Brooke looked at him like he was out of his mind. “Alan, he’s getting a bone marrow transplant. The last thing in the world he needs to do right now is go camping.” As an afterthought, she added, “Besides, I have the Black and White Ball to go to next week. I haven’t even bought a dress.”
Alan tried to understand. They’d been a camping family a long time ago, back before the inheritance, before the Wheeler Foundation, before he had assumed his role in the family corporation. A long time ago, they’d been an entirely different family. He’d been an environment attorney whose goal had been a better world. Or at least, a cleaner one. And she had helped out at the soup kitchens, even though it had seemed like an odd fit. But then came the money, and with the money, the obligations. He understood that, but a small part of him wondered how their once-strong convictions had been corrupted so thoroughly. He now drove the gas-guzzling luxury car he’d once mocked, and the environmental law of his youth had morphed into the corporate maneuverings of a major energy concern.
He looked up at his wife. “Don’t you remember those years? When we used to go camping? As a family?”
Brooke smiled. “When we were too poor to afford a real vacation? Sure, I remember.” She sipped her wine, her manicured nails wrapped elegantly around the glass. Her mood seemed surprisingly good. “I’m glad we have a few more options now.”
Alan looked at her, searching for the woman who had once reminded him of a young Ali MacGraw. He wasn’t sure what he saw now. He heard his voice again, responding to her, but it seemed like it was a long way away.
“What did you say?” Brooke said, a puzzled expression on her face.
“I was just saying, do we really have more options now?”
Tom Hodis peered silently through the small window into Jenna’s isolation room. Susan knew the old researcher regarded all the medical students and residents as his own children and felt their suffering keenly. She decided to leave him alone with his emotions.
She crossed to the nurses’ station, where Ezra was on the phone. The ID fellow hung up when he saw her.
“The blood culture results from Muller came back,” he announced. “He had drug-resistant Yersinia pestis, just like that case up at UCSF.”
Susan stared at him. “But how? Lake Tahoe’s five hundred miles away from Arrowhead.”
“Maybe there was a common vector.”
“No flea can fly five hundred miles, Ezra.” Susan said.
Hodis walked up. “Fleas don’t fly. They jump. What are you two talking about?”
“The drug sensitivities came back on our Arrowhead patient. He had drug-resistant Yersinia pestis, just like that kid at UCSF.”
Hodis glanced back at Jenna’s isolation room and said softly, “That’s bad news. We’d better notify Public Health.”
Ezra was already dialing.
Later, Hodis, Ezra, and Susan sat in Hodis’s office, eating a makeshift picnic that his secretary had ordered.
“I called Helena Wang’s office this morning to let her know about our patient, but she’s still in Washington at the infectious disease conference. I spoke with one of her fellows, Jim Carson. He said the plague case died yesterday.”
“No shit?” said Ezra, around a mouthful of pastrami on rye.
“They’re taking prophylactic antibiotics up there, which I don’t think is such a bad idea for you two, since you were exposed to both the Arrowhead case and Jenna.”
“So was Andy, our med student,” said Susan. “But what’s the point of prophylactic antibiotics if the sensitivity panels show resistance?”
“The CDC recommends it,” Hodis said, as if this were reason enough. “More importantly, though, I trust you used good isolation precautions around our plague patient.”
Susan shook her head. “Jenna told me that she wore a mask around him the whole time. I don’t get this.”
“Maybe she doesn’t have plague. Maybe this is just a very bad pneumonia.” Ezra wiped crumbs from the front of his shirt. A small dollop of mayonnaise rested on the angle where his chest ended and his belly began, and he dabbed at this with a paper napkin, leaving a quarter-sized oil stain behind. “It wouldn’t be the first time a resident got pneumonia.”
“Do you think we need to go into quarantine?” Susan asked.
Hodis shook his head. “I don’t think so, Susan. Your main worry is your contact with Jenna, but you last saw her the day the Arrowhead patient died. Even if she’d already been infected, she wasn’t contagious yet. The incubation period for pneumonic plague is one to three days. By those calculations, you and Ezra are free and clear.”
