I was being followed. Whenever I started out to the vehicles for supplies, or went to a quarantined hut to isolate an advanced case from their family, or carried a body to the morgue, the girl with vitiligo shadowed me along the quarantine border. As I worked over patients she sat on the grass across the dividing line, hugging her pink dappled legs, watching me. There were by then only seventeen people remaining on the healthy side. Her time was running out.
At midday I found that I could no longer ignore her, and left trauma suddenly, crossing to the center of the mall. She stood as I started to move, hesitated when I began in her general direction, then rushed to meet me at the quarantine line. I pulled her groping hands from my suit and examined her eyes with a penlight. I inspected her mottled arms and legs, which she displayed proudly, following my gaze with rapt anticipation. She exhibited no signs of the illness. I called upon a nurse to run PCR tests on the remaining seventeen asymptomatics, then wrested myself away again. The girl struggled against me, lunging at my shoulders as I twisted free, stopping only at the quarantine threshold, calling after me as I walked away, "Docteur!
Docteur!"
By the middle of the fourth day, I knew that all our efforts were in vain. Working in the stifling heat, my body weeping dollops of sweat-I had already lost more than ten pounds-treating patients 'who only days before had carried me their brothers, their mothers, their children, I struggled to retain some facade of humanity, to make contact with these masklike faces before passing them down the line to Peter to be taken apart and studied. Preventive therapy had failed and supportive therapy was inadequate, and worse, unable to keep up with demand. We had reached the limits of our medical expertise with the resources available.
We were not the cause of this, I reminded myself. But neither were we the cure. We were merely the facilitators.
PCR tests comparing the virus in Jacqueline Moutouari to samples taken just that day showed dramatic changes in the genetic architecture of the virus. The pathogen was incredibly labile, which we attributed to the virus's aeonian radioactive exposure.
The cries came at midafternoon and lasted for several minutes, a feral bellowing somewhere north of camp that halted relief work and commanded our attention, myself and the two nurses, all looking in the same direction as though expecting something to charge out at us through the trees. The sick listened distractedly to the animal screams as though receiving long-delayed news, and a few, such as the strapped-down, wasting figure of Dr. Kaunda, emulated the wild baying, pearls of foam drying at the corners of his broken lips.
Peter left to investigate and later returned to lead me out across the grass bridge, along a macheted path to a high spot outside the camp.
It was a ridge overlooking the jungle terrain rolling out to the west.
The largest of a thick grove of ancient black trees there had been ravaged, the bottom meter of trunk bark rent to the bare wood and scored with blood and bits of greenish-gray fur. A green monkey lay dead atop a bed of shavings. Its fur was burst with pustules, and black, blood-sodden eyes stared out of its small, drawn, side-turned face. One long arm lay across its belly, the leathery black fingers of both forepaws broken and bloodied. A few paces away, a baboon lay ripped to shreds. The infected monkey had savaged the larger animal before turning its attack upon the tree trunk, then bled to death from its subsequent injuries. "My God," I said.
Peter opened up the disinfectant pack he had brought along and uncapped a gallon bottle of industrial bleach. He began sloshing it on the monkey carcass. "A quarter mile outside camp," he said, dousing the tree wound. "The virus is making its move."
Peter often spoke of viruses as though they had motives, as though they were forward-thinking, free-will life forms with plans and hopes for a deviant future. "Flies are already visiting the kill," he continued.
"Whether arthropods can vector this is anybody's guess, but we have to assume for the purposes of containment that they can. It's starting to break."
I looked out over the ridge into the virgin land below. The camp river continued there, a sparkling blue stripe, eventually pooling into a soft clearing that floated hazily, like a mirage, in the emerald distance. Birds arced in slow, careless circles over pink flamingos high-stepping in the shallows. "We can't quarantine the entire jungle," I said.
Peter nodded his agreement. "That is exactly what I told Krebs."
I turned back and took a step toward him, then stopped. Dr. Martin Krebs was the director of the CDC. "When did you-" "Earlier today.
