappointments and heartaches. His ER mantra was <i>See 'em, fix 'em</i>, and <i>send 'em</i> on their way. All interchange was strictly medical, and that's how he liked it.</p> <p>The woman was still talking when David patted her on the shoulder and gently interrupted, "Well, you're fine now. Let's hope all your bad luck is behind you now."</p> <p>With a wave to the ship's doctor, David left the sick bay and walked over to the elevator. He wished again that he hadn't taken the cruise aboard the <i>Grand Atlantic</i>, because it wasn't turning out to be a vacation at all. He was trapped on a giant ocean liner that had 750 passengers, with a retired military doctor and a seasick general practitioner as the only healthcare providers. And the ship's doctor now knew that David was an experienced ER specialist. So, in case of any real emergencies or mass illnesses, David would be called in. He grumbled to himself as he thought about the sun-drenched beaches of Hawaii. That was where he wanted to go. But his twelve-year-old daughter, Kit, and his girlfriend, Carolyn, ganged up on him and insisted they all take a cruise on a fantastic luxury liner. David was good at a lot of things in life, but negotiating with women wasn't one of them. </div></div><br/> <i>(Continues...)</i> <!-- Copyright Notice --> <blockquote><hr noshade size='1'><font size='-2'>Excerpted from <b>PLAGUE SHIP</b> by <b>LEONARD GOLDBERG</b>. Copyright © 2013 Leonard Goldberg. Excerpted by permission of Llewellyn Worldwide Ltd.. <br/>All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.<br/>Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.</font><hr noshade size='1'></blockquote>