“We need to find out who Jenna was in contact with while she was infectious. Those people are the ones who really need quarantine.”
“Public Health takes care of that,” Ezra said. “Besides, we don’t even know what she has yet. The last thing we need to do is panic.”
Hodis nodded. “Let’s let the Public Health people decide whether to put anybody in quarantine while we wait for the blood culture results to come back. Ezra’s right. The last thing we want to do is jump the gun.”
Ezra was pulling open a bag of chips, his pastrami and rye gone. Susan stared at him in amazement before looking down at her half-eaten sandwich. Hodis’s sandwich was still on his desktop, untouched.
“Multi-drug-resistant Yersinia pestis. How likely is that?” Susan asked.
“Antibiotic-resistance, as you know, is pretty common now,” Hodis said. “But resistance to the number of antibiotics that this Yersinia pestis is…that’s uncommon. Frankly, I’ve never seen it before.”
Susan shook her head in dismay. “How are we going to stop plague without antibiotics?”
“Prevention,” Hodis said. “We’ve got a vaccine. And we know a lot more about sanitation than they did back in the Middle Ages. We know what the vectors are. We know how to control those vectors.”
“Think about it,” Ezra said, balling up his empty potato chip bag. He tossed it at the garbage basket in the corner. “They didn’t have antibiotics in the Middle Ages, and they had lousy sanitation. Not everyone died.”
“Only a third of the population, Ezra,” Susan cried. “Are you nuts?”
Ezra turned to Hodis. “See? This is why we can’t go releasing this information to the public. Susan’s a doctor, and even she is panicking.”
Susan felt her face flush. She glared at the ID fellow.
“Susan’s not panicking,” Hodis said, ever the diplomat. “She just knows this is a serious issue. Jenna’s her friend, and she’s in trouble.”
“Well, Public Health better get on top of this, or else it won’t just be Jenna in trouble,” Ezra said. “It’ll be all of us.”
Hodis’s voice was firm. “They know their job, Ezra. We’ve got one documented case here in LA. That doesn’t make an epidemic. This is the twenty-first century. We’ll control this.”
Seven
George Mack and Tyrone Hayden met out at the Evergreen Club Lodge, or at least as close to it as they could get. Placer County had erected a temporary chain link fence around the building. Now, with the inn’s windows sealed off and plastic wrap covering the door, the lodge looked like a haunted gothic mansion.
It gave Tyrone Hayden the creeps. Almost as much as the fat man with the cigarette dangling out of his mouth in front of him.
“Turn the damn thing off, would you?” Mack snapped, when Tyrone held out a microphone. “Get the back story first, for Christ’s sake.”
If Tyrone was put out by this, he didn’t show it. After seventeen years behind the news desk, he was used to difficult interviews.
He turned to his cameraman. “Go get some footage of the lodge. I’ll get the back story.”
The cameraman turned to go, his camera on his shoulder. Mack called out after him, “Watch out for the squirrels!”
Tyrone was certain the fat man enjoyed the look of unease on his cameraman’s face, but again he said nothing and watched silently. His cameraman moved tow
ard the lodge, his gaze scanning the ground quickly, undoubtedly looking for the squirrel that would be his death sentence.
“How many so far?” Tyrone pulled out a narrow spiral-bound notebook and flipped the cover open.
“Six cases here. Two more in Los Angeles.”
“That’s a lot, isn’t it?”
“Not really,” Mack said. “We get upwards of fifteen to twenty a year in the US.”
“But that’s the whole year,” said Tyrone. “It’s only May. And you’re saying we already have eight cases?”
Mack shrugged. “There’s no telling how these things shake out. We may not get another case for the rest of the year.”
The reporter wasn’t buying it. “I understand that plague is a seasonal thing and that there are typically more cases in the summer. If that’s the case, then this could be the beginning of a terrible epidemic.”
Annoyance flashed in the county health director’s face. “Look, Tyrone. I know your goal is ratings, but there’s something bigger at stake here. Yes, this isn’t usual, but it’s a far cry from an epidemic. And that’s where you’ve got to show some journalistic balls.” He pierced the reporter with a steely glare. “Don’t go starting a panic. That’s the last thing we need. We’ve definitely got a problem. Some people have died. But we’ve got a handle on it.”
