Livestock, Dead Stock

By Seymour Grufferman

"I, for the life of me, cannot understand why the terrorists have not, you know, attacked our food supply, because it is so easy to do."

                              

• Language: English
• Publisher: Seymour Grufferman MD
• Release date: Sep 15, 2020
• ISBN: 9781732330245

Seymour Grufferman

Seymour Grufferman is a physician-epidemiologist who began his medical career as a pediatrician and went on to obtain two masters' degrees and a doctorate in public health from Harvard. After serving in the Air Force in Japan, he taught and practiced public health at the Gondar Public Health College in Ethiopia. He has held faculty positions at several universities-Haile Selassie I, Duke, Pittsburgh and New Mexico- teaching and doing research, and has published numerous articles in leading scientific journals. He taught courses in epidemiology in Third World countries such as Pakistan, Thailand and Zambia for the International Agency for Research on Cancer and has traveled widely from Afghanistan to Tanzania. He draws on these experiences to create vivid images of the novel's settings. After being invited to participate in conferences on US food safety, he became deeply concerned about the startling vulnerability of US food supplies to terrorist attack. This novel is intended as a wake-up call to America.

Book preview

1

Addlestone (Weybridge), Surrey, England, 1986

It was a cold, dreary afternoon in southeast England. What a God-awful, pathetic sight, the tall blond man in green scrubs said as he and his assistant watched an emaciated, black and white cow lying on the ground panting. The holding pen smelled of wet straw and manure. It was drizzling and the cow was covered with mud. She looked confused as she tried to stand up, only to slide and fall again. The tall man wiped his brow and said, All right, let’s put her out of her misery. Abdullah, euthanize her and take her inside for an autopsy, chop-chop.

Abdullah replied, We’ll put her down and cart her inside, Sir.

Abdullah waited until Hitchings went inside and then got to work. He called to one of the animal handlers in a nearby pen, Lionel; I need some help over here.

Lionel ambled over, dressed in a yellow rain suit, and asked. What’s up?

I need to put this cow down and she’ll need some restraint. She’s weak, but still could kick out when I inject her. She’s got a halter on and she’s down on her side, which may be enough if you restrain her neck and front quarter.

Are you ready, Ab?

Yeah; I have the pentobarbital already drawn up, Abdullah said as he removed a large syringe from his coat pocket. Let’s go.

The handler expertly took hold of the cow’s halter to extend her neck while he placed his knees on her shoulder. Abdullah quickly palpated the cow’s neck for her carotid artery and the nearby carotid vein and plunged the needle in. It took less than a minute for her to relax and another minute for her to stop breathing. He opened the cow’s eyelid and pressed on her cornea with no response. Well, the poor creature is out of her misery now, Abdullah said. Let’s get her inside.

Abdullah and Lionel trussed the cow with rope and then used a small crane to lift the carcass onto a heavy-duty cart. They wheeled her to the doorway and then used the crane again to position her on a stainless steel autopsy table set on wheels. They moved her into a fluorescent lit, tiled autopsy room where Abdullah took off his plastic raincoat and got to work. He hosed down the animal and checked that the table was positioned properly. He donned a surgical gown, mask, safety goggles, and gloves and used an electric saw to open the cow’s cranium. He sawed through the chest to expose the heart, lungs and great vessels. He used a large scalpel to open the abdominal cavity and then paged Hitchings.

Hitchings swaggered in and said, Right! This is our first autopsy of a cow with this new disease, so we need to get specimens from all organs and tissues for microscopic exam. Snap freeze the large pieces and then put the smaller specimens I give you into formalin. I’ll section the brain and we’ll need formalin fixed samples from each section that must be clearly labeled. We’ll just freeze the rest. Do you follow me?

Yes, Sir, Abdullah said. He would have liked to say, Yes, Sahib.

Damn it, Abdullah, you idiot, you didn’t arrange the overhead lights the way I like them.

I’m sorry Sir; the animal turned out to be larger than I expected.

Abdullah was certain Hitchings looked down on him as some dark-skinned wog from one of their former colonies, with a cockney accent and a third-rate education to boot.

