introduces two of Jack'spersonal internal conflicts (recklessness, AmeriCare), one of his personal external conflicts (battling unjust externalities; symbol: the taxis), one general external conflict (office politics) and the central external conflict of the novel (nosocomial infection).

Chapter 1 starts out with gusto with Jack begging for trouble (personal and racial trouble) by challenging a New York City taxi driver, with feigned courtesy that thinly disguises a challenge, to a fight.

    "Excuse me," Jack Stapleton said with false civility to the darkly complected Pakistani cabdriver. "Would you care to step out of your car ...?"

Jack then follows his "slalom" bike route through New York to the Medical Examiners building. This slalom, incidentally, is the dual symbol of the upcoming adventure and of Jack's personal life that we are told more about as the story unfolds.

Once inside and arrived at his fifth floor office, Jack is told the day's autopsy assignments from which he picks the mystery nosocomial infection. We learn, as Jack interacts with the characters he works with, that nosocomial infection is acquired while in hospital. In other words, this is an infection that, in the normal course of events, a patient would not have gotten if not admitted to a hospital. The hospital in this case is Manhattan General (called "the General"), which is owned by AmeriCare.

Before Jack goes off to begin the autopsy on Donald Nodelman, the man who suddenly died of the nosocomial infection at the General, he tells his supervisor and assignment dispenser, Laurie Montgomery, that it would give him personal satisfaction if he could cause AmeriCare some trouble.

    "[It] might make this case personally rewarding," Jack said. "Maybe I'll be lucky enough for the diagnosis to be something like Legionnaires' disease. ... [I'd like] giving AmeriCare heartburn."

During the autopsy that follows, Jack learns surprising and important information about the infection that impels the rest of his actions as the story unfolds.

Chapter 2 introduces one of Cook's routine changes in point of view (a stylistic pattern he shares with John le Carre) by going to Colleen and Terese at Willow and Heath advertising agency.

Colleen and Terese, Colleen's boss, are in charge of the advertising campaign for National Health hospital (the National), the local challenger to Manhattan General (the General), which is an AmeriCare corporation-owned hospital. National Health has been losing clients to the General and hired Willow and Heath to reverse the loss trend.

The first TV advertisement put together by Colleen and Terese, who is the character through whom the narrator focuses (i.e., focalizes) this chapter, was guaranteed to raise the National's market share of customers. As Terese learns to her dismay, the TV commercial was unsuccessful and she is given one week by the National spokespersons to get a new--and this time successful--campaign publicly aired.

After the meeting, Terese presents the bad news to Colleen. Colleen, under Terese's orders, pulls her team together to make a presentation of the ideas they have at the moment. This set-back could have devastating effects on Terese's fast-track plan for business promotion and she is "dazed" and shocked by the challenge set before her.

    "... I mean, it's my best sixty-second spot. You told me yourself. ... Well, I want to see what you have [now]," Terese said. "I don't care how sketchy or preliminary. ... I want to see it today."

As a side note, Teresa and Colleen seem to have a mixed work relationship. At times, Terese, the boss, looks to Colleen for support and confirmation, while at other times, Colleen, the "hire," offers reprimands to Terese, her boss. This suggests that Cook didn't have the familiarity with advertising that was needed for authenticity between Terese and Colleen.

In Chapter 4, "Wednesday, 2:05 P.M., March 20, 1996," we hear a conversation between Chet and Jack that is designed to tell us a little more detail about Jack. As a side note, technically, this an awkward place for this information. By Chapter 7 we already have a firm image of Jack in our minds, for instance, perhaps as a tall, slim active man with brown hair parted at the left and sort of floppy, as in the British style, yet now we find out that "he is a stocky, six-foot man accustomed to serious activity." These are two very different images and men. In all probability, every reader at this point has to mentally stop, erase, and rebuild Jack's image, an exercise that detracts from the quality of the novel.

Having additional information about Jack (even though some of it would have been welcome earlier) gives us more insight into his actions and attitudes and lends cohesion to his interactions with others. After an interruption to their conversation, Chet hastily follows Jack out of their shared office into the hall after Jack has impulsively decided to take advantage in his superior's absence to get "more information" from Bart Anderson in order to pinpoint where the plague originated, a plan that worries Chet:

[Jack] got in the elevator and hit the Down button. "I need more information. Somebody has to figure out where this plague came from or this city's in for some trouble."
    "Hadn't you better wait for Bingham?" Chet asked. "That look in your eye disturbs me."

In the elevator, the narrator confirms Jack's dislike of AmeriCare by reminding us of his earlier remarks through Jack's interior thoughts as he muses about his wish to "give AmeriCare some heartburn." His conversation with Bart leads to two telephone calls. One to the Commissioner of Health and one to Nodelman's wife. 

Jack's conversation with Bart leads to a telephone inquiry with Mrs. Nodelman, the wife of the diabetes patient who died of the plague as the result of hospitalization for diabetes treatment. From Mrs. Nodelman, Jack learns that foreign travel, foreign visitors, a domestic pet, neighborhood rats and wild animals, like rabbits, were not the originating cause of Nodelman's plague virus.

The chapter concludes with Jack alarming Chet again by declaring it was time to apprise Laurie Montgomery of the situation that Jack had begun to sketch out:

    "There's that facial expression again that scares me," Chet said. ...
   "[I'm going to] tell Laurie Montgomery what's going on," Jack said. ... "She has to be apprised."

In Chapter 5, Jack goes to Manhattan General, now owned by AmeriCare, in his capacity as Medical Examiner, an intimidating law enforcement capacity as witnessed by his examiner's badge, to inspect the rooms of the pneumonic plague victims and the vicinities around the rooms. His first meeting is with Dr. Wainwright who seems appalled to hear of the cause of death of the victims and who fully cooperates with Jack in organizing the first steps of the investigation. Wainwright calls the hospital infection-control officer, Dr. Mary Zimmerman, to authorize testing of every patient, while Jack goes to the seventh floor to begin his investigation.

"Not that I know of," Dr. Wainwright said, "but you can rest assured that we will find out immediately.

Things don't progress as smoothly as they begin though because Jack is later ordered out of the laboratory area where they are consulting (or being reprimanded) on the latest hospital victim to contract and die from the plague. Before Jack is ordered out by Kelly, Richard and Nancy Wiggens convince Jack they are shocked by the news of the latest victim and explain to him that since they were so far behind in the lab work and since all staff was drawing blood to test for plague, they didn't act upon noticing the first signs of the virus.

"As behind as we are in the lab, I couldn't take the time [to follow-up]. All of us ... have been drawing blood."

Chapter 7 of Contagion is another chapter that has a changed point of view. Point of view is provided by the character through whom the narrator focuses events and other characters behaviors. The thoughts of feelings of the point-of-view character (the focalizing character) are the thoughts and feelings the third-person limited narrator reveals.

In Chapter 7, the setting switches to an advertising agency, and the point of view is that of Colleen. The action centers around the conversation Colleen and her very ambitious friend Terese have about when Terese will or won't be promoted to president of the advertising agency she works for:

Colleen said ... "You should be content and do what you are good at: doing great ads."
    "Oh come on!" Terese said. "You know we advertising people are never satisfied. Even if I make president I'll probably start eyeing CEO."

