“He got sick; everybody was getting sick. See.” Listera rolled up his sleeve to reveal a line of blood-filled blisters up his arm. Two other soldiers followed suit and pulled up their sleeves, and another opened his shirt. All of them had the same lesions.
Garcia backed out of the knot of soldiers. “Mrs. Scott,” he yelled.
“Right behind you, Lieutenant,” Bernice said. “I heard what he said. Does any of it make sense to you?”
“No,” he answered quickly. “What are those things on their skin?”
CHAPTER 9
“She just walked in from the jungle and passed out,” Mary Ecklers told Dr. Greenburg as the pair hurried behind Oso, the large Honduran private. He carried a small bleeding woman, whose moaning had ominously ceased.
“Senor, take her over to the tent.” Greenburg pointed to the large pavilion that had been erected just minutes before. In time it would serve as triage and, if needed, an open air hospital ward.
“His name is Oso,” Mary teased. The large man grunted at her; she had been calling him Oso since they had landed, and his fellow soldiers were starting to pick it up.
“My name is Miguel,” he said, reaching the tent and lowering the stricken woman onto the only clear spot, which happened to be a stack of bottled water cases.
“Help me clear this, Oso.” Greenburg had started to pull boxes off of a large wooden crate.
“Miguel,” he said, brushing aside the physician and opening the side door of the crate. “I am guessing that you want the exam table.” He slid the folded table from the crate and in a single move expanded the legs.
“I never knew they opened like that. Thanks, Oso.” Greenburg stood back and examined the crate’s side door.
The big man shook his head and gave Mary a long look as he lifted the unconscious woman onto the exam table.
“Sorry, but it suits you,” she said, tearing open bags of saline and IV supplies.
“She’s been shot,” Greenburg said in surprise. “We’re going to need more help.” He applied pressure to a small wound in her upper right chest. “Get me a set of vital signs and a couple of IVs as soon as you can.” He reached around the small woman and his hand came back bloody. “Shit, the bullet went all the way through. She’s got an exit wound that’s as big as my fist. We could use some help in here.” He yelled, “Hey Oso, or whatever your name is, see if you can find us a pair of gloves.”
Dr. Jorgenson and four other people rushed into the tent. “What’s going on?” he asked his colleague.
“Gunshot wound to the chest; as if these people didn’t have enough problems now someone is shooting them. Can you get me a blood pressure?”
“I can’t get a blood pressure,” Mary said, stabbing the woman’s arm with a large-bore needle.
“She’s still bleeding so she must have one. Get me some instruments—maybe I can clamp this damn bleeder off.”
Twenty minutes later, and after fifteen minutes of CPR, David Jorgenson tapped his partner’s back. “She’s gone, Eli; you need to stop.”
Greenburg reluctantly stopped chest compressions. He was dripping in sweat and had blood up to both elbows. “Not even two hours and we’re already pulling the sheet over one of them,” he said bitterly as Miguel helped him off the table. “I’ll bet she’s not even thirty.” He brushed the dark, bloodstained hair from her face and then paused. “Hey David, what do you make of these?” He pointed to a crop of small clear blisters that had appeared over her otherwise smooth face. “She didn’t have these when we started.”
“Allergic reaction?” Jorgenson bent close.
“To what? All she got was saline and epinephrine. We didn’t even have gloves for a latex allergy.” He lifted both his bloody hands as proof.
“Doctors, she’s got them on her arms as well, and she definitely didn’t have them when I started the IV.” Mary raised one flaccid arm, which was now covered in a cobblestone rash.
“Okay, I’m starting to get a little concerned here.” Jorgenson pointed to the skin of the young woman’s neck, which moments earlier had been completely normal.
“What the hell?” Greenburg said, watching her skin blister before his eyes. Instinctively, he checked for a pulse. “This is impossible,” he said and then backed away from the table. “I need some alcohol and Betadine to scrub this crap off of me.” He held up his arms and one of the nurses led him outside. She began pouring alcohol over his bloody arms. “Can someone find me some hydrogen peroxide?”
