by T K Kenyon
A thin sliver of cheap steel shouldn’t be able to undo the inconceivable number of chemical reactions that had built and maintained his body over decades. Each reaction started with atoms, was catalyzed by an enzyme, and produced a protein or other molecule within a cell within a tissue within an organ within a system within his body.
Physics doesn’t understand time. Time as a vector has no ordained direction. The equations work just as well backward as forward, so they don’t describe reality. Leila was constantly pinned between the past and the future with no now, no point of reference, just her foreboding slowly becoming memory, sliding, draining from her head down into the belly of her soul.
A slip of steel into a pocket in an organ, and Conroy’s arrow of time had ceased, as if the knife had deflated his soul.
Such idle speculations were not like her.
Conroy’s body had lost its fight with entropy. That was all. It meant nothing else.
Leila flipped open Conroy’s lab notebook to his last entry, yesterday. He had written lab notes in that horrible doctor’s prescription scrawl on the alternating pages of white and yellow graph paper. It was a wonder that the pharmacists hadn’t killed him for that handwriting.
He had split tissue culture, passed cells and virus, and done mouse work.
No notes about Danna.
Damn it, where were his notes? Conroy wrote everything down. If he had bought heroin from a drug dealer, he would have written a note about it in his lab notebook: its cost, color and consistency, and effects.
He should have written down what he thought about Danna and what tests he had ordered.
An experiment was titled: Rhabdovirus lyssavirus neurovirulence factor 1: glycoprotein targeting and amygdale involvement.
Rhabdovirus lyssavirus?
No one in the lab was working with a rhabdovirus. They didn’t even have any rhabdovirus stocks.
God only knew which rhabdovirus he was talking about, the way a generic herpesvirus could be the virus for chickenpox or genital cold sores or mononucleosis, or a retrovirus could be chicken cancer or horse anemia or HIV.
Basic Virology: Rhabdoviridae is an RNA virus family that includes haematopoietic necrosis virus, hemorrhagic septicemia virus, vesicular stomatitis virus (VSV, a common gene vector for experiments), lyssaviruses, and a weird cow virus.
Maybe Conroy had a VSV vector. Leila flipped through the reference pages, but there was no link to a viral vector, just a lyssavirus strain from the ATCC, the American Tissue Culture Collection, a cell and virus bank.
Their lab didn’t even have any lyssavirus stocks. She turned on his desktop computer and waited for the huge screen to fizz and crackle to life.
Her chest ached.
She launched the web browser, pulled up the PubMed search engine, and typed in rhabdovirus and neurovirulent.
All the papers cited, listed from the most recent, were about rabies viruses.
The monitor vented desert wind, and Leila felt the first stirring of panic.
Emerging Pattern of Rabies Deaths and Increased Viral Infectivity.
Human Rabies – Iowa, 2004.
Differential Stability and Fusion Activity of Rabies Lyssavirus Glycoprotein Trimers.
All the papers were about rabies.
The only neurovirulent rhabdovirus was rabies.
Motherfucker. Conroy had live rabies virus in the lab and hadn’t warned anyone.
Leila smashed the keys with her typing and brought up the ATCC catalog page. She typed the reference number that Conroy had written in his journal into the search field.
Lyssavirus, the entry read, rabies virus, isolated from Pipistrellus subflavus (bat), replicates in most strains of Mus musculus and mouse-derived tissue culture. P4 containment required. Restricted access. Submit restricted access order form and supporting documents.
A hot saliva drip gathered at the corner of Leila’s mouth and she snapped her jaw shut.
That motherfucker Conroy had live rabies virus in the lab, their lab that was only rated at P2, and the live virus was floating around and growing in cells.
Conroy’s strange-acting mice were rabid, and they were in open cages.
And, oh God, oh God, Danna was sick with viral encephalitis.
A flush burned Leila’s face like the exhale of a steam autoclave and her heartrate jogged double time. She felt feverish, and that panicked her: feverish meant symptomatic and that meant too late for vaccination.
She was dying. Death crawled up her arms and legs toward her head.