The team was efficient and after completing the autopsy in 40 minutes they found no gross abnormalities other than emaciation, though more work would be done later in the microscopic review of the tissue specimens. It’s curious that there were no gross abnormalities of the cow’s brain when there were such obvious neurologic signs, Hitchings said as he took off his rubber gloves and threw them on the floor, You wrap things up here, Abdullah. Now don’t screw things up. This is a very important autopsy. Do you understand?

Yes, Sir. I’ll take care of things. Abdullah sighed and rolled his eyes after Hitchings left.

Abdullah had another hour of work, taking the carcass over to the disposal unit, labeling the tissues in preservatives, logging and storing the tissue specimens. He seethed as he cleaned up Hitchings’ mess, vowing that someday he would get back at the bigoted and arrogant British bastards.

It was a decision he wouldn’t forget.

2

Addlestone, England, 2005

Nineteen years later, Abdullah was just a day shy of retirement from Weybridge, the UK’s Central Veterinary Laboratory. He’d miss the work. He’d been there 25 years. He’d always wanted to be a veterinarian and this was as close as he could get to his dream. On the other hand, he’d get a pension that would afford him a modest retirement. He grimaced and slammed his fist on his desk. He knew that if he were a white Brit, he would have been promoted many more times and his pension would be a lot more substantial, but he had a plan.

He got up, went to the coat locker in the corner of his small, windowless office and removed a duffel bag. He checked that the hallway was clear and walked out and down the hall to a high security area. He used a plastic key card and then a metal key to open a thick glass and stainless steel door to gain entry. He then went to a nearby room with a heavy steel door that he unlocked with another key. He went inside quickly, turned on the lights, and locked the door behind him. The Lab was a major international repository of infectious agents for animal diseases, past and present, and this was where they were stored.

Underneath his surface calm, his heart galloped as he entered the large room filled with noisy freezers. There were no windows, only white concrete-block walls. He took out an index card from his shirt pocket and set it on a counter. He then removed an array of wide-mouthed Thermos bottles from his bag, placed them on another counter, and got to work. He first went to the ultra-low temperature freezer where specimens from the first autopsy of an animal with mad cow disease were stored. He remembered the day in 1986 when they did that first post-mortem exam and he had handled the specimen storage. His labeling of the specimens was exemplary and he could easily find what he wanted. His hands trembled as he put on heavy insulated gloves and removed ten canisters labeled with the autopsy number and Brain. He emptied them into two large containers to which he added liquid nitrogen from a nearby tank before sealing them. He next found canisters labeled Spinal Cord that he packed similarly.

He closed the freezer, checked the list on his card and went to another freezer removing specimens labeled Foot and Mouth Disease, a disease of cloven-hoofed animals, and Newcastle Disease, a disease of birds. He next went to another freezer and extracted tubes labeled Swine Flu. He also removed tubes labeled Rinderpest, a highly lethal disease of cattle that had been eradicated worldwide the year before. He had selected the highly contagious animal diseases carefully. He packed the specimens in insulated containers filled with liquid nitrogen and then put them in his bag. He opened the door cautiously, looked both ways before exiting, relocked all the doors and walked slowly back to his office.

He slumped in his chair and threw his head back. He had altered the freezer inventories the day before so no one would realize any specimens he planned to take were missing. All had gone without a hitch. He let out a deep breath and smiled at the thought of how he would now supplement his income with these treasures and get back at the British bastards.

3

New York City, 2007

Jim Stewart and three colleagues were enjoying a steak dinner at the O’Brien and Shaughnessy Steak House, an upscale watering hole on the Upper East Side of Manhattan. They were seated in a frosted-glass-walled cubicle at the rear, wearing their collars open and their expensive ties askew. The dinner was to celebrate Jim’s promotion to vice-president of one of New York’s top advertising agencies; it was his treat. He was drinking 16 year-old Lagavulin and his friends Glenmorangie Scotch whiskies; they drank it the right way—with a wee dram of water and no ice—and after a few rounds, were laughing raucously and didn’t notice the long wait between their shrimp cocktails and salads and the arrival of their steaks.

