Rabbit Fever, page 5
“Gillian, you have to understand,” Tina stammered, “a claim of Bubonic plague, especially from such an isolated place in the country, and coming from you... We had to, well, make sure before we dispatched all our resources. We wanted to—”
“You wanted to ensure I wasn’t seeking attention or playing a trick, that’s what you mean. And by ‘we,’ you mean George, don’t you?” Kauffmann interjected. “Well, here you go. See it for yourselves. This is the situation. I’ve managed it the best I can for now. Based on my diagnosis, there is a highly infectious disease in my hospital. As you stated yourself, I’m incredibly isolated here. Plague didn’t originate in Porthaven; it must have been brought here. I think I know who brought it, but they are now deceased. If he managed to bring it here and has obviously travelled through other places, then this isn’t just a case of ‘Crazy Kauffmann’ acting out.”
Tina nodded in agreement, acknowledging, while she understood the reasons behind the actions taken, there had been no verification from anyone other than Kauffmann regarding the existence of this supposed infectious disease.
She wondered why Kauffmann hadn’t pushed harder for a response and shared images to provide more information about the situation. Gillian smirked and tossed a small object in a clear bag towards them.
“I thought this would come up next,” Kauffmann said. “Take a look at this, and you,” she pointed at Will, “I assume you’re the Hospital Liaison Manager I spoke to. Well, check your emails. All the pictures from the phone in that bag are also waiting in your inbox. I assume you haven’t checked yet. Oh, and don’t open the bag, as Tina wisely said, ‘we don’t know what the disease is yet.’“
Kauffmann chuckled, showing even in a situation like this, she maintained her wit and sharpness.
Will whispered to Tina he had received the emails but, given the earlier drama in the meeting and the threat to his job, he hadn’t looked at them. He didn’t know what he was being sent and was afraid of George’s reaction if he added more controversy to the situation.
While Tina understood his reasoning, she was understandably frustrated. This situation could have been resolved from an office instead of standing in a car park surrounded by burning fabric and being reprimanded by someone she preferred to spend as little time with as possible. Even if she remained highly sceptical Kauffmann’s claims were valid.
Kicking the bag with the phone back to Kauffmann and shouting they would check Will’s phone; she urged him to immediately open his emails and view the attached pictures. Fumbling with his phone, Will finally accessed his emails and handed the device to Tina. She began to examine the first few images, which appeared to show a young man looking unwell, sweating, and discoloured, but nothing more deadly than a severe flu.
She glanced at Kauffmann and raised her eyebrows, who gestured for her to continue.
As Tina reviewed more photos, her initial cynicism faded, replaced by shock and horror. The images depicted a rapid progression from mild symptoms to a horrifying deterioration. The young man’s skin turning an eerie shade of blue, his veins standing out like dark rivers, and a look of agony etched on his face.
She dropped the phone, the impact with the tarmac causing it to bounce and a small crack to appear on the screen. Ignoring this she turned to Will, her face a mask of terror.
“She’s not crazy. Based on those photos, that’s my initial diagnosis too.”
Tina searched her handbag for her phone and made several hasty calls. Will wasn’t sure who she was speaking to but presumed it was likely the people who had been in the meeting a few days ago. The conversations mostly involved Tina asserting ‘she was right, based on the pictures, it’s what I’d say as well’. There were many affirmations, nervous agreements, and requests for support in Porthaven.
The last call was evidently to George. Tina had to gather her courage to speak with him, and it didn’t sound like the conversation went well. She signed off with,
“I’m sorry to say that’s my professional opinion, and it will have to be disclosed that the decision not to respond as we should have was made by you.”
Turning to Kauffmann, Tina spoke with a tremor in her voice.
“Well, Gillian, I think we need to start from the very beginning to understand your situation and determine how we can assist you.”
Chapter 6
Tina and Will descended the hill toward the town, following Kauffmann’s declaration that standing aghast in the small hospital car park next to her makeshift decontamination unit served no purpose.
They passed seedy bars and abandoned storefronts, their windows covered in grime and graffiti. Locals, their expressions worn and wary, shot furtive glances at the newcomers. All the while, the salty tang of the ocean mixed with the growing tension that hung between the pair, painting a gloomy picture of a town that had seen better days.
Kauffmann had made it clear; they were not going to be granted access to the hospital, leaving them with a deep sense of foreboding as they navigated the decaying streets.
