Her squeals pitched higher, and, pupils dilated with fright, she struggled to free her head from his grip. The blacks of her eyes appeared so blank, he wondered if she could even see him. “Listen to me. What’s your name?”
Her gaze darted frantically in every direction, as if seeking the source of his voice, and she broke into deep convulsive sobs.
“Did you ever have kidney problems?” he asked, feeling like an idiot. But if she couldn’t pee, pulling all that extra water into her blood stream would throw her into heart failure, and she’d drown in her own fluids.
More sobbing.
I’m not getting through, he thought, stepping to the next stretcher.
A well built, middle-aged man whose muscles bulged under mahogany skin strained to sit up. The effort caused him to glisten with perspiration, and his gaze, as tightly focused as two black laser beams, left no doubt that he had Terry in his sights. Yet he yanked at his restraints so savagely and bellowed so loudly, a few rational words on the state of his kidneys seemed highly unlikely.
Someone young, Terry thought, looking around him, determined to find a candidate who he could be sure was free of the deadly risk factor. Because if he croaked the first person they tried mannitol on, there wouldn’t be a second. Doctors still feared lawyers with lawsuits worse than a mystery illness.
A few stretchers away, he saw a girl arch against her ties, silhouetting herself against the glare of overhead floodlights. Head thrown back, red hair dangling halfway to the ground, mouth open in mid scream--on a normal night, she might have been waving pompoms and yelling, “Give me an A!”
He made for her. Eyes squeezed shut, she didn’t see him approach.
He leaned down, wanting to speak directly into her ear. “My name’s Terry, and I’m a doctor,” he said in a normal voice despite all the noise, hoping not to startle her. “I may have something to cut the pain.”
Her lids flew open as she snapped her head around to look at him. Her expression flared into one of bewilderment, as if he’d stepped into her private hell from another dimension. “Pardon?” she said, her voice frail.
“I have to ask you a silly question first. Do you have kidney disease?”
Her face did another twist, this time into an are-you-crazy stare.
“What’s your name?” Terry asked, raising the volume and locking in on her gaze to create a tunnel between them that would block out all else.
“Sam,” she said, her voice halting.
“As in Samantha?”
She nodded
“Where are your mom and dad, Sam?”
“I don’t know. They’re sick, too . . .” Her voice trailed off into a prolonged groan that quickly swelled into a howl. “Ohhh please, make it stop . . .”
The sound usurped her voice and rendered it subhuman, as if her slender throat had channeled the final agony of a savage animal.
Hank was over at the side of the field riffling through a portable equipment cart with one hand and cradling a cell phone to his ear with the other. Nurses and doctors milled around him, grabbing liter bags of clear fluid, presumably mannitol, and ripping open packets of IV tubes. The haunted look in everybody’s eyes had vanished. At last they could do something.
Hank caught Terry’s wave and started toward him, nurses in tow, all of them clutching bags with tubing.
“Okay, Sam,” Terry said. “Answer my question, then we go to work on you. I repeat, any kidney disease?” He spoke with the practiced calm of one well versed in penetrating fear and screams.
She replied with a shake of the head, and grabbed his hand, squeezing it with the strength of a mad woman.
Hank’s team swarmed around them.
“Hang on, Sam, We’ve got you,” Terry said, his mouth at her ear while the others set up the IVs. “Be brave just a little while longer. Then the pain will lessen.” He prayed God not prove him a liar.
Twenty minutes later, Sam’s grip on his hand loosened. “Thank you,” she whispered, and soon was asleep, succumbing to exhaustion as much as all the narcotics she’d received earlier in the evening.
“Now we help the others,” Terry said, looking up at the cluster of nurses and doctors who’d pressed in to watch.
“What about people who can’t tell us if they have kidney failure,” a nurse asked.
“Sniff test,” Terry said.
“What?”
“If they stink of pee, assume their kidneys work.”
Everyone sprang to action.
