Past

I walked through the parking lot, avoiding the occasional syringe sticking out of the cracks in the asphalt. I looked around for numbers on the apartments, but they had been ripped off. A group of people sitting on a stoop eyed me warily. I showed them my Public Health ID and asked for directions. They discussed a bit before pointing in the direction of a dark stairway. "On the top floor," they said vaguely, "I think her place is up there."

The heat was stifling in the stairwell. Window screens littered the steps along with every imaginable type of trash. I paused at the top of the stairs surveying the scene. A row of apartments in each direction. Which one was hers? I walked along the balcony. An open door with babies crying. I called hello and she came out. She looked tired, disheveled, and annoyed that I had come.

I get that a lot, I thought. Mistrust. Bitterness. Scrutiny. At least at first.

Her apartment was damp and hot. She showed me her kitchen, small and cramped, and her famous refrigerator, the malfunction of which, made the food in it become teeming cesspools of pathogens, which a few days earlier, she had served to an entire party of guests. I took my samples from her kitchen surfaces and some leftover food. The kids wandering by were enthralled with my sampling tools. I wondered why they weren't in school.

Then I started with my questions. Usually, I just talk to them. Slowly, the insights would follow. More like a conversation than an interrogation. It is amazing what you can find out if you are respectful and let people talk. Luckily for me, most of the people I had to interview were in 50 feet of the place. Once word got out I was there, people just happened by, wanting to be included, wanting to be counted as someone who was sick.

As a woman proud of her cooking, I could see this whole process pained her. Though, as the day wound down, she looked relieved that it was over, that she could get on with being a hostess again, that her neighbors might forgive her for "giving them the runs." We discussed proper hand hygiene and food preparation tips and she promised that she was going to have her fridge looked at. When I left, her place was buzzing with people, including those, who earlier, weren't even sure where she lived. Right.

Outbreak. Salmonella. Fecal-oral. Yup, poop in the food. All those people ate feces. Nice, heh? Millions of colony forming units in one little swab of countertop, one little dab of food, and one little stroke from a utensil that contaminated almost every dish that was served.

In my past life, I was a communicable disease epidemiologist. I followed up on thousands of disease reports and most of my investigations were quite memorable. Salmonella, shigella, Lyme disease, meningococcal, West Nile virus, pertussis, over 50 different conditions we were required by law to investigate. While there was some resistance by most everyone to be interviewed, each person has a story and I got to listen to every last infectious detail. It was a job I really loved.

In immunology class, we are finally learning about those diseases I spent so much time on. At our last session with Bret, every disease he mentioned brought back a flood of memories of outbreaks, people, politics, and pathogens. I hope I can write about some more in the future.

"So, is anyone familiar with shigella?" Bret asks.

Yeah, I think to myself. Oh, yeah.