Leila grabbed the lab telephone directory hanging on the wall next to Conroy’s phone and a tape dispenser loaded with yellow biohazard tape and strung the locked lab door with tacky yellow ribbons crawling with red spider symbols before sprinting for the emergency room.
~~~~~
Dante left Bev while she was sleeping and rubbed his stubble-overgrown jaw as he headed through the emergency room to his car. He was exhausted. He needed two hours of sleep, at least, before he needed to pray Terce at nine. He had already missed Lauds, half an hour before, at six. He tried hard to pray the Divine Office every day, at least minimally by going through the motions designated by the app on his phone. During the first few months when he had taken Holy Orders, the Prayers of the Hours had kept him from hunting in the nightclubs.
Dante walked through the hospital, reading the app on his phone, praying, and dodging people. The ER was harshly lit but quiet. Mint-clothed nurses drank coffee. The chairs area was empty but for a man sleeping on the floor. His straw cowboy hat covered his face, and his arms and boots were crossed.
A swinging door slapped open hard behind him. Dante turned.
Leila sprinted past him to the nurses’ desk, skidded on the tile and half-flopped over the desk. Pens flipped. Papers swished.
She said, “I need help.”
Dante had just left Bev’s bed, but if something had happened to Bev, a blood clot or shock, someone not knowing Sloan’s circumstances might have called Bev’s emergency contacts. Leila might have answered Sloan’s lab phone.
Dante ran.
“There’s a problem,” Leila said.
Dante grabbed the nurses’ desk to stop himself beside her.
“I’ve been exposed. Other people, too.” She shook a list of phone numbers. “And the lab. And there’s mice. I need a consult from I.D., right now.”
I.D., Infectious Diseases? Dante waited.
“I’ll page the resident,” Luis said.
“Get the I.D. attending, not the resident. The last thing we need is a goddamned half-trained resident playing God. And the police. And Danna’s attending, Marlin Pettid, neurology. Why the hell didn’t Conroy tell him?”
It didn’t seem to have anything to do with Bev. Dante waited, just in case he could help and because he felt awkward walking away now, when something was obviously very wrong.
He asked, “Leila, can I help?”
She jumped sideways away from him. “Jesus. Why the hell are you here?” She stopped herself and stared at her spread-open hands. “Jumpiness, irritability, my God. I’m sorry. Oh, my God.”
She was exhausted and panicking, almost manic.
He asked again, “Can I help?”
Leila’s slanted black eyes widened. “Yes. Nurse! Nurse!” She grabbed a handful of Dante’s black shirtsleeve.
Luis covered the phone and said, “I’m paging the attending I.D. physician.”
“Good. And the police.”
Luis dialed three numbers. “What do I tell the police?”
“Hazmat team,” Leila said. “Biohazard. Get the bioterrorism unit.”
Her slim, ungloved hand clutched Dante’s black shirt. Her hand seemed suddenly malicious, contaminated with something that required a bioterrorism team and an infectious disease consult.
Leila grabbed the nurses’ desk, contaminating it, too.
The nurse gasped. “Airborne?”
Leila ranted, “Pipistrellus is a bat. Bat strains can be ae
rosolized. Yeah, maybe airborne. At least one infectious patient, Danna Kerry, up in neurology, maybe more. I have a phone list. We have to call them all, get them here. Do you have Conroy Sloan here?”
The nurse was solemn. “Dr. Sloan’s remains were taken down to the basement an hour ago.”
“Disinfect everything. Decon everyone. The EMTs, ambulance, surgical staff, the O.R.”
Dante had scrubbed his oily, bloody hands after he had performed Extreme Unction for Conroy, but he was contaminated if there was a pathogen. Blood had seeped onto his shirt sleeve. The brown stain was still there.
Luis set down the phone. “Hazmat team’s on its way. What agent is it?”
“Rabies,” Leila said and a tear leaked out her panicking eye. Dante reached over and grabbed her cold hands. Her straining fingers twisted under his and held on. “Rabies virus. I need to start vaccinations now. Everyone in the lab does. This is Dr. Petrocchi-Bianchi, a physician.” She jiggled Dante’s hands. “He can tell you. It’s infectious. It’s dangerous.”
