Chuck Hogan

by The Blood Artists (epub)

  The news footage of the White House ceremony had shown me at the podium in the Rose Garden, holding forth on my vision of the future of medicine and disease control. Peter, seated in a chair behind me, folding and refolding the event's program repeatedly in his gloved hands, his white hair glowing in the morning sun, declined to speak that day, and each day that followed. After Krebs was forced out, and I was appointed BDC director almost by acclamation, Peter, who could have had-anything he wanted, asked only to head the small Special Pathogens Section, with the proviso that he be well left alone.

  Another question. "What can you tell us about Dr. Maryk? What is the 'Special Pathogens Section' and why is its work so secretive?"

  "Special Path is a separate unit of the BDC," I said, "dealing primarily in disease detective work involving unknown or emerging viruses. There is nothing secretive about that."

  "What would you say to those who claim you are putting your own personal agenda ahead of that of the BDC?"

  "I would say, 'What personal agenda?' I want to see the world healthy. That's all."

  "Where do you go from here, Dr. Pearse?" This particular accent was American. "What's next?"

  "Next?"

  A smile passed over my face. For some reason, the question tickled me, perhaps because of the bad taste left in my mouth from my performance on The Disease Dilemma. "Perhaps my resignation as surgeon general," I said, as much for the charm of hearing myself say it aloud as anything else. I hadn't given this any serious thought.

  There was a stirring within the-press corps. A buzz started throughout the room, and a camera light or two. came on, and questions began overlapping-all of which only further provoked me. "The directorship also," I said. "It may be time for me to get back to research. The Nobel has reminded me of why I got into medical science in the first place, before I got caught up in the parenting of PeaMar23. But only if I can first set up a smooth transition of power at the BDC.More commotion. I was entertained anyway, and oddly relieved; the announcement seemed to ease some of the pressure that had been building up inside of me that strange night and morning. It was as though my career fever had suddenly broken, and I was waking up, looking around the room with new eyes.

  A signal tone sounded above the fray, and I looked off to the side of the dais. There was Peri, looking back at me, troubled by my candor.

  After some confusion as to whose tablet was going off, she opened her own and then held it for me to see. It could have been an inelegant ploy to get me off the stage, but something in her manner compelled me to stand. She met me at the step, her quick blue eyes anticipating my suspicion. "It's real," she said. "Dr. Chiles."

  Reporters were surging toward us now, and to get away we withdrew through a pair of rear doors into the auditorium control room. Two women looked up disinterestedly from a computer station, then resumed their work. Pen turned her tablet around for me and held it, patiently, as I scanned the header.

  It was indeed from Bobby Chiles, my deputy director at the bureau, forwarding an EPI-AID alert originating in a federal hospital in Orangeburg, South Carolina. The disease class caught my attention, listed as UNK, or Unknown.

  I pulled the headset out of the tablet and dialed Bobby's office in Atlanta. A window opened in the lower left corner of the screen and Bobby's face, jowly and brown-skinned with a bush of rusty hair on top, appeared. "Stephen," he said. I saw the familiar black vinyl headrest of his chair behind him. His Georgia accent was strong in my ear, concerned. "No confirmation yet, but it looks like Plainville."

  I stared at the screen. The letters "UNK" stood out to me in bold blue pica. "South Carolina?"

  Bobby read from a piece of paper. "A tuberculosis ward inside a hospital, burning fast. Eleven down already and we're just now pulling up curbside."

  My pulse quickened. "No link to the last outbreak?"

  "Nothing so far. Looks like the same deal as the others. Maryk's out in Nevada, chasing down a low-grade hemorrhagic dengue. Protocol's the only reason I'm bothering you. You are both still down as case agents on this thing. Just need your say-so before I call him in."

  I was nervous but, moreover, excited. "No," I told him. "I'm taking this one, Bobby. I'm leaving here right now."

  Peri said over the top of the tablet, "You are?" Bobby looked at me across thousands of miles, through the screen. "Come again?"

