Pestilence: A Medical Thriller (14 page)

37

After speeding away in the jeep, Howie was going so fast that he nearly lost control and tipped over on a sharp turn. He slowed down and noticed the sky. No choppers. He glanced to his daughter in the passenger seat and saw that her hand was on his knee.

“You okay?” he said.

“Yeah. Mike looked after me.”

Howie
glimpsed in the rearview. “Thanks,” he said.

“No problem.”

After driving in silence for a few more minutes, Howie realized he was hungry. An Italian place called Cosimo’s was up near the intersection, and he pulled around back and parked in the handicap section.

“I don’t think they’ll mind,” he said, looking at his daughter.

“What’re we doing here?” Mike said.

“You guys hungry?”

“Starving.”

“Let’s go. I’ll whip something up.”

The restaurant was open. They walked in through the front door, and Jessica went to turn on the lights, but Howie told her not to. They would have to eat in the dark.

“See if you can find some candles
, though,” he said.

Walking to the kitchen,
Howie saw food still out on the tables. A dish of gelato had melted and was soaking the tablecloth. Everyone had gotten out of there in a hurry.

Mike came with him as Jessica lagged behind. The lights in the kitchen
as well as the grill and oven were still on. He turned them off and went to the fridge on the other side of the room. Taking out some beef, pasta, and vegetables, he then found the olive oil and cooked macaroni with sauce.

Mike stood in the corner and chewed on some bread with butter. “Where we heading?”

“I don’t know. I was thinking out of the state. See if whatever’s happening here is happening there, too.”

“I heard all the highways are closed. How you planning on getting out?”

“We got a jeep. We’ll fill her up and try the desert.”

“You want to risk driving through the desert on one tank of gas?”

“I don’t know what to do, Mike. I’ve never been in this situation before. If you got a better idea, by all means, share.”

Mike took another bite of the bread. “I was in Iraq
.”

“I didn’t know that.”

“No, you wouldn’t. We had taken this small town, called Karim. The insurgents, that’s what we were forced to call them, they had taken the town, and we got it back. It took four days. Two days of no sleep. Some o’ the guys took amphetamines to stay awake, and it did things to their minds. No sleep and drugs aren’t the best solution to anything, but we were young. So we take the town. And we decide we don’t know who’s with them and who’s with us, so we impose a curfew and patrol the streets. Anyone suspected of working with the insurgents was rounded up, and we turned this mosque into like a camp for them.

“At first
, the people were happy. They hated the insurgents more than we did. One guy told me they were all Arabians, and what the fuck did he care about Arabians. But after a while, we started acting… different. I don’t know what it is or why it happens, but once you got power over someone, you start treating ’em different. Like they ain’t even human. A lot of horrible things started happenin’, especially with the women.”

He swallowed and placed the bread down on the counter. His eyes were lost, staring into nothing as he spoke
, and Howie didn’t interrupt him.

“So after a little bit, the people started fighting us. They thought they’d just exchanged one conquering army for another. And that’s when the suicide bombings started. We took an entire village that loved us and made it so they would rather blow themselves up than live with us. That’s what happens. That’s what’ll happen here, and lots of people are going to get killed.”

Howie didn’t say anything for a while as he coated a pan in olive oil, and then he turned to the stove and fired it up. He didn’t know what to say, so he cooked instead, and Mike went to another fridge down a hallway.

H
owie watched Mike go to a metal door with a lock on it, and he searched for something to break it open with. After finding a hammer and other tools in a box, he slammed the hammer into the lock until it clinked to the ground. The fridge was a walk-in and he found some beer and brought out six bottles, placing them on the counter. He popped open the first one and took a long drink.

“Better give me one of those too,”
Howie said.

38

Katherine only remembered pain against her jaw and then a headache. Next thing she knew, she was in the Audi, and Ian was sitting in the passenger seat. He opened a sports drink.

“Here,
” he said, handing her the bottle.

She drank
the warm drink without protest. After swigging half of it, she stopped to wipe her lips with the palm of her hand. Ian took the bottle and drank some before replacing the lid and putting it on the floor between his feet.

“You feel okay?” he
asked.

She nodded but didn’t say anything.

“I need you to drive,” he said.

“Drive yourself.”

“I can’t. I’ve injured my leg, and it’s starting not to respond. I need you to drive. There’s just two more.”

“Do you even care that
they had a family? That they’re the ones that are going to find them? I know what that will do to their kids. They won’t ever be the same.”

“How do you know that?”

“My mother died of cancer. When she finally passed, I was the one in the hospital with her. She couldn’t talk, but she was trying to say goodbye to me.” She held his gaze. “You think taking lives is a game, but I think you’re scared. I think you’re scared that you’re going to die one day, too.”

He didn’t
react but instead watched the landscape through the windshield. They were in a residential neighborhood, and a car stopped in front of one of the houses. A teenage boy of maybe sixteen stepped out and went to the front door. He carefully placed his key in the lock and opened the door, stopping for a moment to see if anyone heard him. Then he went inside and shut the door behind him.

“When I first killed someone, I was so scared
, I pissed myself. I mean, I literally pissed my pants. I still remember how warm it was going down my leg. I was in Moscow at the time, and it was freezing, but I remember the comforting feeling of how warm it was. After it was done, I went back to the little room I’d been staying at and cried. I actually fucking cried. Like a little girl that had lost her puppy. It tore me up for a long time. But after the second one, I didn’t cry. I thought I should, and I wanted the tears to come, but they never did. I couldn’t do it. By the fifth one, it didn’t feel like anything anymore. And now… it’s actually fun. It’s probably the only fun I have left in my life.”

