The Patron Saint of Plagues

by Barth Anderson

Isabel Khushub was still up to her chin in Pathology, then. Minister Diego Alejandro was no doubt up to his scalp in whatever panic the D5 crisis had awakened in the world’s largest city. Stark desperately wished he could get information about the virus from before noon today.

  Wait a minute. Stark forced himself to sit and think. Perhaps Joaquin had given him the earliest information about the virus available. Perhaps the age-old pattern of viruses leaping from Africa to the New World had been reversed, and the Ghanaians had been fighting D5 without knowing it.

  “Mum, one more thing,” Stark said. “I want you to contact a Dr. Kodzo in the Ghana Department of Health and scan all Ghanaian public health docs related to outbreaks in the cotton industry.”

  “There is a Dr. Imanuel Kodzo working for the GDH, and, yes, it appears that he’s been working a yellow-fever outbreak in a remote village of the country,” said Mum. “I just left him a message on his personal phone.”

  “What? He a health official. He got to have another way of getting hold of him.”

  Queen Mum lagged long, apparently parsing what Stark had just said. “Unfortunately, Dr. Kodzo doesn’t have sat access of any kind—neither hookup, nor pilone,” Mum said. “It could be several hours before he responds.”

  “Hours?” Stark shook his head, feeling like a new Special Pathogens agent on his first urban outbreak. Outside his window, the dark prairie sailed past and the moon raced alongside him. “Hours?”

  SUNDAY, MAY 15. 9:08 P.M.

  THIS WHIMSICAL COMPLEX of cells with its wobbling, oblong construction didn’t resemble any other in the bloodstream. Though it was half virus, the complex passed unhindered through the body, because it was also half white blood cell. It was unique, a centaur trotting up Main Street.

  Four days earlier, a different virus had entered the body and initiated a slow infection. Aware that something had infiltrated its precious system, the body slicked moisture upon its skin and elevated its temperature, while mounting a more complicated response to the virus. A killer T cell investigated the viral infection and learned the identity of the virus.

  Dengue. You don’t belong here, the T cell decided. Previous generations of mine have killed you.

  The T cell then replicated itself and spread through the body like a healing epidemic, attacking and killing the virus wherever it had found purchase in the body. Once the virus was subdued, these antibodies remained in the bloodstream, vigilant for another dengue infection.

  After four days, a brother strain to the first virus entered the bloodstream. The dengue killer T cell, seeing what appeared to be a familiar foe, attached itself to the new virus before it could do any damage. The brother virus, however, was not dengue, at least not dengue as this T cell knew it, nor as previous generations had ever seen it. Though it tried, the antibody couldn’t kill the virus. It could manage only an awkward grasp on the invader, so that now white cell and virus clutched one another. They rolled as a single mass through the blood’s flow, a whimsical marriage of enemies in a battle fought to a draw.

  Or so it seemed to other agents of the immune system. Noting that the T cell had done its duty in arresting a foreign body a voracious macrophage cell with grasping tentacles approached the immune complex, preparing to eat whatever polluting molecule the antibody had disabled.

  But the macrophage ignored the danger posed by this new virus, handcuffed as it was to the antibody like a violent criminal to the body’s own cop. As the macrophage attached itself to the immune complex, the virus ambushed it. Hundreds of times smaller than the macrophage, the virus pierced its cell wall, stripping back the outer sheath, and dumping the macrophage’s contents into the bloodstream. The new virus then found the macrophage’s DNA and unzipped it, pulling the strands apart like a pair of legs, inserting its own code into the cell and replicating itself. Worse, it sorted through the macrophage’s DNA and gleaned the body’s unique, identifying protein, the code that designated the body’s own cells as integrally belonging to this body, and adopted that code like a clever disguise.

  Offspring from the new virus’s infection scattered into the blood’s flow of traffic. They attacked with swift purpose, plunging themselves first into lung cells.

  The body coughed and coughed again. The man thought something was wrong but merely asked a colleague to hand him a glass of water.

