No, said Barney Fried to himself, can’t be. But maybe it was. Barney was one of two emergency room physicians on duty the morning Cole Younger Smith plowed into the rear of a perfectly appointed white Cadillac. The Caddy had been parked long enough to let out a woman and child in front of the ER door.

            The driver of the Caddy, a big man who had to be at least 70, came out mad as hell, shouting, “You could have killed my daughter and granddaughter, you...”

            He opened the door of the pickup and stepped back fast as Cole coughed in his direction, leaned over and managed to vomit whatever remained in his stomach.

            Barney Fried was 36. He had tried obstetrics and decided that he liked the action of the ER. He was good, but good didn’t prepare him for what he half expected he was about to see and deal with. He asked a nurse to find Dr. McMillan, and he called for a battery of blood tests and a swabbing of the throat of Cole Younger Smith, who lay in one of the small rooms in the ER corridor.

            “Patient says it came on fast, from start to acute pulmonary distress in an hour,” said Barney. “He says he’s had a cold for a few days and started to feel a little queasy yesterday. The cough sounds deep, very deep, not typical upper respiratory.”

            Steve McMillan was 48. He thought he had seen it all. But he hadn’t seen anything quite like the man gasping for air in spite of the oxygen flowing through the mask over his face.

            “You know what this looks like?” whispered Barney.

            “Lots of things,” said McMillan calmly.

            “Lots of things, Mac,” Barney agreed, “but not lots of things we’ve seen.”

            “You’ve got a hurry-up call on the swab?”

            “Damn right.”

            “I think we should call the county health department and get that swab up to Tampa before we even think about giving this a name,” said Barney. “And...”

            “Isolation,” said McMillan. “Masks, gloves, gowns for everyone who comes in this room.”

            “Goggles?”

            “Goggles, too,” McMillan agreed.

            Fifteen minutes later a Department of Health driver was at the ER entrance. She was handed a tightly sealed box and was on her way.

            Mixed with Barney’s fear was the guilty spark of a hope that his suspicion might be right, that he might be the first physician to identify a case of avian flu in the United States. It wasn’t likely. They had determined that Cole Younger Smith hadn’t recently been out of the country, not even out of the county. In fact, he had never been outside of Florida.

            A team from the health department rushed to Smith’s home and found a scattering of dead chickens.

They bagged two of the dead birds and, taking no chances, killed all of the remaining birds and then headed to Smith’s neighbors to check on whether they had chickens or pigs that might be infected, if, indeed, they were dealing with avian flu.

            By the time the call came from the lab in Tampa, two more people had been found with the same symptoms as Cole Younger Smith. One was a Home Depot clerk who two days earlier had helped Cole find a replacement for a drill head. The other was a woman whose front steps Cole had repaired last week. All three were in isolation at Sarasota Memorial when the lab report came in from Tampa. Eleanor Wosniak at the Sarasota County Health Department got the report. Eleanor, 33, thin, dark-haired and a recent transplant from Chicago, brought the bad news to the hospital.

            “They ran a PCR, polymerase chain reaction,” she said.

            Both Barney and Mac were familiar with the molecular bio test. What they weren’t familiar with was what it had revealed.

            “H5N1 virus, avian flu,” Eleanor said, “but it doesn’t fit the profile, which shouldn’t surprise us. It’s mutated.”

            “None of the three in isolation have been out of the country or in contact with anyone who...,” Barney began, and then stopped.

            “So the bird or birds that did this came through here,” Eleanor said. “We’re on a migratory bird path from Canada. Primarily ducks.”

            “We can’t kill all the migratory ducks,” said Mac.

            “No, we can’t,” Eleanor agreed.

            “So?” asked Mac.

            “State Health has a team on the way,” she said. “We’ve got an inventory on all the Tamiflu available in Sarasota and surrounding counties. More can be brought in