by Wendy Devore
“But how?” My voice was weak. “I mean, it’s just the flu…”
Dr. Patel’s grave look was frightening. “The fever is making her delirious. Her preexisting asthma is contributing to her breathing difficulty. I must be honest with you, Kate. She’s at high risk of sepsis, and if that occurs, there is a forty to fifty percent chance that she will not survive. She also has elevated levels of tumor necrosis factor-alpha, which can lead to increased production of other cytokines.”
My head was reeling. “A cytokine storm,” I mumbled.
Dr. Patel looked at me curiously.
“Is Mimi sick too, then?” I asked.
“No. Not yet, at least. However, due to the severity and rapid progression of your sister’s illness, we requested an expedited reverse transcription-PCR assay to determine which flu strain we’re dealing with, and the results were…unexpected.”
“What do you mean, ‘unexpected’?”
“Michelle is infected with the influenza strain H5N1—you might know it as avian flu or bird flu. Normally this strain is not transmissible via human-to-human contact, but your sister has none of the risk factors for contracting this illness. Frankly, we have no idea how she may have come into contact with the virus. Until we understand what we’re dealing with, your sister is quarantined under isolation. Out of an abundance of caution, we have quarantined Miss Wilhardt as well.”
With every word Dr. Patel spoke, I felt more and more nauseated. H5N1 was not at all unfamiliar to me. H5N1 was burned into my mind—but I remembered it by a different name. I remembered it as the Luzon Flu outbreak of 1942.
“Oh, no…” I gasped. “Michelle threw up at work. At the restaurant!”
Dr. Patel removed his glasses and rubbed his eyes.
“The Centers for Disease Control has been alerted; they are serotyping the sample now to confirm our diagnosis and are also in the process of identifying the staff and restaurant patrons that may have been exposed. My contact at CDC has indicated that over the past twenty-four hours, their colleagues at the World Health Organization have reported seven hundred sixteen suspected avian flu diagnoses. Just over half of the patients have succumbed to their illness, an indication that this strain is significantly more deadly than we’ve seen in the past. To give you some context, in 2006, the worst year on record for avian flu, just one hundred fifteen cases were detected—in the entire year. Even more dire, the cases are occurring in urban areas, and in countries where it’s not culturally common to have close contact with fowl.
“Again, this is out of an abundance of caution. H5N1 has not yet shown human-to-human transmission, but the fact that we have seen a massive uptick in cases in a short period of time, and that we can’t explain how your sister contracted the disease is troubling.”
The implication was not good. I hoped against hope that I was wrong. “So what do I do now?”
“We’ve already assembled a team consisting of a critical care specialist, a pulmonary specialist, and an infectious disease specialist. CDC’s tests will provide more details on the exact virus subtype we’re dealing with.” Dr. Patel fixed me in his gaze and spoke in a measured tone. “For now, we watch. And we wait.”
Chapter 27
Kate
October 31
I found a quiet corner of the ICU family lounge and dialed home. Mom picked up on the first ring.
“Finally. Kathryn, we have been sitting by this phone for hours. What on earth is going on?”
“Mom, I need you to sit down. Dad too,” I said. Then I relayed Dr. Patel’s diagnosis.
“They won’t let you see her?” Mom asked.
“No. They are worried that she’s contagious.”
“What is her prognosis?”
“I don’t know, Mom. There is a whole team of specialists taking care of her, but no one will tell me anything concrete.” I overheard my mother as she conversed with my father.
“Dad is already on the computer. We’ll drive up to Chicago tonight and take the first flight out of O’Hare tomorrow morning. We’ll be there by lunchtime tomorrow.”
My shoulders drooped. I suddenly felt tremendous exhaustion. Last minute plane fare would cost her a fortune. “Mom, I can send you the money for your tickets.”
Her voice was firm and unwavering. “You’ll do no such thing. My baby is standing on death’s door; we’ll figure it out.” She promised to send the flight details as soon as she had them.