  The body mounted a new response. It poured young T cells into the bloodstream to identify the mysterious invader, clone themselves, and begin another bodywide attack on the child viruses. Infections throughout the lungs and esophagus cried to the antibodies, begging to be investigated. But when T cells swarmed over the infected site, searching for traces of the invader, the virus presented the appropriate code of identification, designating itself as belonging.

  The man convulsed.

  The immune system, recognizing that the T cells had failed their mission, spiked a fever in a vain attempt to burn and kill the new virus and its children. The viral cells, however, could survive a higher temperature than the body. A red-pink rash prickled across the skin of the man’s throat.

  The virus wreaked havoc, feeding and breeding at the body’s expense. It rolled back the walls of infected lung cells. It unsheathed esophagus cells and dumped their innards into the bloodstream.

  The man coughed again, spraying the air with infected sputum. He covered his mouth with a handkerchief, saw dots of red when he lifted the cloth from his lips.

  Layers of tissue lining the man’s lungs and throat were dissolving and the body expelled them through the mouth and nose, through the ears and eyes and rapidly forming sores on the skin. The same thing was happening in the stomach, the intestines, the urethra, as the virus destroyed cells throughout the body.

  The mouth tried to speak. “Ave Virgen de Guadalupe,” was all it said before the coughing became too wet, drowning the voice.

  Around him, the man’s colleagues crumpled to the ground. The man used his pilone hookup to link with the Holy Renaissance’s net. > From Dr. Miguel Cristóbal: Quarantine Zapata Hospital’s second floor. Code Blue Klaxon, now! A hemorrhagic fever. Perhaps airborne.

  The man fell to his knees, frontal lobe suffusing with blood, dead before his head hit the floor.

  He was the last person of fifteen to die.

  SUNDAY, MAY 15. 9:29 P.M.

  THE CONFERENCE ROOM stank with released bowels, vomit, coppery blood—the smell of sudden death. Every instinct in him commanded him to flee. But he had stayed to watch the doctors—versed like Bible students on the symptoms of hemorrhagic fever—as they looked about the room in panic, as breath became short, as the cramping and seizures began, and their body temperatures soared. No more computer models running on his home AI. No more hellish nightmares, dark musings in his diary, nor empty confessions.

  The war was under way.

  A moment earlier, Miguel Cristóbal, whom the man admired deeply, had told the group that he had given the order to quarantine Zapata Hospital and Ascensión via pilone. Miguel, moustache standing out like a smudge of shoe polish on his pale skin, then looked right at the man who stood guarding the door in hospital scrubs. Recognition. Confusion. Betrayal. Then Miguel clutched his head and folded up into a ball, slacks and suit coat staining wet.

  The man closed his eyes in respect for his longtime colleague, then slipped the aerosol can in his backpack. He zipped it up and stepped out of the conference room, shutting the door behind him.

  The elevator chimed, and the man, all alone in the hallway, threw himself at the conference-room door in fright. To hide his face, he cupped his hands around his face and pressed his forehead against the glass of the door’s window.

  “Get away from there! Are you crazy?” came a voice from the elevator.

  Three orderlies in Racalitos, disposable biohazard suits and helmets were standing in the air lock with what looked like a giant white doorframe. An ALHEPA air lock, the man noted, the new generation of biohazard-grade air filter. “Didn’t you get the Code Red?” an
orderly shouted. “It’s airborne! Are you insane? Get away from the door!”

  The man had just enough time to slip a surgical mask over his face. Then he picked up his backpack and inched away. “I’m sorry. I heard the quarantine alarm and I wanted to—”

  “Shut up and get out of our way,” the orderly muttered. “We have to get this up fast before it spreads. If it hasn’t already.” The orderly looked through the conference room’s window and shook his skullcapped head in slow disbelief. “Holy Mother of God.” Behind the plastic mask his eyes were round and damp.

  Balling one hand into a fist, the man watched him look into the room. Was the worker simply frightened by the bloody scene? Or did those eyes see past the man’s white lab coat, surgical mask, and gentex gloves to the larger horror at work? Backpack clutched to his stomach, the man felt as if he were standing with a bloody knife in his hands.