Their waiter, a bearded man wearing a black vest and apron, had taken their steaks from the kitchen to a service alcove and set them down. He reached into a vest pocket, retrieved a small jar containing a brown powder, removed the screw top and carefully sprinkled a small amount over each of the steaks. He was careful not to inhale any of it. He would repeat the process with other customers until all of the powder was gone and then he was to discard the jar in the kitchen trash and wash his hands carefully. He’d been paid five hundred bucks for the job by an elder at his mosque and assured the powder wasn’t a poison, so he’d asked no questions. He was unaware that a similar process was being carried out in Chicago.

The waiter finally served Jim’s party their steaks, recoiling at the strong smell of whiskey at the table. Before they started on their steaks, Jim raised his glass and said, Here’s to my good friends who helped me get my new job.

One of his friends responded, Here’s to Jim’s success! He earned his promotion the old-fashioned way—by working his ass off.

As they were eating, Jim commented, My steak’s really first-rate. How’s yours?

One of his buddies answered, This steak really lives up to this joint’s reputation. His other friends nodded in agreement.

4

New York City, 2017

Jim Stewart looked bewildered as he tried to comfort his wife June, who sat sobbing in the kitchen of their Manhattan apartment. Oh Jim, what’s wrong with you? First you forgot our anniversary and now my birthday; you always remembered those dates. You’re just not your usual self. You don’t smile or crack your silly jokes, and we don’t make love any more. Jim, are you depressed?

Sorry Honey, I had a crazy day at the office. I just forgot. He got up to go console her and tripped over a chair leg.

Jim, have you been drinking again?

No, no. You’re right, June; I’m not myself.

Are you having problems at work?

I’ve had some trouble concentrating on tough jobs, but my assistants really help out. I’m just not feeling a hundred percent. I’m sorry if I haven’t been a good husband.

Honey, when was the last time you had a doctor’s check-up?

It’s been ages.

Jim, I’m going to set one up. I’ll come with you.

Jim hung his head, looking like he was about to cry. June came over to hug him, promising to call the doctor the next day.

***

On the day of the appointment, June was waiting for Jim when he arrived at Dr. Jerome Schwartz’s office on 5th Avenue. When she asked how his day had been so far, he told her that he was working on a presentation to a potential new client and the whole office was a madhouse.

I’ve had the worst headache, which didn’t help. He loosened his rep tie as they waited.

A nurse invited Jim into a small room where she weighed him and took his vital signs. She made a face as she commented on Jim’s weight; he’d put on 6 pounds since his last visit. When Jim was called in to see the doctor, June insisted on joining him. Dr. Schwartz had been their primary care physician for years and was an old family friend. They had watched him turn grey over the years. Well what brings you two in here today?

June answered, Oh Jerry, Jim’s just not himself any more. He’s glum, withdrawn and can’t sleep. Most of the time he acts as if I’m just not there.

Jim, what seems to be wrong? the doctor asked as he led Jim into a windowless examining room and gestured behind his back for June to remain behind.

I don’t know. I just feel weird and down all the time. My memory seems a bit off, but then I’ve been super busy at work.

The windowless exam room was small and had diplomas on the wall. The doctor directed Jim to the paper-covered examining table and told him to strip down to his shorts so he could do a physical. Asked when his last vacation had been, Jim told him it was a couple of years back.

Since my promotion, I’ve been working harder than ever.

Have you ever had depression?

No. You know me; I’ve always been happy-go-lucky.

Have you been getting enough sleep?

I’ve had terrible insomnia lately.

The doctor listened to his heart and lungs, probed his abdomen and then did an extensive neurologic exam. He checked Jim’s reflexes, his eye movements, his muscle strength, his coordination, his balance and gait. He turned off the lights and used an ophthalmoscope to do a careful exam of Jim’s eyes. He turned the lights back on and took a seat at his desk. Why don’t you get dressed Jim? I think you have depression, and I always like to make sure it’s not due to a neurologic problem.