Will, still convinced there were cult-like aspects to this situation, repeatedly pressed Tina,
“Why won’t she just let us in to have a look? If it’s okay for her to be in that homemade biohazard outfit, why can’t we do the same? Let’s get this over with and go home.”
Tina paused for a moment and contemplated what Will was likely making of this situation. He was a young man, in his twenties, she thought, who had shown up for what he had assumed would be a brief visit to a hospital.
He wore a stylish suit and carried a leather messenger bag. While Tina wasn’t sure what he had in the bag or what he considered essential for this visit, it was evident such a quality bag would have required substantial savings or credit.
Will seemed clueless about the situation. Thinking this trip would allow him to assert his importance as the Hospital Liaison Manager. Hence the expensive, obviously new bag and the sharp suit. Then use his experience and predicted success on this trip as a notable case study in his next performance review.
“Will, what do you actually know about the plague?” Tina asked patiently and was met with a blank stare, followed by the response she expected.
“We studied it in primary school, it killed a lot of people, they used leeches to treat it, but it was an ancient disease that doesn’t exist anymore,” Will explained matter-of-factly.
Tina’s sigh echoed with a weariness that seemed to seep into the very fabric of the worn promenade. She gestured for Will to take a seat on one of the battered benches that bore the scars of countless seasons by the sea.
With a swift kick, she nudged aside the discarded remnants of impromptu street parties from the night before. The discarded drink cans, empty bottles, and crumpled plastic bags had become a symbol of fleeting, carefree moments amidst the backdrop of a once vibrant but now faded coastal town.
Settling next to Will, she noticed the early morning sun was slowly gaining strength, casting long shadows that stretched toward the salt-stained railing overlooking the beach. Seagulls wheeled and cried overhead, as if bearing witness to the serious conversation about to unfold.
Turning to Will, Tina’s expression turned grave, her eyes reflecting a blend of determination and concern. Her words held a weight that matched the seriousness of the situation, and she urged him in a hushed but resolute tone to listen carefully, as if every word carried the destiny of their next steps.
Tina clarified to Will that, while he was correct, the plague was not prevalent in developed countries, there were still sporadic cases in less developed regions. She explained, in recent years, there had been outbreaks of plague in India, causing significant panic and mass migration as people tried to avoid it.
She also pointed out that within medical circles, it was well-known, plague still existed, particularly in places like Madagascar. She mentioned that just over a century ago, it had claimed the lives of nearly 100,000 people in China, and there was even an outbreak in Los Angeles in 1924.
Will listened with a mix of fascination and horror. Realising, this medieval disease they had studied in primary school, dressing up as plague doctors in their long, beaked outfits, was still very much a reality in the modern world.
“So, it could be another Covid?” Will inquired, seeking to draw parallels with recent experience.
Tina tried to allay his concerns, explaining the distinctions between bacteria, viruses, and infections caused by parasites. She informed Will Bubonic Plague was transmitted through flea bites, which probably explained why Kauffmann wanted them to maintain a safe distance from her. Why she had taken measures to ensure no part of her skin was exposed. It wasn’t a matter of staying clean or avoiding a virus, like with Covid, but rather preventing fleas from gaining access to her skin. This was likely why she had been burning items she deemed contaminated as well.
“Think about how small a flea is,” Tina continued to Will. “How can you be certain you’ve sealed a plastic bag tightly enough to prevent a tiny flea, just one millimetre long, from escaping? Consider how far a tiny flea can jump and the risk if the bag is ever opened or develops a slit, the flea can escape. A flea can easily jump 60 times its body length, has a lifespan of up to 3 months, and a single female can lay up to 5000 eggs.”
Will began to comprehend the situation. That’s why she was burning everything; she wasn’t attempting to kill a virus but to exterminate the fleas to prevent the spread of the disease. While he thought he had grasped the situation, his attempt to showcase his understanding only revealed his naivety.
“Well, that’s simple, isn’t it? We don’t need to panic. We can just leave them all in there for three months, wait until the fleas die and the plague is no more, and then we can let them out. This is a tricky situation, but it’s not the emergency Kauffmann made it out to be in her calls to me,” he suggested.
Hoping Tina would concur, and they could depart from this peculiar town with its even more peculiar hospital and return to civilization.
