Penned up in here with nothing to think about, except how you might turn into a monster. I suppose they were looking for a feel-good distraction, and had raided the DVD shelves.
‘Hey.’ Tony said.
Something was wrong. That was the least amount of words he’d ever said in one go. That, and I could see from here his eyes were red, both of them, despite there only being scratch marks over the left side of his face. They looked worse than I’d been able to see last night, deeper, definitely not made by regular human nails.
‘Here for a check-up Tony, shouldn’t take long.’ Claire said, cheerfully waving her ophthalmoscope.
There wasn’t enough room for us to swing a cat in there, so we sat Tony on the back of the sofa and checked him over. Eyes first. It’s important not to lead the patient when you’re discussing symptoms – so you ask them what exactly they’re feeling, rather than asking them if they’re feeling it. Half the time, someone will say yes because you put the idea in their head.
‘How do your eyes feel Tony?’ I asked, while Claire snapped on a pair of gloves.
‘A little itchy, and tired,’ he said, ‘like I want to rest them but keeping them closed doesn’t seem to help either.’
‘Would you all say the same, or is anyone else feeling a different symptom?’ I asked the room.
Granted, Tony might have just put the idea in their heads instead, but it’s not like we had a private consultation area besides the bathroom, and I figured the walls would be pretty thin anyway, in a hut designed for one.
The group burst into nods of agreement and began rephrasing the same symptoms. I took it all in.
‘Have you been wiping them?’ Claire asked.
‘Yeah, we all have. We found tissues in the kitchen.’
‘And have you been touching your non-injured eye without washing your hands? Or have you not been wiping from the inside point to the outside?’
‘No, promise, we did just what you said last night. I know you can pass pink-eye from one to the other, but this just spread on its own. Right?’ he checked with his companions.
They confirmed that they’d been good boys and girls.
I made a mental note of that. Rapidly spreading bacterial conjunctivitis. Hopefully that was all it was.
‘Grey-green discharge, itching, soreness, bloodshot…’ Claire listed, having a closer look at Tony’s eyes with the ophthalmoscope, ‘definitely bacterial conjunctivitis. Particularly aggressive, but that’s to be expected given where it’s come from.’
‘Will we be okay?’ the man sat on the stairs asked.
‘Too soon to say,’ I answered, ‘I don’t want to lie to you. This is all new to us. If it stays as what it is, then we’re good. If it becomes something else…we’ll have to see.’
‘I’d like to check you all out, just to see if everything’s consistent across the board. Like Nurse Cox says, this is a new field of medicine, and we need all the information we can get.’
Claire changed gloves between patients, putting each used pair in the kitchen bin once she was done. We were going to go through gloves pretty quickly but they come in packs of a hundred.
‘Anything you can do to help us in the meantime? It’s driving me mad.’ Tony asked me.
‘I’m sure I saw some chloramphenicol ointment when we were raiding Rob’s first aid box.’ I said, ‘I’ll have someone bring it over to you. Wash your hands before applying, and afterwards as well.’
‘Ointment, for the eyes?’ stairs-guy cringed.
‘Sorry,’ Claire said, and I swear her hand twitched towards the lollypop pocket, ‘it’s the best we can do, I don’t recall seeing any eye drops and they weren’t included in any of our medical packs. You can also wash your eyes over the sink, which might help for a little while.’
‘I’ll try anything.’ Tony told us. ‘Just let us know if there’s anything we can do to help. I’ve seen people heading out towards those guest houses. What’s going on?’
‘They’re salvaging materials we’re going to use to fortify the farm,’ I said, ‘Sergeant Bailey says it’s just until Captain Hale and the others get back, but if they don’t come back…we’ll just be glad of the extra security.’
‘Cool, cool,’ Tony nodded, visibly straining to not rub at his infected eyes, ‘just let us know, right? Feel useless in here.’
‘You’re wounded. Be useless for a while, get better faster. Maybe the tears from this heart-rending romantic comedy of tangled loves stories will help.’ I added, clapping him on the shoulder. Different kinds of bedside manner work better for different people.