Reached him in Washington. I told him what we had. It's over, Stephen. We're out of here in four hours."
The -caustic smell of the bleach just then began to drift into my suit hood. "What do you mean?" I said. "These people."
"Are dying."
His voice was flat, yet urgent as always. "The relief effort has failed. Fifteen minutes after we're airborne, air force jets will fly in and take out everything within five square kilometers."
"Jets?" I moved closer toward him in my suit, as though running underwater. "The Congo government would never allow-" "The prime minister and the president have already been briefed on the outbreak.
They signed off on anything that would avoid the panic of an Ebola-like winter."
"But that kind of disruption would whack out the cave's ecology. We'd only be escalating it."
Peter calmly shook his head. "A few strategic strikes on the top of the rise to re-seal the cave for good. The rest, a surface exfoliation.
Plants, bugs, animals: every living thing."
"But the camp people. The asymptomatics. How do you propose evacuating them?"
Peter moved on to the baboon, bleach glugging out of the upturned bottle. In the heat and sweat of my contact suit, I felt a bracing chill. "This is the hottest thing we've ever seen, Stephen. You know that. It's only a matter of time before someone slips up and draws a contamination. This bug could burn through every living thing on this planet if it gets out. That cave is simply too hot to preserve. It is the tumor of the world, never meant to be found. So we bury it. We sea] it back up, and work with the samples we have."
"And the asymptomatics?"
He looked at me over his half mask. "You'd bring them back into the U.S.?"
"Murder," I said. "Don't pretend this is humane. It's preemptive, and misguided, and premature. Murder."
"Our job is to protect humans as a species from an extinction event such as this."
"By slaughtering a few? Offering up the remaining healthy ones as sacrifices to the viral god?" I battled to control my breathing.
"Going to Krebs without me. Without even consulting me." Peter's betrayal shocked me most of all. "I knew what your position would be."
"And so you ignored it? Went around me? Never even considered that you might be wrong and I right?"
"If you have an alternate plan," he said, shaking out the last drops of bleach over the dead baboon, "now is the time."
"We wait."
"We can't wait."
"Let it run its course.
Let it burn out. For God's sake, Peter." He sounded strangely disappointed. "This is Andromeda, Stephen. The Holocaust paradigm: bombing the rail yards to cut the transport lines, martyring those already in the cattle cars to the millions who would die in the gas chambers. That's what disease control is all about: trading the dead for the living. This is no laboratory, Stephen. Categorical imperatives are fine; it's all right to be contemplative on the front porch some warm summer evenings. We're facing world genocide here.
Krebs understands that. I am sorry these people are sick. But I am even sorrier they are contagious. De mortuis nil nisi bonum." Of the dead say nothing but good.
I watched him recap his bottle of bleach. "What's happening to you?"
"You can't save everyone, Stephen. Not even you. Mercy was right enough for the girl."
It was all I could do to keep from ripping off my suit, as though only my self-destruction would change his mind. "She was dyin
g."
He was kneeling before me now, repacking his disinfectant kit.
"If we don't stop it here, cauterize it, now, it's going to slip out of the jungle and march across this continent and the planet."
I saw it all then, the bulletining of Special Pathogens black-baggers, his reluctance to issue an international alert. "You were going to bury this from the beginning."
"No," he said. "Not from the beginning. But early on."
"I'm calling Krebs."
"I told him to expect you. But the jets won't be called back. The uranium mine is in violation of international treaties and the Department of Defense will strike whether we remain here or not."
"Peter," I said. "Listen to me. Burning these people alive. .."
He snapped the kit shut and stood. "We don't have the supplies to euthanatize everyone. But if you have a favorite or two, be my guest."
He started away with his plastic kit like a salesman moving on to his next call, leaving me standing with the two animal carcasses.
Vapor waves of bleach, formerly the essence of cleanliness, of household chores and gym socks in the wash, of pale grout and a gleaming bathroom floor-now and forever the effluvium of disease containment, of ablution.