Action follows through, in this brief chapter, a presentation, called a "ripomatic," that Colleen shows Terese in the "arena" of the advertising agency where rough presentations are rehearsed and critiqued. This chapter is important because of Colleen and Terese's connection to developing the advertising for National Health hospital, the local competitor against Manhattan General, the unfortunate hospital where the plague broke out.

Chapter 8 increases the Jack's personal conflict. There are several conflicts in Contagion. The most obvious conflict is the external conflict between the medical examiner team, especially Jack, and the outbreak of plague. At first this conflict seems to be human against nature but later it becomes clear that it is a different kind of conflict. Jack's personal conflict, which is further developed in Chapter 8, is a variation on a human against human theme; we might be inventive and call it human against the system.

After talking to Bart Anderson to get "more information," Jack does two things: he calls Mrs. Nodelman to ask about possible foreign contact and animal contact as origins of the plague and he calls the Commissioner of Health who is his boss's boss. In other words, as Bingham suggests to Jack after summoning him, Jack has broken office procedural policy and gone to the top of the chain of command without observing protocol requiring speaking to the supervisor immediately above.

"Just so I can try to understand," [Bingham] said ... "did you not think that I would find it inappropriate for you to call the commissioner before talking with me?"

While being reprimanded for this breach and for going to Manhattan General, more about Jack's inner qualities and turmoil emerge.

"Knowing the General was an AmeriCare hospital, I wanted to go over there and rub it in a little. ... It's a personal thing," Jack said.

Chapter 9 returns us to Colleen and Terese, the advertising representatives for National Health hospital, the competitor against Manhattan General. In an interesting sequence, Cook presents General's competitor in Chapther 7, Jack's actions and attitudes against AmeriCare (the owner of Manhattan General) in Chapter 8, and the details of the marketing campaign for National (in other words, against Manhattan General) in Chapter 9.

In Chapter 9, Colleen and Terese go out on the town, mostly to get Terese's mind off her aspirations to become president of the advertising firm though still in her 30s. While out, of course the topic of their advertising project comes up in conversation. In the taxi on the way home, Teresa and Colleen compare personal notes about General and National. They know about the plague association with General hospital. Terese has been to General and explains that when it comes to cleanliness, National "is the antithesis" of General, suggesting that General has sanitation and cleanliness problems.

From this emerges a slogan tag line for their advertising campaign when Terese suggests that an old cliche is applicable: National is so clean that people could eat off the floor there. Terese composes the tag line and suggests it to Colleen:

    "I even have thought up a tag line," Terese said smugly. "Listen: 'We deserve your trust: Helath is our middle name.'"
    "Excellent! I love it!" Colleen exclaimed.

In Chapter 10 of Contagion, the hero medical examiner, Jack, rides his bike in to work in the morning to discover a TV news crew in front of the office. He then discovers that overnight three deaths from plague or suspected plague have occurred. The deaths were all patients of Manhattan General Hospital but all unassociated with Nodleman, the first case examined. The chapter continues through the autopsies and a conversation about the involvement of the Center for Disease Control (CDC) in tracking the cases. It ends with a conversation about Public Relations involvement.

Chapter 11 presents, in a short chapter, another point of view change as Cook takes us to Manhattan General hospital, Donald Lagenthorpe and Dr. Doyle. Lagenthorpe is "a thirty-eight-year-old African American oil engineer who had ... awakened with progressive difficulty breathing ... and he'd come into the emergency room" at 4 a.m. This chapter sets up the possibility of another case of plague but a case that may have an origin not remotely related to Manhattan General in New York if it originated in Texas where Lagenthorpe had recently spent time.

Donald Lagenthorpe had been to Texas the previous week and was due to go back. Since Chapter 10 focuses on Jack's further efforts to identify the originating cause of the infection at the hospital, with help from the Center for Disease Control (CDC) ("[CDC] sent someone up here from there plague division"), the fact that we have a suspicious incidence of difficult to interrupt asthma and a remote connection to Texas raise alarms and suspense. Alarms are further heightened because Lagenthorpe is being kept longer at General to administer more intravenous corticosteroid treatment and to monitor the development of his hoped for full recovery.

    "This was a difficult attack to break."
    Donald nodded again. No one had to tell him that.
    "I want to keep you on the IV steroids for a little longer," Dr. Doyle explained.
    Donald ... was supposed to go back to Texas the following week.

In Chapter 12 Jack undertakes the autopsy of Susanne Hard, a woman who died at Manhattan General in the maternity ward after delivering her baby through a cesarean section birth.

Clint, whom Jack dislikes to begin with, nervously watches on and makes a sympathetic remark about Susanne Hard's death being a sorrow to her husband, now a widower with an newborn infant. Jack reacts with violent internal emotion that he can only control by exiting the autopsy room. The narrator describes Jack's reaction as ire at the cliché spoken by Clint when in reality, Clint was being uncharacteristically sympathetic toward the Hard family. Cook uses this exchange to reveal more about Jack's internal personal conflicts by suggesting that Jack knows what it is to lose a spouse while Clint only knows clichés about it.

A knifelike stab of emotion went down jack's spine. ... Abruptly he left the [autopsy] table and exited to the washroom. ... [He] leaned on the edge of the sink and tried to calm himself ... It always irked Jack when he heard such cliches from people who truly had no idea.

Jack progresses with the Susanne Hard autopsy while Calvin, Clint, Vinnie and, eventually, Laurie look on and make attempts to understand and make comparisons to Nodelman's autopsy (the first patient to die from the nosocomial infection acquired at Manhattan General).

When the examination results differ in some particulars from Nodelman's plague-confirmed autopsy, Jack hesitatingly suggests the rare infectious disease tularemia, a suggestion that seems as extreme as the prior day's revelation of plague.

Laurie laughed. ... "That would be pretty rare, although not as rare as your diagnosis yesterday of plague."

The chapter ends with Jack instructing Agnes in the Lab to send tissue samples from Susanne's autopsy to a "reference lab" where highly infectious microbes are routinely and safely handled.

Chapter 13 is the follow-up to the night out enjoyed by Terese and Colleen, of the Madison Avenue advertising firm, during which they meet Jack and Chet and find inspiration for an updated National Health hospital campaign, one to replace the previously failed campaign and due in a week from the date of notice. Terese begins the point of view focalization (i.e., focusing point of view) but Helen takes the focalization later in the chapter.

Teresa and Colleen compare opinions about how the new ad campaign is moving along and briefly compare opinions about Jack and Chet, too. After some discussion of the Hippocratic Oath in relation to the ad campaign, Helen decides to venture into untried territory and work in tandem with Helen in the accounts representatives department. Creative and accounts departments are typically seen to be adversarial rather than cooperative departments.

With a change in focalization to Helen, after "the impromptu meeting," Helen heads right over to Robert Barker's office to report the substance of the meeting to him. Robert exposes his "devious" nature and suggests that Teresa and Colleen be encouraged to run with an ad that has the potential of losing National's account. His competition against Terese for advancement in the upper echelon of management comes to the fore through this attitude as he expresses himself to Helen.

    "I'd like [Terese] to propose a tasteless  campaign."
    "I see your point," Helen said. ...
    "The problem with the idea about nosocomial infection in general is that it could be a good one. There might possibly be a legitimate difference ...."