While his uneducated conclusion seemed reasonable, Tina cautioned Will,
“How do you think it got here? Kauffmann told us very few people visit this town, but it must have arrived somehow. How did it get into her hospital? Who else might be at risk? Remember, Will, some countries facing pest problems like fleas take significant precautions: no carpets, no pets inside, separate indoor and outdoor clothing, and more. We don’t have any of that here.”
She realised she was becoming overly dramatic, took a deep breath, and amended her statement,
“That is, of course, Will, if it is indeed plague in there! If we confirm Kauffmann’s diagnosis, then we should be concerned. While her photos seem to depict a case of plague, they are only images she has shared with us – no one else, not even those inside her hospital, has confirmed this to be the case.”
Will was perplexed by the mixed messages he was receiving from Tina. She seemed to convey both alarm and calm at the same time.
He prodded Tina for clarification, asking about the appropriate course of action. In his attempt to be helpful, he suggested the victim might have recently visited one of the countries she had mentioned, making it the most likely scenario.
Will stressed if the plague-infected fleas could be contained within the rundown Porthaven hospital, there might not be any need for alarm. He also pointed out reassigning the hospital’s work wouldn’t be necessary, given Kauffmann had already ensured her establishment made minimal contributions to the overall regional healthcare service.
Growing weary of the conversation and sensing the young and naive middle manager was struggling to grasp the potential seriousness of the situation. Tina tried again,
“You know the story of never being more than six feet from a rat in a built-up city—,” she began, but was interrupted by her ringing phone.
Tina felt frustrated, she had made it explicitly clear she should not be disturbed during this trip. She wanted to avoid taking a call during her visit that might be overheard by Kauffmann or one of her associates and later used against her.
Despite her initial irritation, Tina welcomed the distraction from her frustrating conversation with Will.
“I have a call here from a Gillian Kauffmann,” her PA informed her. “I think it’s ‘the’ Gillian Kauffmann. She’s been calling the main switchboard for the last fifteen minutes, insisting on speaking with you. I’m sorry, Tina, but I didn’t know what to do,” the PA apologised.
The PA understood that Tina, though generally reasonable and easy to work with, could become difficult if her direct instructions were not followed. Surprisingly for her PA, Tina sounded relieved and pleased to take the call.
Instructing Kauffmann to start from the beginning and signalling for Will to begin taking notes, Tina placed her on loudspeaker and listened as she recounted the events of the past two days.
The doctor started by describing her expectation of another routine and uneventful day, due to the ongoing doctors’ strike. She didn’t anticipate any new admissions and expressed her surprise when her one junior doctor on shift admitted a new patient. Kauffmann explained how her inexperienced student suspected the patient was either high or hungover. She admitted the patient’s initial presentation with fever and shortness of breath might have suggested Covid.
However, she felt it was not a typical Covid case since the patient was fit, healthy, and appeared to take good care of himself. She went on to share her hunch that the symptoms reminded her of something she had seen during her student days while working for Médecins Sans Frontières, caring for disadvantaged communities in rural India.
Kauffmann continued to explain, she didn’t trust her own judgement.
Nevertheless, she instructed her junior to check the lymph glands, which didn’t appear any larger than those of a typical fever or infection. To satisfy herself, she decided to take one last look for buboes, the lymph gland swellings often associated with this type of infection and found some in her patient’s groin area.
She made sure to emphasise, her junior had also noticed this, but his inexperience had led him to dismiss it as a drug injection site, based on his initial misdiagnosis. Kauffmann understood the importance of highlighting where her junior staff had made errors, even given the current situation, if only to claim some of the limelight for herself.
Tina interrupted her,
“So, that’s when you called Will, correct?” Kauffmann confirmed, “so then what did you do?” Tina questioned.
Detailing how she spent a few hours questioning if she had overreacted. Kauffmann explained she had ordered the staff to burn the patient’s clothing and bedding.
Her senior nurse, who often had a cantankerous attitude, saw this as Gillian causing unnecessary drama. This nurse continued to visit the patient, partly out of curiosity and probably to gather stories for gossip about how Kauffmann had made a misdiagnosis.
Kauffmann also took more pictures of the patient as his condition deteriorated and sent these images to Will. She also cross-referenced her diagnosis with various online resources to be sure. She emphasised the need for discretion, as she didn’t want the situation to escalate into a national panic.