Ah, so she needed him for his medical knowledge. All right.
“I thought you were a priest,” Luis the nurse said. “You gave Dr. Sloan Last Rites, and said Mass.”
“I am both. This lady is absolutely correct. We need infectious disease consult.” He wrapped one arm around Leila’s narrow shoulders. “And an exam room.”
“Exam two is open.” Luis ran to the door.
He walked Leila to the E.R. corridors and whispered, “Did you lock the lab door?”
Leila nodded. “And taped it with biohaz tape, but it’s been contaminated for months.”
“You did what was right. You are all right.”
“I can’t feel my feet. It’s neuropathy. Paralysis starts at the feet. It’s already started.”
“You are panicking. They will start vaccinations. You are going to be fine.”
“Why was he working with rabies? What kind of idiot would grow live rabies virus?” She dropped her head against his shoulder and sobbed. “He’s killed us. He’s killed us all.”
Dante eased her away, and she sat on the exam table. Her slim face pleated into sobs. She reached for his shirt, so he stepped into her drowning arms. Her torso was only skin stretched over her thin rib cage, more waif-like than a fashionable la figura bella.
She said, “Even when Danna got sick, he didn’t tell anyone. They might have been able to try something, but he didn’t tell them. He’s killed us all.” Her voice muffled on his shirt.
He smoothed her soft black hair.
Leila clung to his hand even while a gloved, gowned, and face-shielded Luis drew blood, nervously watching her maroon blood fill a tube. Luis said, “We need saliva samples, but they’re going to start vaccinating you. At least they don’t do it in the stomach any more.”
Dante would have held onto her even if he hadn’t already contaminated himself in the operating room performing Sloan’s Extreme Unction.
This felt right, holding someone because they were mortally afraid, even if they were infectious.
Priests had always attended the lepers.
~~~~~
Hours later, after the first of the vaccinations, after Leila had sobbed in the priest’s arms and then insisted that she was fine so he should go home, she dialed her cell phone’s tiny keys with her thumbs and listened to the rattle of Father Petrocchi-Bianchi’s phone ringing.
When the priest’s answering service cut in, ‘Allo, this is Father Dante Petrocchi-Bianchi, she hit end and redialed, and it rang more.
This time, a click, a beep, scrambling like an animal clawing its way out of a hole, and the priest’s hoary voice, “Si?”
“Monsignor Petrocchi-Bianchi? Dante? This is Leila Faris,” she whispered. She glanced down the hospital corridor. “I’m sorry to call you.”
“Ah, it is all right,” he said. A scuffle. “What time it is?”
“It’s six-thirty, Sunday night.”
“Merda.” His voice croaked.
“I’m sorry, but the hospital minister isn’t here, and,” Leila pressed the side of her face flat against the chalky plaster wall and shielded herself with her arm from the eavesdropping nurses’ desk and the wandering residents and med students, “and some folks are about to get some really bad news about their daughter, a friend of mine,” Leila’s scratchy throat closed and she blasted a cough to clear it, “and her dad is a minister, and I’m really sorry, but could you come back here?” Leila’s damned vocal cords slapped. “I don’t know who else to call.”
Stupid hot lines dripped down Leila’s cheeks.
~~~~~
Dante looked through the half-open door to the darkened hospital room.
Inside, a shaft of hallway light picked out Leila, dressed in baggy green surgical scrubs, sitting near the foot of the girl’s bed while the girl’s parents wavered on either side.
They didn’t touch the girl in the bed. Her head twitched when one of them came close to her, but the rest of her body didn’t move.
He cleared his throat.
Leila looked up, a trace of silvery light from the hallway lights lining her face.
She left the bed, came over to the door, and whispered to him, “Let’s go down the hall,” and fluttered her hand down the door-lined corridor.
Each door sported a chart. Each chart summarized someone’s life expectancy and organized their remaining time into dosages and intervals. Dante had always balked that aspect of medicine: the cold, clinical assessment of death. He had wanted hope for his patients, even though most of them were in the end stage of Alzheimer’s.