  The orderly blinked away his fear and turned back to the ALHEPA air lock. “Come on, come on,” he kept chanting as he and the other two fitted the particle arrester over the conference-room door.

  “Can I help?” the man asked.

  “You’ll need a blood draw to make sure you’re clean.” The frame sighed as it sealed itself to the wall around the door’s frame and hummed to life. “Marcos, take this guy up to the biolab on seven. Dr. Cristóbal just certified it. You’ll be one of the first patients,” he said to the man. “Congratulations.”

  “Come on,” Marcos said, walking to the elevator. “We should use the stairs to keep the lifts free, but I think you qualify as an emergency. Let’s go.”

  When they reached seven, the elevator doors opened on an entire floor that had been turned into a hot lab. The man figured it had probably been an old surgery unit, which would have been easily made into a series of sterile fields with low-pressure atmospheres. Hospital staffers and paramedics were already queuing for bloodwork, according to standard outbreak protocol.

  Marcos led the man deep into the hot lab. This was no longer a unit for sick people, but a place to cull the immune from the doomed.

  They were about to pass through an ALHEPA filter fitted across an office door when Marcos stopped, and said, “Cover your mouth and close your eyes.”

  The man did as he was told, placing a hand over his eyes. Marcos picked up a spritz bottle, the kind used for misting ferns. He sprayed the man down until he had a fine sheen of moisture all over his head, lab coat, and pants. “What’s this?” the man asked, smelling that it was a contact antiviral, probably cytolise-9. Useless.

  “It’s routine, don’t worry,” Marcos said, leading him through the doorway. On the other side, two nurses sat at a desk in front of a line of medicos—one was interviewing, the other leaned casually on the corner of the desk, swinging her leg. Both wore baggy biohazard suits.

  Marcos scooted past the line of doctors and ambulance drivers, and said to the interviewing nurse, “This guy was down on two.”

  All chatting in the queue stopped. Both nurses looked up. The stately older woman being interviewed didn’t look at the man, but she leaned away from him. “Take Dr. Carpintero,” the interviewing nurse said, nodding at her. “I’ll get this guy.”

  Marcos said to the man, “Have a seat.”

  The others in line watched the man with the backpack warily as he pulled the chair out and sat. Everyone noted where his hand touched the back of the chair.

  The nurse pulled out paper and pen.

  Funny to see paper, thought the man.

  Marcos apparently thought so, too. He gave her a quizzical look.

  “The pilone is down, OK?” she said. “Can you remember anything without your Connection?”

  The man was grateful that he happened to be seated for that exchange. The pilone is down? He tried to clear his throat, but it had gone dry as ash.

  Already?

  After he’d gathered himself, he asked as calmly as he could, “Has there been a netcrash?”

  “They hope to prevent one,” the nurse said. “They’re advising that no one Connect tonight.” She didn’t look at him as she shuffled through her papers, which she handled awkwardly, as though unfamiliar with their shape. She began reading in a well-rehearsed drone, “Where were you at the time of the quarantine announcement?”

  The Holy Renaissance’s greatest strength was its pilone network, and he’d presumed it would take days of geometrically increasing mortality rates before the network crashed, if it happened at all. “Name?”

  He blurted out his cousin’s name. “Andres Villanova.”

  “Position.”

  “Orderly. Volunteer.”

  “Which is it?”

  “Um. Volunteer.”

  The nurse cleared her throat. “Where were you?”

  “Will I need a blood test?”

  “Of course.”

  Clasping right hand over left wrist, the man felt with his fingertips for the case he had taped there this morning, the syringe inside loaded with a lethal dose of bumped-up palitoxin. The viruses were both loose. If they weren’t here already, WHO and the CDC would descend on this hospital like paratroopers soon.

  And now, the blood test. This happened so fast, so incredibly fast.

  The nurse seemed to be interpreting his silence as emotion. “Señor, where were you please?” she asked, softer this time.

  He decided that if he had to speak, then the closer to the truth, the better. “I was down there. On the second floor. I accompanied Cristóbal’s—Dr. Cristóbal’s field team into the hospital.”