I ended the call and slumped down in my chair, considering my options. If I had my laptop I could work, but then again Satori was a black project; no way they’d allow the code to be taken outside of the building. My phone vibrated with an incoming text from Andrew.
Andrew: When will you be back?
Kate: Michelle is in ICU, has complications from flu. No ETA for my return
Andrew: Anything I can do?
Kate: No. No visitors, not even me. While I’m out can you review my code? My branch is called
Andrew: I thought your branch was
Kate: Nope. It’s definitely
Would the reference fly under Andric Breckinridge’s radar? I could only hope. In the meantime, what to do? It didn’t seem right to leave the hospital with my sister fighting for her life. My phone’s battery was running low, and of course I hadn’t thought to bring a charger. I put the device in low power mode and fidgeted. I tried flipping through old magazines, but nothing held my attention for more than a few minutes. I needed to calm down; I needed to concentrate. Surely, a little mindfulness could help. I settled into a chair, closed my eyes, and began to focus on my breath.
My head spins; I am suffering from considerable disorientation. Where am I? All around me, I hear the steady droning of traffic, and I detect the faint odor of urine. The air I’m breathing is damp, and I shiver. Whatever I’m sitting on is hard and uncomfortable; it’s leaching cold through my jeans. I open my eyes. My heart leaps into my throat. Where am I, and why am I here? I vividly remember that I am supposed to be in the hospital, waiting. Waiting because I can’t see my sister, who is deathly ill and in isolation. Waiting for my parents, on an early morning flight they can’t afford.
I’m supposed to be in the hospital, but instead I’m sitting on the concrete, on a sidewalk, in the dark night under a streetlight. The signs at the corner of the intersection read Green and Fillmore. Green and Fillmore—why does that sound so familiar? I’m groggy and my reasoning is sluggish, but slowly a realization dawns on me. Is it possible I’ve managed to dream my way back to the slice that has bequeathed my world with a killer strain of pandemic influenza? Have I inadvertently managed to end up somewhere useful? There is only one way to find out.
I struggle to my feet and take stock of my surroundings. If this is the place, my answer is not far away. I turn slowly around, surveying the nearby homes. Then I spot it—a three-story structure in ivory stucco with entire walls made of glass. Stainless steel. Exposed wooden beams. It stands out, aloof, from the Victorian arches and turrets and scrollwork and finials of the neighboring structures. This modern mansion is where he would choose to live; I am sure of it.
I cross the street, climb the six gray slate stairs to the landing, and knock on the front door. It’s made of a single slab of some kind of blond wood and it’s very solid. My knuckles hurt and I’m sure the sound won’t carry at all. After a moment’s search, I find a keypad panel with a call button. I press it and hold. After a moment, I press it again. Press, release. Press, release. Minutes pass. Nothing happens. I fidget, moving my weight from foot to foot, rubbing my bare arms in the chill air. My nerve is about to give out when the intercom suddenly hums.
“What?” a familiar but extremely irate voice explodes from the small speaker.
For a moment I’m paralyzed. If I’m right, I don’t exist here. My name means nothing.
“Damn homeless shits, fuck off!” he grumbles.
“Wait!” I shout into the intercom. “I know you gave your CereLink awa
y. Last month.”
There is a sharp pop as the speaker is turned off, and I am left despondent.
I’m trying to figure out how to intentionally wake myself up when the door swings open. He stands there in some sort of silky pajama pants—barefoot, shirtless, and with tousled hair, but it’s definitely him. The sight of him half-clothed makes my pulse race, and yet I wonder: who answers the door half-naked?
“Who are you?” he barks.
“My name is Kate.”
“Get in the house,” he orders, standing aside. I scurry through the door, shoulders hunched but relieved to be in from the frigid night air. The foyer is harsh and unwelcoming—polished concrete floors, stark white walls, angular stainless light fixtures.