“It was only eighty people who died in the end during the last outbreak in India, Tina, but it caused such panic hundreds of thousands attempted to migrate to avoid it. We’re all still on tenterhooks after Covid, and I didn’t want to start another national panic. Imagine how that would go down given previous events. All I wanted was someone here to verify my diagnosis and work on a plan,” Kauffmann explained.
With her initial shock from the scene in the hospital parking lot fading, Tina began to regain her trademark objectivity and rational thinking. She sympathised but remained somewhat puzzled. Perhaps she, like Kauffmann, had overreacted. Kauffmann’s years of dealing with coughs and colds probably meant she was struggling when presented with anything more serious.
On the other hand, Tina had been greeted by a post-apocalyptic sight filled with biohazard signs, burning braziers, and chained hospital doors. Maybe all involved had let the situation spiral out of control, and this was just a rare disease that had somehow found its way into the UK. The right protocols would be activated, a media plan devised, and then they would sit back and wait for things to settle.
It definitely didn’t sound like something to start comparing to mass migration events.
Tina started to rationalise the situation and jotted down questions to pose to Kauffmann once she finished her storytelling:
‘Why was every piece of fabric in the hospital being burned?’
‘What is the reason behind Kauffmann and staff donning makeshift biohazard suits and barricading themselves inside the building?’
‘Why, with only a single suspected case, is the hospital undergoing extreme measures?’
From an outsider’s perspective, Tina considered this might look like an errant doctor’s attempt to reignite the panic that had accompanied Covid and focus it on her small hospital in this tiny town. She couldn’t help but cynically wonder if there was a larger plan at play, something to thrust this small community into the global spotlight.
Even if there were no plague, the mere claim of it would go viral, making people flock to take selfies outside the hospital where the eccentric doctor had locked everyone inside and created a bonfire in the car park. It could be the kind of story that would become a documentary on a streaming service in a few years.
While Tina recognised she might be getting carried away, she couldn’t help but see similarities with social media videos her teenage son had shown her. People sometimes did things for the sheer shock value and attention they could get, no matter how crazy or extreme.
She considered the possibility Kauffmann and local officials might be cooperating, using this event to put their otherwise unremarkable town back on the map.
Will seemed to be dwelling on similar thoughts. He scribbled a note at the top of the pad he was taking notes on and showed it to Tina:
“You wanted to ensure I wasn’t seeking attention or playing a trick, that’s what you mean. And by ‘we,’ you mean George, don’t you?” Kauffmann interjected. “Well, here you go. See it for yourselves. This is the situation. I’ve managed it the best I can for now. Based on my diagnosis, there is a highly infectious disease in my hospital. As you stated yourself, I’m incredibly isolated here. Plague didn’t originate in Porthaven; it must have been brought here. I think I know who brought it, but they are now deceased. If he managed to bring it here and has obviously travelled through other places, then this isn’t just a case of ‘Crazy Kauffmann’ acting out.”
Tina nodded in agreement, acknowledging, while she understood the reasons behind the actions taken, there had been no verification from anyone other than Kauffmann regarding the existence of this supposed infectious disease.
She wondered why Kauffmann hadn’t pushed harder for a response and shared images to provide more information about the situation. Gillian smirked and tossed a small object in a clear bag towards them.
“I thought this would come up next,” Kauffmann said. “Take a look at this, and you,” she pointed at Will, “I assume you’re the Hospital Liaison Manager I spoke to. Well, check your emails. All the pictures from the phone in that bag are also waiting in your inbox. I assume you haven’t checked yet. Oh, and don’t open the bag, as Tina wisely said, ‘we don’t know what the disease is yet.’“
Kauffmann chuckled, showing even in a situation like this, she maintained her wit and sharpness.
Will whispered to Tina he had received the emails but, given the earlier drama in the meeting and the threat to his job, he hadn’t looked at them. He didn’t know what he was being sent and was afraid of George’s reaction if he added more controversy to the situation.
While Tina understood his reasoning, she was understandably frustrated. This situation could have been resolved from an office instead of standing in a car park surrounded by burning fabric and being reprimanded by someone she preferred to spend as little time with as possible. Even if she remained highly sceptical Kauffmann’s claims were valid.
