Freddie reared back to deliver another blow when he heard a commotion behind him. A quick turn of his head, some movement in the corner of his eye, and that was when he felt a sharp burning sensation at the back of his neck. His entire body seized up, like his brain had issued his muscles a lockdown order, and that was when the world went dark.
INTERLUDE
From Selected Twitter Accounts
Hashtag #Flu
August 6
1:16 p.m. to 1:18 p.m. Eastern Daylight Time
@RoseLover: Worried about my neighbor. He was c/o #flu symptoms yesterday. Ambulance came today. Hope he’s better soon! #bronx #influenza
@AbbyWeinstein: I live in the #Bronx. A LOT of my neighbors are really sick. Maybe #flu?
@NYHotMama: Boss is sick with #flu, got to leave work early! #Booya! #philly
@BigRigger: This #flu’s hitting me hard. Scheduled to head out on long haul 2morrow. Wish I could rest up, but gotta work.
@GoYanks55: Feel like sheeeeeit. Thought it was too early for #flu season! LOL!
@LovePS3: Summer school cancelled this afternoon ‘cuz Teach is sick with #flu! Hellz to the yeah!
@TomZapata: #Doctors out there? Saw a weird strain of #flu-like illness in Queens last night. hit me w/ @ reply if you’ve seen it.
@BlogginBobby: RIP, Carl Hubbard. My uncle died today of the #flu. Came out of nowhere.
#
From CNN’s Facebook Page
August 6
3:31 p.m. to 3:33 p.m. Eastern Daylight Time
CNN is tracking a possible outbreak of influenza in the Northeast. Do you or does someone you know have the flu? Leave a comment!
Thuy Beltran
My husband got very sick very fast. We are in hospital. He had fever 106 degrees!
Megan Waddell
I’m an ER nurse in the Bronx. We were slammed overnight with patients. High fevers, pneumonia-type illness. Multiple deaths. Scared.
Eric Martin
I’ve got a terrible sore throat. I don’t feel too hot right now. I’ve been traveling a lot for work. I always get sick after a long business trip!
Michael Horton
I bet the government’s behind it! We’re all doomed! lol
Carolyn Mixon
My brother is a doctor in Philadelphia. He’s worried about this outbreak. He won’t say much. Any doctors out there?
#
From the New York Times, Online Edition
By CLYDE MORGAN
New York Times Staff Writer
Posted to nytimes.com @ 11:59 p.m. Eastern Daylight Time on Saturday, August 7
DEADLY FLU HITTING THE BRONX
THE BRONX – At least three Bronx-area hospitals are dealing with a deadly flu-like illness that has claimed dozens of lives in the past day, raising concern among New York City medical professionals that a novel and lethal strain of influenza has emerged. Calls to the Bronx Health District and the New York State Health Department earlier this evening were not immediately returned.
A physician at one of the hospitals, speaking on the condition of anonymity, reported he had never seen anything like it in two decades as a physician.
“We’re overwhelmed,” the doctor reported. “We just got slammed one morning with patients and it hasn’t let up. Young, old, all races, all ethnicities. I’ve never seen anything like it before in my life. I suspect it’s viral, but that’s a total guess on my part. We notified the state health department and we’re just trying to ride it out, hope it doesn’t get worse.”
The doctor further reported that the hospital has established a quarantine unit in the facility, as there are some fears in the hospital that the illness is airborne. The doctor confirmed that symptoms of the virus include sore throat, high fever, seizures, and internal bleeding.
“This thing is a monster,” he reported. He urged anyone in the New York City area experiencing these symptoms to be examined by a physician.
All three hospitals refused to comment, citing patient privacy concerns.
CHAPTER FOUR
The knocking at the door was firm and insistent, the kind of sharp rapping that said this late-night visitor didn’t really want to be knocking on your door at one-thirty in the morning, but they really had a good reason, and if you could help them out just this one time, they’d be forever grateful. Adam was awake and nursing a scotch, dressed in a pair of Syracuse University lacrosse shorts. He was watching Goodfellas on DVD, about a third of the way through, the scene in which Ray Liotta’s character pistol-whips Lorraine Bracco’s old boyfriend from her snooty country club.
