by Jim Shepard
She flipped through the journal articles and sample questionnaires and told herself every few minutes that she was just a small part of a very large team effort. And that every new position she’d ever taken had come with the same panicked questions: Was she prepared, and could she find the right people to help her out? And in each case she’d found her way. Whatever the urgency of the situation, she’d need to stay patient. A field investigation was never as clean as a research study, being way more poorly controlled, but the key would be avoiding something quick and dirty and pulling off the quick and clean instead. All she could do was take in what she could and then think for herself. They didn’t know what the agent was or anything about its infectiousness, incubation period, lethality, or susceptibility to the usual containment measures. They didn’t know if it could go airborne and, if so, whether it could travel meters or hundreds of meters. They did know that the worst news would be a person-to-person spread via the respiratory route, since adults took in about ten thousand liters of air per day and couldn’t avoid inhaling each other’s discharges. And Jeannine remembered reading somewhere about an outbreak of foot and mouth disease on the Isle of Wight that turned out to have been caused by a virus that had been windblown fifty miles across the English Channel from France without having lost its infectivity.
All That’s Neither Here nor There
What Jeannine wasn’t thinking about, in her focus on the problem at hand, was the state of her private life, which, a month or so earlier by way of explanation for her behavior, she had described to her supervisor as two or three plane crashes beyond dire. During her postdoc she had through trial and error sussed out two discoveries—a way of driving boys wild with a tantric mix of kissing and touching, and a new method of targeting virulence traits without effecting the viability of the pathogens in her study—and she’d gone back and forth as to which had been the bigger breakthrough for some years afterward until she’d met Branislav when he’d been shoveling out an old man’s car in a sleet storm. He’d dumped a load of snow on her legs and she’d teased him about it, and it had turned out that he didn’t even know the old man. His hair later that night when she’d buried her face in it had smelled like bread and paprika, and the experience of certain of their kisses had never left her, like she’d harvested her happiness from them. Even in her Air Greenland seat she continued to touch her mouth as if she didn’t know what to do with her lips. She had appreciated the way that first night his lack of hesitation had seemed to suggest Why couldn’t they be together? and had appreciated even more the way, in the presence of their conversation, she had become as interesting and electric a person as she might have hoped.
All that had lasted ten months and had weathered easily the differences in their careers (he was a social worker), their backgrounds (his knowledge of Algerians was limited to the Pontecorvo movie and hers of Serbians to a recollection of some problems with the Croatians), and their families: his mother’s central hope for him was that he would get back together with his ex for the sake of their child, and her mother once a week sent her links to articles with titles like “Why Are the Balkans So Violent?” under the subject heading “FYI.” Ten months had allowed her to imagine that that kind of joy wasn’t something that necessarily disappeared, and maybe was something that a woman could shelter inside indefinitely.
But little Mirko, Branislav’s son, had been the kind of kid who’d turn over potted plants to see if the dirt would rain out or drop out in one big clump, and he never said much to her but his body language seemed to imply that things would improve if she took herself somewhere else. When she tried to show an interest he seemed automatically evasive, and she finally figured it was like the carcinogens you might pick up on a walk—you had to take the bad with the good—an attitude Branislav seemed to sense and resent. Most of his work was with at-risk kids and she had started a few conversations on the subject of how inept she was with children in general, and especially problem ones, and he’d always seemed unconvinced by her claims. He had arranged any number of times that she and Mirko could spend together, which she had watched the boy endure for his father’s sake, and then a year ago on a return to the old country to meet his great-grandmother’s relatives Mirko had spiked a fever of 104 and when the broad-spectrum antibiotics had had no effect he had died of sepsis in a hospital in Belgrade. It might have helped to have had the sepsis recognized before hospital arrival, but she had missed it. She was no MD but she was an epidemiologist and in the early stages she had been preoccupied with other things and had just missed it.
It took her weeks to figure out afterward that they now saw their relationship so differently that there were misunderstandings even where she most hoped for connection. Each time she told Branislav she loved him it had less effect, as if the notion had to be renovated to make it real to him. She spent longer periods in the shower, singing to no one. She’d been startled to find herself with someone who now seemed to experience desire as a weakness rather than a bond. He was dismissive of her need for him, as if it were dependence rather than what enabled her independence, and what he seemed to see as pride—as in, he wasn’t going to pretend to something that wasn’t real—she experienced as stinginess. Pleasing him felt like negotiating a box, and she started going into work like the local distributor when it came to sadness. For a week she thought of it as her own private form of civil disobedience before two of her coworkers at the lab she’d left for the CDC hauled her out of her chair and got her drunk and read her the riot act. It took a month after the breakup for her to realize that she was refusing to go anywhere that didn’t have cell service on the off chance that he’d call, and after that revelation she found herself wondering if you were wrong to believe that you went on as yourself even after the loss of that person who had so decisively shaped you.
