Excerpt from Isolation Ward by Joshua Spanogle, plus links to reviews, author biography & more

Madison spoke quickly. "Thank you, but I think we can handle this here."

Gary Hammil said, "Jean--"

"We have access to the state labs," she interrupted. "We don't need to call in the federal government."
 
A word about CDC's relationship with everybody else in medicine and public health: our jurisdiction is everywhere and nowhere. Really. We intervene only at the request of individual counties and states. If there's no request, CDC stays out of it. And though there are a million reasons why someone would want to ask for help from Atlanta, there are a million reasons why they wouldn't, most of them having to do with control.

During my training in Atlanta, they drummed into us, over and over again, the finer points of dealing with the locals. In general, we try to tread very softly. It's not something I'm particularly good at. In my evaluations over the previous year, "professional relations" was an area that consistently contained the phrase needs improvement.

Hammil looked at me. "Dr. McCormick, we appreciate your offer of support."

I nodded. I nod when I'm not exactly sure what to say.

Madison sighed. "Well, it looks like we have the lab situation worked out, for the time being, anyway. We'll use state." She turned to Verlach. "Baltimore City will head the outbreak investigation?"

"Yes," Verlach said. "I already spoke to the commissioner. We'll call state for more hands if we need to. Since Dr. McCormick is already here and familiar with the city, I'm going to ask that he stay on for the investigation."

Silence.

"I'd be happy to help," I said finally.

"I thought we agreed to rely on state," Dr. Madison said.

"For the labs, Jean, not for the investigation itself. Dr. McCormick is more familiar with this situation than--"

"Having CDC involved is going to signal the press--"

"He's already here, so we can downplay the request. Besides, not having him on board would seem like an oversight."

"I want to emphasize," I said, "CDC is here to help at your request. Just as it was with setting up the surveillance program, we can be as much or as little a presence as you want. The investigation and outbreak control will all be locally led, as well as contacts with the press. We'd also be happy to provide you with clinical expertise."

There was a long silence, and I knew I had just stepped into it somehow. Jean Madison--the Consistently Aggrieved--finally blew. "Oh, come off it. Clinical expertise?"

I stammered, "I'm merely offering assistance if you should need--"

"--if we should need clinical expertise. I know. Thank God you're there for us."

I looked at my shoes, covered in light blue paper booties. I sighed.

Jean Madison let out a sharp little laugh. "What do you think we do here, Dr. McCormick?"

"I--"

"We have some of the finest staff in the city to--"

"Jean--" Dr. Hammil said.

Excerpted from Isolation Ward by Joshua Spanogle Copyright © 2006 by Joshua Spanogle. Excerpted by permission of Delacorte Press, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.