Chapter 14 finds Jack in his fifth floor office with Chet first thing in the morning. The first thing Jack wants to do is get to work and call Susanne Hard's husband to question him about possible originating causes of her infectious disease. The first thing Chet wants to do is confirm Jack's hoped for but not promised appearance at their planned date with Terese and Colleen.

After Chet wrings an explosive agreement from him, Jack calls Mr. Maurice Hard. Before being able to question him about pets and travel, Jack learns that Susanne's parents are accusing Maurice of some sort of foul play in Susanne's death. Finally Jack learns that the family dog is healthy and that Susanne had not traveled anywhere because of her uncomfortable pregnancy except up to their rural country house in Connecticut where Susanne wandered by the pond and in the grounds where she fed the wild deer and rabbits.

The other information he gets is that their visitor from India had stayed one week three weeks prior to Susanne's hospitalization, he was well at last contact, and Susanne hated hospitals so had not been in one prior to going into labor to give birth. Similar information emerged when he called the husband of Katherine Mueller, the woman who died who had worked in the hospital supply room. In the end, Jack still has no clue to originating causes, which prompts his sudden impulse to go to Manhattan General again to look for physical clues in the building itself and to look at the laboratory slide that was prepared at the hospital.

All Jack learns at the hospital is that there are no obvious physical connections between the seventh floor OB-GYN and medical ward; supply workers don't have contact with patients; the slide in the lab showed no plague but did exhibit excessive "pleomorphism"; and that the administrative staff, who were friendly the previous day, were adamantly unfriendly to Jack now, even threatening a slander action. Jack is now convinced that the missing information he needs is to be found at Manhattan General, but he doesn't know where.

    "I'd say your presence is more than disruptive," Kelley said. "In fact, you've been downright slanderous. You could very well be hearing from our lawyers." ... [They] now acted as if Jack were the enemy. What could they all be hiding? And why hide it from Jack?

Terese and Colleen meet Jack and Chet for dinner after work. The structure of this chapter weakens since Collen essentially vanishes along with a mysteriously non-present meal, during the restaurant scene. Terese learns that hospitals must track their nosocomial infection rates (rates of hospital originated infections), which are reported to a government supervisory commission (the Joint Commission of Accreditation) that grants or withholds hospital accreditation. Terese also manipulates a visit to her office to get Jack's reaction to the new ads and then a visit to his office where she overhears that one of the autopsy cases was not plague but tularemia, another virulent infectious disease.

Despite the length of Chapter 16 of Contagion and its wealth of detail, there are only a few new things added to the story. Jack goes in early to the Medical Examiner's Lab and finds that three new cases of death by infectious disease have come in from Manhattan General, accompanied by one unrelated (thus far) gunshot death.

Jack performs autopsies on Donald Lagenstorpe, who was suffering earlier from an asthma attack that wouldn't respond to treatment thus required hospitalization, and on Maria Lopez, who worked in Manhattan General's central hospital supply department as did the earlier victim Kathrine Meuller. Laurie performs an autopsy on another infectious disease victim, Joy Hester, and sees the presentation of tularemia.

It is noteworthy (and something to remember in case there is a later connection made) that Calvin and Bingham both appeared in the autopsy room in connection with the shooting victim being autopsied by Chet. The shooting was police related and of a suspicious nature.

After assembling the needed samples and specially requesting frozen organ sections, Jack solves the mystery of Lagenthorpe's previously unrecognizable symptoms as those indicating the infectious disease rickettsia. Agnes informs Jack that it is extremely dangerous in "aerosol form" (when loosed into the air), perhaps more dangerous than aerosol tularemia or plague.

Agnes called out to [Jack]: "I appreciate you letting me know about this as soon as you did," she said. "Rickettsias are extremely dangerous for us lab workers. In an aerosol form it is highly contagious. It's as bad or worse than tularemia."

At present, the infectious disease count is:

1. Nodelman: plague
2. Katherine Mueller (central hospital supply department): plague
3. Susanne Hard (mother, died in childbirth, Connecticut house with rabbits): tularemia
4. Maria Lopez (also central hospital supply): tularemia
5. Donald Lagenthorpe (asthma victim): unconfirmed rickettsia
6. Joy Hester: unconfirmed tularemia

Chapter 17 of Contagion returns to Willow and heath advertising firm. Helen, the account representative for National Health hospital, which is the competitor of Manhattan General hospital, has learned that while National has a lower than average nosocomial infectious disease rate (nosocomial: hospital originated infection the patient would not have gotten if not hospitalized).

Helen takes this news to her boss, Robert Barker. Together they are developing Robert's idea that it would be a good thing if Terese's ad campaign for Manhattan General was rejected by the hospital. With the rejected ad campaign would go Terese's hopes of being promoted to president of the advertising firm.

Helen then shares the nosocomial rate news (or at least the outline of it) to Terese who realizes it might good to consult Jack and Chet about the ad. Colleen volunteers to make the phone call since she and Chet had had such a lovely evening out the night before.

    "Having Jack and Chet take a look at this is not a bad idea," Terese said. "A professional response might be helpful."
    "I'd be happy to make the call,' Colleen offered.

Chapter 18 picks up from Chapter 16 during which Jack discovers the rickettsial infectious disease Rocky Mountain spotted fever. Rickettsias are extremely contagious and dangerous to laboratory personnel you would normally work with diagnostic samples. For this reason, rickettsia samples, like tularemia samples, are sent to a reference laboratory that has the equipment for safely working with them. In this chapter, the reference lab calls Jack directly to confirm the diagnosis of Rocky Mountain spotted fever and volunteers to report the outbreak to the city health commissioner and board.

Since Jack now has confirmation that Donald Lagenthorpe died, after hospitalization for a virtually unmanageable asthma attack, of Rocky Mountain fever, he is more convinced than ever that the something "weird" going on over at Manhattan General is peculiar to something happening at the hospital and well outside the bounds of probabilities of chance occurrences.

    "Lagenthorpe expired from Rocky Mountain spotted fever," Martin said gruffly. "Find out who get the samples and who processed them."
    Richard stood for a moment, obviously shocked by the news. "That means we had rickettsia in the lab," he said.

Jack bikes over to give them the news, since their lab assistants handled the Lagenthorpe samples without knowing what they were thus exposing themselves to the disease and learns that at the very moment Kelley has been called to the emergency room (ER) because two hospital staff are ill with an undiagnosed "fulminant infection." Lagenthorpe condition was also fulminant. Jack deduces correctly that the two staff work in central supply and in nursing.

Returning to the Medical Examiner building, Jack learns that the shooting victim had three bullets shot from the back during a problem with police and that Colleen and Terese have requested their presence after work at the Willow and Heather ad agency to look over the new National Health hospital advertisig campaign.

Chapter 19 of Contagion is where Jack begins to see his life with a new perspective. It starts when Jack is with Chet at Willow and Heath advertising agency and it ends in his apartment kitchen.

Colleen and Terese have asked Chet and Jack to stop by the ad agency after they finish work to get their reactions to the new campaign ads for National Health, the hospital that is the chief competition of Manhattan General. While there Jack begins talking about the latest outbreak at General (isn't a medcial examiner supposed to keep from disclosing these things?) of the third infectious disease: first, plague; second, tularemia; third, Rockey Mountain spotted fever. Being (slightly irrationally) pressed by Terese (who seems unable to follow logic all that well), Jack reveals his only half-conscious suspicion that the infectious diseases are being deliberately planted.