  Peter and his Special Pathogens group had managed the original Plainville outbreak and each subsequent recurrence, shielding the operation from the public eye and, more important, containing the spread. But I remembered my claim on The Disease Dilemma broadcast, and thought that now would be a good time to begin living up to it. "I can be there in a few hours," I said. "They should have the pathogen properly typed by the time I arrive."

  I pulled down the headset and signed off, and Peri took back her tablet. "South Carolina?" she said. "We're heading back. You'll need to clear my calendar for the next few days."

  "But the London speech - - ." She broke off, and did not persist.

  She must have sensed my determination. "I'll extend all apologies," she said.

  Her smile brought back some of the night, and in her face I saw again that thing I had glimpsed under the chandelier, that had endeared her to me: Behind the learned cynicism of her profession lingered, like a smattering of character freckles just visible beneath camouflaging cream, the bright liveliness of a small-town girl.

  Our shared silence was, rather than uncomfortable, thoughtful.

  Even encouraging. "I panicked this morning," she said. "It was stupid. I'm sorry I ran out."

  I smiled and shook my head. "Good morning," I said. I blushed.

  She didn't. "Good morning." Later we returned to the States together, conversing over meals in first class like any other couple, and the time passed pleasantly, but too quickly. After a small kiss inside the main terminal at Dulles International Airport, we departed for separate airplanes, hers back to Atlanta and mine on to South Carolina, that dread feeling in the pit of my stomach returning.

  But for now she reached up to swipe a wayward lock of hair off my forehead, then nodded back at the door. "By the way," she said. "Did you actually mean any of that in there?"

  The medal weighed heavily in my hand like a gilded ashtray. "All of it, I think."

  The chief resident of the Orangeburg Federal Hospital waited anxiously to be introduced. "An honor, Dr. Pearse," he said, and we shook gloved hands, under the ambulance entrance overhang. I was being sealed into a biohazard contact suit, its design much improved in the years since Africa, a lighter, saffron-colored, tearresistant polymer jumper that was cooler inside and allowed greater mobility of the head and shoulders. "We've isolated the green zone," he said, "and evacuated all nonexposed patients, support staff, personnel."

  "Leaving how many infected?" The chief resident took a dramatically deep breath. "Sixty-four. Eleven dead already and as many as twenty in the late stages. We would have picked it up sooner, but with the TB patients, it was difficult to tell."

  The hood came down over my head. There were many people moving around me. "The catatonics, Dr. Pearse."

  They were pulling tape around my ankles, knees, and elbows, sashing the slack suit material. I nodded my hood at the doctor, prompting him to continue. "Clinical catatonia, nonresponsive to medication. None of them has spoken or moved in at least the past ten years. They were in the room next to the TB ward, undergoing neurological tests. Dr. Pearse-they're speaking. The infected catatonics. They're waking up, asking questions." The suit hood smelled of plastic inside, with a lingering coolness like that of a Halloween mask. A Velcro tag labeled S. PEARSE was affixed to my breast, beneath the black BDC logo. I thumbs-upped the Biohazard Containment Unit without enthusiasm and looked again to the doctor.

  "The virus we suspect here has been known to have a pronounced effect on the brain," I said. "Now, if you'll excuse me."

  I walked alone to the nylon-tunneled entrance way, known as "the umbilical," its pale blue
wails rippling in the Carolina breeze. The advance BioCon team had removed the automatic doors to the hospital and installed air locks and negative pressure doorways. I stopped at a steel door papered with safety stickers, checklists, and red warnings, placing my triple-sealed hand upon it. It had been a long time since I'd been inside a suit. I took three deep, filtered breaths, loud inside the hood, then entered.

  The second door opened on a hospital corridor and whooshing gusts of air accompanied me inside. The building was sealed under negative pressure so that no microbes could escape to the outside environment; whenever the control doors were opened, air was made to rush inward.

