Chapter 33 is a shocker and we find out why we are not fond of Terese for it is she who bursts angrily through Richrad's door as his accomplice in spreading contagion. And why does she play with lives so cavalierly? She does it to increase the market share for National Health hospital by decreasing that of Manhattan General hospital's. Outraged at Jack's interference and complicating presence, she lets it slip that Richard is her brother when they decide to take him to the desolation of "Mom and Dad's place" in the Catskill Mountains.

"I think he should just disappear," Terese said. "What about Mom and Dad's farmhouse up in the Catskills?"

Prior to this conversation, Terese had ordered Richard to throw all the pathological microbe cultures down the toilet, sending them to the sewer. [Readers fear what the rats might do to humans once they are infected with the microbes but Jack isn't and Terese and Richard surely aren't: "Jack hated to think what had just been sent into the city's sewers to infect the sewer rats."]

Injecting Jack with ketamine, a veterinary anaesthesia (not for humans) that immobilizes and may produce hallucinations, they get him to Richard's Explorer and to the Catskills with a few extra blows to his head. There, they handcuff him to the kitchen drain pipes under the sink. Critical to the falling action is the fact that while in the Explorer, Jack's flu symptoms were worsening and at the peak of severity, meaning he was sneezing and coughing during the ride to the Catskills.

Terese and Richard's quarrels about who is to blame for the wretched state of affairs reveals the backstory of Terese's idea of getting Richard to help and his idea to spread infection through humidifiers, making the infections look like hospital caused nosocomial infections, and Terese's shock at learning about the deaths but her pleasure at seeing national health's market share numbers increase, and Richard's pursuit of spreading further infections.

Neither Terese nor Richard can bring themselves to pull the trigger to kill Jack in cold blood. They decide to sleep on the question while Jack dreads the coming morning in between attempts at escaping.

If he were to escape it would have to occur when he was allowed to go to the bathroom. ... Jack shuddered when he thought of what the morning might bring.