He set down the scotch and remembered he was shirtless. As he looked for his misplaced shirt, the knocking ceased, and he wondered whether his visitor had simply given up, or perhaps, had decided he was banging on the wrong door.
A few seconds later, the knocking resumed, more frantic this time, as if whomever was out there had seen a gaggle of zombies closing in. Screw it, Adam thought, abandoning his search for the shirt. His guest was just going to have to deal with his pale, mealy upper body. Adam stepped out into the corridor and made his way to the front door. He pressed an eye to the peephole and, in the spill of the yellow porch light, saw a middle-aged woman, her eyes wide with panic, repeatedly running her fingers through her long brown hair. Her lips were pressed tightly together. Adam instantly recognized the look on her face; as a physician, he saw it almost every day in the faces of patients waiting for test results. He opened the door a crack, fairly certain this woman meant him no harm (because no one who wanted to slit your throat in the middle of the night knocked first, right?), but just a crack because you just never knew these days.
Adam opened the door, but she didn’t notice. Her head was turned north, and she was tapping a finger against her lips. She wore a pair of green shorts and a grey sweatshirt on this cool night.
When he cleared his throat to let her know he was standing there, she jumped and let out a little scream. When her eyes met Adam’s, she planted a hand over her chest and let out a long sigh, as if she’d been holding her breath for a while.
“Oh, thank God you’re home,” she said. “You’re a doctor, right?”
“Yes,” Adam said. “How did you-”
“The sticker on your car,” she said. “We noticed it the other day.”
“Right,” Adam said, remembering the hospital-issued Physician parking sticker on the rear bumper of his truck.
“My family and I are staying two doors down,” she said. “I’m sorry to bother you so late, but my husband is really, really sick. I called an ambulance, but they said it might be twenty minutes before they can get here. Twenty minutes!”
“I’d be glad to, but I’ve had a few drinks,” Adam said. “You’re probably better off waiting for the ambulance.”
“Please, I don’t care,” she said, her hands clenched at her chest, almost in prayer.
“What’s the problem?”
“He’s burning up, and he’s bleeding from the eyes, ears and mouth.”
“Sure, sure,” Adam said, trying to mask his alarm at the symptoms the woman had just described. “Let me get some clothes on?”
“Oh,” the woman said, the question catching her off guard. “Oh. Yes, of course.”
Adam slipped back inside the house to get dressed, his juices flowing, his mind on high alert, in a good way. He’d been at the cottage for three days, living a primal existence: eating, drinking, sleeping and shitting. His supplies would last him for at least another week, and so he hadn’t had to leave the cottage. He hadn’t bothered checking news or e-mail, because quite frankly, he’d started to enjoy not hearing the same stories reheated like leftovers and spun out to the hungry audiences desperate for another salacious detail about this child murder or that political scandal. He’d been drinking a lot, probably more than he should have, but what the hell – everyone was entitled to a bender every now and again, right?
As he pulled on a shirt and sandals, he considered the man’s symp
toms. Bleeding from one of those orifices wasn’t alarming in and of itself, but bleeding from all three was not a good sign. Before exiting his bedroom, he snagged a pair of latex gloves from a box he kept in the closet.
Adam closed the door behind him and followed the woman downstairs. As they made their way up the road, Adam trailed behind a length. It didn’t seem appropriate to walk side-by-side on this beach road. That was for husbands and wives, boyfriends and girlfriends, families headed for a day by the ocean.
They walked in silence for another twenty yards, and she turned up a wide driveway leading to a large home, her pace quickening as she slalomed around a Toyota Sequoia parked in the carport. The home was set closer to the water than Adam’s cottage, and it provided a spectacular vista of the ocean. The moon was full tonight, a large coin hanging in the inky blackness of space, its shine cutting a long shimmery path across the top of the water. The night was awash in the crash of waves against the beach, just a little bit to their south. By the time they’d made it up to the expansive front deck of the house, she was weeping, her shoulders heaving up and down.