Claire finished up and I grabbed the bin-liner full of potentially biohazardous materials. When we’d shut the door and gotten out of earshot, disposing of the liner in a commercial dumpster near the stables, Claire and I looked at each other, but still didn’t risk saying anything. We went around the side of Rob’s house, still not saying a word, and made our way inside his shed, where it was just Claire, myself, and the body on the table.
Only then did we let out a deep breath, together.
‘What do you think?’ she asked, shoulders tight.
‘Too early to tell about Tony and the others. But so far, I think different methods of transmission result in different manifestations of the infection. There’s enough documented evidence that the bite, somehow the most common means of transmission, results in the slow moving, animalistic cannibal which we’re calling the zombie.’
‘And the people who’ve been forced to drink blood,’ Claire continued my train of thought, ‘they’re the ones who turn into ghouls. They think, they plan, and they scare the pants off me. Any theory as to how the hell they’re so different to the zombies? And what about the runners?’
‘Runners might just be the most physically fit in life, that’s what Yanis thought was most likely.’ I shrugged. ‘The difference between the zombies and the ghouls though, is the necrosis, I think. A zombie bite spreads all kinds of poisons through the blood, it’s supposed to help accelerate the rate of infection, but I think it goes to work on higher brain function as well.
‘With the ghoul, you get a stomach full of blood, and from there it begins to work its way into the body from the inside. A function of digestion maybe, or perhaps by osmosis – don’t ask me how. From there, the virus takes over the host just like from a bite, only it does less damage to the brain because it’s not spreading necrotic toxins all over the place.’
‘Leaving the brain more intact, and the ghouls better able to think.’ Claire concluded for me. ‘Zombie blood isn’t exactly liquid though, it coagulates in the veins, harder to get that in your mouth by accident, and the blood you found was more liquid.’
‘Raises more questions, doesn’t it?’
‘We’re right here on the cutting edge of medical discovery. I don’t like it. Didn’t you say the soldier in the basement had a cut across his neck? Like the one on Carmichael? What’s all that about?’
‘Come on, I don’t have all the answers.’ I said, tilting my head to the side. ‘This is so far outside my wheelhouse that it’s on another boat entirely.’
‘No, really, you worked with that CDC guy you keep bringing up, and you’ve got all these theories. Why do so many of the ghouls have slit throats?’
I paced about, struggling for my best guess, making vague hand gestures as I tried to think.
‘When a person dies from bites, either from the blood loss or trauma, but not the infection itself, they can still reanimate. The infection doesn’t have to be cause of death, it just has to be present before the subject expires, right?’
Claire nodded, and followed up. ‘Slitting a throat is an efficient means of killing a person, and ensures a healthy, mostly injury-free ghoul is ready to rise again later.’
‘Exactly. We may be wrong, it may be something else entirely, but despite being capable of basic speech, they’re probably not going to stop being all murderous for a second and answer a few questions.’
‘I
’m glad Dave insisted on putting a screwdriver through the eyes of those the ghouls killed last night.’
It took me a second to process that.
‘He what? I mean I get why, but…damn.’
Claire gave an apologetic half shrug.
‘We all got a version of the info-pack. He knew the bodies might reanimate, and we learned the hard way at the hospital that headshots are the way to go, so he said we should destroy their brains before it was too late. It was a little macabre, but now I’m glad he went through with it.’
That explained the blood on his hands this morning.
‘Dave is a scary guy.’ She remarked. ‘And I am glad he’s here.’
‘Strong, silent type. He’s kinda the opposite of Kelly. He can talk too much sometimes.’ I smirked, stopping as I caught Claire’s eye. I cleared my throat. ‘So. Where do we start?’
We looked at the workbench, which had been cleared of Rob’s projects and had the dead SySec solider laid out instead. Sergeant Bailey had consented to autopsy. That other soldier was going to be pissed, but that wasn’t my problem.