Part of his reason for suspecting this is that (1) the outbreak of three rare infectious diseases in (2) thee days (3) in a hospital environment (4) in the wrong season of the year defies probability. Another part of his reason is the existence in some victims of a high maintenance pre-existing medical condition: sever back trouble requiring multiple surgeries in Susanne Hard, asthma in Donald Lagenthorpe, diabetes in Mr. Nodelman. On his ride homeward through Central Park, the implications of having for the first time voiced his previously only half-conscious suspicions came home to him filling him with a sense of dread and ominousness. Simultaneously, he began to feel the dread and ominous threat of Central Park at night. Upon reaching home, he found that his apartment (now also looking unappealing and ominous) had been broken in to.

As Jack rode deeper into the dark, deserted [Central] park, its gloomy and somber views add to his disquietude. ... Jack streaked into a puddle of light beneath a lonely streetlight, braked, and skidded to a stop. He forced himself to turn around and face his pursuer ... he [then] understood that what was threatening him was coming from inside his own head.

While there was nothing to steal, all his belongs--such as they were--had been torn apart and tossed around. When he went to check the kitchen, he found the men who had broken in sitting around with their weapons, including semi-automatic weapons, gathered on the kitchen table. After inviting him to sit with them, the told him they'd been sent as a warning by someone who was unhappy about his visits to and questions as Manhattan General. To emphasize the warning the leader threw a "sucker punch" knocking to the floor and nearly unconscious. To supplement their payment for the hired attack, they took Jack's bike.     

In Chapter 19, Jack was knocked out cold by intruders who were paid to warn him to stay away from Manhattan General hospital. In Chapter 20, Jack comes to and regains consciousness; he comes to have a new perspective on himself; he comes to a deeper knowledge and understanding of Terese.

The first thing Jack feels is excruciating pain in his jaw. The first thing he hears is the ringing in his ears that turns out to be the ringing of the wall phone above his prostrate head. Terese is calling from the ad agency to consult him on a point related to the ad campaign she is developing. She thinks she has awaken Jack from sleep but he assures her he was not sleeping--he was knocked unconscious. Terese comes over directly after ordering him to phone the police and makes sure he sees a doctor by putting him in a taxi and taking him herself.

In keeping with the emergency room doctor's orders, she takes Jack to her perfectly ordered apartment so she can check him during the night for signs of consciousness and equal pupil dilation, signifiers of neurological symptoms. After Jack has freshened up in the bathroom of the flower bestrewn guest bedroom, he finds Terese is still sitting up; she has not gone to sleep yet. While Terese vigilantly keeps watch over his pupils and for signs of confusion, she asks him pointed questions, the ones Jack avoids asking himself.

Jack looked into Terese'a pale blue eyes. She was asking questions that he strictly avoided. The answers were too personal. ... "I suppose I have been courting danger," he said.

This opportunity affords them closer knowledge of each other. For both, this means knowledge about what lays below the brusque all-business exterior each wears. Jack reveals the tragedy of his wife's death without mentioning the full extent of the tragedy by withholding information about his children.

"My wife died," Jack managed. He couldn't get himself to mention the children.

Chapter 21 opens on Saturday morning at Terese's apartment where she woke Jack periodically per doctor's orders to check for signs of neurological damage after being knocked out cold. Terese goes off to the ad agency in view of her looming Monday morning deadline and Jack goes home on the subway to face his vandalized apartment. After an attempt at tidying it, he goes in to the Medical Examiner's building because the cases at Manhattan General's emergency room the day before are worrying him.

He finds that Laurie is the weekend doctor in charge of autopsies and that all three sick hospital employees, whom he left as patients at General, were now patients on slabs with the medical examiners and were awaiting postmortem autopsies. Laurie is in the middle of her third autopsy when Jack joins her in the autopsy theater. The new she gives him is that all three women--one a lab assistant, one a nurse, and one in central hospital supply--died of Rocky Mountain spotted fever, the third infectious disease to break out in Manhattan General in less than a week.

Nancy Wiggens had been brought in at four A.M.! The provisional diagnosis was Rocky Mountain spotted fever.
    Jack found two more cases with the same diagnosis: Valerie Schafer, ... and Carmen Chavez ....

Jack then gets an invitation from Laurie to a dinner party before he works through some of his backlog of paper work. With the dinner invitation pushed to the sides of his mind, jack goes home for a vigorous turn on the basketball court. Here Warren questions him about his sudden curiousness about a gang and quizzes him about why his jaw was "banged up."

Feeling particularly lonely after the unexpected kindnesses he received from Terese and then Laurie and finding nothing left in his refrigerator except moldy cheddar cheese and old eggs, Jack took a chance on calling Terese at the ad agency for possible dinner out, which she declined begging her deadline as a valid excuse. With the loneliness still gnawing, Jack calls Laurie to accept the dinner party invitation.

Chapter 22 develops Jacks internal conflict about the solitude and social ostracism he has inflicted on himself in a sort of self-penance for, as we learn in this chapter, an event he feels is his fault. jack realizes he is being confused because suddenly, after five years of insular privacy, he is surprisingly receiving attention from and attracted to Laurie and Terese, women very different from each other.

Laurie calls to tell him there are no new deaths from Manhattan General and to say that her parents were impressed with him from the previous night's dinner party and that she had enjoyed her time with him. Jack muses about his suddenly awakening feelings, an awakening inspired by the kindnesses of the two women. He then responds to Terese's previous request and calls her for a coffee date. They meet at a coffee shop near Willow and Heath ad agency.

Responding to the uncomfortable feeling of having told his secret for the first time in five years--his secret sorrow at his wife's death--he feels the drive or compulsion (perhaps guilty compulsion disguised as relief at speaking up) to tell Terese that there was more. He says that it was in a commuter crash that his wife died along with their two daughters and that he has always felt responsible because they were in the commuter because of him.

    "My wife wasn't the only person who died," Jack siad haltingly. "I lost my two daughters as well. It was a commuter plane crash. ... The problem is, I've always felt so responsible," he continued. "If it hadn't been for me they wouldn't have been on that plane."

Terese responds by saying the whole story for her, which she told part of the night he was attacked, is that not only did she lose her only child but she also lost the ability to have other children and she lost her husband.

Trying to make light of their mutual discomfort at their confessions and at having confided closely guarded personal information, they laugh off their feeling with jokes about therapists and promises of seeing New York's Cloisters in the heart of the upcoming spring.

    "You'll love [the Cloisters in spring]," [Terese] promised.
    "I'll look forward to it," Jack said.

Still using the subway because he hadn't bought a bike Saturday, in Chapter 23 Jack enters The Medical Examiners Building to see a full ID (body identification) waiting room. Vinnie tells him that eight cases of "meningococcal deaths" had come in over night.

Jack, Laurie and Chet discuss the irregular outbreak pattern of cases followed by an abrupt ending of cases. In other words, once an infectious disease occurs, there should be further cases that can be tracked as being related in some way to the original "index" case. Jack uses this unusual occurrence to suggest that there is some sort of intention, by some sort of person, behind the outbreaks; he also suggests there is a connection to chronic illness in the index cases.

