by James Abel
“Great.” Eddie moaned. “That’s about a thousand possible routes of infection.”
So we start eliminating possibilities. I asked, starting a written checklist on my lap, “Anyone check the ventilation systems on base for microbes?”
I was thinking about Legionnaires’ disease, a fatal pneumonia that can break out at hotels, and spread inside old air circulation systems or even hot tub steam.
“Air systems clean,” Vargas replied.
“Any military activity inside Galilee? Maybe a drone went down, got recovered in town or nearby.”
“Nothing.”
“Do all the victims know each other?”
“Some do. Some don’t.”
Eddie asked, “Did some special event occur recently where townies and base personnel mixed?”
“I told you, the bar. Look, can I ask you a question? If they’re not coughing, how is it passing from person to person?”
“Don’t assume it’s contagious yet,” I said.
Chris Vekey stared at me.
“You still don’t think it’s contagious?”
“I’m just not assuming it’s passing from person to person yet. Could be point source. Water. Food. A building. Tell me about Galilee,” I asked LeHarve. “The town.”
“Anything specific you want to know?”
“Whatever comes to mind.”
LeHarve glanced at Vargas, then shrugged.
“Nothing special, Colonel. Boring old mining town. Its heyday was in the 1950s. Uranium mines nearby. They closed over a quarter century ago. They’re boarded up.”
Eddie’s breath caught. “Uranium?”
The agent’s eyes in the rearview mirror flicked to me. Vargas drove evenly and LeHarve’s voice was low and accented, her “a” an “ahhh,” as in Boston. Three white biohazard suits, folded and wrapped in plastic, lay in the trunk for us. The AC was on in the car, temp control at seventy.
I asked, “Has anyone visited the mines recently? Kids? Researchers? Any chance that water there mixes with the drinking supply for Galilee or the base? Do the town and base share a water source?”
The agents looked at each other. “I don’t know.”
“Well, someone needs to check.”
“I’ll do that,” Chris said.
I continued thoughtfully, “Nobody said anything before about uranium mines. About how radiation can change cell DNA.”
Eddie agreed, agitated over the lapse. “Nobody in D.C. saw a connection between a possible mutant organism and uranium mines? Hell, didn’t anyone think of the new bacteria coming out of Chernobyl? That fucking black fungus there? And how about old nuclear test sites here? The 1950s. Nevada. Anyone check if this location was downwind of those old tests? If this place got a dose?”
Chris said, “I’ll check that, too. But if this microbe originated in Africa, why are you asking about sources here?”
“Because maybe someone here went to Africa. Contracted it here and carried it there. Like the Spanish flu in 1918. Soldiers got it at Fort Riley, Kansas, and brought it to Europe. Agent Vargas, is there any possibility that someone from Creech or Galilee went to Somalia recently? Or Kenya? Missionary work? Scientist? Soldier? Hell, a tourist even?”
It turned out that the agents had not been told that anyone was sick in Somalia so they had not asked—goddamn need to know. Now that they knew, “We’ll check that, too.”
Eddie had had it with the lack of information, with goddamn need to know. He snapped out, “Well, what the hell have you been checking if not water, mines, or travel?”
“So far, sir, possible connections between anyone in Galilee or the protesters and extremist groups. We’ve been checking hard drives, phone records, background, even of locals.”
“Find any? Connections?”
“A couple of those wackos at the gate have visited some pretty dicey websites. We’re also tracking license plates. There’s a woman from Tulsa who is a second cousin of the Oklahoma City bomber, McVeigh. So! Website links to African and Mideast Islamic groups, and links to right-wingers.”
I turned to Chris. “We need a list of victims in Somalia. Background. Family. Travel. Check backward from Somalia, see if there are connections here.”
Chris looked unhappy. “We’re on that. State had a list of everyone in that research camp. SUNY had to submit applications. So far, nothing.”
The problem is that we’re in a race. A minute-by-minute race. Because this thing may be spreading. Leapfrogging. Like a forest fire that suddenly breaks out miles from the source, just touches down, and starts up in a new place.