Like most physicians, Dr. Schwartz saved the sensitive questions for last. Tell me Jim, how are you and June getting along. Are you having any problems?

I don’t know. June thinks I’m ignoring her and I lost interest in having sex with her. She’s really upset.

The picture you’re describing fits well with endogenous depression. It’s probably biologic in most people. I’m going to put you on an anti-depressant for starters. I’ll also give you a prescription for a sleep medication. Do you need a drug like Viagra?

No, that’s not my problem.

Why don’t you finish getting dressed? I’ll bring June in and explain what’s going on. I’d like to see you again in a month. I’d also like you to plan a vacation.

Thanks Doctor. You know, I’ve been worried that I’ve been depressed.

5

New York City

Hi June, this is Buzz at Jim’s office. I’m calling about Jim. He’s had some sort of blackout and he’s been groggy ever since. I hope it’s not something serious like a stroke. We offered to call an ambulance, but he refused.

Oh, no! I’ll come over and get him after I call our doctor. Thanks Buzz. If he seems to get worse before I get there, please call 911and get an ambulance, no matter what he says.

June immediately called the doorman at their apartment building to get a taxi and call her when one arrived. She next called Dr. Schwartz’s office and luckily he was in. His receptionist asked June to hold since he was with a patient. While June was waiting, she switched to speakerphone and went to fetch her handbag, coat, and cell phone. Dr. Schwartz got on the line finally, June, what’s going on with Jim? My receptionist said he’s had some sort of seizure at work.

Oh Jerry, Jim’s been getting worse since you saw him some months ago. She repeated what she’d heard about his blackout.

Why didn’t they call an ambulance and get him over to a hospital?

He refused. He’s been getting argumentative lately, at least with me.

Okay, go get Jim at his office and take a taxi over to the Emergency Department at New York-Presbyterian Hospital at York Avenue and 68th Street. I have admitting privileges there. I’ll call the ED and give them a heads-up on Jim. Call my office when Jim gets admitted to the ED. Don’t worry; we’ll get him well taken care of. I’ll see you later at the hospital.

Thanks Jerry. I’m scared.

The doorman called to let June know a taxi was waiting. While in the cab she called Buzz back and asked if he would collect Jim’s things and bring him downstairs where she’d pick him up. It took only 15 minutes to get Jim in the cab and on their way to the hospital, where they followed signs to the Emergency Department.

New York-Presbyterian Hospital is an imposing tall, gray-white edifice at East 68th Street alongside the East River. June had delivered their son at the old Lying-In Hospital that was part of the hospital complex. Jim was able to walk in under his own power though he was a bit wobbly. He sat while June got him registered and had him sign all the forms. The ED was a madhouse with screaming patients, policemen, crying relatives, and crowds of people. Luckily, it wasn’t long before they were ushered inside. A nurse in scrubs took his history and vital signs and got him in a wheelchair that she wheeled into a small, brightly lit examining room that had a green curtain instead of a door, leaving him hooked up to a monitor while he waited to be seen.

June held his hand and asked, Are you feeling okay, Jim?

I guess so. I must have passed out at the office and I’ve been fuzzy since then.

They were interrupted by someone screaming, Help! Get me outa here!

After a long wait, they were startled when the green curtain parted and a young woman in blue scrubs under a white jacket came in. She extended a hand to Jim and introduced herself as Dr. Falcone, an emergency medicine resident. She asked how he was feeling and he explained about the blackout and subsequent grogginess.

Have you had episodes like this before?

No. Dr. Schwartz has been treating me for depression and I just haven’t been myself lately.

The resident took a lengthy medical history from Jim and then did a physical examination. She was particularly concerned about the drug he was taking for depression. The only abnormalities she found were slightly slurred speech, an abnormal gait with impaired balance, and hyperactive reflexes. She turned off the lights and did a careful examination of his eyes. Her only comments to the Stewarts were that Jim’s history and physical were puzzling and that Jim would likely need to be admitted for evaluation, as Dr. Schwartz had thought. She patted Jim on the hand and went out to report to her attending physician.

