We all fall down, p.1
We All Fall Down, page 1
Praise for Daniel Kalla
OF FLESH AND BLOOD
“[Kalla] plunges us straight into the frenzied pace of the OR and [into] a medical drama that spans a hundred years. He’s a strong storyteller who keeps his characters moving and struggling, and we’re right there, struggling with them, rooting for them.”
Vancouver Sun
“A rich medical narrative that combines the past with the present and throws into the mix visionary doctors, supportive nurses, hospital politics, children with cancer, celebrity patients, a lethal infection, adultery, and unrequited love.”
Library Journal
COLD PLAGUE
“Similar in many ways to Michael Crichton and even Dan Brown’s bestsellers, Cold Plague is testament to just how good commercial fiction can be: entertaining, informative, and downright fun.”
Winnipeg Free Press
“Plenty of suspense and layering on the kind of scientific detail that fans of medical thrillers crave. Recommend this one to fans of Robin Cook and other such A-listers.”
Booklist
BLOOD LIES
“Kalla strikes again with another perfect page-turner.”
LEE CHILD, New York Times bestselling author
“Fast-paced and smartly written. . . . Kalla has quickly matured into a force to be reckoned with.”
Booklist
“Fans of Presumed Innocent will find welcome echoes of that modern classic in Blood Lies.”
Publishers Weekly (Starred Review)
“Kalla’s well-paced medical thriller has twists that surprise us, but always make sense.”
Entertainment Weekly
RAGE THERAPY
“[Kalla’s] first novel, Pandemic, was as fine a medical thriller as I’ve ever read; his newest, Rage Therapy, is a taut psychological thriller that will pull you into a world of sexual deviancy, murder, and mind games. A very good read.”
NELSON DEMILLE, #1 New York Times bestselling author
“Kalla navigates the emerging fields of impulse and rage control therapy, and the issue of doctor-patient abuse, turning it all into an ingenious thriller.”
Ottawa Citizen
RESISTANCE
“Daniel Kalla’s prescription for a perfect thriller includes snappy characters, a pace that sweeps up a reader, and not too much technical jargon. . . . The kind of magnetic story you can’t put down.”
Vancouver Province
“[Kalla] continues his remarkable side career as the author of knowledgeable, but very scary medical thrillers.”
Seattle Post Intelligencer
PANDEMIC
“Michael Crichton ought to be looking over his shoulder. He has some serious competition in Kalla.”
The Chronicle Herald
“Kalla expertly weaves real science and medicine into a fast-paced, nightmarish thriller—a thriller all the more frightening because it could really happen.”
TESS GERRITSEN, internationally bestselling author of the Rizzoli & Isles books
“Very much in the Michael Crichton school of cutting-edge scientifically rooted thrillers. Pandemic is an absorbing, compulsive thriller, the sort of book you could stay up too late reading.”
Vancouver Sun
For my daughters,
Chelsea and Ashley
Chapter
One
There he is again. Watching, always watching. Doesn’t the old bastard have anything better to do? Vittoria Fornero wonders as she rolls up the blueprint and tucks it under her arm.
The little monk has shown up at the site every day since the first crew arrived to tear down the old monastery. As always, he’s wearing a traditional black Benedictine habit with the hood down, exposing a wispy ring of white hair around his otherwise bald scalp. Every morning at about nine o’clock or so, he appears with a rusty fold-up chair held under one arm and a black satchel worn over the other. Sometimes he sips from a thermos or reads from a well-thumbed leather prayer book. But usually, like now, he just sits near the edge of the excavation pit and watches like a pigeon perched on a building’s eave.
Most of the time the monk blends into the scenery along with the site’s other fixtures such as the giant yellow diggers, piles of lumber, and mounds of rubble and rock. But this morning Vittoria has no tolerance for the uninvited spectator.
“Se n’è andata!” Vittoria calls out to him, as she bundles her flimsy windbreaker tighter to fight off another vicious chill. “Your relic, she is gone, old man, gone. And the funeral is over!”