Terry felt a surge of elation. Tradeoffs were the currency of ER. Sacrifice a hopelessly damaged organ in return for a second chance at life. Give up a shattered leg for a chance to crawl. Breathe on a tube long enough to hear a loved one whisper a final goodbye. Every day he’d helped people he didn’t know make such choices, and thrived on it. This was really no different, now that he’d shown it worked. If some went into heart failure to buy time for thousands, so be it.
Hell, make that to buy time for millions. He whipped out his Blackberry and e-mailed Betty Houston. Advise you post the following mannitol protocol on CDC web page . . .
And lawyers be damned.
More ambulances pulled into the stadium, bringing more victims.
He ran over to the hospital carts and counted the remaining mannitol supply. It wouldn’t be nearly enough. If Hank couldn’t scrounge up more from other hospitals, they’d be out by dawn.
Out came the Blackberry again.
P.S. Beseech pharmaceutical companies to up mannitol production! Before signing off, he added, “Remember the Alamo!”
Minutes later, a bag of the precious stuff in hand, he crept up on the man to whom he’d initially given a wide birth, and kept the IV needle hidden from that laser glare.
* * * *
The Headache Bowl, read Sunday’s front page in The San Antonio Star.
It’s Going To Hurt, the tabloid papers blared, setting off a nation-wide run on over-the-counter pain pills.
Monday morning, people stayed home from work and pulled their kids from school. Uncertainty multiplied. Tempers flared. Confidence drained.
Wall Street halted trading twenty minutes after the opening bell.
In other ways, life went on: Appendices burst, motor vehicles crashed, pregnant women went into labor--until an already overwhelmed medical system teetered under the total load.
And a back page item in The Seaway, an upstate weekly, lamented the dangers of wood stoves after the badly burnt remains of a woman and two men were found in the ruins of a cottage leveled by fire on the Canadian side of the St. Lawrence River. Nobody in America paid the article any notice.
* * * *
When going up against a microbe, Terry never usually read, watched, or listened to the news. He turned to the Internet. At times of crisis, if you knew where to look, it replaced older, more rigid forums for the exchange of ideas in the scientific world. Up popped sites where the lowliest of the low could duke it out with the loftiest on high in the academic hierarchy, and the wackiest, most preliminary experimental results or theories were bounced around in their most unpolished form. This free-for-all generated no end of off-the-wall observations, and, occasionally, gave birth to the most spectacularly innovative eureka gems.
On Tuesday, January 27, 2009, at 10:35 A.M. EST Dr. Mary Clark, the third year family medicine resident who’d examined Frank Rajensky at New York City Hospital five days earlier, tapped her way into history by clicking on one of the more popular sites and being the first to ask: Anybody else out there seeing that people with SHAKES previously had bird flu in the 07 pandemic?
The reaction was like a tidal wave.
A million hits fired back at her.
All of them confirmed her observation, or at least tried to. The site crashed within minutes from the onslaught.
But not before Terry Ryder, still mired in the tedious work of isolating his rogue proteins, saw the entries. Now this could be an interesting piece of the puzzle, he thought, and immediately e-mailed co
pies of the exchanges to Anna.
Care to explain it all! he demanded, fingers hammering the keys.
That same Tuesday, January 27, 2009. 11:03 A.M. EST
Wells Beach, Maine
“Mom, I want to go for a run,” Kyra repeated for a third time.
The insistent voice finally tugged Anna out of her thoughts and away from her computer.
Terry’s e-mail had devastated her, and not because he’d added such an angry kicker. Rather, the bird flu connection had triggered something Yuri had said. That strange claim of his after he’d returned from China in 2002--You’d be proud of me, Anna. I’m going to save the world, just like you--echoed up from a storage bin in her brain. Why the Chinese would have need of him, what he gave them, and how he could have kidded himself into actually believing I’m going to save the world--a scenario snapped into place. Just the possibility of it being true balled her stomach into an acid-broiled knot and sent her into a rage--at him for being such a fool, at herself for not cluing in sooner.