Chris said, more softly, “Colonel, in the hospital, you take the lead. That’s why I brought you.”
Was that a peace offering? If so, it did little good. I thought, No, I’m here because you fired my boss and threatened me with military prison. Fuck you and fuck Burke, both of you.
Then I pushed away the hurt pride. I owed it to Lionel Nash and the other victims, and the sick people here. As we reached the base hospital, I saw two ambulances pull up to the emergency entrance. Medical personnel in protective gear moved to open the back doors.
Chris said morosely, “If this is spreading naturally, my God, at this speed, we better clamp down pretty damn fast. If it’s seeding, we may be up against the biggest mass murderer in history. I don’t know which is worse.”
SEVEN
Dr. Inoma Okoye, who met us outside at the hospital, was fiftiesh, brisk but personable, a pear-shaped smoker of pipes who smelled of Borkum Riff and Old Spice aftershave. He’d been flown in from Montana to manage the situation. I was glad to see him. In the small world of biowarfare prep, he was a standout. I’d met him at Harvard. I’d also read several of his articles on quarantine procedures in third world countries in Prevention Monthly. He was the kind of person you wanted in charge when improvisation was called for. He had no ego involved. Just smarts.
“Ah, Joe and Eddie! It is good that you came. Too often the decision makers hang back in the capital, and that’s how you make mistakes. And you were in Somalia? Yes?”
“Close as it gets,” Eddie said.
“Maybe you will spot something we missed. We are getting a whole new round of sick. Come.”
Okoye had been born in London to Nigerian diplomat parents. He’d gotten his med degree in Chicago, married here, and stayed. He’d worked in West Africa with Doctors Without Borders, in an Ebola outbreak. He was calm and unflappable, qualities I associated with top emergency doctors. There was no mistaking the quiet alarm in his eyes.
“We face something totally new. I have not seen anything like this, even in Africa. First we had the initial group. Now we are up to twenty-two, with more coming in hourly.”
To accommodate new arrivals, he’d directed modifications in the hospital, normally a fifty-bed facility that could handle emergencies, but not more complex cases.
“Joe, we brought in state-of-the-art portable patient isolator units, the British ones. Blocked off two floors, used air blowers and plastic sheeting to create makeshift air locks elsewhere; chemical showers for doctors; collection tanks for runoff; separate disposal units for biohazardous material.
“We sealed off air vents on other floors, replaced nurses with trained staff from Montana, and upgraded the lab in the basement. Now we can analyze samples here, even as duplicate versions are flown to Atlanta.”
“At least there’s air-conditioning here,” Eddie said.
I told Okoye, after we suited up, and as we headed upstairs, “In Somalia, everyone got sick at the same time. But not here, you said?”
“No. There was a gap. A first group as a mass. Then a one-by-one increase.”
“Uno,” Eddie asked, “you thinking what I am?”
“Yeah. In Somalia, since everyone got symptomatic at the same time, they were all infected at the same time.
That suggests point source. Food. Water. Something common. But here, you have an initial infection, then it starts to spread to a different group.”
Okoye finished my thinking. “Meaning, if you are right, both initial groups were infected intentionally, and in Nevada the pathogen began to move outward. Contagious.”
“It must be. I’d been hoping it wasn’t.”
Okoye nodded unhappily. We were in the elevator. “We always knew it was just a matter of time, that small changes in the DNA of even benign bacteria could amplify toxicity. Ramshaw and Jackson and their virulent mousepox. They created it in a lab and promptly destroyed it.”
“Or Furst,” said Eddie morosely, referring to the researcher at Totalgen, Inc. in Wisconsin who designed an E. coli strain—one of the most common bacteria—to be thirty thousand times more resistant to antibiotics. Furst also destroyed his creation, after an outcry by other professionals. His work proved that small changes could turn common bacteria into super killers.
Okoye sighed. “I’ve started half of our cases on a normal anti-leprosy regimen: rifampin, clofazimine, and dapsone. Too soon to see if it works. On others I’m trying different strategy, broad spectrum combo: penicillin, aminoglycoside, metronidazole.”