In truth, Vittoria can still see the ancient brick and stone monastery in her mind’s eye: a simple Romanesque structure that was already crumbling on the south side of the cloister where part of the attached arcade’s roof had collapsed years before. Dilapidated as the monastery was, Vittoria had appreciated its decrepit charm. And even though she is an unrepentant atheist, she carries enough childhood memories of intimidating nuns to feel a bit uneasy over her role in having leveled the ancient house of worship.
The old monk responds to Vittoria’s calculated belligerence with a friendly wave, making her question his hearing as much as she already does his sanity. Regardless, Vittoria isn’t about to be appeased; not this morning, not after he has already compounded her workload and aggravated her piercing headache.
Vittoria wasted fifteen minutes in the cramped overheated trailer that passed for her office trying to calm one of the workers, a pimply-faced apprentice named Emilio.
“Listen to me, Emilio!” Vittoria cut him off in midsentence, unable to listen to another moment of his alarmism. “That freeloading monk is bitter about losing the roof over his head! Nothing more.”
“But, Vittoria,” Emilio muttered. “Brother Silvio . . . he says it’s not just the monastery.”
“What, then?”
“Brother Silvio, he says that the monastery . . . it is built on hallowed ground.”
“To a monk, maybe. But to us it’s just a construction site. No different from any other.” Although, she silently conceded, the crypt below the monastery had come as a surprise. The excavators had not expected to unearth such a complex cellar, with its convoluted network of passages. And all those tiny bones. When Vittoria had first glimpsed them, she instinctively thought of her own two children. But she was in no mood to discuss medieval architecture.
“What about Yas?” Emilio asked.
“What about him?” Vittoria demanded, sounding more defensive than she intended.
“The day before last, Yas wasn’t feeling so good,” he said. “And then yesterday he didn’t show up. I haven’t seen him since.”
“So what? He’s probably just hungover.”
“Yas doesn’t drink. And he’s not answering my texts or calls. Brother Silvio says—”
“Enough, Emilio! For the love of God!” Vittoria held up her hands. “Not another word! Or you’ll end up on the docks looking for work scrubbing the fishing boats. Just like where Yas will soon find himself!”
Vittoria digs her thumbs into her temples, trying to squeeze away the throb along with the memory of her conversation with the panicky boy. She wishes Emilio hadn’t mentioned Yas.
Her legs tremble and another chill overcomes her. The ecstatic TV weatherwoman promised record temperatures for Genoa this morning. The bright April sun has already risen high over the rolling hills above the city, where the site is nestled, but Vittoria doesn’t seem to benefit from its warmth.
Maria warned her that she was too sick to work. Of course, Maria was like that, keeping their twins home at the first sniffle. Vittoria can’t help but smile to herself. Life hasn’t always been easy for two of them, living together in a city as traditional as Genoa, but Maria is still the best thing to have ever happened to her. And, as usual, Maria was right. Vittoria can’t remember ever feeling worse. Her breathing is inexplicably heavy. Each step is an effort. Her head is on fire. But it’s her armpit that bothers her most. The bluish lump under it has swollen to the size of a robin’s egg and throbs like a toothache. Even the light contact against her overalls is agonizing.
But Vittoria hasn’t missed a day’s work in twenty years. She’s certainly not about to take time off now, not when the crew is behind schedule and the boss is so worried over the financing. Her first order of business today is to permanently rid the site of this interloping monk before he scares other workers and puts them further behind. She should have had the security guards deal with him weeks ago, but now she will just have to do it herself. She squares her shoulders and marches toward Brother Silvio.
As she reaches close enough to inhale a whiff of his coffee, Vittoria has to pause to catch her breath. An invisible flame ignites her innards from toes to scalp. Her knees tremble so violently she half expects them to clatter.
The old monk tightens the cap on his thermos and leans forward in his chair. His eyes twinkle. “What is wrong, my dear?” he asks. “Can I be of assistance?”