Kicking the bag with the phone back to Kauffmann and shouting they would check Will’s phone; she urged him to immediately open his emails and view the attached pictures. Fumbling with his phone, Will finally accessed his emails and handed the device to Tina. She began to examine the first few images, which appeared to show a young man looking unwell, sweating, and discoloured, but nothing more deadly than a severe flu.
She glanced at Kauffmann and raised her eyebrows, who gestured for her to continue.
As Tina reviewed more photos, her initial cynicism faded, replaced by shock and horror. The images depicted a rapid progression from mild symptoms to a horrifying deterioration. The young man’s skin turning an eerie shade of blue, his veins standing out like dark rivers, and a look of agony etched on his face.
She dropped the phone, the impact with the tarmac causing it to bounce and a small crack to appear on the screen. Ignoring this she turned to Will, her face a mask of terror.
“She’s not crazy. Based on those photos, that’s my initial diagnosis too.”
Tina searched her handbag for her phone and made several hasty calls. Will wasn’t sure who she was speaking to but presumed it was likely the people who had been in the meeting a few days ago. The conversations mostly involved Tina asserting ‘she was right, based on the pictures, it’s what I’d say as well’. There were many affirmations, nervous agreements, and requests for support in Porthaven.
The last call was evidently to George. Tina had to gather her courage to speak with him, and it didn’t sound like the conversation went well. She signed off with,
“I’m sorry to say that’s my professional opinion, and it will have to be disclosed that the decision not to respond as we should have was made by you.”
Turning to Kauffmann, Tina spoke with a tremor in her voice.
“Well, Gillian, I think we need to start from the very beginning to understand your situation and determine how we can assist you.”
Chapter 6
Tina and Will descended the hill toward the town, following Kauffmann’s declaration that standing aghast in the small hospital car park next to her makeshift decontamination unit served no purpose.
They passed seedy bars and abandoned storefronts, their windows covered in grime and graffiti. Locals, their expressions worn and wary, shot furtive glances at the newcomers. All the while, the salty tang of the ocean mixed with the growing tension that hung between the pair, painting a gloomy picture of a town that had seen better days.
Kauffmann had made it clear; they were not going to be granted access to the hospital, leaving them with a deep sense of foreboding as they navigated the decaying streets.
Will, still convinced there were cult-like aspects to this situation, repeatedly pressed Tina,
“Why won’t she just let us in to have a look? If it’s okay for her to be in that homemade biohazard outfit, why can’t we do the same? Let’s get this over with and go home.”
Tina paused for a moment and contemplated what Will was likely making of this situation. He was a young man, in his twenties, she thought, who had shown up for what he had assumed would be a brief visit to a hospital.
He wore a stylish suit and carried a leather messenger bag. While Tina wasn’t sure what he had in the bag or what he considered essential for this visit, it was evident such a quality bag would have required substantial savings or credit.
Will seemed clueless about the situation. Thinking this trip would allow him to assert his importance as the Hospital Liaison Manager. Hence the expensive, obviously new bag and the sharp suit. Then use his experience and predicted success on this trip as a notable case study in his next performance review.
“Will, what do you actually know about the plague?” Tina asked patiently and was met with a blank stare, followed by the response she expected.
“We studied it in primary school, it killed a lot of people, they used leeches to treat it, but it was an ancient disease that doesn’t exist anymore,” Will explained matter-of-factly.
Tina’s sigh echoed with a weariness that seemed to seep into the very fabric of the worn promenade. She gestured for Will to take a seat on one of the battered benches that bore the scars of countless seasons by the sea.
With a swift kick, she nudged aside the discarded remnants of impromptu street parties from the night before. The discarded drink cans, empty bottles, and crumpled plastic bags had become a symbol of fleeting, carefree moments amidst the backdrop of a once vibrant but now faded coastal town.
Settling next to Will, she noticed the early morning sun was slowly gaining strength, casting long shadows that stretched toward the salt-stained railing overlooking the beach. Seagulls wheeled and cried overhead, as if bearing witness to the serious conversation about to unfold.
Turning to Will, Tina’s expression turned grave, her eyes reflecting a blend of determination and concern. Her words held a weight that matched the seriousness of the situation, and she urged him in a hushed but resolute tone to listen carefully, as if every word carried the destiny of their next steps.
Tina clarified to Will that, while he was correct, the plague was not prevalent in developed countries, there were still sporadic cases in less developed regions. She explained, in recent years, there had been outbreaks of plague in India, causing significant panic and mass migration as people tried to avoid it.