“How do you want to handle this?” Jorgenson asked Greenburg after his arms had been scrubbed raw. The body of the small woman lay unattended in the now off-limits tent.
“No way we can get this body out of here, huh?” Greenburg was sixty-eight and the senior physician by more than three decades. A retired internist, he had volunteered only to break the monotony of retirement. Jorgenson was a general surgeon who had just finished eight years in the employ of the US Army and was donating a month of his time to the Red Cross before starting a private practice position in Boston.
“Not until the morning,” Jorgenson said as everyone looked up into the darkening sky.
“The lab is the one thing we have up and running, and I’d sure like to know what that shit is. How about I gown up and take some tissue?” Greenburg was asking for advice, but ultimately the decision was his.
“So long as we maintain isolation. I’d do skin scrapings only and reduce the risk of contamination. We might want to freeze some while we’re at it, and bring it back home.”
“Good idea.”
***
Ten minutes later, the lights around the compound began to come on, and the drone of the jungle was partially replaced by the hum of small generators. Lieutenant Garcia led the way into the clearing and four of his ten soldiers followed, with Bernice and Amanda bringing up the rear.
“Are we just going to let those men spend the night in the jungle?” Amanda whispered to Bernice. They had had the first serious disagreement with the Hondurans over the fate of the six men, all of whom were clearly sick. Garcia had disarmed each man, then detailed six of his men to watch over them until his superiors could decide what to do with them.
“We could at least bring them to the clearing and give them food and water,” Bernice had pleaded.
“They are soldiers and have been trained to do without,” Garcia answered tersely. “My orders are clear: they are to remain where we found them.” His tone closed the door on any further discussion.
“They are sick and dying men,” Bernice said, stomping after the lieutenant. She fumed all the way back to the camp.
“I’m glad you’re back,” Greenburg said, greeting Bernice outside of the large tent. The corpse and exam table had been removed. He filled her in on the last hour’s activities, and when he was done she shared her adventure. “So it’s not an isolated case; we’ve got some sort of outbreak going on.”
“Looks that way. I’ll contact our people in El Progresso. Garcia has already talked to his superiors, who are busy pulling their puds trying to decide what to do with the six in the jungle. Can I see the slides so I can at least sound like I know what I’m talking about?”
“Absolutely. Any woman who talks about pulling puds can have anything she wants. Follow me; the lab is set up over here.”
The pair walked to a smaller tent that sheltered the three small generators and an even smaller medical lab. Bernice noticed an odd collection of empty crates and boxes just past the arc of lights. “The body,” he said simply, and she nodded.
“After you.” He lifted the tent flap to find David Jorgenson bent over one of their two microscopes. “Did you figure it out yet?” Greenburg said loudly, causing his younger colleague to jump and knock over a bottle of water.
“Damn it, Greenburg, you better sleep with one eye open tonight.”
“Relax, it’s only wa
ter. What do you see?” He peered over the smaller man’s shoulder, as if seeing the slide would answer his questions.
“Nothing; you have a look.” Jorgenson backed up and let the internist take over.
“Dermatology was never my strong suit.” Greenburg pulled up a small stool, and Jorgenson and Bernice shared a look and broke out into broad smiles wondering if the stool would bear Greenburg’s weight. “I can feel you smiling,” he said as he adjusted the focus. “Hmm. Extensive dermal damage. Even the subdermal blood vessels are necrotic. That would explain the fluid.”
“How about in English, Doctor?” Bernice asked.
“Something has affected the cells of the skin, not just the epidermis, the outer layer, but the living skin beneath, and its blood vessels. When the dermis is injured it loses some of its grip on the overlying epidermis, which can peel away, allowing fluid to accumulate in the space. Voila! A blister. The problem is that, whatever the process, it should have stopped with her death, but this one didn’t.” He pulled back from the scope and began to stroke his chin.