At once I started after him. The girl with the vitiligo was watching for me at the huts, but I brushed past her grabbing arms to search the camp for Peter. I passed the trauma area and a patient cried out, and I stopped only long enough to treat him. Soon there were others calling for my attention, more than the nurses could handle. After a while I stopped looking over my shoulder. I began treating the doomed as fast as I could.
Steaming rain rang off the shanty roof and pelted into the mud. I had received no satisfaction from my terse conversation with the expedient Krebs, and the rest of the team had been informed of the evacuation and were hurriedly packing up supplies and samples.
Peter reappeared at dusk with jerricans of gasoline from the Pinzgauer and went around burning the huts. With the camp in flames, he joined me in the failed enterprise that was trauma. His head was now completely bare. No mask or shield or goggles, his mouth, nose, ears, and eyes daringly exposed, his white hair glowing under the argent rain-light of the rising moon. Only the latex gloves remained, poreless, wrinkle-free sheaths protecting his vulnerable surgeon's hands.
Fury and despair had synergized into fatalistic resolve, and though my head pounded without mercy, my hands were steady as I worked.
I was fighting the clock to treat the untreatable. Death was coming to these people either by nature's hand or by man's, and I was trying to provide some small measure of comfort in place of hope.
Peter was performing agonal biopsies, rapid sampling of the tissues of those closest to death. Heavy rain crashed after nightfall, but no drums, and I understood then where he had disappeared to earlier. He had gone to warn the Pygmies away.
In retrospect, Peter's divestment now seems inevitable. But it was not his claustrophobia-a simple psychological condition, separate from his cascades-that triggered it, as I had then thought. Nor was it Africa itself that drove him to this Kurtz-ian breakdown. I learned its source as Peter worked over the carcass of a middle-aged woman, drawing bloody slush out of her brain where clear cerebrospinal fluid should have been. "Life, Stephen," he called across trauma, rainfall crashing outside the mosquito net hanging behind him. He set his instruments aside and crossed the corpses toward me. "Eating.
Feeding. Consuming, and being consumed. The beauty of decay. All here, Stephen, all the secrets. All the questions and answers, here for the touching but for this thin membrane-" He flexed his fingers inside his gloves. "Warm, stewy. Consumption." He nodded, stopping on the other side of my patient, smiling. "The viscera of our existence. The slime we crawled out of, claiming us back. Creation; destruction. Our end game peeking out at us from inside a cave-and you and I facing it down. Life, Stephen. In our hands alone. We are the boundary. Death. Life."
Blood dripped from his gloves as his hands formed enthusiastic fists.
I was terrified.
The girl with vitiligo dogged me through sheets of rain as I rushed along the far shanties to the vehicles. She had been at me all night.
"You are leaving," she said, alarmed by all the movement inside the camp. "We will go away now, Docteur. You will not leave me here to die."I stopped finally, the rain smashing at my hood. I turned to her and set my feet in the mud of the narrow walkway, and heard her plead once more. "La pluie, la pue la mort." The rain, it stinks of death.
I then grabbed her suddenly with both gloved hands, one on her neck, the other covering her mouth. Her eyes fluttered wide with surprise and I propelled her around to the shaded rear of a shanty, thrusting her up against the metal wall. She was squirming in my grasp, trying to speak. She was trying to breathe. I saw the rain falling in the inches between our faces, smearing my mask and breaking like bits of glass over her nose and lips-and then returned to my senses, and at once let her go.
I stepped back. I looked at my suit gloves and they were clean; I had just come from a formalin soaking. If not for that I would certainly have infected her. "Murder," I mumbled, huffing inside my stale suit, mad with despair and frustration and the unforgiving rain.
She regained her breath and came at me undaunted, begging to be saved, her pink-stained hands pulling at my wet rubber chest. "No," I told her, each time with less conviction. "Stop," I said finally, seizing her thin wrists and holding her arms fast. The downpour rang off the metal roof of the shanty as I scrutinized her clear, desperate eyes.
She looked so small and young in the rain. "Wait," I said. "Wait here."