‘Thought you’d done an autopsy with Dr Lines?’
‘That was my cherry. You ever done one before?’
‘Ugh, not for a while.’ Claire said, almost cringing away. ‘Thankfully the paediatric autopsies were handled by Dr Grey’s department. We’ll have to muddle through together.’
We took off our coats, her white one and my bike jacket, and donned sturdy leather aprons, the original function of which, I wasn’t entirely sure. Then we pulled on clean sets of gloves and unrolled the tools. Everything had been set up for us by the other medical staff while we examined Tony and company.
There were doctors around more qualified to perform this procedure, but they wanted nothing to do with an infected cadaver, perfectly content with whatever assignment Bailey had thrown at them after setting up the infirmary-snug. Probably digging trenches.
‘What about the eye scratches then?’ Claire asked, as we cut open the ghoul’s clothing. The bulletproof vest needed to come off over the head, and it was a bit of a struggle getting his arms to cooperate.
‘Like I said, I don’t know what to think,’ I told her after a long pause, ‘it could just be as simple as ABC-’, a paediatrics acronym for acute bacterial conjunctivitis, which I thought she’d like, ‘-or it could be the early signs of a different infection transmission, leading into a new aberration type. Something not a zombie, not a ghoul. We can only be sure in a couple of days.’
‘Yes, at the very least. I wouldn’t want to wait any less than that. The ghouls seem to turn in a matter of hours if young Aaron is anything to go by. But the transition to zombie-state takes place over the course of a day or two, depending on the patient, severity of the bite and proximity to major blood vessels. The ocular infection…it’s closer to the brain, so perhaps it’ll work faster. Still, even if nothing more presents in the next couple of days, we should keep them under close observation until the ABC clears up.’
Speculation out of the way with, we commenced with the backyard autopsy. We might have had some of the same tools, but the environment was very different to my last one. Gone were the sterile tiles and stainless steel table. Instead, we made do with the cobwebby shed and a worktable that still smelled like sawdust.
There was a touch of old-timey autopsy about that smell, reminding me of the operating theatre at County, or rather, what it must have been like a hundred years ago. For those public procedures, sawdust was often laid under the floorboards or spread around before the procedure, to soak up blood and other bodily fluids. I remember reading about it at a museum back in Linkoln, dragging my father around, blocky old school cell phone never far from his ear.
The scalpel bit through the ghoul’s skin with a touch more resistance than I’d have expected. The body was long dead, so there was no welling of blood, just a line of dark red traced by my blade through mottled grey skin.
We gained access to the stomach by sawing through a couple of ribs – no electric saw this time, we used a fucking coping saw. This wasn’t a complete, proper autopsy so we weren’t going to do the thoracic extraction, just get to the good stuff and confirm my little theory. We didn’t even have to do any paperwork, which was great – though I should really be recording my findings.
I wondered if someone could lend me their dictaphone, but they’d probably rather I use my fingers.
Took Claire a second to get the joke as well.
The ghoul’s internal organs were in a state of slight decay. No pinks or reds were present on the colour palette, just greys, brown and a tinge of blue. It was less like looking at the inside of a person, and more like a bucket of offal around the back of a butcher’s shop. Somehow, that made it even worse. Then there was the smell.
‘Gods, that’s foul!’ I cringed.
I had to take a step back for a moment, reeling from it. We couldn’t exactly open the door, in case someone came walking by and got an eyeful of what we were doing. Fortunately there was a sliding window along one wall, and we took advantage of the fresh air and garden view for a moment, before getting back to it.
No doubt Dr Grey would have been in his element right now, but even my stomach has its limits, and you don’t go into paediatrics because you like cutting into bodies.
Once we had eyes on the stomach, we sutured it to prevent leakage and snipped it out of situ, placing it on an old oven tray which our colleagues had commandeered from Rob’s kitchen. There was a pang of guilt that it was not going to be used in whatever delicious meal was being cooked up, but it filled a higher purpose now.
We emptied the stomach out onto the tray, holding our breath, and moved over to the window, where there was a little more air. There wasn’t much chance of anyone seeing us poking at the contents, as the window faced over Rob’s garden and everyone was too busy with their own work to be relaxing on a deck chair.
‘Meat.’ Claire said, shoving a bite-sized morsel around with her scalpel. ‘I’m going to say unidentifiable, but we can all have a good guess.’
I nodded. ‘Does it look partially digested to you?’
‘Yes.’ Claire said, ‘From what I remember of my rotation with Doctor Grey at least, and I’m going back to when I first started on at County General. But if you make me swear to it, I would. This meat was being broken down by the digestive process.’
‘That shouldn’t happen,’ I said, shaking my head, ‘when I was talking shop with Yanis he said that the infected had no stomach function, they couldn’t digest what they were eating, they’d just keep going until something ruptured. Even then, they wouldn’t stop.’
‘Digestive function might be shut down in the more common infected, the zombies and the runners, but in a ghoul? Perhaps it’s retained. Like you say, more of the brain is intact. Why not more of the body?’ she suggested. ‘They’re certainly lighter on their feet than the zombies, and more physically coordinated than the runners.’
‘You’re probably on to something there. But what does it mean?’
Claire looked back down at the tray. Her turn to theorise.
‘Alright. Let’s see…the ghouls will have access to nutrients the zombies don’t. Biologically speaking, they should be able to heal damaged cells and grow new ones, because they can actually process the proteins they’re consuming.’
‘There was evidence of tissue remodelling on the basement ghoul, that’s what Yanis said.’ I added, ‘I wouldn’t really have known what to look for.’
‘On the wound to the throat? That would definitely mean it began to heal the damage after he died as a human, and was reanimated as a ghoul. But that can’t have been a significant period of time, not long enough to have noticed remodelling. Unless…’
‘Oh fuck me.’ I said, closing my eyes. ‘Does that mean…?’
‘Accelerated healing,’ Claire said, holding up a finger as the lightbulb over her head switched on. ‘Nothing superhuman, a wound wouldn’t heal before your
eyes, but they’d certainly heal faster than a human could, and healing of any kind is not something that a regular zombie is capable of at all.’
I sighed, keeping my eyes closed as I processed.
‘One problem at a time. That’s blood isn’t it? Traces at least. Stomach fluids shouldn’t be that red.’
‘It’s not unheard of,’ Claire said, ‘but this is my area just as much as it’s yours. I can only make an educated guess, and from that, I’d say we’re looking at blood in the stomach. Does that confirm the theory?’
I nodded. ‘I’m satisfied at least. Yanis would say it’s too small of a sample size to confirm, but I’m sure enough for now. Blood in the mouth, in significant quantities at least, will turn you into a ghoul. Not sure about blood splatter from regular zombies. Our info-pack says you’ll be infected, but if the medical board knew that much, then they’d certainly have known about ghouls too, and from the sounds of it, they were considered a rare, unproven, aberration.’
‘Maybe you can only become a ghoul if you drink the blood of a ghoul?’ Claire suggested.
‘Would that make any sense?’ I asked.
‘Does any of this?’ she said, waving a hand at the body. ‘Viruses mutate to cross the species barrier, and strains of influenza constantly mutate as they pass from person to person. The strain of the virus present in a ghoul may be more potent than the one present in more common undead.’
‘So as well as the method of transmission having an effect on the subject, the carrier doing the transmitting might too?’
‘I really wish this Dr Lines were with us right now.’ Claire said.
‘Me too. Or just anyone from the CDC. This isn’t the A&E, and it isn’t paediatrics. I’d kill for a specialist consultant right now.’
‘Dr Lines might still be alive. We only got split up in traffic.’
‘Doubt he’s going to find his way here though. Maybe we’ll see him again in Sydow, if we make it.’ I added with a dark little laugh.
The Suburban Dead (Book 2): Emergency Page 26