I recognized these drugs. “You think it’s related to necrotizing fasciitis? To flesh-eating bacteria?”
Okoye shrugged. “No response there either, Joe.”
—
Air Force Captain Joaquin Reyes, first official victim at Creech, lay like a space traveler inside a cylindrical patient isolator unit, a high-tech tent of reinforced plastic that looked like a gigantic roll of cellophane and came with built-in hoods, sleeves, and gloves to allow medical staff protection while they worked on a patient.
Bolted to the cylinder was a smaller, squarish airlock through which nurses could pass food and drink to Reyes, and remove body waste.
“The waste is heat sealed and removed for disposal in an autoclave,” Dr. Okoye said.
Air inside the cylinder was kept at negative pressure by pumps, to lower any chance of aerosolization of bacteria if Reyes started coughing.
Between the air pumps and plastic screens, Reyes and I would communicate through three layers of protection. The face looking out, distorted by plastic sheeting, was monstrous, mottled by growths, right eyelid drooping almost shut. The irises were inflamed, red, veined, and watery. Earbuds piped music or TV into him. He balanced a screen-tablet TV on knees poking out from beneath his hospital gown, the skin rife with more sores. The gray hospital socks bulged outward, as if the feet were bandaged. The hands balancing the tablet looked like bandaged paws. Half of his condition seemed to consist of flesh growing, half of it being eaten away.
Before I could speak, Eddie nudged me. Following his gaze, I looked up at the corner TV. CNN was on, and a banner running across the screen read, U.S. DRONES HIT SOMALI TERRORISTS. I saw a global hawk reconnaissance shot of a Somali town, houses wrecked, Technicals burning, bodies sprawled on a street.
U.S. RETALIATES FOR MURDERED SCIENTISTS. DEAD INCLUDE WOMEN AND CHILDREN. OUTRAGE SPREADS ACROSS ISLAMIC WORLD.
As the scene changed to a mob outside the U.S. Embassy in Cairo, I had a sense of the contagion spreading in a different way. There came an overpowering sense of malignant forces converging.
I glanced sharply at Chris. I figured that she’d known the attack was scheduled, and hidden this from us.
But she looked shocked beneath her plastic visor. “I knew they were thinking about it.”
“But why?” I said, aware that Reyes had looked up. The swollen face stared out at me, left eye bulging, like a fish in an aquarium.
Chris said, “Why? They killed Americans. You witnessed it, Joe. How can you even ask why?”
“Because what I saw in Somalia were people trying to protect themselves from infection, same as protocol 80 here, a recently revamped worst-case strategy, buried in a Pentagon drawer.”
“You’re defending them?”
“No, but now we can’t talk to them, can’t learn anything else from them. There’s no proof that they’re even responsible for the infection in the first place.”
“They burned thirty people to death, including healthy ones,” she snapped. “I would think that you of all people would regard retaliation as—”
She stopped abruptly. She turned bright red. At that moment of face-reading honesty, I knew that she’d seen my file. Burke must have shared it. She knew the truth about me.
And then the patient cleared his throat and I concentrated on the wrecked face, and wiped away personal concerns to give full attention to the man lying below.
Even in this first second, if we hadn’t had lab verification, it was obvious, It’s the same thing. He’s not the first patient. He’s fortieth in a growing line.
The nose was eaten away. The nostrils—what was left—seemed raised up. The eyebrows were gone, the neck and wrists a mass of bumps, so joined together in places that they formed the entire surface of his skin.
“Captain Reyes? I’m Colonel Joe Rush, a former U.S. Marine. I’m also a doctor. I’m here to help. I’d be grateful if we talked, if you don’t mind.”
On the wall, someone had hung glassed-in Matisse posters. Jazz instruments, cut-outs. They didn’t lighten the mood. Their cheeriness accentuated the grotesque.
“Marines?” said Reyes in the same ravaged whisper that I’d heard overseas. The same fucking thing.
“Yes, Captain.”
His face showed no emotion. It couldn’t. The muscles had no mobility. But the anger was raw and that was welcome. I’ll take rage in a patient over resignation any day of the week.