  She looked up at him tenderly, showing him her sadness for just a breath. Apparently everyone knew that the entire Dengue Task Force was dead. “Were you gloved and masked?”

  “And skullcapped. Yes, luckily.” That’s how Cristóbal and the others had missed identifying him through the course of the Conference.

  She continued reading. “Have you touched anyone, eaten anything, used the bathroom? Have you changed your gloves and/or mask and if so, did you dispose of them according to proper hospital biohazard protocol?”

  He gave all the correct answers, of course.

  “Well, you’re probably going to be all right,” said the nurse, clearly not believing her own words. “Sign this. Here’s a pen. Put the pen in that sharps box when you’re done. Then roll up your sleeve.” She pulled out a syringe and uncapped it.

  He signed the piece of paper and disposed of the pen in the red box next to him marked by a cartoon of a needle. Then he rolled up his right sleeve.

  The nurse stopped him and pointed to his other shoulder. “Left arm.”

  That arm had the palitoxin-syringe case taped to it. He stammered, “What?”

  “I said I need your left arm.”

  He looked at his wrist and the case taped there seemed to bulge like a gun holster. “What happened to infrared? Can’t you take a blood test with infrared?”

  “Whatever you say, Doctor.” She looked bored with him and held up her needle. “Look, sharps are Ministry of Health protocol. So is the left arm. Been this way all weekend. Now let’s go.”

  “That arm is hurt.”

  If the nurse had gum, she would have snapped it. To make her point she blinked once, very slowly at the man.

  The man had a point to make, too. He batted his eyelashes at the nurse and let his brows knit for the slimmest of heartbeats. “I just gave blood, miss.” As if embarrassed, he whispered, “It hurts.”

  She looked away from him quickly as if he had shined a light in her eyes. She sighed, relenting, and pointed the needle at his right arm. “You must have been a beautiful little boy.”

  He smiled at her with his eyes and rolled up his right sleeve, but he felt little accomplishment in his victory. He was still getting a blood draw. If the hospital was testing blood with a nanophage-based assay, which was de rigueur in state-of-the-art hospitals, the nurse would be intrigued, to say the least, by the eight octillian dengue-5 cells broiling in his blood. If she was using ELISA, however, an assay that
examined white blood cells to see if the immune system was fighting an infection, he might slide past unnoticed.

  The nurse pressed her needle to his skin, and he distantly wondered if he would be sticking himself again in a moment. She slid it in neatly, no blubbering around the vein, and quickly filled the syringe with blood. Then she carried it over to a pheresis machine and plugged the syringe into a capsule dock.

  He wanted to ask which it was—ELISA or nanophages. Both assays would use the same hardware these days, he figured. Surely Miguel Cristóbal would have brought nanophage-based assays to Zapata Hospital the minute he realized that this dengue wasn’t being spread by mosquitoes. The woman had her back to him as she set the correct centrifugal speed. Reaching up the sleeve of his lab coat, he carefully peeled the syringe case from his left wrist and held it out of sight beneath the desk. He could stick himself fast—it wouldn’t matter where—and drop the plunger. The doctors here would piece the whole thing together from his blood draw, his suicide, and later, his autopsy.

  The machine chugged to a stop. The man held his breath. He watched the nurse. She was just staring at the machine.

  She is staring longer than necessary, he thought. He opened the case. She’s amazed, no, she’s aghast. Eight octillian? She’s in shock. I would turn and scream if I saw that number. The man had his syringe in hand when the nurse finally shook her head.

  “Dios, I’m sitting here waiting for the report to come by pilone.” She rapped her helmet with two hollow knocks then typed in a request for a readout. “What a moron.”

  The man swallowed hard as she turned back to him with the printout in her hand. “ELISA says you’re clean.” The nurse sighed in relief. People in line behind him sighed, too. “Good. Take this piece of paper, it’s the only indication you have that you don’t have the disease.”

  “Mother of God.” He crossed himself with his free hand. “Is that piece of paper official?”

  “The pheresis notarized it in the corner.”