I moved under the branches behind the shanties to the road barrier and quickly disinfected. The seventeen asymptomatics' blood samples had come back dirty-all except hers. Remarkably, for someone living in the tropics of central Africa, she had been demonstrably free of any viral infection as of noon that day. I was beginning to think that perhaps I had stumbled upon Peter Maryk's immunological equal.
In my duffel bag in the trunk of the Pinzgauer I dug out my blue thermos and unscrewed the jar top. Dry ice steamed out. I had included with my provisions one 2-cc ampule of PeaMar4, just to have on hand, just in case.
The glass ampule containing the golden sera slid into my hand.
The bottle was small and cool and smoking in the heat. I took one of the last remaining clean hypodermics and hurried back.
She met me as I approached. I showed her the hypo and instructed her to make a fist with her left hand and clench her left biceps-"Like this"-with her right. Fumblingly I drew the immunoserum into the barrel. "The cure," she said brightly. "No," I said. "But this will help to protect you."
I braced her arm at the shoulder, then paused with the needle just over her skin. I looked again into her eyes. They were clear, and the trust I saw in them was overwhelming.
I jabbed the needle into her biceps. She looked away but did not grimace or call out in pain, and when it was over she released her fist, slowly, and then her hand. She smiled and flexed her arm, gently rubbing the puncture spot. She looked eager and thankful and suddenly quite lovely, and it thrilled me, and I knew then beyond any doubt that I had made the correct decision. "Now run," I said. "Down along the river, beyond the lake. And never come back here."
She touched the fabric of my chest. "But I am going with you."
I grabbed her other arm beneath the shoulder. "No," I said. Her strewn, dripping hair made her look petulant, and I shook her roughly, once. "If you want to live, go now. If you want to die-stay."
I released her, and after a moment she smiled at me admiringly, and again I hated her. She was like a stray that followed closest when kicked. "If you tell me to do it," she said proudly, "I will." It was as though her blind trust in me were her thanks. I turned and started back toward the mall. "I will go now, Docteur," I heard her say behind me, her proud voice drowning in the rain. "I will go."
I went around the corner of the shanty and ke
pt walking.
Their sunken faces stared up at us through the rain, a silent, staring chorus. It was too late for anger and too early yet for regret. I tried to imagine the cymbal crash of immolation and the waves of orange flame, and their drawn faces flaring up, the diseased skin blackening and melting back, and their final revelation: "This is why the doctors abandoned us."
The air force helicopter rose out over the river and the waterfall beyond, pulling away from the hazy clearing and the shrinking pink forms of the flamingos, higher and higher. I looked hard for the girl with vitiligo, as though I might see her there, waving good-bye.
The window was cool against my bared forehead. PCR lymphatic tests had confirmed each of us infection-free, and we seven sat strapped into our seats: malnourished, clinically exhausted, rocking lifelessly with the motion of the military helicopter climbing through the rain. We had shed our contact suits, leaving them collapsed on the mud road with the vehicles and contaminated equipment like so much trash awaiting incineration. We were all finally free of the suits and yet no one could bring him- or herself to celebrate. My own skin felt just as constricting.
Viruses traditionally are named for their place of origin. Ebola River, Democratic Republic of the Congo. Marburg, Germany. Lhasa, Nigeria. Machupo River, Bolivia. Lyme, Connecticut, and Muerto Canyon, Navajo Nation, USA. I wondered what exception would be made when the place of origin no longer existed.
Peter was strapped in across from me, and I saw that the first stage of his cascade had begun. His sluggish half eyes watched me, his chest emptying and filling deeply. He roused himself awake like a drunk coming to in a strange chair, blinking lazily and licking his thin, red lips. "Twenty-one days of quarantine on an aircraft carrier," he mumbled. "Doesn't seem so bad right about now."
I saw then something in him that I had never seen before, or perhaps had seen but ignored as I tried to shape his deviance for the benefit of humanity: the monstrous aberrance of Peter's genetic superiority.
My eyes opened to his utter inhumanity.
Chuck Hogan Page 5