"All the index case from these recent outbreaks have had some sort of chronic illness," Jack said.
    "A lot of people who are hospitalized have chronic illnesses," Laurie said. "In fact, most of them. What does that have to do with anything?"

After Jack, Chet and Laurie complete the eight autopsies, Jack further notices another emerging pattern. The last case in all four disease outbreaks--plague, tularemia, Rocky Mountain spotted fever and now meningococcus--was a woman from central hospital supply. Jack makes a prediction about the next outbreak they will see: diphtheria, pertussis, or influenza.

"I'd use drug-resistant diphtheria, or maybe even drug-resistant pertussis. Those old standbys are making some devastating comebacks. Or you know what else would be perfect? Influenza! A pathological strain of influenza."

Terese calls Jack for emergency help over coffee where she tells him that she had had the foresight to meet with a friend from college who works at National Health hospital before her presentation and learned that mention in an advertisement of nosocomial infections (hospital originated infections) would never meet with National's approval.

She relies upon Jack to help find a new angle. In the conversation, Jack mentions the new outbreaks at Manhattan General and just before dashing off, Terese insists that there be no secrecy like National's secrecy over their nosocomial infection outbreaks (though theirs were of milder diseases that nonetheless led to deaths).

Starting on a personal note, the narrator conveys Jack's musings about Terese's unpredictability since she "agitated" him because she seemed attractive one moment and off-putting the next. Jack's wonderings switch to the puzzle of whom he offended so much as to have vandals and threats sent after him. With these thoughts inspiring his vague determination to "be careful," he pursues his decision for revisiting Manhattan General.

Two important pieces of information are developed in this chapter. One is that the hospital is doing everything possible to control the spread of contagions even going so far as the self-impose semi-quarantine enforced by city police on guard out-of-doors. This is an important idea to develop as we approach the upcoming moment when Jack uncovers who or what is behind the outbreaks of contagions. Is his theory correct that it is someone with limited knowledge of how contagion spreads, thus starting with a contagion that didn't spread human-to-human, who will next spread a human-to-human contagion, such as influenza?

The second is Jack's surprise finding at the ease with which pathogenic microbes can be ordered over the phone. Beth tells him that this can and is routinely done. Not believing the plausibility of acquiring life threatening pathogens with such simplicity and ease, he simulates a order himself by calling the number Beth gave him.

The route of Jack's actions in the chapter is that he enters Manhattan General and, seeing that everyone has been ordered to wear a protective medical face mask, he dons one too, then finds a white coat in his size in the Doctor's Room where laboratory coats are hung. He goes first to Central Medical Supply to talk again with the manager, Gladys, there who had helped him earlier (debatable move since she had also grown hysterical and complained about his supposed assertion that the infections were for a known fact generated by the hospital ...). What he learns from her is that the hospital staff is pursuing the same lines of inquiry he began with, including a check on the air circulation system.

Next he goes up to the laboratory and finds it filled with hospital staff. The reason is that every staff member is giving a throat culture to test for meningococcus. After safely getting through the crowd without being recognized, where even Martin is taking throat cultures, he finally finds Beth who tells him (1) that him he is really disliked by the administration and (2) that pathogenic infectious disease microbes can be ordered over the phone and can even be over-nighted for rapid delivery. On his way out, after placing his phone call and simulated microbe order, he is caught in the act of leaving the lab by Martin and Richard who are entering with trays full of throat culture swabs in their arms. Jack is trying to exit and they help him to do so after Martin first calls Kelley and complains very earnestly, the end result being that Jack is to be invited out by security guards, if they can catch him.

    Jack dialed the number [to the pathogenic culture company]. The phone was answered and ... Jack pressed two for sales ... [a] friendly voice ... asked if she could be of assistance.
    "Yes," Jack said. "This is Dr. Billy Rubin and I'd like to place an order."
    "Do you have an account with National Biologicals??" the woman asked.
    "Not yet," Jack said. "In fact, for this order I'd just like to use my American Express card."
    "I'm sorry, but we only accept Visa and Mastercard," the woman said.
    "No problem," Jack said. "Visa will be fine."
    "Okay," the woman said cheerfully. "Could I have your first order?"
    "How about meningococcus?"
    "... We have hundreds of meningococcus subspecies."

Chapter 25focuses on advancing the two threads that will ultimately lead to the who or what, how and why behind the spread of the contagions of the infectious diseases of plague, tularemia and Rocky Mountain spotted fever. The two threads are (1) the Black Kings and whoever is behind paying for their violent services and (2) ordering the culture probe to identify if any of the victim's pathological microbes are "tagged" with National Biologicals' phage-type identifiers that can confirm a culture's origination with National Biologicals by means of a "fluorescein-labeled DNA probe."

This two-pronged plot development is wrapped in advancing Jack's personal internal conflicts aimed at revealing more of his psychological characteristics. The subplot conflicts developed are (1) Terese versus Laurie and (2) his job security after five years of cynicism and sarcasm. Pertaining to the first, Jack gets dinner invitations from both Laurie and Terese giving Jack a second chance to muse over how after five years of social estrangement, he suddenly finds that two women with opposite personalities are both actively attracted to him. Pertaining to the second, Bingham is one breath away from firing Jack for going to Manhattan General again and turning every official in the city against Jack when he has a change of heart because he recognizes Jack's concern about the inception of the contagions.

The chapter opens with Terese and Colleen holding a meeting with the "creatives" at the ad agency to start plan three for national Health hospital's ad campaign. It will focus on "no waiting." It will be kept strictly secret from "accounting" since that department has sabotaged the creatives' efforts in order to undermine Terese's chances at becoming company president. It is not clear yet how this subplot is critical to the main plot except as a means of introducing auxiliary information about the nature of medical advertising, nosocomial infection regulations, varying levels of hospital administrative efficacy.

After Jack nearly gets fired by Bingham, he goes to his office to find that Gladys has sent over the medical files for the index patient case in each of the contagion outbreaks. While examining these to find any commonalities between them, he is asked to dinner by Laurie, then by Terese. Each mention the danger Jack may be in by returning to his apartment, reminding us of the threat posed by the Black Kings gang on hire by someone.

Jack ends his examination of the files with reaffirmation of the common factors (1) of infections first showing symptoms after they were checked into the hospital and (2) of an existing costly medical condition in each: diabetes, back surgeries, asthma.

Next Jack takes a decisive step that might be instrumental in uncovering the truth behind the contagions (if there is a hidden truth). Jack calls National Biologicals and learns that cultures can be traced back to their originating laboratories, in other words, microbes from the hospital infections patients are traceable back to National Biologicals if that is indeed where they began and came from. It would be critical if such a connection were to be made: it should indicate deliberate acquisition and, moreover, deliberate intent.

    With the advances in DNA technology [Jack] thought it was scientifically possible for National Biologicals to tag their cultures, and ... he thought it a reasonable thing to do. ... Jack reached for the phone number [of national Biologicals]. ... Jack asked for the probe [identifier] to be sent over-night express.

Chapter 26 focuses on what faces Beth Holderness, form the microbiology laboratory of Manhattan General, and exposes some of the conspiracy behind the contagions while complicating Jack's danger.