“Well
, then I feel sorry for you.”

He took a deep breath, staring off into space. “Start the car.”

“No.”

He
was quiet for a second. “I said, start the car.”

“You’ll have to kill me. I’m not helping you anymore.”

“I won’t kill you,” he said. “I told you I wouldn’t, so I’d stick to my word. But I will kill your father. And then your sisters and your brother. Any man you ever love will one day disappear, and you won’t know if it was because they left you or because I paid them a visit. You’ll live the rest of your life with me hanging over your shoulder, and you’ll never really know if I’m there or not. Now turn on the fucking car.”

She sat still. No more tears were left. H
er emotions were so frayed that she couldn’t even bring up enough passion to plead with him. She turned on the car.

“Who’s the next one?” she said.

“A doctor. Samantha Bower.”

39

The hospital was as still as a museum after hours. No one spoke, the televisions were all off, and the radio, walkie-talkies, and cell phones were silent. Many of the staff, a nurse had told Samantha, had simply left without clocking out or letting their supervisors know. Something was wrong, and everybody knew it, so they wanted to be with their families. Only a handful of the staff remained, including maybe a dozen doctors. Samantha sat outside hematology to ensure that the doctor running her sister’s negative staining test was one of them.

Duncan had fallen asleep on the chairs in the waiting area. He spread out over three of them
without armrests, and Sam had unplugged the television to ensure he didn’t wake up. His eyes had black circles underneath them. He wasn’t as used to sleep deprivation as she was.

She went down to the vending machines and got a Diet Coke
and a small bag of peanuts. Going back to hematology, she took the long route around the corridor to get blood back into her legs. Hospitals all seemed as though they had been designed and decorated by the same person. The linoleum was spotless in parts and as filthy as mud in others. Antiseptic smells mingled with cleaning products and lifeless, sour air. And they all used lighting that, in a certain percentage of the population, caused migraines.

S
he had always noticed that they weren’t comforting, and she wondered why that was. Maybe the association with them was so strongly negative that no decorations could ever overcome it. People, of course, only came there when bad things happened. The only exception was childbirth.

F
or a time during her medical school rotations, she’d thought about going into obstetrics, but pathology and trauma had called to her. When she had joined the CDC, something about it seemed so thrilling, so cutting edge. There she was, hardly out of medical school, and she was in a village in Chad performing an emergency surgery on someone whose gallbladder had ruptured. Initially, she had gone there to investigate a water-supply contaminate.

Samantha discovered the source of the contamination
was a single well rumored to contain the feces of some children that had defecated in it as a practical joke, causing an E. coli outbreak. She was the only doctor within two hundred miles. A man suffering from poor hydration and malnutrition had drunk from the well, and the E. coli infected his gallbladder and caused it to rupture.

The
village elders had begged her to perform the surgery, and she’d spent just enough time as an emergency room physician and surgeon to operate without killing the man.

She removed the gallbladder and closed the incisions, hoping that no sepsis would occur. The man was rushed
211 miles to the nearest hospital for follow-up care and antibiotics. Sam found out later that the man had survived. He even sent her some homemade trinkets, including a giraffe carved out of yellow wood.

Now, she wasn’t certain
that joining the CDC had been the right decision. But she knew the history of infections was the history of the world, and sometimes, she felt there was no greater calling in medicine than to stop the spread of disease.

Microorganisms were responsible for the shaping of
antiquity. People thought that history had variables that could be rearranged to predict with some accuracy how history flowed. One country falls to dictatorship, and a certain result follows. Another country inflates its currency, and a specific result was expected. But Samantha knew that wasn’t true. Humans had always been at the mercy of beings too small to see them, except through powerful instruments.

The Emperor of the Byzantine Empire, Justinian the First,
had the misfortune of being attributed with the worst plague in history. He expanded the reach of the Byzantine Empire, and by all historical predictions, the Byzantines should have conquered the known world, much as the Romans had. But a simple plague brought the empire to its knees and halted expansion, which allowed the Muslim nations to grow stronger.

The Mongols used to infect their enemies with
Plague by catapulting infected persons over the gates of cities they had besieged. The cities would surrender, then the Mongols destroyed them and enslaved their people. Hundreds of cities were conquered this way, and entire nations had been forced to change the way they traded and conducted their politics and economics, based on avoiding confrontation with the Mongols.

And the Black Plague of Europe
forever changed the balance of power between the great nations, causing, in some way, everything that came after it in Europe and consequently affecting every territory under the British crown.

People
were the slaves of bugs a million times smaller than particles of dust.

And the worst of them was the poxvirus
, which was so deadly and contagious that humanity worked to abolish it. Humans understood they could not co-exist while this virus was still alive in nature. But it had returned and had become unlike anything anyone had seen. Samantha estimated that it had a 99.9998 percent mortality rate. She knew of only one person who had survived infection, but she had been so badly scarred by the virus that she was blind, deaf, and unable to walk because the infection had destroyed her nerves and blood vessels. Sam would rather have died.

The door to hematology opened
, and the young doctor stood there, his safety goggles pushed up onto his forehead. He handed a printout to Samantha.