“Is the CDC involved?”
“Yes.”
“Why are they covering it up?”
“They’re not covering it up,” Mack said. “But it’s a situation that has to be handled very carefully.”
Tyrone gave him a wary look. “What exactly does that mean?”
“I want you to play the good guy. I want you to educate people. I want you to spread the word. What I don’t want is for you to scare the people into a fucking panic, got it?”
They measured each other with a long stare. Tyrone spoke first. “It’s bad, isn’t it?”
“Yeah,” Mack said grimly. “It’s bad.”
The dead ground squirrels were getting so numerous that John Harr momentarily thought of calling the Department of Fish and Wildlife. He figured something other than drought was killing them, maybe pesticides or some other poison, but his cattle were fine, and he hadn’t seen any other dead animals. It didn’t make sense.
He scratched his head, weighing whether it was worth it to bury the dead squirrel at his feet. Sure, Gage wouldn’t find it if he buried it, but god knew it seemed like there were a thousand other dead animals lying around the high desert, enough to make even a vulture feel sick.
Harr shrugged and headed back to the truck. It was hot out, and sweat trickled down his back. Like most ranchers, Harr wore jeans and a long-sleeved shirt, regardless of the weather. He pulled off his hat, dragged his sleeve across his forehead, and squinted at the dog lying in the back of his pickup.
“Gage,” Harr said, scratching the dog’s neck. “What’s the matter? Sun getting to you?”
The dog looked up listlessly and then let his head fall back against the truck bed. A kernel of worry took root in Harr’s gut. Heat or no heat, this wasn’t like Gage. Harr rubbed a slow hand over the dog’s head and peered into his eyes. The German Shorthair lay there, panting.
Just then, a movement caught Harr’s eye. A tiny speck leaped from the dog’s pelt to Harr’s sleeve. He swatted at it, trying to brush the bug from his shirt. Several more specks sprang from Gage’s fur.
“Jesus, Gage. No wonder you feel lousy,” Harr said irritably. “You’re covered in fleas.”
Gage gave no sign of having heard. The dog lay pitifully on his side, his eyes staring straight ahead.
Harr regarded the sick dog for a moment and made up his mind. “All right, old buddy. We’re going home, and if you’re not better by tomorrow, it’s off to the vet with you.”
He threw the shovel into the back of the truck and climbed in the cab. He started for home, the dead squirrel long forgotten.
The sight of Jenna on the ventilator sickened Susan. Jenna’s face was inanimate and waxy, and the twin flesh-colored pads designed to protect her skin from the straps of the breathing tube didn’t prevent them from cutting into her swollen cheeks.
Once again, Susan marveled at how unrecognizable people became when they were unconscious. The animation of their faces disappeared, the force of character that so defined them suddenly fading away, such that only the wasted shell of their bodies remained.
Tears stung the back of Susan’s eyes. She tried to squash them down, to fight for professional composure, but the water in her eyes coalesced and fell in little droplets that splashed against her wrists.
Everything Brian said about her was true. She was too soft for the business. Not enough emotional distance. But despite his admonitions to toughen up, she could no more harden herself against suffering than she could cut off her foot. She would care until it killed her. And right now, she felt like she was dying, right alongside her friend.
Susan pulled her hair back, slipped into protective gear, and entered the room. She didn’t know where the hell the nursing staff was and why they’d abandoned Jenna in such a state. The poor medical resident lay in a knot of soiled sheets, her uncovered leg at an angle that Susan considered indecent, the bladder catheter visible as it tracked up her thigh. Susan pulled Jenna’s leg straight, covered her with the sheet that was bunched at the side of the bed, and tried to neaten her hair.
And then she sat with her friend, holding her swollen and bruised hand, while the ventilator whooshed breath in and out of her dying lungs.
Hodis’s office was big enough to accommodate Susan, Ezra, and Andy after Hodis cleared the couch of all the detritus he’d allowed to accumulate there. Andy sat on one end, wearing a more haggard look than usual.