“Mom, I told you, let’s run--”
“Tonight,” Anna said, managing to conceal her turmoil from Kyra, “When its dark, we can go together, as usual.” Right now she needed to think and make some hard choices, fast.
“Awww,” her daughter said, giving the sound two syllables, raising the pitch of the second.
It reminded Anna of an exotic bird cry.
“I’m not stupid enough to show myself to the Feds, you know,” Kyra continued. She slapped one hand on a cocked hip, elbow akimbo, and leaned her trunk in the opposite direction--the official stance of a displeased teen.
Anna saw only the little girl who used to adopt a similar pose and sing, Here is my handle, here is my spout. “Tell you what, Kyra. let’s compromise.” An all out sprint through icy winter air would be just the ticket to unfrazzle her head. “I’ll have a look around. It’ll only take me twenty minutes--”
“Hey, you can’t go if I can’t--”
“Hey, yourself. The mama deer always checks first if the meadow is clear--”
“Lose the Bambi routine, Mother. It’s real old,” Kyra said, attempting to sound world weary. “Besides, look what happened to Mama.”
Anna laughed despite the churning in her gut, and enfolded Kyra in a hug, easily overpowering her daughter’s half-hearted attempt to squirm out of it. “The truth is, my love, unless I take a break from this damn screen, my eyeballs will explode. And I was about to suggest that it’ll be your turn to go for a run when I get back, provided I don’t see anyone suspicious.”
Kyra leaned away and studied her mother, withholding forgiveness.
“You wouldn’t want my eyeballs to explode, would you?” Anna asked.
“Oooh, exploding eyeballs!” Kyra mimicked, providing the appropriate sound effect by sucking the air out of her mouth, lips sealed, and springing them open with a loud pop.
Anna pressed her own lips together and smacked away, out-popping Kyra. Soon they were both trying to top one another, until anyone listening would have thought they were imitating a microwave full of exploding Jiffy-Corn.
Kyra broke first, beginning to giggle.
Anna chased her onto a bed, tickling the sophisticated teenager mercilessly until she yielded to being mommy’s squealing little girl again. It felt good, marvelous in fact. They hadn’t shared a real laugh since leaving New York--
In a blink, Anna’s heart began to pound, her breath quickened, and a sense that something terrible was about to happen pressed in on her with suffocating force. Her clinical self immediately recognized the signs of a panic attack, each symptom attributable to the chemistry of an adrenaline surge. But everything she was seeing and doing with Kyra felt as if it were actually for the last time, their playful exchange no more enduring than a final gasp of air prior to being sucked back into the old nightmare.
She started to tremble.
Unless you take Ryder’s offer, an inner voice taunted. Inform on Yuri, in exchange for being cleared as a suspect.
That would blow things wide open. But would Ryder believe she’d only just figured Yuri’s folly out, or at least thought she had. Or would he assume she’d been an accomplice? Would anyone else trust her if he didn’t? And whether or not they let her go, it might be a death sentence for Yuri.
Minutes later, sick at heart, she stepped out on the deck and into a cold January fog. Pulling the hood of her track suit closed until nothing but her eyes and nose remained visible, she started to jog toward the beach, thigh deep in spindly gold stalks of dormant dune grass. The continuous roar and hiss of waves sounded a hundred yards away, yet she couldn’t see more than thirty feet in any direction. The limited visibility heightened her sense of being cut off from the rest of the world, a welcome feeling to any fugitive.
Reaching a wide stretch of open sand, she crested a slight rise and accelerated down a shallow slope on the far side. The ghostly ridges of surf on a pewter-colored sea came into view as if seen through a veil.
She pivoted south, dug in the toes of her running shoes, and ran hard, sticking to the flats near the water’s edge where incoming waves had firmed up the sand. But the usual warm flush that would normally wash her muscles free of tension failed to show.