Thank you Doctor, June said.

The attending physician, wearing a long white coat over green scrubs, came in an hour later to inform them that they would admit Jim to the hospital for a work-up and it could be a while before they found a bed for him. He warned them that this was a teaching hospital and Jim would be evaluated by a lot of students and doctors.

After two more hours, they took Jim to the ward and got him settled. He was exhausted and had to face a procession of residents, medical students and subspecialty fellows who examined him and took medical histories. After a wiped out Jim was asked the same set of questions three times, June wished she’d prepared a typed medical history that she could hand out and spare him this ordeal.

Finally they served him supper, which gave him a respite. There was a knock on the door, followed by the appearance of a friendly face, Dr. Schwartz. Hi. Sorry to get here so late. I’m sure you’re both exhausted by now. How are you feeling, Jim?

Tired. Really tired. I don’t know what happened to me today.

Do you have any recollection of blacking out?

No. I just remember being foggy afterwards.

At this point, it’s hard to figure out what’s wrong. We’ll need to observe you. Tomorrow we’re going to exhaust you with a battery of tests. We plan to do a brain MRI, an EEG, that’s a brainwave study, several psychological tests, a spinal tap, a neurological examination, and a lot of blood work. Depending on what we find, we may do further testing. In the meantime, we’ll keep you hooked up to some monitors.

How long will he have to be in the hospital? June asked.

It’s hard to say, June. I expect two to three days. Jim, you never came back for a follow-up visit. Did the medications I gave you help?

I don’t know. I think I was able to sleep better. I’ve been having bad thigh pain that keeps me up if I don’t take the sleeping pills.

He’s still depressed and he’s gotten stubborn and argumentative, June chimed in.

All right, June, why don’t you go on home and get a good night’s sleep. Jim will be fine here and we’ll give him something to help him sleep soundly. He’ll need to be rested for tomorrow.

6

New York City

Two days later, June stood outside Jim’s room engaged in a heated discussion with Dr. Schwartz. Jerry, I insist on sitting in on Jim’s conference. I’m his wife, damn it!

June, you won’t understand most of the discussion and you may find it upsetting.

Look, I’ll eventually be told whatever is discussed and I want to hear it sooner rather later.

A nurse rushed over and said, I overheard your conversation and have to inform you that Mrs. Stewart can not attend the conference on her husband’s illness. It’s strictly against hospital rules and it’s also unwise. I’m sorry, Ma’am.

Dr. Schwartz hugged June and said, Stay here, June. I’ll brief you after the conference. Don’t worry. He winced as he walked down the hall to the ward’s conference room.

The room was jammed for the presentation of Jim Stewart’s case. Word had gotten out that Jim had a fascinoma, such an esoteric disease that his case was proving a magnet for medical students and house staff. Senior staff were seated at a conference table in a room too small for the crowd. Some of the younger-looking doctors, probably students, stood pressed against the walls or sat on the floor.

The senior resident on the ward began, We’ll be presenting the case of Mr. Stewart this afternoon. It involves the medical, psychiatric and neurologic services, which is why we’re having this multidisciplinary conference. He nodded towards one of the residents, Dr. Ramos will present the case.

The resident who got up, appeared nervous in the presence of several big-name doctors. He spoke in the ritualized fashion of medical rounds. The patient is a 48-year-old, white, male advertising executive who came into the hospital because of a blackout spell. He was in good health until he developed signs of depression that progressed over the course of three months to involve neurologic signs and symptoms. He droned on with further details.

The next to speak was the Chief Resident in Neurology. "So what we have is a middle-aged gentleman who presented initially because of depression and then progressed to having neurologic issues. We’ve ruled out potential causes like a brain tumor or meningitis. The patient has a characteristic abnormality on his brain MRI, the presence of a protein in his spinal fluid that usually only occurs in the disease we’re considering, and several neurologic and psychologic problems. He has cognitive deficits, loss of muscle coordination, impaired memory, and a low-average IQ