“Skin cells continue to grow and divide after death,” Bernice said.
“Only for a very short time,” Greenburg said. “So obviously whatever caused this had already been in the dermal tissue before blood flow stopped. Which means either a toxic or infectious etiology. In fact, I’ll go further—it means either heavy metal intoxication or a viral infection.”
Without warning, Jorgenson suddenly scrambled backward into a generator. Bernice nearly tripped getting out of his way in the close quarters and Greenburg spun in his chair. “What the hell are you doing?”
“Bernice, back away from Eli,” Jorgenson said. She hesitated. “Bernice, now, back away.” She looked at him and then back at Greenburg, completely confused until she saw the small red and clear blisters on the backs of his hands.
“Oh shit!” he said, more angry than concerned. “Well, I guess we can cross heavy metal intoxication off our list,” he said, examining the backs of his hands. “You two need to get out of here. Go clear some space for me in the big tent, preferably by a window and the fire.”
Bernice and Dr. Jorgenson slipped out the back of the tent and literally ran into an uncharacteristically disheveled Lieutenant Garcia. Amanda was only steps behind the officer. “I am so glad I found you,” Garcia addressed the doctor. “We have a situation with some of the soldiers from town. Six of them were found wandering in various states of delirium outside of Tela. Their arms were covered in lesions. I left some of my men with them and they have radioed back that one of the six men has died, and the other five are close to death. I need you or Dr. Greenburg to go and see if it is safe to bring the men back here.” Bernice and David hesitated and then looked at each other.
“What’s wrong?” Amanda asked.
“While you were gone we had a woman come into camp. She had been shot, and we couldn’t save her. She had lesions—small blood-filled blisters …” Jorgenson began to answer.
“Yes, that’s what these men have,” Garcia interrupted.
“Dr. Greenburg has developed the same lesions,” Jorgenson finished.
“Oh my God,” Amanda whispered, and Garcia made the sign of the cross.
“We can’t let those men into this camp until we have a better idea what’s going on. I’m sorry, Lieutenant.” Jorgenson tried to walk passed Garcia, but the larger man stepped in front of him.
“But they will die. Can’t you just come and see them. It’s not far.” Garcia was pleading.
“I don’t understand this sudden change in heart,” Bernice said suspiciously. “Thirty minutes ago you were happy to leave them out there all night.”
“They are soldiers, just like me. They have families just like me.” He began to cry and then dropped to his knees.
Amanda took a step away from the sobbing officer. “He’s been like this for about fifteen minutes. It happened so fast; one minute he was talking to the general on the radio, and the next minute he was crying and smashing the radio,” she said quietly to Bernice. “Ours is still okay.”
“Where’s his rifle?” Bernice asked.
“I’m not sure. I think he handed it to someone when we went to radio the general.”
“Good. Everyone who came in contact with the men in the woods, or with the dead woman, needs to be disarmed and isolated,” Bernice whispered.
“I understand the isolation, but what does this have to do with weapons?” Jorgenson asked.
“The soldiers in the forest told us that after their colonel became sick he started killing people,” Amanda answered.
“Great. Apparently whatever it is that’s killing these people isn’t doing it fast enough.” The doctor shook his head. “We’ll have to take it to secondary contacts as well, which I’m guessing pretty much includes everyone.”
“Well, at least I’ll have some company.” All three turned to find Dr. Greenburg standing just outside the lab tent. “Can I come out now? I promise not to shoot anyone.”
“What are we going to do?” Amanda asked the obvious question over the lieutenant’s renewed sobs.
“First thing is to segregate everyone who is clearly infected, which includes the doctor and the lieutenant. Then we need to check everyone for signs of infection, and keep checking, let’s say every hour. Then we need to get on the horn and get us some help.” Bernice had once again become the grand organizer.