Leila led him to the residents’ crash pad, a small room with a bunk bed, a table, a couch, and a kitchenette.
In her eyes, fine blood vessels covered the whites of her eyes around her black irises like lace. Her lank hair was damp.
She said, “Conroy should have been here, damn him. I tried calling some of the other professors but I couldn’t reach anybody. They have to tell her parents.”
He gestured to her green scrubs and high-heeled black boots. “Have you been home?”
“No. A friend of mine is a resident. He let me shower in the lounge here and gave me the scrubs. I should page the attending.” Her exhausted eyes quavered and she listed to the side. Leila flipped out her cell phone, thumbed keys faster than a video game, and flipped it closed. “He’ll be here in a minute.”
Dante stepped closer, in case he needed to catch her when she keeled over. “Sit down, Leila. Just for a minute.”
Her eyes blinked, slowly, almost falling asleep. Her hand drifted up and pressed her temple. “He went for coffee at Staff Caff.” She looked out the door. “He’ll be right back.”
The lack of sleep was punishing her frail body. Dante had slept a few hours, not enough, but he could make do. “You have not slept at all, have you?”
She smiled, a minimal weary lip curve. “I’m fine.”
Dante didn’t know what his role here was, but he was glad that Leila had called him. He must not have done too badly when she needed a shoulder. “Is she conscious?”
“The paralysis is creeping up her body,” Leila said. “The doctor said it will paralyze her diaphragm and she’ll suffocate. It seems like she should be unconscious but she’s not. She’s aware. She responds. She answers questions.” Leila shook her head. “She’s not demented like you would expect from an organic disease like Alzheimer’s or AIDS-related dementia. Her brain is fine, at least the part that thinks, except that she’s dying of rabies.”
It didn’t seem right, not at all, that this girl was dying. Dante had read all the treatises and papers and dogma that the Church had produced, but he still had no idea what to say. “I am sorry.”
Leila looked out the door. “Marlin’s back.”
Her polished black boots clacked on the hallway tile, and Dante followed her back to the girl’s bedside in the darkened room. Leila whispered introductions: her lab friend Danna Kerry, who flinched even at the whispers, her
parents the Reverend and Mrs. Jebediah Kerry, and Marlin Pettid, Danna’s attending physician who wasn’t a marlin at all but a jellyfish with glutinous, translucent skin and a boneless, floating manner.
Leila reeled off Dante’s honorifics and surnames and degrees, which lasted too long and was mortifyingly accurate.
Dr. Pettid waved a hand toward the door. “There’s a conference room down the hall.”
They reached a small, clinically blue conference room with a round table. Marlin Pettid sat between the Reverend and Dante, and Leila sat between Dante and Mrs. Kerry. Mrs. Kerry patted Leila’s hand. “It’s so nice of you to be here,” she said.
Leila stared at the dark wood veneer table. “Dr. Sloan should have been here,” she said, “but he passed away early this morning.”
Mrs. Kerry said, “He didn’t sound sick.”
“It was sudden,” Leila said.
Marlin Pettid efficiently explained the cause of Danna’s viral encephalitis, and his jellyfishiness stiffened.
By the time Marlin had explained the unavoidable, fatal outcome of advanced rabies virus infection and her probable proximate expiration, his face was raw potato white and his clinical vernacular obfuscated connotation. “She was symptomatic at presentation, so vaccination would not have been efficacious. Presenting symptoms were atypical,” he explained, “unlike a canid-origin infection. An inaccurate differential diagnosis of prionic new variant Creutzfeld-Jacob Disease further complicated accurate diagnosis, before the viral encephalitis was established as due to a neurotropic lyssavirus, rabies virus. Palliative care is recommended.”
Dante, because he was also a medical doctor, understood everything that Pettid had said.
Danna had sought help too late. Bat rabies has different symptoms than dog rabies, and that was why they hadn’t figured out what she had. Conroy told them that she had a prion disease, and they hadn’t questioned it. She had rabies, and she was going to die, but they could make her death less painful, because death by rabies is a horrible way to die.
The Reverend Jebediah Kerry stared across at Dante, unblinking. His gray eyes became shiny.