“Yes! You can get the hell off my—” A sudden coughing fit silences her.
Vittoria feels phlegm climbing up her windpipe and shoots a hand to her mouth. For a moment or two, she can’t breathe at all. When the hacking finally subsides, she senses sticky warmth in her grip. Panic seizes her, even before she opens her palm and sees the wad of congealed blood.
Chapter
Two
The poor woman looks like death warmed over, Sonia Poletti thinks as she runs a gloved hand along the patient’s forearm in search of a vein. The skin is unnaturally cool to the touch, and the patient’s breathing is ragged despite the bulky mask that mists concentrated oxygen over her mouth and nose. Experience tells Sonia that the woman will soon wind up in the intensive care unit on a ventilator, but it’s not her place to comment.
Sonia assembles a rainbow array of color-topped test tubes on the stretcher beside the patient’s elbow. Once filled, each of them will be destined for a different analyzer, ranging from a highly sophisticated protein spectrometer to a plated slide under a pathologist’s microscope.
The woman raises her head off the pillow but can only hold it up for a few seconds before it flops back down. “Are you a doctor?” she asks in a raspy, air-hungry voice.
“I am from the laboratory. I’m here to collect more blood samples.”
“More blood? Will you leave me any?”
“Yes.” Sonia smiles behind her surgical mask. “More than enough.”
The patient coughs so violently that the test tubes on the mattress rattle. “They still don’t know what I have?”
The nurses outside the room mentioned possible tuberculosis, but Sonia didn’t delve. She’s too preoccupied with making sure she gets out of work on time today, of all days. She touches the woman’s arm. “We have the best doctors here. If they don’t already know, they will soon.” She pauses. “You are Vittoria Fornero?”
The patient nods.
Sonia kneels beside the bed. Out of habit, she spins the hospital bracelet over the woman’s wrist, double-checking the identity. She applies a tourniquet above Vittoria’s elbow, tightly enough for the vein below it to pop to attention. She effortlessly slides a butterfly needle through the skin and into the vein. Blood snakes up the connected tubing. Sonia attaches the other end of it to the first of the test tubes.
“You have children?” Vittoria croaks.
“One.” Sonia suppresses a smile. “Florianna—Flori—she is five.”
“I have two, myself. Twins. Eight years old. One of each.”
“Good for you, the complete set,” Sonia says, but there is little chance she will ever have a boy or another girl. Flori’s father had left her before the end of her first trimester. Sonia is only thirty-one years old and, as her mother keeps telling her, could still have several more children. But she won’t. Flori is joy enough for her.
Vittoria hacks another wet cough. “I wish I could hold mine again.”
“Soon,” Sonia mutters, but her mind has already drifted back to Flori’s dance recital, which will be held later tonight. She must get home in time to finish sewing the tail onto her daughter’s tutu.
Vittoria’s body jerks with another coughing fit. The noise is awful, like an old truck engine struggling to turn over. Sonia notices Vittoria wiping at her eyes. Blood-splattered phlegm has sprayed out from under the oxygen mask and onto her own forehead.
Sonia grabs a tissue from the box on her basket. She leans forward and wipes the mucus away. Vittoria offers her a small smile. Their eyes lock, and Sonia spots fear in the other woman’s eyes.
Suddenly Vittoria convulses with another cough. Sonia feels something wet graze the exposed cheek above her mask, and she jerks her head back.
Dammit! She stumbles back a step, grabs an alcohol wipe—the ones meant for cleaning the equipment—and scrubs roughly at her skin.
Vittoria can’t stop coughing now. The stretcher shakes with each fit.
Sonia reassures herself that her own skin test has long been positive for tuberculosis, meaning she had already been exposed to it and cannot acquire it again. She knows she should still report the incident to her manager and to Employee Health and Safety. But there’s no time. She promised to send her mother a video clip of Flori’s dance, and she still has to charge the camera. So, instead, she scrubs her cheek with another wipe and then sweeps up the tubes and hurries from the room.