“What’s your name?” Adam asked as she swung the screen door open.
“Katie,” she said. “Katie Sanders. We’re from Annapolis.”
“I’m Adam Fisher,” he said.
“It’s nice to meet you, Dr. Fisher,” she said.
“Hey, we’re on vacation,” he said. “You can call me Adam here.”
This earned a smile, Adam was relieved to see. He had no idea what was in store for him on the other side of this door, but things would go a lot more smoothly if Katie Sanders remained calm.
“Sorry for busting in on you like this,” Katie said. “I just didn’t know what to do. He started getting sick at lunchtime. It seemed like he was just coming down with a cold, and then things just went down from there. I’ve never seen him so sick. I’ve never seen anyone so sick.”
Adam nodded.
“Let’s go on in and have a look.”
#
Adam knew things were bad, possibly even worse than Katie Sanders from Annapolis had feared, as soon as they stepped inside. They were in the kitchen, quiet but clean, bright and awash in fluorescent light. A peninsula-style countertop separated the kitchen from an eat-in area and served as the home base for the array of snacks fueling any good beach vacation. A large bag of potato chips sealed shut with a plastic chip clip that looked like a pair of bright red lips. Two trays of store-bought cookies were stacked at the edge of the counter. A six-pack of bottled water and two bottles of wine.
Despite the home’s outwardly cheery appearance, the air was stuffy and rank, the sweet stench of something that has just turned over hanging thickly in the air. He hated the smell, not because it nauseated him (because it didn’t), but because it meant he had already lost. He knew the smell from his hospital’s intensive care unit, where his patients occasionally ended up and often never left. It was subtle, like a woman’s perfume dabbed on the inside of her wrists, easily missed.
It was the smell of death.
“He’s over here,” Katie said, pointing toward a room around the corner from the kitchen.
Adam crossed through the living room, where two teenagers sat on the floral-print couch. The older one, a girl, had her knees drawn up to her chest and was chewing her nails. Her brother, maybe thirteen, was sitting next to the girl and was staring at his hands. The television was on, tuned to CNN, but the volume was muted.
“These are our kids,” Katie said. “Leigh and Chris.”
Adam nodded toward them. He didn’t see the need to dispense empty pleasantries. They nodded back, in simpatico with Adam’s desire to remain silent.
A pathetic moan from the bedroom broke the silence. The girl drew her knees in even more tightly, as if she was trying to make herself disappear, and tears began streaming down her face. The boy sat stone still, his eyes down, his hands folded on his lap.
“Is he going to be okay?” the boy asked, never looking up from his hands.
“I’m here to help,” Adam said. He had not answered the boy’s question, defaulting instead to a weak platitude that didn’t mean a whole hell of a lot. He didn’t know what else to say. Maybe something stronger, a potent elixir of encouragement that would have eased these kids’ worrying, but he couldn’t bring himself to do it.
“Doctor?” she said softly, dipping her head toward the closed bedroom door.
She rapped twice on the door, and called out: “Terry? Honey, I’ve got a doctor here to see you.”
She swung the door in toward the bedroom. From his vantage point at the threshold, Adam could see a figure prone on the bed, buried under about ten blankets. The odor was stronger here, a sourness in the air. Adam pulled on the latex gloves and approached his patient.
“Terry?” Adam said, sitting on the bed next to the man. “I’m Dr. Fisher. Your wife says you’re slacking off on the chores, wants me to make sure you’re actually sick.”
The man did not respond, but it did draw a half-chuckle, half-sob from Katie Sanders. It never ceased to amaze Adam. No matter how dire, how bleak things were, a well-placed joke mocking the crappy situation in which his patients and their loved ones found themselves often bonded them to Adam. It seemed a little phony to Adam, but he could not deny it reinforced the doctor-patient relationship like concrete rebar.