“The CDC called me,” Hodis informed them. Every eye in the room was suddenly focused on the old researcher. “They want me to determine the genetic sequence of the bacteria.”
“Why aren’t they doing that in Atlanta?” Susan asked. She knew Helena Wang had asked for Hodis’s help, but the CDC? They had their own labs and specialists.
“Well, first of all, they want to know how this bug is resistant. We won’t know until we sequence it. Maybe there’s a plasmid. Maybe there’s more than one plasmid. I don’t know.”
Ezra looked at Andy. “Plasmids are bits of DNA outside the cell’s nucleus. They can code for proteins. Proteins that can inactivate antibiotics.”
Hodis allowed the interruption and took a sip from his coffee cup.
“I’d like to start sequencing immediately,” he said when Ezra finished. “But I need some help.”
“I’ll help!” said Andy.
Susan couldn’t help smiling. This was more like the Andy she knew. Boundless energy and enthusiasm.
But Hodis wasn’t looking at Andy during all this. He was looking at Susan. Hodis’s gaze was direct, unwavering, and conveyed meaning that Susan couldn’t begin to fathom. She felt a cold wave wash over her skin.
“What’s the other reason?” she asked.
“They want to know its provenance. Haven’t you wondered where this drug-resistant Yersinia pestis came from?”
Susan was puzzled, but Ezra’s eyes glittered with excitement, and he sat forward in his chair. “And not only drug-resistant, but resistant to every fucking antibiotic we have.”
Hodis nodded gravely. “We went from never even having a case of Yersinia pestis with single drug resistance to a Yersinia pestis that is resistant to all drugs? That’s a pretty quick evolution.”
Susan felt a deep and unpleasant pit forming in her stomach. She spoke slowly, “Are you suggesting it’s bio-engineered?”
Hodis lifted his shoulders noncommittally. “I don’t know.”
The temperature in the room seemed to change. A strange chill ran up Susan’s spine. “But surely you don’t think our government would spike a bunch of ground squirrels with antibiotic-resistant Yersinia pestis. It could have been a random plasmid transfer in the gut of a flea,
for all we know.”
“It could be,” Hodis said evenly. “Anyway, the request came from Harry Kincade at CDC. He’s an old-timer I’ve known for years. I’d appreciate it if I could count on your help.”
Eight
For once in his life, John Harr didn’t know what to do.
A hot wind blew through Burns, whipping up dust along the main drag through town. He walked along the strip, feeling the wind at his back, tugging at his shirt and dusting the back of his neck with a fine layer of grit. Burns felt like a ghost town, but then again, it always felt like a ghost town. It was a town this side of dying, which was what his dog was doing now, Harr was pretty sure.
He’d left Gage at the vet hospital half an hour before. The vet had told him to go away, that he needed time to hook the dog up, to get the medicine running.
So Harr walked sightlessly out onto Broadway and plodded down the sad little strip through town. There really wasn’t anyone about, save an occasional pickup truck passing through. The banks and stores didn’t open until nine, and who knew when the taverns opened? They weren’t places Harr went to in the daytime. He was too busy working.
But he wasn’t working today, just pacing down the street, his boots thudding against the cement sidewalk, the dull sound obliterated every few minutes by a gust of wind.
It was already much hotter than usual for early May. He thought about things he needed to do at the ranch, like take the Cessna 180 up to check on the cattle. Harr, like other eastern Oregon ranchers, used an airplane to keep track of his far-ranging herd.
But his heart wasn’t in it. He kept picturing the way Gage had looked when the sun peeked over the eastern horizon that morning. The dog had lain at the base of the sliding glass door, his head flat against the dog mat, his body as still as a corpse.
But he hadn’t been dead. Harr had seen that once he opened the sliding glass door. Though difficult to tell at a distance, up close, Harr could see Gage’s chest moved in rapid, shallow breaths. The dog’s tongue, tacky with drool, lolled from his mouth.
DRYP Trilogy | Book 1 | DRYP [The Final Pandemic] Page 10