  The gloomy admitting room and hospital lobby were empty, the talking head on a high monitor still automatically welcoming visitors and issuing paperwork instructions. Hospitals were no longer places where the sick went to be cured. All surgeries, diagnostic tests, and physical examinations were performed at neighborhoodbased "parish" clinics under the auspices of the national health care system, at a flat rate surcharge. Federal hospitals had become "managed care facilities," or sanitariums for long-term care of the chronically and terminally ill.

  The walls and ceilings were all coated with a white, meringuelike viricidal foam. Eight colored bands ran along the center of the clean corridor floor. I followed apple green where it veered off from the rest.

  Around the first corner, other BDC personnel moved about in yellow suits like astronauts burdened by gravity, backs emblazoned with the cardinal red, three-petaled biohazard symbol. One stepped out and approached me, calling to the others in a muffled voice, "Dr. Pearse is on-site." A second suit holding a glassine-shielded tablet, the administrator of the situation log, called out the time in response: "Mr. Director on-site, thirteen-oh-two."

  The approaching scientist strode out to meet me, her arms and legs moving naturally inside the baglike suit, the cap lining her forehead and the frame of the Plexiglas shield giving her face a pronounced V shape of dark eyes and slanting cheeks, a sharply tapered chin. The woman's face was striking, but like a sculpture made of glass, her beauty was cold and fixed. Two thin auburn eyebrows arched smartly into an uncreased forehead. Her name tag read U. FREELEY.

  Freeley was Peter Maryk's number two in Special Pathogens. She joined me and strode confidently at my side, following the green stripe ninety degrees around another corner. -PCR typing confirms the pathogen," she said. Her voice lowered commensurate with the privileged nature of the information. "It's a confirmed Plainville drift."

  "We're absolutely certain?"

  "Oligonucleotide mapping will take a day or two, but it's here, and it's hot."

  An antigenic "drift" described a slight change in the makeup of a virus. A virus that has "drifted" has undergone a subtle genetic mutation, and can elude previously produced antibodies to successfully reinfect an immunized host. An antigenic "shift" is a wholesale recasting of the virus. Plainville's frequent shifts were as alarming as they were unexplained.

  She said, "It originated with the catatonics." That was meant to surprise me, which it did. "Not the TB ward?"

  "Catatonics first.

  Then immediately jumped to the lungers down the hall."

  "No amplification outside the hospital?"

  "None yet. Again, a nice, tight environment for containment. We have the hospital logs for all visitors and contact tracing is under way.

  Quarantine Services should have everyone rounded up within the hour."

  "Good. The hospital is locked down?"

  "FEMA Biohazard is settled in. Epidemiology is represented by General Investigation, Identification, Host Factors, Pathogenesis-" "Fine." I cut short the roll call. We had arrived at another air lock bolted to the wall and sealed with drying epoxy, the removed door leaning next to it. The tiles beneath our feet were entirely green. "Trauma," Freeley said. "We grouped the catatonics here to facilitate treatment."

  I nodded and reached for the door handle. I wanted to pick up the old feeling before proceeding with the investigation. "Just patients inside," she said. "Serology can handle the blood sampling."

  "I want to take a look around for myself."

  Freeley stepped back, her eyes narrow and steely, like Peter's, and humorless. Her deference to me was forced; she either disliked or distrusted me, or both. I attributed it to Maryk's influence and left her there in the hallway, moving through the portal alone.

  The forced air washed me inside the trauma unit. Curtains printed with pharmaceutical advertisements segregated the patient bays, numbered two to twenty-nine around the room. Yellow suits conferred in the central nurses' station, stocking trays and updating computer charts. One nodded to me as he passed, the laminated pages of a small book held in his rubber-gloved hands; the Velcro tag upon his chest read CHAPLAIN.

  The fact that the outbreak had not originated with the hospital staff was in itself remarkable. In epidemiological terms, it was the hound that did not bark. The catatonics' incapacitated state seemed to be, at that point, our first solid lead in establishing the epidemiology of the Plainville strain: The disease could have been communicated to them only by a visitor. Thus the vital importance of contact tracing.