In Chapter 24,Jack asked Beth to look around to see if she might find anything that looked like suspicious cultures that might be related to the contagious outbreaks of infectious diseases at the hospital. At the close of her shift in Chapter 26, Beth finds herself alone in the laboratory. She begins to look around. Since the chapter switches to Beth's point of view (the narrator tells the story focused through what Beth sees, feels, thinks and does), the narrator can let us know what she thinks about the odd behavior she has seen around the hospital, and her thoughts confirm Jack's opinion that Martin and Richard are acting unusually volatile and moody, even though typically moody. This point of view allows the narrator to establish credence for Jack's observations thus confirming Jack as a reliable assessor of what he sees.

Beth goes straight to the insulated refrigerator-type boxes that Jack had earlier noted and that stood at the back of the microbiology lab. One held the cultures actively being worked with in an incubator, and Beth had been in and out of that one all day, while the other held frozen cultures. Being less familiar with the freezer box, she chooses to look in there for anything suspicious. At the rear of the large double-rowed freezer box, Beth finds metal boxes, about the size of shoe boxes. Not knowing what the contents of those are, she pulls one out to examine it. From its new position on the floor, Beth is surprised to see that it has a small padlock on it. An external examination, feeling around each by hand, shows that all the metal boxes have similar padlocks, except for one that has a lock that hadn't caught and is hanging open.

While Beth is tentatively examining the two culture dishes in the metal box, one of which she had picked up and taken the lid off of, the freezer door opens. Hastily trying to reassemble the cultures, the box and padlock, Martin catches her by coming around the corner and meeting her, with considerable surprise and even more anger, face-to-face. Richard soon joins them and as the culmination of yelling from both, Beth is dismissed from her job starting immediately; she is fired.

The story switches point of view to Twin, the leader of the Black Kings, and we learn that someone has put a $500 hit order out on Jack and Beth: they are both to be killed, and Reginald is going to do it.

Returning the point of view to Beth, we accompany Beth to her apartment, where the building entrance door has been broken into, by all appearances, with a crowbar. Beth takes no notice except for dismay at the need to postpone moving and goes upstairs to her apartment. The first thing does is to phone Jack and leave a message telling him that they need to talk because she did find something suspicious. A violent crash rips her door from the door jam and Reginald stands before her, pistol in hand.

Jack finds himself in danger when, after playing a game of neighborhood basketball, he goes for a run in Central Park where he is pursued on foot by Reginald. After a horrible set of events, Reginald has Jack in his sights when Spit appears after having shot Reginald. Warren, the leader of the basketball gang, sent Spit to save Jack and promises Jack protection after first confirming that Jack is not involved in drugs.

    "Let's go, Doc," the man said.
    Jack descended the last three steps. When he got to the bottom he recognized his rescuer. It was Spit!
    "What are you doing here?" ....
    Jack had no idea how Spit happened to be there at such a crucial time, .... 

In Chapter 27,Beth still doesn't answer her phone when Jack calls first thing in the morning. Jack is followed by Slam, the protection Warren promised he would have, as Jack takes the subway in to work (he still hasn't replaced his bike). Entering the Medical Examiners building, Jack is shocked to find Bingham and Calvin in the autopsy "pit" already doing an autopsy on a new infectious disease death from Manhattan General. The diagnosis is influenza. This is a horrifying confirmation of what Jack predicted would be the next contagion: a contagion that is spread through airborne human-to-human contact or transmission.

Jack is further shocked to find that several shooting deaths came in overnight. He opens the first file and sees Beth Holderness' name classifying her dead from a gun shot wound. Jack reels in shock, dismay and, then, guilt. Needing to compose himself since he has decided not to give out any more information thus needs to keep an appearance of composure, he asks about the other shooting deaths and finds that Reginald is among those awaiting autopsy: Reginald Winthrop, found in Central Park.

Jack asks Laurie to call her police detective friend (a difficult task for her to perform), then suits up to go to the autopsy pit. Bingham and Calvin, working with Vinnie, show Jack the extent of virulence in the lungs of the Manhattan General influenza victim. Jack takes water "washings" samples of the lungs for testing. Jack wants to learn two things: (1) what is the subtype of the influenza strain and is it a new strain; (2) is it tagged with the DNA biomarker of National Biologicals microbiology culture laboratory? He arranges for CDC and the Examiners' DNA lab to get started on these tests using the washings he took with Vinnie's help.

At least the viral sample was on its way to the CDC and the DNA lab was working with the probe from National Biologicals. Maybe soon he'd start to get some answers.

The final event of the chapter is a return to Jack's growing internal conflict with Terese (she is rudely bossy). She calls and asserts his wrongheadedness in getting "beaten up" again based in her belief that Colleen was told the correct story by Chet, who in fact didn't believe Jack's statement that he fell while jogging (which he did do ...). Terese then demands ("I'm going to have to insist") that Jack meet her for dinner (since her work schedule has a lull, she is oblivious to Jack's work obligations), a demand to which Jack capitulates: they plan to meet for a short dinner.

Chapter 28 ends in cross-fire action in a pharmacy. It begins with strained agitation in Jack's fifth floor office in the Medical Examiners building. Jack can make no progress on the case work he is supposed to be finishing. On an impulse, Jack remembers his earlier meeting with Kathy McBane, a member of the Infection Control Committee. When he phones her, she says she would be happy to talk with him--and to keep their meeting strictly secret--and that he might come directly over to her office on the first floor in the administrative department, suggesting that Jack would be safe from seeing Kelley or Zimmerman since they were meeting with AmeriCare officials.

Jack leaves immediately and takes a taxi to Manhattan General. Slam jumps into action and follows in a second taxi. BJ follows both in a third taxi. 

Together Jack and Kathy call staff who worked on the floor during the evening shift when Kevin Carpenter displayed initial symptoms of influenza. They discover that the registered nurse, Kim Spenser, who had contact with Carpenter, had suddenly been struck with violent flu symptoms as had the LPN, George Haselton. After recommending rimantadine to her, Jack and Kathy check with the lab and find one lab tech also has sudden and violent flu symptoms as does Gloria Hernandez, the worker in central hospital supply who filled the orders for that floor though having done so without patient contact. That makes four hospital staff sick: three had direct contact with the patient and one, Gloria from central supply, had no contact.

Kathy apprises her boss, Dr. Zimmerman of this development and is told that no action can be taken without confirmation of the illness because AmeriCare would not approve of it from a public relations perspective. Jack also received the printout of patient supplies that Gladys promised him. Plus Kathy promised him a follow-up of a supply printout for a random patient to act as a control for supply analysis.

Jack impulsively decides to visit Gloria Hernandez from central supply, who indeed phoned in being too ill to work, and so stops at a nearby, very large, drugstore and pharmacy to get a prescription of rimantadine for himself as protection against his visit with Gloria.

When Jack goes into the drugstore, BJ sees the perfect opportunity as Slam and Jack will be in close proximity and he can target them both. When BJ attacks, having somewhat lost the element of surprise, Jack throws himself onto the display shelf in front of him, while Slam slams himself to the floor to fire back. People run screaming. Jack makes his way to the employees entrance and finds his way out. At the end of the alley he enters, he sees the staff and the white-coated pharmacist at the far end fleeing for their lives. Slam is still inside facing off with BJ.     