Greenburg still seemed unfazed. “We need to keep people away from each other. I’m afraid that our little meeting here has probably infected you two ladies. David, I’m guessing that you were infected earlier when we tried to save Patient Zero. I would spread the word that no one gets closer than ten feet to anyone else in case the agent is spread by airborne droplets.”
“That’s going to make it difficult checking for signs of infection, but I see your point.” Bernice said. “I’ve got a bullhorn and I’ll spread the news. One last thing—he has six men in the forest guarding the ones already infected from the village. Do we bring them in? They had been ordered to keep away from the sick men.”
“Yes,” three voices said at once. “I doubt that the risk here is any less or greater than out there. Do you think he’s in any shape to give that order?” Jorgenson asked the other three. Garcia had rolled onto the ground and curled into a ball, but at least he had become quiet.
“No,” Greenburg said flatly. “Is this what we have to look forward to?” He faced Jorgenson.
“Why is it affecting him like this? None of the men from the village were this bad.” Amanda stared at the man who earlier in the day had been strong, articulate, and vigorous. “This is terrifying.”
“You’re telling me, sister,” Greenburg said under his breath. “I’m guessing that whatever this is has a variable presentation. Let’s hope that he’s at one end of the spectrum and we’re at the other.” The small group nodded as the lieutenant began to moan again.
It took an hour to get everything organized and for the rest of Garcia’s platoon to make it back into camp. Two more of the stricken six died before the remainder were left to die alone in the dark jungle. David Jorgenson and Mary Ecklers had both developed the tell-tale blisters, and along with Oso had joined Dr. Greenburg and Lieutenant Garcia in the large supply tent. Within minutes Greenburg had organized a poker game. Out of sheer luck it had been placed downwind of the rest of the camp, but that didn’t stop Bernice from ordering everyone to wear surgical masks and cover as much skin as possible, even in the stifling heat and humidity.
***
“The lieutenant grabbed that man, remember?” Amanda asked Bernice, who sat the requisite ten feet away while waiting for the Honduran liaison to radio her back. The sun had gone down several hours earlier, and the air was filled with flying insects.
“I remember,” Bernice said. “It’s been a long day, and it’s going to be a long night,” she mu
sed. “It’s been several years since I’ve spent the night in the jungle. I remember the stars being brighter, but also the bugs being smaller.”
“You want to know a secret?” Amanda asked.
“This is going to be about sex, isn’t it?”
“No!” Amanda answered.
“Good, because if you were about to tell me that you had a thing for Dr. Greenburg I’d have to get off this chair, come over there, and punch out your lights. That man is mine!” Bernice tried to keep a straight face but failed, and the two women started to laugh. She stood and began to shake her considerable bulk. “Cause I like my men big and jiggly.” She flopped back into her chair, barely finishing her pantomime through the laughter. “Oh God, I needed that,” Bernice said after the laughter had begun to die away.
“No, despite my secret attraction to Dr. Greenburg, I was about to say that this is the first time I have ever been out of the country.”
“I can’t even remember how many countries I’ve been to. I’ve been all over the world. But I always like coming home the best. Maybe it’s familiarity or convenience, but even with all its warts and worms I’ll take the good-ole US of A.”
“Did we just make a beer commercial?” They both started laughing again, and as it faded they fell into a comfortable silence.
Amanda had become so relaxed that when the radio squawked she nearly fell from her chair.
The first part of the message was delivered in rapid Spanish. “Slow down; I can’t understand you,” Bernice sent back. “This is the Red Cross camp in Tela, Honduras. I’m waiting for Dr. Leon Martinez.”
“Yes, this is Dr. Martinez,” a masculine voice responded in heavily accented English. “Is this Mrs. Scott?”
“It is. We have a situation here.” Bernice gave a concise summary of the condition of Tela, the camp, and the mysterious illness. “Everything we know about Tela comes from the soldiers in the jungle. None of us have actually been in the city, but we did get close enough to hear gunfire.”
Amanda's Story Page 8