Chapter 32
THIRTY-TWO
HOLLY
I’m elbow-deep in charts when Greta bursts into the tiny shared charting space. Her face is flushed, hair escaping from her usually perfect bun.
“Dr. Chang, did you see my message? It’s about Emma Frost.”
My heart drops. I last checked my messages only an hour ago, but she wouldn’t be coming to me directly if it weren’t something serious. “No, sorry. What’s happening?”
“Jesus.” I immediately reach out for the chart Greta is holding. “What happened?”
“Poor girl is in a coma. They’ve transferred her to the pediatric ICU at Anchorage General.”
It takes a few seconds for her words to filter in. “Oh, no.”
“We got a call from the hospitalist this morning. Emma started seizing this morning, then wouldn’t wake up. Evan’s condition is deteriorating too.”
I scan the notes, my stomach knotting tighter with each line. The twins were stable a few days ago—sick, but stable. Now this.
“Is Dr. Mercer with a patient right now?” I ask, mind racing. Maybe the old man will finally listen now that a child is in critical condition.
“No, he just finished with the walk-ins.”
“Maya Calloway is coming in this afternoon with her mother. She’s another kid with similar symptoms. Please pull her chart for Dr. Mercer.”
I take a deep breath, steadying myself. This is too important for me to let Mercer’s old-fashioned attitudes get to me. His opinion of me is less important than helping these kids.
Dr. Mercer stands at the nurses’ station, flipping through charts with a bored expression. He looks up as I approach, his face immediately shifting to professional concern.
“Dr. Chang. I heard about the Frost girl. Unfortunate development.”
“It’s more than unfortunate,” I say, keeping my voice level despite the frustration bubbling beneath. “It’s part of a pattern. I have another child coming in today with very similar symptoms. Metallic taste, joint pain, cognitive changes, tremors—“
He holds up a hand. “I’m aware of your concerns about a potential cluster. But the hospital team in Anchorage has taken over the Frost case. They have resources we simply don’t have here. You should let them handle things and focus on your work here.”
“With all due respect, Dr. Mercer, they don’t have the context. These children are all from the same town, experiencing the same set of symptoms we can’t identify the cause of. This is more than just coincidence or a bad flu season.”
He sighs, setting down his pen. “Look, I understand your concern, and it’s admirable.
But sometimes in medicine, we have to accept that not every medical mystery is one we can personally solve.
The hospital team are experts, leave it to them.
These children are already getting the best care possible. ”
I bite my tongue to keep from saying something I’ll regret. Dr. Mercer’s sympathy feels rehearsed, empty. He doesn’t actually care about solving this—he just wants it off his plate.
“What about Maya?” I press. “Her mother is bringing her in today because her symptoms have only gotten worse. Am I supposed to tell them there’s nothing we can do?”
“I suppose writing them a referral to Anchorage won’t suffice for you.
” At the expression on my face, he glances at his watch with an annoyed sigh.
“Then by all means, continue your investigation. I have a wilderness rescue coming in—hiker with a possible spinal injury. That’s where I need to focus right now, and I wrongfully assumed that was the sort of case you came here to see. ”
And there it is. The adrenaline cases, the dramatic rescues—those are what interest him. Not the slow, methodical work of diagnosing a mysterious illness affecting children.
“I understand,” I say, jaw tightening enough to make my teeth ache. “I’ll keep you updated on Maya’s condition.”
“Do that,” he replies with a tight smile. “Pediatrics is a good fit for the soft-hearted. You may want to consider that before you settle permanently into a specialty.”
Before I can decide how to respond, Mercer is already walking away. I stand there for a moment, chart clutched to my chest, feeling frustrated and alone.
No. Not alone. I have Noah.
I find him in the medical library, bent over an open journal. He looks up when I enter, his expression softening at whatever he sees on my face.
“You heard about Emma?” he asks.
I nod, dropping into the chair across from him. “Mercer basically told me to let Anchorage handle it.”
His smile is faint. “And you disagree.”
“Of course I disagree!” The words burst out louder than I intended. “Sorry. It’s just—we’re missing something. These kids are getting sicker, and nobody seems to care except me.”
Noah closes the journal and faces me fully, giving me his full attention. “I care.”
The simple statement hits me like a wave of warmth. Through our bond, I feel his sincerity—and beneath it, his own worry.
“Help me figure this out?” I ask.
“Always.” He pushes aside the files he was working on. “Let’s get back to basics. What do we know for certain?”
I open my notebook, flipping through the pages filled with my hasty scribbles. “Four children have been sick enough to be seen at the clinic multiple times in the last two weeks. You already know about Emma and Evan Frost, I saw Maya Calloway last week and now Owen Barton.
“Ages?”
“The twins are eight. Owen is ten. Maya is twelve.”
“And the symptoms?”
I tick them off on my fingers. “Initial presentation included fever, vomiting, joint pain, headaches, and a distinctive rash. Secondary symptoms developed within days—metallic taste in the mouth, tremors, cognitive changes including confusion and memory issues.”