BJ liked the idea of a drugstore from the moment he saw Jack enter. He knew it would be close quarters ... [and] there was a subway entrance right out the door. ... [He] started glancing down the aisles, looking for either Jack or Slam ....

Jack goes through a lot more events in Chapter 29 than we can accompany him through. This chapter is important because information starts to come in; events escalate; people find the ultimate ends of their actions and the who or what, why and how begin to show through the fog of uncertainty.

Laurie's detective friend, Lou Soldano, enters the plot (we are given a little discouragement to think Laurie and Jack might become a couple). Laurie tells Lou that:

• Jack had some material information about two homicides.
• Jack has been beaten up by gang members at least once and warned to stay away from Manhattan General.
• Jack has irritated administrators at work and at General.
• Jack has a theory that the contagions are being spread intentionally.

Lou has the intelligence to see that Jack's dislike of AmeriCare would not explain the gangs threats and the evidence linking Reginald to Beth. Lou says he'll look into and help Jack.

[Lou] stood up. "Anyway, I'll help the guy, and it sounds like he needs help."

On his way out, Lou stops in the communication area to chat about Jack with his friend Sergeant Murphy. Fleeing the scene of the drugstore shooting during which Slam saves his life, Jack runs while hearing sirens the whole time. Feeling he should go back and not flee the scene of a crime--a felony that haunts him--he remembers Warren's warning and keeps heading away from the drugstore. Jack wanted to know who was trying to kill him and why. What did they think he knew or might find out?

At a second drugstore, family owned and run, he orders the rimantadine that resists flu. Armed with at least some protection against the virulent influenza, Jack takes a taxi to upper Harlem to talk to Gloria Hernandez, from central hospital supply, who is sick at home with flu contracted suddenly since last night when Kevin Carpenter died. Gloria tells him that she had no contact with patients and that there was nothing unusual about what she did.

Returning to the Medical Examiners building, he sees David waiting to identified a murder victim. Then he sees the prostrate form of Slam. Dead. Another death on Jack's conscience.

Jack developed a computer program to isolate the items that were supplied to the infectious disease index cases (the first individuals with a disease). He finds that the one item in the long lists that was different between the random control patient and the contagion patients was "humidifier," cold air humidifiers. Putting in another call the central supply, he learns that humidifiers are cleaned after use and resupplied to other patients.

He calls Gloria and learns that she had washed a couple of humidifiers the night Kevin Carpenter got sick and died. He then learns from Kathy that the two nurses, the LPN and the lab tech who were exposed and ill have been hospitalized for severe flu symptoms, with Gloria on the way in an ambulance. Jack asks a reluctant Kathy to take samples from the sink drainage pipe where the humidifiers are washed. Nicole at the CDC says she will rush the sub-typing of the microbes through during the night with results first thing in the morning.

Terese demands Jack keep his dinner date with her. He agrees (he seems to not be able to fend off her stubborn pushiness). Leaving, Jack sees Murphy in conversation with someone not known to Jack. He takes elaborate measures to snake through town to get their dinner destination without being followed. Jack and Terese are sitting down at a cozy table in a tranquil restaurant while a conversation takes place between Twin and Phil, the next hit-man for the Black Kings. Twin says that Phil has 30 seconds after entering the restaurant door to get away after the death-hit.
Phil enters and begins to walk through as though looking for a friend. He finds who is looking for and walks toward Jack, who is sitting alone at the moment. Jack, riveted in place, sees Phil raise his right hand with an automatic weapon in it and aim it straight at Jack's head. A blast rings out. Phil falls across the table. Jack sees a man run over yelling to everyone to stay in their seats; he is with the police. Phil is dead from the dectective's shot.

In Chapter 30,Officer Magoginal tells Jack that he and Sergeant Murphy followed him from the Medical Examiners building, which teaches Jack that evading detection is harder than he thought. On the drive over to police headquarters, as Magoginal has told Jack that Detective Soldano wants to talk with him, Jack is worried continually about being a felon--fleeing the scene of more than one crime and withholding evidence in a criminal investigation--in between rounds of wondering who it is who wants him dead.

At headquarters, Jack meets Laurie's friend, Detective Lou Soldano who wants to know what Jack knows. Jack, remembering Warren's warning, still can't bring himself to talk. Lou reverses the conversation and tells Jack everything he already knows, which, it turns out, is just about everything except Jack's connections to Beth, the drugstore shooting and the Central Park deaths (Reginald and the homeless men).

Jack convinces Lou that there is danger to many people if Jack speaks up because of the looming epidemic that he fears and that is at the root of all the trouble. Lou agrees to 24 hours of delay reminding Jack that he could be charged with several criminal counts including obstructing an investigation and accessory after the fact.

"When do you think you might be willing to talk about these murders we've been discussing if you're not inclined at the moment?" [Lou asked.]
    "Give me a day, Jack said. "This epidemic scare is real. Trust me. ... I need twenty-four hours," Jack repeated. "By then I hope to be able to prove what I'm trying to prove. ..."

In Chapter 31, the answers to who or what, how and why the infectious disease contagions are occurring at Manhattan General are gaining momentum as more pieces of information come to Jack's knowledge.

• Jack has a horrible dream while hiding out in a cheap, hot hotel about having virulent infectious disease symptoms.
• At his medical examiner's office, he finds that in just over 24 hours after exposure, Gloria Hernandez from central supply, the two nurses Kim Spenser and George Haselton, and the lab technician William Pearson are having autopsies performed on them having died in the night.
• Their lungs all show the same pathology as Kevin Carpenter's lungs so all had primary influenza pneumonia.
• With phone messages from Abelard and Zimmerman from Manhattan General waiting, Jack returns the calls from Nicole with CDC.
• Nicole says the viruses are virulent and probably remnants of the 1918-1918 killer influenza pandemic (world-wide epidemic). CDC has called the Surgeon General of the U.S. and New York health officials. All are on alert and a CDC team is headed to New York.
• Terese is her usual broadminded self scolding Jack for not calling her as he "promised" to do; reprimanding him for trying to avert an epidemic; detaining him by telling him her "good news" of assurance of the president position with the advertising firm and insisting he take time out from averting a health disaster to have lunch with her (we are not fond of Terese and hope Jack isn't either).
• Laurie warns Jack that Detective Soldano has said he cannot keep up a 24-hour protective watch on Jack.
• Tom Lynch in the DNA lab confirms the phage-tag showing that tularemia and plague cultures came from National Biologicals.
• Jack learns from Igor at Biologicals that both Manhattan General--delivered to Martin--and National Health hospitals have recently ordered tularemia, while plague was order by Frazer Labs.
• Jack goes to track down Frazer Labs and finds it is a rented mailbox in a seedy mail shop in an nearly abandoned section of town.
• He develops a clandestine plan to find out who is behind Frazer Labs. Disguising himself as a Fed Ex delivery man, he delivers an urgent, faked Fed Ex package to the mail box shop and waits to see who will claim it.
• Twin has clandestine activity of his own when he and BJ go to a "meeting of the brother" in a busy park where they meet the imposing Warren. Both gangs exchange apologies for the gang deaths and call a truce to violence that includes "Doc."