I follow him through the open space as we reach a room with low-slung, gray, boxy furniture. He drops heavily into a club chair and stares at me with unsmiling eyes. I glance nervously about, unsure where to sit. At a loss, I perch on the edge of the gray sofa. The cushions are very, very hard.
Finally he speaks. “So…Kate. What do you think you know?” The chill in his voice matches the chill of the city, and it’s disconcerting. It reminds me of someone. It reminds me of Andric Breckinridge.
“I know your name is Andrew Breckinridge. I know your company makes CereLink. And I know that a month ago, you were visited by yourself. By my Andrew. I know he persuaded you to give him your CereLink and the nanoprobes that support it.”
He appraises me with coolness, rubbing his chin with his thumb and forefinger.
“Your Andrew? You must be the sidekick. The return ticket. He didn’t mention you were a Jane.” I’m unfamiliar with the slang but not with the tone. The slight stings.
A figure appears in the doorway. It’s a woman—a thin, statuesque blonde with big eyes and fantastic legs. Her long hair is tousled, and she is wearing a man’s long-sleeved dress shirt and nothing more. The top three buttons are undone. She leans against the doorjamb, cocks her head, and asks, “Baby, who’s she?” She is petulant and the slightest of pouts graces her full lips.
“Cerise, baby, go back to bed. I’ll be up soon.” The words are innocent but the tone is lascivious.
Cerise looks annoyed but obeys. As she retreats down the hallway, she swings her hips seductively, and he leers at her backside until she is out of sight. My chest aches; it’s as if my heart has been stabbed with an ice pick, but I try to push my feelings aside. I need his help; I can’t afford to alienate him in any way.
His attention returns to me, and he arches an eyebrow. My shoulders shrink farther as I involuntarily measure myself against the Amazonian princess who has just sauntered out of the room. I feel sorely lacking. But still. I have a job to do.
I take a deep breath and try to compose my thoughts.
“CereLink technology is not the only thing that has come back with us to our reality,” I admit. “We had an unexpected hitchhiker: the Luzon Flu. It’s a small outbreak now, but it’s spreading fast, and none of our antivirals are helping. Please tell me you have some amazingly effective medication or some other kind of treatment that we can use to stop this thing.”
He seems wholly uninterested in my plight. “There is no treatment.”
“How is that possible?” I lament. “With all the advanced science you have, how is it that you haven’t developed any treatment for deadly influenza?”
He drops his chin, stares up at me, and yawns. “We don’t need to treat it because no one gets flu anymore. We have a universal vaccine. Influenza hasn’t been a concern anywhere in the world for the last twenty-five years.”
I know a vaccine can’t help my sister; she is already too sick. I wonder if I can actually dream myself into a world where a cure exists. Then I wonder if it’s even technically possible to develop an antiviral that will help Michelle. I wonder if she has enough time left for me to try. A feeling of dread begins building in my chest, but I press on.
“How does the universal vaccine work?”
He sighs as if he resents the effort, then rises from his seat. He’s gone for a few moments, and when he returns, he’s wearing his CereLink. He stares at the ceiling for a moment, then speaks in monotone.
“The surface of influenza virus is covered with protrusions called hemagglutinin molecules. The protrusions make the virus look like a ball covered in lollipops. The hemagglutinin proteins allow the virus to invade our cells. Early vaccinations used a dead or deactivated virus to induce an antibody response; the antibodies generated by the immune system immobilize the virus by attaching to the head of the lollipop. But the vaccine won’t work for long because the virus undergoes antigenic shift—it is constantly mutating. The exact configuration of the proteins on the head of the spike changes all the time, which renders your body’s antibodies useless. The way to circumvent antigenic shift is to find a target on the virus that doesn’t mutate rapidly, or at all. A vaccine of this nature will produce antibodies that can combat any flu variant.”
“Okay, that all sounds great,” I reply. “But how do we find the target on the virus that doesn’t mutate?”
