This is one of a collection of stories that are like “Final Destination” meets “The Monkey’s Paw” (W. W. Jacobs, 1902). As such, they are tragedies more than either mysteries or horror, and would appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. In each story, a protagonist makes a wish that comes true with fatal results for someone, often the person making the wish. Nothing supernatural, but just how things work out. (Or is it?) The technical details surrounding the fatal (or near-fatal) event are drawn from real cases in the US OSHA incident report database and are therefore entirely realistic even if seemingly outlandish. The plots draw lightly from cultural beliefs around actions such as pointing at someone with a stick or knife, wishing in front of a mirror, or stepping on a crack.


 

Fred Hoskins was a spy. He worked in the grimy-but-lucrative world of industrial medical espionage. A trade secret here, and a formula there, and Fred could afford a very carefully disguised-but-well-heeled lifestyle. Since the recent death of his brother from cardiovascular disease at 45, however, Fred wanted to pull his retirement back by a decade or two to enjoy life while he had time. In practice, this meant double dipping. He had started by selling the stolen formulation for a liver cancer drug to a third party after receiving payment from his client. After a few similar double sales, he realized he could also steal from his customers and sell to his victims while he had access to both.

In his hurry to pile up money before early retirement in splendor, Fred made a few tiny mistakes. Not enough for the law to catch him, but while stealing a genetically engineered virus, for example, he left just enough traces for the head of security of the client to send him packing with a warning that if he ever set foot in their building again, they would stick his money up his nose and let him die from it. Fred responded by selling their research on a CRISPR tool for constructing hybrid viruses to a foreign competitor. He used the data exchange to slip Trojan malware into their network and stole some interesting research that he felt he could sell.

He suspected that they may have realized this, because a week later at his favorite cafe, someone spiked his coffee with Fentanyl, and he collapsed before he could reach his phone to dial 911. Luckily, there was a physician at the café who used a nasal applicator to administer a dose of Naloxone. A single burst of compressed gas up his nostrils and Fred was back on his feet in minutes. He counted it as a lucky escape and started being more careful where he ate or drank, as well as how he covered his tracks. He also wondered if he should retire even sooner than planned.

Chriss “Calamity” Cole was an editor at a radiology journal. As the lead for the journal’s continuing medical education program, she spent a lot of her time constructing the training materials and competency tests. The biggest time investment was actually going through the video clips and images from example scans, and by her third year, she had probably viewed more images, and in more depth, than the average final year resident.

Chriss had earned her “Calamity” title as a result of a series of mistakes and misadventures in her first week as a probationary editor. On her first day, she had forwarded a rude joke to her friend Jan, failing to notice that the email autocomplete had selected the very strait-laced Dutch CEO, Dr. Jan Brand. Barely a day later, she dropped a new five-gallon water bottle while wrestling it onto the top of a water cooler and doused the CFO. The bottle hit the floor on its side, and a jet of water hit the CFO just as the elevator doors started to close. The entire floor heard him shrieking in surprise and anger all the way up to the executive floor. Her week was rounded out by setting fire to a birthday cake and then festooning a dozen staff members with cake when she used a nearby carbon dioxide extinguisher rather too close to the burning cake.

Perhaps because of the narrow margin by which Chriss escaped being fired in her first week, but probably just due to an inquisitive nature, bright mind, and sheer conscientiousness, she survived. She immersed herself in her tasks, especially the CME program, and started working out of the office as much as she could. She figured that out of sight and out of mind would be her best bet until people forgot these events. Luckily, getting new radiological images was part of her work, so it became her standard practice to spend time at several local hospital radiology departments collecting images, observing work methods, and getting to know the staff. She stayed away from water coolers, but although the memories that people had of these events faded over time, her reputation was part of the office culture, and even spread over the next years.

This week, Chriss was down in Radiology at St. Barts, collecting images for an upcoming change to the CME on viral neurological cases. Dr. Owen Fitzpatrick called her over to his workstation, “here’s an example of ground glass opacity in a brain scan.” She peered over his shoulder and pointed at a region of the screen, “what’s that?” Owen removed his spectacles, and in a slightly condescending tone, explained that it was what she had asked for.

“No, not the cloudy ground glass bit, I mean this,” and she traced a finger along a faint line from the cloudy region to the edge of the image. “Technical artifact,” he shrugged. Chriss adjusted the image, entered some parameter changes, and the line sharpened and brightened. “No way,” she shook her head, “that’s no computer glitch or sensor aberration; that’s an object.”