Adam peeled back the blankets far enough to expose the man’s face, and a chill ran up his spine when he saw it. Terry Sanders was bright, almost shiny, with fever; Adam could feel the heat radiating from his body, as if he were standing too close to a hot oven. Blood had caked around his nostrils and his ears, and it was trickling from the corners of his mouth. It gave him a horrifying visage. Older blood had dried and caked to a rusty brown on the pillowcases. Adam ran his fingers along the underside of the man’s jaw and found the glands to be badly swollen, like the spine of a wet paperback book. His cheeks were sunken, and his eyes were cloudy. The man had clearly developed some sort of infection, but that diagnosis was about as specific as saying that the man was sick. Without tests, there was no way to know whether the infection was viral, bacterial or fungal. Hell, it could have been a case of severe food poisoning.
“Mr. Sanders?” Adam called out, loudly and firmly. “Can you hear me?”
Terry Sanders was curled up in the fetal position, his face turned upward toward the ceiling. It looked tremendously uncomfortable, but he didn’t seem to care, which only underscored the level of misery the man was experiencing. Adam touched the man’s forehead with the back of his hand and jerked it away. The man was roasting with fever; Adam would have gambled his medical license on a reading of at least 105 degrees, a terrifying reading for an adult.
“When did you say he started getting sick?” Adam asked as he continued to examine Terry Sanders. He didn’t look up at Katie because he didn’t want her to see the look of hopelessness he was certain was plastered across his face. To keep himself busy, he checked the man’s pulse, which was weak and erratic, like a radio signal from deep space.
“Let me think,” she said. “Lunchtime. He mentioned he had a sore throat, chills, that kind of thing. He napped most of the afternoon and evening, and then he started coughing up blood about an hour ago.”
Adam did the math. Twelve hours from the onset of flulike symptoms to death’s door. He racked his brain, trying to remember what he knew about infectious diseases from medical school and the random conference where he was trying to catch up on his continuing education requirements. This wasn’t his specialty.
“Anyone else sick?” he asked.
“I don’t think so,” she said, her voice growing louder with each successive word. “Is it contagious? What’s going on?”
“I’m just asking right now,” Adam said. “First things first. We need to try and get his fever down a little. It’s not good for it to be this high.”
“Why is he so sick? What’s wrong with him?”
Adam took a deep breath
and let it out slowly.
“I don’t know,” Adam said. “I need you to get me a wet washcloth. Cool water. Not too cold. We need to bring it down slowly. And some ibuprofen or Tylenol.”
“I gave him some Advil an hour ago.”
“Jesus,” Adam whispered to himself. “Any antibiotics in the house?”
She shook her head.
“The washcloth, then,” he said.
Katie Sanders nodded, pressing a tight fist against her lips and closing her eyes. Adam could tell she was trying to keep her wits about her even as her psyche was fracturing like glass. She left the room, leaving Adam alone with Terry Sanders. He could hear a brief discussion in the living room as the children sought a status update on their father.
Adam took in the room while he waited for his putative nurse to return. It was a standard beach cottage bedroom, sparsely furnished with a rarely used chest of drawers and a flat-screen television mounted in the corner. A penciled rendition of a Holden Beach map hung over the bed.
He checked on the patient again, pressing the back of his hand against Terry’s cheek. Still scorching hot, like the man was chewing on a lit match. Adam couldn’t recall ever encountering a patient with a fever this high. As he pulled his hand back, Terry started seizing, as if his whole body was experiencing a massive internal earthquake. Adam gently rolled him over onto his side and held him there as his body quivered and heaved, flopping around like a fish in the bottom of a boat. It stretched on interminably. In all his years as a physician, Adam had never seen a seizure go on for so long, had never seen one so violent. Finally, mercifully, it ended, leaving Terry Sanders on his back, his eyes open and glassy and staring at the ceiling.
The Immune Box Set [Books 1-5] Page 4