He yawns; it is obvious this topic holds no interest for him. “If I tell you, will it get you the hell out of my living room?”
I get the feeling he is still preoccupied with Cerise. Lips pursed, I manage a single nod.
He sighs, then stares past me with unfocused eyes. For a moment I think he’s not going to tell me after all. “Viral neuraminidase. You don’t need the whole protein; the gene for this structure codes for four hundred and fifty-three amino acids, and the section from one hundred fifty-three to three hundred seventy-nine are the key to evoking a reasonable antigenic response. And if your dimwit biochemists are still manufacturing vaccines with eggs, then you’re screwed. This needs to be a recombinant vaccine produced in bioreactors,” he said. “Can we call this visit concluded?”
I hesitate, straining hard to remember the details. “Thanks,” I reply nervously, “but I need to ask you one more thing.”
He pulls his CereLink from his head impatiently. “You’re going to tell me that the prototype for the device he’s building isn’t working.”
I nod.
He shakes his head. “I told him he was going to get hung up on the wetware. What are you using as a coating for the nanoparticles?”
“We’ve tried polysorbate-80, and we’ve tried some kind of sugar derived from lobster shells—I think it’s called chitosan,” I reply, racking my brain for the details.
“Polyethylene glycol grafting?” Andrew asks.
I wish I’d paid closer attention during the morning scrum meetings. “That’s PEG, right?”
Andrew’s nod was succinct. “Tell him to use PEG-grafted alginate, and this is important: the PEG grafting density must be zero-point-six-five chains per nanometer squared, or it won’t work.”
“PEG-grafted alginate, zero-point-six-five chains per nanometer squared.” I repeat it to myself on a loop, hoping desperately I can remember all of this accurately, long enough to get it home.
“Our deal was that after I installed the CereLink, he would provide the details for how he managed to hack the multiverse. But then he never showed. He was also extremely cagey about the role that you play in the whole enterprise. You’re decidedly less sophisticated than I expected. But perhaps you can hold up his end of the bargain.”
I resolve not to tell him anything, either. “You said it yourself; I’m just the return ticket. I have no idea how his technology actually works.”
I put on my best poker face, but unbidden thoughts about what is necessary to achieve slice exit fill my mind, causing my cheeks to burn. I shrink back into the uncomfortable sofa.
For the first time, his face breaks into a grin—but rather than reassuring me, his expression makes me feel like he is the wolf and I am the henhouse.
“You’re blushing. Rather more than a work relationship you have going on, I presume. Unexpected.”
The way he looks at me makes my skin craw
l. The word repeats inside my head, increasing in its intensity. “No, no, no, no, NO!” And then I am awake.
I jumped into instant alertness, nearly falling out of my chair in the ICU waiting room, intensely irritated but with a completely clear head. I was surprised that I’d fallen asleep while meditating, and my neck was stiff enough to indicate that I had been slumped in my chair for quite some time. I checked my phone and realized that it was not yet even light outside, and quickly thumbed some notes about the scientific details for the nanoparticles and vaccine design I couldn’t afford to forget. Risking the last of my battery power, I retrieved the email containing Mom’s flight itinerary.
I checked in with the reception desk. The nurse called Dr. Patel, and he brusquely informed me that my sister’s condition wasn’t improving, and that the team caring for her had started additional antiviral medications. I was still not allowed to see Michelle, and my parents wouldn’t arrive for hours; there was nothing more I could do here. But there was something I could do if I could muster up some resources. And resources meant heading back to Albaion.
Although it was barely five in the morning, I marched straight to Andrew’s office and pounded on the door. It didn’t take long for him to let me in. Of course he had started his workday early, or more likely he had worked through the night.
“I just have to say, you can be a real dick,” I said.
“Kathryn? What are you talking about? I thought you were at the hospital with your sister. How is Michelle? Are you sure she has Luzon Flu?” He looked exhausted. Definitely an all-nighter.