Owen replaced his spectacles, and with a slight air of fatigue, scrolled through the images and pulled up an alternative angle. Sure enough, once the image was adjusted, there was the thin line again. It showed up clearly in sagittal and transverse planes as a line, and as a short arc in a coronal view. By the third image, Owen’s demeanor had shifted from humoring a slightly irritating visitor to sitting bolt upright and looking a little alarmed. He tapped at the phone and spoke one of the most irritating phrases in the medical world. “Hi, Linda, yeah, I need clinical correlation for one of your deceased patients.”

Owen hated this kind of thing, but not as much as either the clinicians or the pathologists. Firstly, odd unexplained radiology images usually didn’t mean anything, and finding them looked like a vague accusation that clinical staff had messed up and pathology had missed something. It was possible, but unlikely. And yet, there it was. He also had to explain how he came to be looking for something like this.

“Calamity Cole?” they both looked at him like he had grown horns. “Seriously? You sure this isn’t a prank or spilled water or something?” Owen brought up the images and flipped from one plane to the next. They grudgingly agreed that it didn’t behave like an artifact and there was tenuous evidence that might support it. Slight bleeding in the nose for one. “More likely due to nasogastric tube or just having an oxygen mask.” The record also showed recent nasal Naloxone administration that might explain the slight nosebleed at admission. But still, there were those images.

Pathology checked, and the body was still on the premises, and with great reluctance, they agreed to look. Getting into the skull would normally have been a tedious affair, but because a basic autopsy had already been performed, there was no need. The brain had been sliced to provide plates showing the ground glass region, but no trace of any foreign body had been found. As a last thought, they shone a polarized light into the cranial vault; there was a brief flash, like a beam shining past a spiderweb. Sticking out from the sphenopalatine foramen just behind the nasal cavity was a thread of something stiff.

Chriss wasn’t quite sure what the meeting was about, but she felt intimidated and on edge by all the fancy titles. Her boss had told her to get over to the hospital immediately for a meeting but was unclear what it was about. Maybe something about her CME update. When she arrived, slightly out of breath from her jog from the visitor’s parking lot, the CMO, Chief of Pathology, and the heads of Admin and Legal were milling about, getting coffee, and helping themselves to cookies. Chriss was far too nervous to hold a cup and saucer without rattling and didn’t trust herself not to spill coffee down her front, so she picked a bottle of sparkling water and took a seat toward the far end of the conference room table where she felt she would be out of the way.

The hospital director arrived and sat down two seats from Chriss, who now realized with horror that she was at the head end of the table. The head of Administration pulled out a chair opposite Chriss, and peered at her over his bifocals, “you would be…?” Chriss jumped up out of her seat, and her hand shot forward to introduce herself but connected solidly with her open bottle. The bottle skittered across the table and fountained a torrent of sparkling water that terminated just below the expensive Italian belt buckle of the head of Admin.

“Bullseye!” quipped a New Jersey voice to Chriss’s left, followed by a peal of laughter. Warming to Chriss, the CMO positively beamed, “You must be Calamity Cole, call me Linda”.

While the head of Admin sat glumly in damp trousers, the head of Pathology started the meeting by giving the executive overview of the main points. Owen then described the discovery of radiological anomalies and gestured toward Chriss when he displayed the images and described how she had adjusted parameters to enhance the anomaly. Pathology went into the details of discovering a single stiff rod about as thick as a hair that had entered the brain through the nasal cavity.

Pathology explained that, on further examination, it was shown to be exactly 30 mm long and 0.08 mm in diameter. Microscopy had revealed it to be made of twisted filaments of carbon nanotubes, wound around a polysaccharide core. “The important bit here is in the crud in the gaps in the spiral,” and he explained that the scanning electron image on the screen showed it to be brimming with a virus. “The sugar is packed with a virus usually found in anaerobic environments. As the sugar core dissolved in the brain, it released a viral payload.”

In answer to questions of etiology, pathology had both a professional and a private take. Professionally, they had no statement other than accidental introduction, but on a private level, they went further. “Oh, this was deliberate! This is a weapon. This was an assassination. Someone shoved this thing up his nose and into his brain, where it was designed to release a virus that was specifically capable of rapidly colonizing the surrounding brain tissue.”

It never became clear just who had stuffed the needle up Fred’s nose, or even if the event at the café was related, but it added a layer of mystery and intrigue to the reputation of Chriss “Calamity” Cole that would last forever.