On top of all this, Jack is beginning to display symptoms of the influenza he exposed himself to when visiting Gloria to try to find the connection between the contagions and central hospital supply. He is taking his rimantadine, though he is forgetting that now that symptoms have shown up, he may be infectious: he may be spreading the virus.

After Jack paid for his [clothing] purchases, the clerk was happy to wrap up Jack's street clothes. Just before the package was sealed, Jack thought to rescue his rimantadine. With the symptoms he was feeling he didn't want to miss a dose.

Jack had plotted to lure the person behind Frazer Labs--the group that ordered the plague pathogens from National Biologicals--out into the open so he could at least identify them. In Chapter 32, he is sitting in his rented cargo van at a short distance from the mail box shop Frazer Labs uses as an address. In the surrounding dark, he finally sees a nondescript man enter, then leave the shop with Jack's faked Fed Ex package in hand. Jack follows him on foot.

The man disappears into the interior of an all but deserted commercial building that Jack studies from the sidewalk from where he sees a light appear on the fifth floor (ironically the same floor as Jack's office in another building in another part of New York). After Jack lingers from some hesitation about how to proceed, the same man hurries back out of the building in some agitation. Standing near the entrance door, Jack sticks his foot in the doorway to hold the door ajar and slips in after the man is out of view.

Jack's quest for information takes him to the roof and down the fires escape to the fire landing outside the man's fifth floor window (remembering that Jack is afraid of heights). With some nervousness, Jack climbs in through the open the window. What he sees is a home in combination with a fully equipped microbiology lab, complete with captive animals in a shed in a far corner of the warehouse like fifth floor loft. Situated in the lab is a freezer box--cooled to enormously low degrees by a nitrogen set-up--like the freezer box Beth investigated in the Manhattan General microbiology lab, which was an action (instigated by Jack) that got her killed.

As Jack is about to find his way out, the man comes back and by locking the key-only dead bolt, locks Jack in the loft.

The deadbolt had no knob. A key was required from both inside and out. Jack was locked in!

Previously, Jack had confirmed that this home-lab was indeed Frazer Labs, but now there was no place to run to and no place to hide except in the bathroom. When he is found, he is shocked to see the man is Richard, a lab technician from Manhattan General. We know Richard as one of the two people who caught Beth in the microbe freezer at General; Martin and Richard were the two who caught her.

Richard handcuffs Jack to a supporting column in the loft and calls his accomplice. When the accomplice angrily enters the loft some time later, it isn't Martin nor Zimmerman nor Kelly, all from Manhattan General Administration. With the gun in Richard's hand pointed at him, Jack anxiously recognizes the sound of the elevator and waits to see who will come through the door, then meets with surprise.

Jack took a breath and turned his head as he heard footsteps close in on him. When he caught sight of who it was, he gasped.

In the midst of all this, Jack's flu symptoms (a contagion he caught from Gloria Hernandez when he went to see her) are worsening while he diligently continues to take his anti-viral rimantadine.

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.

The main events in Chapter 34, though it is a long chapter, are rather few. Richard and Terese awaken in the house in the Catskill with very uncomfortable cold symptoms that, at one point, cause Richard to ask if Jack caught his 1918 influenza virus and, if so, haven't they now got the virus as well.  The important thing here is that this gives Richard a chance to tell us what he expects the strain of influenza is (1918 pandemic strain), where he got it (Alaska), and from what hidden virus "reservoir" (virus resting place) the microbes came (a frozen man who died in 1918).

Another main event is that Richard calls Twin to come do the assassination hit on Jack since neither he nor Terese can bring themselves to do it in cold blood. Twin rejects the job even for three thousand dollars. But, finally, after Richard's third call to him, Twin does promise that someone will be there in the morning to do what's needed. Jack is left handcuffed to the kitchen sink drain pipe for a second night.

"I'll send someone up there tomorrow morning. ... " Twin said. "I guarantee I'll have someone up there to take care of things."

A critical main event is that, since both Terese and Richard are getting worsening symptoms, neither one bothers to go to their beds; both simply sleep on the sofas where they've been suffering all day. During the night, while Jack is trying to device his fourth rescue attempt, he hears the progress of their symptoms as their sneezing, coughing and breathing worsens and enters different, more serious stages of decline.

This is an important sequence of events for Jack and for author Robin Cook. Jack is faced with making a medical (and moral) ethical decision and Cook, as the narrator, gives voice to his personal concerns over medical ethics, a trademark element of his medical mysteries.

Jack recognizes that Terese and Richard are going to die from the virulent flu strain. He struggles to decide (1) whether his medical 9and moral) ethics require him to tell them contagion they have in all probability contracted and (2) whether his medical ethics require him to share his life-saving rimantadine with two willful murderers.

It was an impossible decision. He couldn't choose. But not making a decision was, in effect, a decision. Jack understood the ramifications.

Jack resolves his ethical dilemma by warning them that Terese (soon to be followed by Richard) needs to go to an intensive care unit in a hospital. Thus Robin Cook posits the limits of medical ethics at sacrificing ones own life for murderers while doing what is possible to warn them of and assist them in their medical danger.

The final main event comes at the end of the chapter. "Their swift deterioration was a frightening display of the power of contagion." Terese died on the sofa at 4 a.m. Richard died on the other sofa at 6 a.m.

In Chapter 35, Jack hears the approach of Twin's guaranteed "someone to take care of things" right while he is frantically trying to dislodge the heavy cast iron and porcelein kitchen sink from the wall by pressing upward with his legs against his feet lodged under the sink's front edge. As the "someone" walks across the fronch porch, Jack suceeds in getting the sink to crash to the floor, breaking the drain pipe connection and his handcuffed imprisonment at the same time.

Fumbling and fleeing, racing time, Jack dashes out the back door and runs, double low to stay out of sight, to a barn at the rear of the property by a pond. Tearing into the barn, Jack looks for a place of concealment and safety. Finally he finds an old chest that he empties and curls up into, lowering the lid on himself and blocking out the dark barn with the darker chest.

Footsteps enter the barn. Voices are talking about pistols and finding him. In a bizarre comic moment, Jack and the man searching the chest "screech" at each other in surprise when the lid is suddenly lifted. The lid slams shut. When it opens more deliberately a second time, the man says, "It's the doc alright ... he's here in a box." In a surprising moment of unexpected relief, Jack sees his friend Warren instead of his enemy Twin. Warren is the "someone" Twin has sent to "take care of things."

After asking what the two in the house died from, Warren tells Jack that there are a lot of people dying from influenza in New York too. Jack, not keeping his lesson learned very long about not treading in affairs that are not his own, says, "I think you'd better tell me what you've heard."

Warren [said,] "So it's up here too. I heard about it on the news last night. There's a lot of people down in the city all revved up about it."

The first three chapters of Contagion set up Jack's present life, which we enter full-blown after he has suffered several tragic events that we learn about later.

We are introduced to Jack as a medical examiner who dislikes boring medical postmortem exams and prefers ones with surprises. Then we are introduced to a virulent and unknown infectious disease picked up during a dead man's hospital stay for diabetes.

Next we are taken to a hospital, with a different character, Suzanne, providing the point of view, to learn a bit about what happens in the AmeriCare hospitals.