She also pointed out that within medical circles, it was well-known, plague still existed, particularly in places like Madagascar. She mentioned that just over a century ago, it had claimed the lives of nearly 100,000 people in China, and there was even an outbreak in Los Angeles in 1924.
Will listened with a mix of fascination and horror. Realising, this medieval disease they had studied in primary school, dressing up as plague doctors in their long, beaked outfits, was still very much a reality in the modern world.
“So, it could be another Covid?” Will inquired, seeking to draw parallels with recent experience.
Tina tried to allay his concerns, explaining the distinctions between bacteria, viruses, and infections caused by parasites. She informed Will Bubonic Plague was transmitted through flea bites, which probably explained why Kauffmann wanted them to maintain a safe distance from her. Why she had taken measures to ensure no part of her skin was exposed. It wasn’t a matter of staying clean or avoiding a virus, like with Covid, but rather preventing fleas from gaining access to her skin. This was likely why she had been burning items she deemed contaminated as well.
“Think about how small a flea is,” Tina continued to Will. “How can you be certain you’ve sealed a plastic bag tightly enough to prevent a tiny flea, just one millimetre long, from escaping? Consider how far a tiny flea can jump and the risk if the bag is ever opened or develops a slit, the flea can escape. A flea can easily jump 60 times its body length, has a lifespan of up to 3 months, and a single female can lay up to 5000 eggs.”
Will began to comprehend the situation. That’s why she was burning everything; she wasn’t attempting to kill a virus but to exterminate the fleas to prevent the spread of the disease. While he thought he had grasped the situation, his attempt to showcase his understanding only revealed his naivety.
“Well, that’s simple, isn’t it? We don’t need to panic. We can just leave them all in there for three months, wait until the fleas die and the plague is no more, and then we can let them out. This is a tricky situation, but it’s not the emergency Kauffmann made it out to be in her calls to me,” he suggested.
Hoping Tina would concur, and they could depart from this peculiar town with its even more peculiar hospital and return to civilization.
While his uneducated conclusion seemed reasonable, Tina cautioned Will,
“How do you think it got here? Kauffmann told us very few people visit this town, but it must have arrived somehow. How did it get into her hospital? Who else might be at risk? Remember, Will, some countries facing pest problems like fleas take significant precautions: no carpets, no pets inside, separate indoor and outdoor clothing, and more. We don’t have any of that here.”
She realised she was becoming overly dramatic, took a deep breath, and amended her statement,
“That is, of course, Will, if it is indeed plague in there! If we confirm Kauffmann’s diagnosis, then we should be concerned. While her photos seem to depict a case of plague, they are only images she has shared with us – no one else, not even those inside her hospital, has confirmed this to be the case.”
Will was perplexed by the mixed messages he was receiving from Tina. She seemed to convey both alarm and calm at the same time.
He prodded Tina for clarification, asking about the appropriate course of action. In his attempt to be helpful, he suggested the victim might have recently visited one of the countries she had mentioned, making it the most likely scenario.
Will stressed if the plague-infected fleas could be contained within the rundown Porthaven hospital, there might not be any need for alarm. He also pointed out reassigning the hospital’s work wouldn’t be necessary, given Kauffmann had already ensured her establishment made minimal contributions to the overall regional healthcare service.
Growing weary of the conversation and sensing the young and naive middle manager was struggling to grasp the potential seriousness of the situation. Tina tried again,
“You know the story of never being more than six feet from a rat in a built-up city—,” she began, but was interrupted by her ringing phone.
Tina felt frustrated, she had made it explicitly clear she should not be disturbed during this trip. She wanted to avoid taking a call during her visit that might be overheard by Kauffmann or one of her associates and later used against her.
Despite her initial irritation, Tina welcomed the distraction from her frustrating conversation with Will.
“I have a call here from a Gillian Kauffmann,” her PA informed her. “I think it’s ‘the’ Gillian Kauffmann. She’s been calling the main switchboard for the last fifteen minutes, insisting on speaking with you. I’m sorry, Tina, but I didn’t know what to do,” the PA apologised.
The PA understood that Tina, though generally reasonable and easy to work with, could become difficult if her direct instructions were not followed. Surprisingly for her PA, Tina sounded relieved and pleased to take the call.