  An attending serologist passed me wheeling an instrument cart.

  "Director Pearse," he said, recognizing me, slowing, straightening.

  His awed greeting reminded me just how remarkable my presence there was. "I'm here to help," I said.

  He gestured to his cart. He was young and thin inside the tightly sashed suit, wearing black-rimmed glasses. "We're just pulling blood," he said. . "Dangerous work," I reminded him, reading his name tag, "Dr. Tenney."

  "Yessir. Of course."

  "Okay if I accompany you on your rounds?"

  "Yessir," he said brightly, and we started across the room.

  I discerned the hazy forms of patients through the plastic tent walls, lying supine or sitting up against pillows, doctors and scientists and nurses in yellow suits at their sides. The bays themselves were each roughly the size of an average parking space, and each contained one bed sealed inside an opaque plastic oxygen tent hanging from the ceiling to the green floor. Tenney led the way to a bed near the door, number twenty-five.

  He peeled open the tent fold on his side and entered, and I did the same opposite him. Resealed, it was quiet inside but for the hiss of oxygen.

  The patient was a woman in her late thirties. The wrinkled sag of her biceps over the bedsheet indicated years of atrophy, though overall the condition of her face and hands evinced care. Her head rolled slightly on her withered neck, illustrating the benefits of dedicated physical therapy.

  Her eyes were open and blinking and blushed faintly with hemorrhaged blood. She was early stage, the skin on her face dark and blotchy, her tongue-she was attempting to speak-scarlet and swollen.

  She looked up at the roof of the opaque plastic tent as though she were falling through the room rather than lying in it.

  When she spoke, her unused jaw moved side to side rather than up and down, and her throat rasped hoarsely. "What is happening?" she said.

  Tenney was punching up her chart on the bed rail console.

  "Negative for motor activity and speech functions for eighteen years," he told me. A moment to do the math, then excitement in his eyes.

  "Since 1998."

  "What are you?" she said.

  I released and collapsed the railing and sat on the mattress next to her. My suit bunched beneath me, but she was small on the bed and there was plenty of room. Tenney said revelatorily, "She's never seen a contact suit."

  I nodded to quiet him. "My name is Dr. Stephen Pearse," I told her.

  "You are in a federal hospital in South Carolina."

  I had to strain to hear her. "Why?"

  "Well, you've been asleep for a while." She swallowed clumsily and raised her quivering right forearm off the bed, high enough that the orange hospital bracelet slid down to her elbow. "See?"

  Soft, russet-colored lesions blemished
her neck and face, but a bedsheet covered her body from the chest down, and her hands and arms were as yet free of any Plainville sores. I realized she was in fact directing my attention to her wrinkles.

  She said, "Old."

  I watched her face as its features, fixed for two decades, shifted slightly with the effect of breaking apart, like ice cracking in warm liquid. They re-formed again in an awkward, lopsided, plaintive expression, and I recognized a teenager's fear in an adult woman's face.

  I took her shaking hand and eased it back down onto the bed, and she gazed up at me, patient to doctor. "Parents," she rasped. "We'll check," I said, and the veneer of her face broke again into another long-unused expression. She wept tearlessly with the fragile eyes of a young girl. I squeezed her hand again. "We're going to need to draw some blood. Then we'll see about getting in touch with your folks.

  I motioned for the apparatus and Tenney handed it to me across the bed.

  It had been a while. I swabbed her elbow and tied and released the rubber tourniquet, drawing out 4 cc as she moaned in pain. Her blood was dark and sludgy. I withdrew and broke off the needle and disposed of it in a biohazard box behind the bed, capping and sealing the syringe barrel. The motions were familiar to me, comfortable.

  Tenney printed a label from the bedside chart, and we met outside.

  "Take care of the blood," I told him, "then see what you can do about her parents."

  He appeared confused. "I've got rounds to do, sir."