It was like she’d left the fast lane. It was like her days tiptoed around questions such as when she was going to clear the clothes he’d left from her closet. Everywhere she went it felt like someone had started to say something and then had decided not to. And then she told herself that she had to stop feeding this misery, and that she had to start to make getting past this a workaday routine. That she was thirty-four years old and there was no reason to stay so worked up. She needed to stop being ashamed of needing someone. People could need each other as much as they could manage. She needed to count her blessings. She had her legs, for example. And a good parking space at work.
Because Times Are Tough All Over
And at least she’d had a relationship like that, Danice would have told her, if Jeannine had been the kind of coworker who opened up to people rather than sitting there like someone worried about a ringing in her ears.
Nearly everyone who had heard that Danice had become a lab wonk after having gotten her MD had annoyed her by remarking, “Well, that must be an interesting story.” And in fact after every rotation in medical school Danice had been tempted to specialize in whatever she’d just encountered—obstetrics or hematology or whatever—but she’d gradually noticed that she kept staying interested in the bigger picture, and she’d ended up in public health, or, as she liked to put it, often on dates, as a medical detective. What she didn’t say on dates was that she’d found she liked the solitary focus of the lab work more than dealing with patients, and after a few weeks in the CDC labs she’d realized that it was like being in the ICU, in that you were working with someone who could die without your help except that you were also trying to save all of those other, future patients that you initially had barely registered were out there.
Labs might have been the poor relation when it came to funding, but even so she ran a tight ship: every so often, for example, she liked to have her two techs prepare by hand the bacteriological and virological media that most labs ordered from catalogs, so that they weren’t only sterilizing everything reusable but also were whipping up the gels and broths like someone starting out in a restauran
t kitchen by chopping the vegetables. She informed her new arrivals that everyone in their line of work needed to be the obsessional type: the kind of shut-in who didn’t throw away anything, especially those bits of data that didn’t fit into their preconceived schemes of how something was supposed to operate.
She believed that, for better or worse, she’d acquired most of her drive from her mother, who liked to tell everyone that Danice’s great-grandfather had started a paint company and her grandmother had run a travel agency out of her basement while raising four kids. The idea her mother was trying to convey was that Danice came from enterprising and adaptable stock. Her mother had also always asked her brother, once report cards were out, if those grades were really the best he could have done, and then after he answered would post Danice’s report card somewhere where he could see it and follow her example.
The medical detective line had seemed to work pretty well on dates, but not much else had. She’d tried to make Jeannine feel better after Jeannine’s one abbreviated account of her Branislav agony by joking that her most recent three relationships had all lasted from about one to five in the morning. She told Jeannine that one guy after sex had shown her a nude photo of his girlfriend on his phone, and another, when she’d been confiding in him how alone she felt, had asked if she’d seen his pocket comb. When she’d broken down about her loneliness to her mother on her last Thanksgiving visit, her mother had waited out her crying and then had reminded her pleasantly that boys had never been one of her talents. And when that hadn’t helped, her mother had further suggested that she just think of loneliness as solitude with self-pity thrown in.
So Danice had gotten even better at embracing her inner perpetual motion machine. Even in a place where everyone worked long hours, she became used to that hush that followed once all of her coworkers had left the lab and everyone else’s equipment was covered and the only sound, every so often, was another workaholic from some other department finally hitting the stairs. One dinner she spent with an old Slinky she’d rescued from a yard sale, toying with it next to her salad while trying to work out how it had ever functioned successfully as a child’s toy. She wanted to be one of those people who remade the world she’d been handed, when it came to both her private and professional lives, but so far the world had not cooperated. When she was trying to rally in the face of that lack of success, she reminded herself that it was her job to just keep trying, and it was when her spirits took their inevitable dip that she remembered, in ways that seemed to sink her days, that that was her default position.
The Conversion of Dross to Gold
They both dreamed of being John Snow, the nineteenth-century London doctor who had converted his nerdiness into heroism by being the first investigator to take the time to painstakingly plot on a map all of the known cases of cholera in his neighborhood, a stupefyingly labor-intensive strategy that inspired the simple recommendation that the authorities remove the handle of one centrally located water pump, thereby ending the outbreak.