Chapter
Three
Eight years. Alana Vaughn hasn’t seen him in over eight years. He has changed so little. True, the cheeks are a bit fuller, ruddier, too. But his smile—“all melty blue eyes and endless dimples,” as a smitten English nurse once described it—is the same.
“Ah, Alana. Ciao bella . . . Even more beautiful than memory serves!” Dr. Nico Oliva says.
His familiar voice, deep and rich with that perpetually amused timbre, ignites long-forgotten butterflies. “And you, Nico, are even more Italian than I remember.”
Nico shrugs in a can’t-be-helped way, and she’s reminded again why she fell for him in the first place.
His office is predictably minimalist in terms of furnishings and with just a few framed medical degrees and three black-and-white photos of African landscapes, one of which she recognizes from their mission together in Angola. He steps out from behind his desk and kisses her on each cheek, leaving behind a trace of citrus. “You didn’t have to come in person.”
“Yes. Yes, I did.” His text was so unexpected, and so welcome.
“Did you have trouble finding my office?”
“Not really.” But she actually did.
Alana has wandered the halls of some of the most formidable hospitals, from Johns Hopkins to the Mayo Clinic, but the Ospedale San Martino is among the most sprawling, seemingly constructed in fits and starts over decades. The signage didn’t help. Alana speaks passable German, having lived in Heidelberg as a teen when her parents were stationed there for a year, but her Italian is almost nonexistent. Navigating the curved hallways and hidden staircases of the labyrinthine hospital to reach Nico’s office in the Department of Infectious Diseases was no easy feat.
Nico studies her unabashedly. “So much catching up to do. Dinner, soon. I insist.” He smiles again. “But you must be anxious to see the patient, no?”
“Yes. Very.”
“Come. I will take you.” He reaches for her arm and interlocks his elbow with hers, the contact familiar, comfortable. Maybe too much so.
The hallway is lit by fluorescent tubes and smells of bleach. It’s crowded with staff and patients, who are lost in conversations, hands as busy as their mouths. No one seems to pay any attention to the sight of two people, one of whom wears a lab coat, walking arm in arm. Alana smiles to herself. Only in Italy.
“Where are you staying?” Nico asks.
“The Grand Hotel Savoia.”
“Ah, by the station.” Nico glances away. “I would’ve loved to have you stay with us, but Isabella . . . and the children . . . there would be no rest for you.”
Of course there’s an Isabella. Alana expected nothing less, but she still slips her arm free of his. “Kids, Nico? As in plural? I had no idea.”
“Yes. Enzo is three now, and Simona just four months. Can you imagine? Me?” He laughs and looks away momentarily. “A boring family man.”
“No. I really can’t.”
Nico finds her gaze again. “And you? Have you . . .”
“I don’t stay in one place long enough to have a hamster, let alone a family.”
She can tell that he sees through her levity. “I miss the action, Alana. What we used to do. What you still do.”
She thinks of her previous outbreak-containment missions, such as yellow fever in Guyana, drug-resistant tuberculosis in Central Asia, and, of course, Ebola in West Africa. The faces of the dead and dying, particularly the children, who are always most susceptible. “Some things are better left unseen, Nico.”
He doesn’t comment, but she realizes he’s not convinced. As they round another corner, he says, “Tell me, I originally tried you at your WHO email address. The email, it bounced back to me. Of course, I would never misplace your mobile number, but . . .”
Alana remembers his unexpected text, and how excited she was to hear from him, their painful parting forgotten. She might have found an excuse to visit him in person regardless of the circumstance, but two words in his note—the plague—had started her packing for Genoa without a second thought. “I’m not with the World Health Organization anymore, Nico.”
“Oh? I thought you were what we used to call a ‘lifer.’ ”
I once did, too. For a moment she considers telling him about her disastrous final mission in Liberia during the height of the Ebola crisis. Nico worked for the WHO; he, of all people, would understand. But all she says is, “I needed a change.”
“You were in Geneva, no?” he asks, confused.