“And now seizures and coma, at least for Emma,” Noah adds, frowning.
“The blood work shows elevated white counts, but cultures are negative for bacterial infection. Liver enzymes are slightly elevated. No response to broad-spectrum antibiotics.”
Noah stands, pacing the small lab. “If it’s not infectious, and it’s not autoimmune based on the markers we tested, what are we left with?”
“Environmental toxin?” I venture. “I briefly considered a pesticide or something, but the kids live in different parts of town.”
Noah stops pacing, his eyes meeting mine. “Or heavy metals.”
The pieces click together in my mind, a diagnostic puzzle finally taking shape. “It could be. The metallic taste. The neurological symptoms. The gradual onset.” I flip through my notes frantically. “Tremors, headaches, joint pain—it fits!”
“Which metal, though?” Noah asks, already pulling up research on the computer. “Lead? Mercury?”
“Could be either. Or arsenic.” I lean over his shoulder, scanning the symptom comparison chart. “We need to test for anything plausible.”
“We can send blood samples to Anchorage, but that will take days.”
I think of Emma, lying unconscious in a hospital bed. Of Maya, who could be next. “We don’t have days.”
Noah turns to face me, his expression serious. “The county health department has a mobile testing unit for lead. Part of their childhood screening program. They might be able to run other heavy metals too.”
“Can we get them here today?”
He checks his watch. “They’re usually in Fairbanks on Thursdays. If we call now, they can detour to us before the end of the day.”
I’m already reaching for the phone when a thought stops me. “Wait. These kids should have been tested for lead already, right? It’s standard at pre-kindergarten check-ups.”
Noah nods. “Yes, but that would have been years ago for all of them. If this is a recent exposure, then they wouldn’t have shown elevated levels back then.”
I dial the county health department, explaining the situation to the coordinator. They agree to send the mobile unit, but it won’t arrive until tomorrow morning.
“Maya’s coming in this afternoon,” I tell Noah after hanging up. “We should draw blood and send it to the lab in Anchorage as a backup.”
“Agreed. And we should call the hospital, let them know to test Emma and Evan for heavy metals, too.”
I start to reach for the phone again, then hesitate. “If we’re right about this—if somewhere in town is contaminated with heavy metals—“
“Then the whole town could be at risk,” Noah finishes, his face grim. “But we need proof before we cause a panic. Let’s test Maya first, then figure out the next steps.”
I nod, the weight of what we’re potentially facing settling over me with a weight that feels almost too heavy to carry. If these children have all been exposed to heavy metals, then the entire town might be at risk.
“One step at a time,” Noah says softly, sensing my distress through our bond. “We’ll figure this out.”
I take a deep breath, steadying myself. “Right.”
But as I prepare for Maya’s appointment, I can’t shake the feeling that we’re already several steps behind whatever is happening here.
The spine case takes hours longer than expected, and I get called in to help for the rest of the afternoon.
By the time we finish, my back aches and my feet throb in my sensible clinic shoes.
Dr. Mercer, of course, seems perfectly fresh, as if he hasn’t spent the past five hours hunched over a patient with a complex spinal fracture from a climbing accident.
“Excellent work, everyone,” he announces to the room at large. “Dr. Chang, your assistance was adequate.”
From him, that’s practically effusive praise. I nod in acknowledgment, too tired to care about his backhanded compliment. My mind is still stuck on Emma Frost, Maya Calloway and the possibility that the sacred springs at the heart of this community might be poisoning its children.
I help clean up, then head to the break room for coffee. The clinic is quieter now, appointments finished and the afternoon rush of walk-ins already done.
The door opens, and Noah steps in. His expression is serious, his movements purposeful. He glances around to ensure we’re alone, then approaches.
“I got the results of Maya’s bloodwork from the health department,” he says, his voice low.
My heart jumps. “Already? How?”
“I called in a favor at the county lab. They ran her samples immediately.”
I set down my coffee cup, suddenly alert despite my exhaustion. “And?”
“This is just the preliminary result for lead. They’ll need a few more days to let us know just how bad it is.
” Noah sighs as he meets my eyes, a combination of sorrow from the news he is about to deliver and relief at having a medical question finally answered.
“Her level is way above the CDC recommendation. Highest the county has ever seen, in fact. This isn’t just some incidental exposure, there is significant contamination somewhere in this town. ”
A complex mixture of emotions washes over me—vindication that my theory was correct, dread at what this means for Maya and the other children, fear for what it might mean for the entire town.
“How bad is this?” I manage to ask.
“Bad enough to explain all her symptoms. Bad enough that she needs treatment immediately and some of her problems might be permanent.” He runs a hand through his hair, a rare gesture of agitation.
“I’ve already called her mother. They’re taking Maya to Fairbanks tonight to get her admitted to the hospital for treatment. ”
I sink into a chair, the implications overwhelming me.
I was right.
But children are sick, maybe even dying.
I was right.
And we still have no idea how to fix it.