Chaos Central
At Ilulissat airport the hillsides were steep enough all around that the initial impression was that the runway had been dug out of the rock. The air traffic control tower was only two stories high and made the rest of the terminal look even smaller than it was. Inside the terminal, just behind a man holding up a sign for an adventure agency, a squat woman in a filthy parka was holding a sign that read “DR. DZIRI CDC!” “Think the exclamation point’s a good or a bad sign?” Danice asked Jeannine. The woman introduced herself only as Doru, and after their bags were unloaded on a hilariously small baggage carousel that emerged from the wall near the door to the gate only to go back into the wall six feet later, she led them to an escort team waiting outside the terminal. The head of the team introduced himself as the translator assigned from the Ministry of Health and welcomed them to Greenland and said he hadn’t realized the CDC was sending two women. He and his whole team looked Jeannine and Danice up and down with poorly disguised dismay, and he seemed further disappointed when he saw how little Jeannine and Danice had brought with them, even though Danice’s portable lab, a cherry-red footlocker of high-impact plastic, was about five feet high. How much the weirdness with which they were being treated had to do with the darkness of Jeannine’s skin was hard to gauge. Danice was being looked at the same way, mostly, but it also felt to Jeannine like there were differences.
It turned out that there were enough people in the welcome party that they’d need an extra small truck for the equipment, which they somehow hadn’t anticipated, and that took a couple of glum phone calls from the escort leader to arrange.
Then, on the ride into town packed into a battered government van while they roared past long stretches of barren rock, Jeannine dealt with her anxiety by demoralizing herself with her overall to-do list: They had to confirm the outbreak and work on verifying the diagnosis. They had to construct a working case definition and record the case information. They had to develop some hypotheses and evaluate those hypotheses epidemiologically. They had to implement control and prevention measures and initiate and maintain surveillance. And they had to then try to communicate the relevant parts of whatever they’d found while managing a near-certain media shitstorm. She asked the head of the escort team where they’d be staying and he asked if she wanted to go there first to drop their bags and she said no, they’d better get started, as long as their bags would be safe in the van.
She asked if a quarantine had been instituted, and the head of the escort team said that they had done their best but they hadn’t had the resources, and the parliament was convening tomorrow in an emergency session, and neither the airport nor the harbor had been closed to exiting traffic.
The road in from the airport wove south along the coast and the houses across the harbor alternated their colors—royal blue, pine green, brick red, taxi yellow—so aggressively that it looked like a children’s book. The head of the escort team broke the silence twice more to ask Jeannine how long she had worked at the CDC, and both times she answered, “A while.” Finally he tried Danice with the same question, and Danice told him, “Longer than her.” The CDC prided itself on throwing raw recruits into the deep end of the pool, the theory being that this was the best way to learn. And also, her supervisor had joked, who else could be spared from the office for weeks at a time? The employee database had turned up one guy who spoke a little Danish who might have gone in her place, but he’d been sick himself when the call had come in.
At the hospital they could see so much chaos in the parking area outside the main entrance that they zipped themselves into their Tyvek suits right there in the courtyard, though the sight of them showing up looking like spacemen and sounding like Darth Vader would almost certainly cause more consternation. Until they knew better what was going on, they would be wearing their masks, and as the head of the escort team led them in, Danice reminded Jeannine not to kneel in anything because the liquid would soak right through, and Jeannine reminded Danice to make sure no hairs had broken the seal on her mask.
Once they were inside, some of the crowd shrank away from them and some milled around like they’d come bearing gifts. Some had tears in their eyes and one asked in English if Jeannine and Danice had come to take them away to safety. Jeannine asked a young woman in scrubs in front of them who was in charge, and she pointed to one middle-aged man and two younger men lying on cots in the hallway. She said that Dr. Kristensen was chief of medicine and Drs. Holm and Hammekin served under him. She said that Dr. Kristensen was holding on but had been unresponsive since early that morning. Dr. Hammekin was doing a little bit better.
Jeannine asked how many doctors they had on staff, and the woman answered six or seven, without explaining where the others were. When Danice asked if some of the others were available, the woman looked stricken and said she thought so but two hadn’t responded to their pagers and the other one’s pager was there on
the counter. She introduced herself as Marie Louisa. She was the head nurse.
One of the other nurses took in Jeannine and Danice’s interest in the men on the cots and said something caustic to Marie Louisa, and when Jeannine asked what she had said, Marie Louisa first looked embarrassed and then said that she’d complained that as far as the rich countries were concerned, the epidemic always began when the first white person got sick.
Some of the staff had clearly become even more alarmed by their suits, and Marie Louisa volunteered that the staff had no masks or goggles and had run out of surgical gloves and was now reusing their gowns and overshoes. The head of the escort team reassured her that all sorts of supplies were coming and said that many of them should have already arrived. Marie Louisa said that only two or three crates had. She seemed shell-shocked, and told Jeannine she usually gave out pills, condoms, and advice, and delivered babies and did minor operations and vaccinations and autopsies. When Jeannine had no response to that, the nurse added that the specialists like eye and ear people visited twice a summer and referred patients for extra treatment in Nuuk or Copenhagen. The same was true for dentists.