Instructing Kauffmann to start from the beginning and signalling for Will to begin taking notes, Tina placed her on loudspeaker and listened as she recounted the events of the past two days.
The doctor started by describing her expectation of another routine and uneventful day, due to the ongoing doctors’ strike. She didn’t anticipate any new admissions and expressed her surprise when her one junior doctor on shift admitted a new patient. Kauffmann explained how her inexperienced student suspected the patient was either high or hungover. She admitted the patient’s initial presentation with fever and shortness of breath might have suggested Covid.
However, she felt it was not a typical Covid case since the patient was fit, healthy, and appeared to take good care of himself. She went on to share her hunch that the symptoms reminded her of something she had seen during her student days while working for Médecins Sans Frontières, caring for disadvantaged communities in rural India.
Kauffmann continued to explain, she didn’t trust her own judgement.
Nevertheless, she instructed her junior to check the lymph glands, which didn’t appear any larger than those of a typical fever or infection. To satisfy herself, she decided to take one last look for buboes, the lymph gland swellings often associated with this type of infection and found some in her patient’s groin area.
She made sure to emphasise, her junior had also noticed this, but his inexperience had led him to dismiss it as a drug injection site, based on his initial misdiagnosis. Kauffmann understood the importance of highlighting where her junior staff had made errors, even given the current situation, if only to claim some of the limelight for herself.
Tina interrupted her,
“So, that’s when you called Will, correct?” Kauffmann confirmed, “so then what did you do?” Tina questioned.
Detailing how she spent a few hours questioning if she had overreacted. Kauffmann explained she had ordered the staff to burn the patient’s clothing and bedding.
Her senior nurse, who often had a cantankerous attitude, saw this as Gillian causing unnecessary drama. This nurse continued to visit the patient, partly out of curiosity and probably to gather stories for gossip about how Kauffmann had made a misdiagnosis.
Kauffmann also took more pictures of the patient as his condition deteriorated and sent these images to Will. She also cross-referenced her diagnosis with various online resources to be sure. She emphasised the need for discretion, as she didn’t want the situation to escalate into a national panic.
“It was only eighty people who died in the end during the last outbreak in India, Tina, but it caused such panic hundreds of thousands attempted to migrate to avoid it. We’re all still on tenterhooks after Covid, and I didn’t want to start another national panic. Imagine how that would go down given previous events. All I wanted was someone here to verify my diagnosis and work on a plan,” Kauffmann explained.
With her initial shock from the scene in the hospital parking lot fading, Tina began to regain her trademark objectivity and rational thinking. She sympathised but remained somewhat puzzled. Perhaps she, like Kauffmann, had overreacted. Kauffmann’s years of dealing with coughs and colds probably meant she was struggling when presented with anything more serious.
On the other hand, Tina had been greeted by a post-apocalyptic sight filled with biohazard signs, burning braziers, and chained hospital doors. Maybe all involved had let the situation spiral out of control, and this was just a rare disease that had somehow found its way into the UK. The right protocols would be activated, a media plan devised, and then they would sit back and wait for things to settle.
It definitely didn’t sound like something to start comparing to mass migration events.
Tina started to rationalise the situation and jotted down questions to pose to Kauffmann once she finished her storytelling:
‘Why was every piece of fabric in the hospital being burned?’
‘What is the reason behind Kauffmann and staff donning makeshift biohazard suits and barricading themselves inside the building?’
‘Why, with only a single suspected case, is the hospital undergoing extreme measures?’
From an outsider’s perspective, Tina considered this might look like an errant doctor’s attempt to reignite the panic that had accompanied Covid and focus it on her small hospital in this tiny town. She couldn’t help but cynically wonder if there was a larger plan at play, something to thrust this small community into the global spotlight.
Even if there were no plague, the mere claim of it would go viral, making people flock to take selfies outside the hospital where the eccentric doctor had locked everyone inside and created a bonfire in the car park. It could be the kind of story that would become a documentary on a streaming service in a few years.
While Tina recognised she might be getting carried away, she couldn’t help but see similarities with social media videos her teenage son had shown her. People sometimes did things for the sheer shock value and attention they could get, no matter how crazy or extreme.
She considered the possibility Kauffmann and local officials might be cooperating, using this event to put their otherwise unremarkable town back on the map.
Will seemed to be dwelling on similar thoughts. He scribbled a note at the top of the pad he was taking notes on and showed it to Tina:
