by Howard, Bob
The plane was overbooked, and there were so many people crammed inside it that Salem was sure they were selling standing room. For once, though, he was almost grateful because the man who was shoehorned into the seat next to him was grossly overweight and definitely overcooked. He was sweating more than Salem, and the smell made Salem feel nauseous. Despite becoming claustrophobic and sick to his stomach, Salem was invisible to the other passengers because he was pinned against the window. He just had to keep from throwing up.
The first leg of the flight was short because of a layover in Miami, and it felt like the plane was landing as soon as it had taken off. Salem started worrying about getting through customs as soon as the plane stopped at a boarding gate. Getting out of South America was easy compared to getting into the United States, but as it turned out, his new friend in the seat next to him was all the distraction he needed. A little oversight involving a package of white powder in the man’s carry on bag was enough to take all of the attention from Salem. It was neatly wrapped up inside his spare underwear, and he no doubt thought the customs agents would avoid those unsavory items. He was wrong, and Salem passed through customs without problems. He was careful to stand up straight and not to touch his hot, sweaty forehead. He also reversed his tactics and tried to make eye contact with everyone. It hurt to look at people, but he succeeded in making them avoid his gaze.
Rather than running the risk of offending someone by getting on the next flight, Salem decided to rent a car and drive the rest of the way. The young woman at the rental counter carefully pointed out that there was a penalty if the car wasn’t clean when it was returned. Salem thanked her for bringing that to his attention, but he was already thinking about making yet another change in his plans.
He really should have asked her where he could find the nearest hospital, but he didn’t think his fever had anything to do with his headache, and he didn’t think his headache had anything to do with his hands. Instead of the hospital, he made a mental concession and asked where he could find a hotel. Maybe a long shower and some sleep would make him feel better, and he could quit worrying about what people were thinking. The woman couldn’t resist the obvious answer.
“This is Miami, Sir. You won’t have to go far to find a hotel.”
Salem learned that she wasn’t kidding because hotels were everywhere around the airport. He checked into the first one he came to, and thirty minutes later he was filling the bathtub with hot, steaming water. He wasn’t sure he could stand up as long as he needed to take a shower, and the idea of soaking was too enticing. He sat on the toilet and peeled away the bandages on his hands. That was when he discovered that it was the smell of infection he had mistaken for body odor. The skin came away in sheets with the bandages, and he almost screamed from the pain.
When he finally stopped sobbing, he forced himself to move his swollen and cracked fingers enough to undress. He held his hands in front of his chest like a doctor who had just finished scrubbing up for surgery and stepped into the hot water. His fever made him shiver with chills as soon as he had both feet in the tub, and he couldn’t wait to get the rest of his body warm. His mistake was in thinking that would include his hands, and he let them both drop to his sides in the soapy bath.
This time he did scream, and the pain surpassed anything he had ever known. The shock combined with his fever caused him to pass out, and for good measure he hit his head against the side of the tub just before he slid under the surface of the water.
******
The housekeeping staff found Salem Townsend the next day. He had been in the tub for at least fifteen hours, and the preliminary cause of death was listed as drowning under extenuating circumstances. To the Medical Examiner that meant it was being investigated for foul play due to the trauma on the side of his head. The police also wanted the forensics staff to determine what had happened to his hands. The official report said it appeared as if he had put his hands into a paper shredder.
It didn’t take the police department long to put together their case. His passport and drivers license gave them everything they needed to know about who he was and where he was from. The letters in his personal belongings meant they would be contacting his next of kin for positive identification, and flight information told them where he had come from. They had a wealth of information to work with, except for one thing. No one had ever seen injuries like those on the man’s hands.
The Medical Examiner had been identifying injuries for almost thirty years, and he wanted to believe the deceased had mangled his hands in some form of machinery, but he couldn’t find the pattern that always gave away the type of machine. Machines operated at high speeds, and they inflicted injuries by repeatedly striking the same body parts before the victim could withdraw. In this case, the hands didn’t appear to be crushed, so they had most likely been withdrawn, but the puncture wounds were too random for them to be made by a machine.
It was one of the uniformed officers who had arrived ahead of the Medical Examiner who provided the observation they needed. He recalled a tragic accident involving a man who had ignored warning signs about alligators. He had his arms extended outward over a pond of water when an alligator grabbed his hands. The man’s friends had rushed to his rescue, grabbing him around the waist and pulling as hard as they could. They got him free, and he kept his hands, but they were torn beyond repair.
Armed with this observation the Examiner asked his associates if they would agree that animals had caused the injuries. He sent photographs to friends and colleagues around the country and asked for opinions. Ironically, a pathologist at the Medical University of South Carolina in Charleston recognized the injuries first. It was ironic because it was already known that Salem Townsend was returning to his home in Charleston when he had checked into the hotel in Miami.
Dr. Grace Williams at MUSC compared the photographs to pictures taken at a recent autopsy of a man who had drowned near Myrtle Beach. His body had been in the water for over four days, and the blue crabs had gotten to him. The difference between the two cases was that her victim had the same puncture wounds all over his body, but otherwise she was sure it was the same wound.
When the identification of the wounds arrived from MUSC, the Miami Medical Examiner had just received the toxicology reports. It was unfortunate that the victim had soaked in a bathtub overnight because the hot, soapy water had cleansed the wounds very well. He would have preferred to see them in their worst condition in order to know how long ago the injuries had occurred. He had also expected to find bacterial infection present in the wounds, and tissue samples confirmed his suspicions.
Something else caught his attention in the lab reports. He sifted through the file that had grown impressively fast and found what he was looking for in the forensic interviews. They were almost duplicate entries, but from separate examiners. He had to wonder if it was likely that a man studying a species of crab-eating fox would be severely injured by crabs. He guessed it was possible if the man somehow got too close to the food supply of the foxes.
Cause of death was still listed as accidental drowning, and the extenuating circumstances were described as severe lacerations to the hands inflicted by South American crabs. The Medical Examiner included an observation that it appeared possible that some of the tissue around the puncture wounds had been exposed to necrotizing fasciitis, otherwise known as flesh eating bacteria.
The Examiner recommended that the findings should be forwarded to the CDC, but in the bureaucracy of his office it wasn’t unusual for paperwork to be buried by more pressing issues, and he would never know that the file wasn’t forwarded to the CDC as he had instructed.
******
Over the next few days there were a series of deaths that were not known to be connected to Salem Townsend until much later. The customs agent in South America had a raging fever and died after several days of burning agony. His wife didn’t tell anyone about the terrible sores he had developed on his back, and no one suspected
anything more than just another viral infection that wasn’t treated early enough. The coroner in the small South American city had never personally encountered flesh eating bacteria, but he was aware of it, and he would have been alarmed to find the victim was suffering from both viral and bacterial infections.
It wasn’t until the coroner in Des Moines, Iowa notified the CDC of a man who had died from an unidentified viral infection that the pieces started to come together, but the missing files and delays in reporting caused them to be slow to respond with efforts to quarantine people who had been in close contact with him. His morbid obesity was thought to be the cause of his inability to fight off an infection, but they didn’t find the bacterial infection until the autopsy. It was also not documented that he had recently flown from South America to Miami.
The red flags started flying when the Medical Examiner in Miami was hospitalized due to a high fever, dehydration, and virulent sores at random locations on his body. The forensic interviewers sent by the CDC reviewed his recent cases and quickly discovered the unreported case of the man with mangled hands. They traced the path he had followed and started locating passengers who had been on the plane with Salem Townsend. They also placed the young woman from the car rental agency in quarantine.
Before the connections were made that led back to the crabs on the banks of the Essequibo River, over a hundred people were either directly or indirectly exposed to the infections carried by Salem Townsend.
The Decline Begins
Kamarang village sits near the border of Venezuela in Guyana but is in disputed territory claimed by Venezuela. Despite its remote location, it boasts a small hospital and an airstrip, and is not as cut off from the rest of the world as most villages in the region. Routine flights are made to Georgetown, Guyana less than two hundred miles away on the coast of the Atlantic Ocean, and tourists who are willing to forego amenities find their way to Kamarang in search of cheap souvenirs.
Sheleza Persaud had been the head nurse at the small hospital for twelve years, and during that time she had never seen a more curious illness than the symptoms displayed by the young man who had stumbled into the waiting room three days earlier. She had seen fever, infections, weeping sores, and all manner of injuries caused by contact with wild animals, but what had happened to the unidentified man was still a mystery.
She had been on duty when he literally fell through the front door. A patient who was leaving had pulled it open from inside just as the young man appeared to reach for the handle on the door. The patient was apologetic and had attempted to keep him from falling but was unable to stop his momentum. To everyone’s surprise, the young man tried to bite an orderly who had rushed to his aid. A wrestling match had ensued in which a guard helped the orderly overcome the man but not before both of them had sustained bites to their hands and forearms.
The man had been strapped to a bed behind privacy curtains away from the other patients, but all eyes were nervously watching those curtains where the man could be heard struggling against his restraints. An eerie sound escaped his lips in a continuous moan as if he didn’t have to take breaths of air. The doctor on duty concluded that it would be better to ease the nerves of everyone by having the man sedated, so he ordered a morphine drip. The needle was taped to the back of the man’s hand and the drip started, but to their dismay the clear liquid wasn’t being drawn into the vein.
Sheleza had no explanation to give the doctor when he asked her if she had inserted the intravenous device properly. She told him the resistance she felt as the tip of the cannula slid into the vein felt unusual, and no blood had escaped into the line when she opened the valve. When he asked her what was so unusual about it, she said it was like the vein was filled with very thick blood or mud.
Dr. Michael Khan had only been in the small hospital for a year, but he was well known by doctors in Georgetown and respected for not quitting when he encountered problems.
“Nurse Persaud, draw a blood sample from another location and send it to the lab. Let me know as soon as the results are back.”
Sheleza gave him a nod and prepped a syringe to draw samples. Without being told how many, she decided that four vials would be enough. Dr. Khan went to see how the security guard and orderly were doing. The rapid onset of their fevers was disturbing. He found them in separate rooms and was surprised by the rapid deterioration of their respective conditions. Both had fevers and were sweating profusely. Their pupils were dilated, and neither were responsive to questions. He checked his watch and saw it had only been fifteen minutes since he had last spoken with them, and at that time both were responsive. It was less than an hour since they had been bitten.
As a precaution, Dr. Khan instructed the staff to put restraints on both men and to draw blood samples. Sheleza met him as he was coming out of the quarantine area and told him she had been unable to draw blood from the first patient, and he suspected he would not have been able to draw a sample from the other two if he had waited much longer.
It was against hospital protocol, but he went to his tiny office where he picked up his phone and put it to his ear. He used his other hand to flip through an old Rolodex to the number for the Centers for Disease Control in the US. He knew he was supposed to notify Georgetown Public Hospital, but he had a feeling that time was important, and he couldn’t afford to wait for approval to call the CDC.
CHAPTER TWO
Where We Were
Six Years After the Decline
It had become a popular insider joke at Fort Sumter. If you were an insider, you knew what it meant. If you were new, not an insider, no one would tell you what it meant until you proved yourself successful on a supply run. Of course, being successful on a supply run meant more than finding supplies or coming back alive. It also meant you didn’t get someone else killed.
The question would always come up when a new survivor was discovered. As strange as it seemed at times, our scouting groups were always finding one or two people hiding in a building, perched in a tree, or sleeping in an abandoned vehicle. Most of mankind was gone, but here and there individuals managed to keep from being bitten and somehow found enough food and clean water to last over six years.
“Where did you want to be when it started?”
That was the question. This time it was Jean who was asking a new couple. They were sitting in the main dining hall eating something that resembled a pot pie, but it was cooked in a crock that was just big enough for one serving. It was the standard first meal that was given to survivors, and the only thing that slowed them down when they started to eat was how hot it was. Turkey, ham, Swiss cheese, cheddar cheese, and an onion broth baked inside a crust. It had come straight from the oven to their table, and both the man and woman were already wide eyed in disbelief at the quality of the food.
Jean gave them a moment to let the question sink in then asked again, “Where did you want to be when it started?”
They kept eating, but the question always got the same reaction. Most people repeated it word for word with emphasis on ‘want’.
Of course it was all a setup, and for the life of me, I don’t know how it got started. Over a mouthful of the delicious food the woman told Jean she wanted to be anywhere except where she was. That was actually a better answer than we usually heard. If they weren’t repeating the question back as if they hadn’t heard it correctly, they were usually saying where they had been when it all started.
Jean said, “You didn’t have some place you wanted to be when it started?”
People who hadn’t taken a real bath in months or years, people who hadn’t eaten an oven baked meal in years, and people who hadn’t felt safe for years didn’t dwell on where they had wanted to be on that first day. Somehow they had only fixed in their minds where they had been, and when they ran into other living souls, that’s the information they traded. Where they had been, not where they wanted to be.
The man fell for the setup first.
“Why, where did you w
ant to be?”
“With Ed.”
Jean stood and left the table before either of them could get an explanation. I heard the man ask the woman, “Who’s Ed?”
I hadn’t met them yet, so they didn’t know I was Ed, but even if they had known who I was, they wouldn’t have known why everyone answered the question the same way.
The truth was that I had turned into somewhat of a folk hero by the joke, and I guess that’s what kept it going. It wasn’t a funny joke by any stretch of the imagination, and it wasn’t meant to be, but it was the only sensible answer if you were an insider. On the day it all began, anyone with any sense would have wanted to be with me. I was the one who had a shelter. I was the one who had enough supplies to last for years and had a shelter that could protect me every day of those years as long as I stayed inside. If I had stayed inside, I would still be safe, and I wouldn’t have put a dent in the supplies. But if I had stayed inside, it was likely that the dirty, starving man and woman eating their hot food only a few feet away wouldn’t be here. None of them would be.
I had inherited the shelter from a man I called my uncle, but the relationship was more complicated than that. We were mostly related by the way we thought, as uncle Titus liked to say.
Titus Rush had become rich over the years, but you wouldn’t have known it to look at him. His long gray hair tied back in a ponytail was a trademark on him. He always needed a shave, and relatives joked that he was born with a bushy mustache, but none of them ever gave him credit for his keen sense of humor and incredible genius. I did, and that’s why he left everything to me.