She upped the pace.
Mother and daughter both craved exercise, and their first full days in seclusion had been enough to give them cabin fever. By Saturday night they hadn’t seen anything more of the FBI agents, so Anna ventured out to sneak a peek at her own beach house, checking where the watchers had set themselves up. The obvious unmarked cars were parked at a neighbor’s who rented places by the week.
Sunday morning had come and gone, yet the agents still hadn’t strolled up to this end of the beach, probably out of some silly notion that to stay inconspicuous, you stayed out of sight. Around here, remaining house bound made a person stick out.
Anna and Kyra had begun their cautious forays Sunday evening, always heading south, away from the FBI. It seemed perfectly safe, especially under the cover of darkness. They blended in with the other residents who came out at night to jog.
On several occasions Anna had even walked the causeway, a half-mile of road that crossed reeds, muck, and shallow tide pools reeking of marsh gas. She bought groceries at a Seven/Eleven in the Esso station on US 1--they changed clerks so often no one would recognize her--and avoided the Safeway where staff knew their regulars. Her squeegee-kid hairdo wouldn’t fool anyone there who took a really close look.
The expected flush to clear her head still eluded her. Nowhere near ready to think about Yuri, she coaxed her legs into high gear.
The farther south she went, the ocean’s edge angled inland and the grasslands narrowed. After a mile, the water had closed to within twenty-five feet of the buildings. At this range, even through fog, she easily spotted the half dozen cars parked alongside a cluster of houses where cottage row met the causeway. The vehicles had arrived sometime Monday, and she’d been keeping an eye on them. It made her uneasy how these newcomers had set themselves up in the one place that overlooked the only way off the spit.
Slowing, she didn’t see anyone outside the houses in question, nor did somebody inside come to the windows. A prickling sensation ran up the back of her neck. Vacationers were always gawking at the ocean.
She again scanned the buildings for signs of life.
No lights from any of the rooms, no movement, nothing. Just blackness behind glass.
Between two of the houses she spotted a seventh vehicle, this one a black Ford Explorer the size of a small bus. It hadn’t been there last night, and the driver had parked it at right angles to the causeway entrance, as if ready to create a roadblock.
A chill rippled up her spine to join the tingling in her neck. The buildup of people at so strategic a position might mean that they were planning a sweep of the entire spit.
Once more she feared that e-mailing Ryder had been a mistake. If the son of a bitch traced her message and this was the result, she and
Kyra would be trapped.
Her heart rate ticked higher, yet she continued to jog in the same direction at the same pace. A sudden about-turn might tip off unseen watchers that they’d flushed their prey.
Breathe slowly, think logically, and settle down.
It couldn’t be the FBI, she tried to tell herself, just as she had last night. If Ryder had turned her in, they’d have had the e-mail trace and known that she was in the neighborhood since Friday. Why wait until now to watch the causeway? They’d have already picked her up.
The sensations in her spine subsided.
Until a small white spot in the void behind one of the windows caught her attention. Like a white doll’s head floating out of night, the luminous oval emerged from the murk, drew forward, and became a face staring directly at her as it pressed against the pain of glass. The wide features, pale skin, and blood red lips sucked the breath out of her lungs.
She couldn’t breathe.
She wanted to run but felt stuck in the viscid slow motion of a bad dream.
It can’t be, she whimpered to herself.
But she’d never forget or mistake that face.
It was Wey Chen.
Anna turned heel and sprinted back the way she came. The pull of sand on her feet brought the nightmare of fleeing through ooze to life. Behind her, deck doors slid open, banging against their stops. Angry shouts rang out, a chorus of men’s voices topped by a solo female shriek, all in Cantonese, cried, “Get her!”
She reached the harder sand at the water’s edge and poured on speed, not daring to look back. Shallow traces of the outgoing tide splashed off her running shoes. Her breath came in hot, jagged gasps.
She’d only one thought.
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