“Actually, sir, I mind plenty. No one answers our questions. All we do is answer yours.”
“Ask whatever you want.”
Chris cleared her throat warningly and Okoye looked stern. I knew the drill. Until we know that base personnel weren’t involved in this, we do not share what we know.
Reyes tried to lay the newspaper on his chest but his hands did not function. One section slipped out, drifted to the floor, by the urine container. “What I want? What the hell is happening to us, sir? Me, and my girlfriend. Jana.”
“We don’t know yet.” My eyes flicked to the TV overhead, where CNN was showing the Africa shots again, over and over. Repetition substituting for depth. “But it may have started in Somalia.” Chris’s fingers tightened on my arm. She seemed about to say something, but I rode over any protest. “I’ve just come from there. What you have broke out there first. And a South Carolina couple came down with it, too, after being here recently.”
“Somalia? But that’s where we fly drones!”
I removed Chris’s hand from my suited-over forearm. Her gloves and mine touched. I felt coolness beneath latex. But she wasn’t ordering me to stop, interesting, because shutting me up here was her job.
Reyes struggled to rise inside his cylinder, and succeeded only in raising himself a few inches. “You’re saying this is an attack? Because of our drones?”
I got down on my knees, to be at his eye level. Eddie and I were stationed in Alaska last year, and something that my Iñupiat friends taught me there stuck with me now. In Eskimo culture, you never talk down to a child, or an old person. It accentuates a helpless feeling. I didn’t know whether the same custom applied to dealing with the sick in Barrow, but it seemed a good idea here. I looked into Reyes’s eyes levelly, from a few protected inches away.
“It’s possible. I need your help to try to figure this out. I’ll probably ask a lot of the same questions you’ve answered already, but I may ask new ones, or have a different take on the old answers. Time is crucial.”
“I want to talk to my girlfriend, sir. Jana’s here, too. But the docs say if we talk, we’ll compare stories. Like we can’t think for ourselves. Like, if she says something, I’ll just agree. But ther
e’s nothing wrong with my brain.”
Okoye was nodding, arms folded. The principle was the same one police used when separating witnesses to a crime, or co-conspirators. For the first few hours, you needed fresh perspectives. So you interviewed people separately. But my witnesses were sick, not criminals. After a while they wouldn’t need to stay apart. I explained this to Reyes. He could talk to Jana soon. He did not like it. But he said, “No one explained it before like that.”
Twenty minutes later I’d learned nothing new about symptoms, but I knew, He goes to the bar in Galilee regularly, and he was last there nine days ago.
I asked, “Anything happen there that night? Out of the ordinary? A person? A taste? Argument?”
“It was Tech Sergeant Mack’s birthday. We celebrated.”
“Is Sergeant Mack sick, too?”
“He died, I heard.”
Reyes’s girlfriend, Jana, was in the snapshot on his night table. A smiling Reyes—handsome man—had his arm around a happy, slim, plain-faced woman in tight jeans, a checkered shirt, and a felt cowboy hat with the brim turned down to highlight blue eyes. They were on a boardwalk. It looked like the Santa Monica Pier. I saw lots of bare skin in it, and all the skin looked fine.
“Pretty girl,” I said.
“Colonel Rush, one more thing. Dumb little thing, but it will mean a lot to her. She’s terrified.”
“Tell me.”
“If I can’t talk to her, I want to do something for her. To make her feel better. There’s this restaurant in Vegas, sir. Jana can’t get enough of the Napoli Volcano Special,” said the wrecked mouth. “I asked the other doctor, can you get her one? Comfort food? Three cheeses? Special sauce? I’ll pay. He said no. She’s scared, sir. Please. She’s like an addict for that sandwich.”
“Dr. Okoye,” I asked, “why can’t she have the food?”
“Dr. Markowitz advised against this.”
“Who is Dr. Markowitz?”
“He’s our gastroenterologist. He’s trying to eliminate milk products as the cause of—”
“Milk products? For Christ’s sake,” I snapped. “Captain Reyes, what’s the sandwich she likes?”