“Yes, of course. I’m here, Natalie. Where are you? Are you all right? What happened?” Ramola has the disorienting sensation of being outside herself, observing this moment from a temporal distance that has yet to be achieved or earned, and it’s as though she expected this call and what is sure to be the delivery of devastating news.
“I’m in the car. Halfway there. I’ll be at your place in five minutes.”
Ramola runs to the bay window, throws open the curtains, exposing the view of the front lot. “Why aren’t you at home? Are you having contractions?”
“I had to leave. Something terrible happened. I really need help.” Her normally assured, insistent voice loses its force the longer she speaks so by the end of her third sentence she sounds like a timid child.
“I’m going to help. I promise.”
Natalie whispers, “Ow, fuck,” in a high-pitched voice, one that breaks into hitching sobs.
“What is it? Are you all right, Natalie? Do you need me to come to you?”
“My arm really fucking hurts.” Natalie grunts as though attempting to reset herself. “We were attacked by some guy. He was infected. Paul was bringing groceries inside and we were in the living room talking, just talking, and I don’t remember about what . . .” She trails off.
“Natalie, you still there?”
“Some guy walked in. He opened the screen door and walked right in our fucking house, and Paul tried to close the door on him, but he fell, and . . . And—and I tried to help Paul, and Paul—” She splinters into shards of tears again, but briefly recovers with a deep, wavering inhale. “The guy killed Paul and he bit my arm.”
Ramola gasps, covers her mouth, and staggers away from the window as though she might see the scene described play out in the lot. What can she say? What can she possibly say to Natalie?
After the initial shock of the news dissipates, the clinical doctor in her brain takes over, wanting to know more about Paul, to ask if Natalie’s sure he’s dead. She wants to ask about the bite on her arm—did it break the skin?—and ask about the infected man, what he looked like, what symptoms he was displaying.
“Oh my God, Natalie. I don’t know what to say—I’m so sorry. Please do your best to focus on driving until you get here. We need you in one piece.”
“There’s a chunk missing from my arm already.”
Ramola cannot tell if Natalie is laughing or crying. “Yes, well, we’ll get your arm cleaned up and we’ll get you vaccinated.” Ramola is aware she’s using the royal “we” she often employs with her patients.
“Rams, Paul is gone. He’s gone. He’s fucking dead. What am I going to do?”
“We’re going to get you to a hospital. Straightaway.” Ramola runs into the kitchen. From under her sink she pulls out a box of Nitrile gloves. They’re from her clinic but she uses them at home for cleaning. Holding her phone against her ear with a shoulder, she puts on a pair of gloves and asks, “Are you close?”
“I just passed under the viaduct.”
The granite-and-limestone Canton Viaduct is a two-hundred-year-old leviathan stretching seventy feet above Neponset Street. Ramola lives only a few blocks away.
Ramola says, “Are you feeling light-headed? Do you need to pull over? I can come to you.” She plucks her handbag from the kitchen table, double-checks that her car keys are inside. Whether or not they swap vehicles there’s no way she’s letting Natalie drive anywhere once she gets here. Ramola pins her medical ID badge to the front of her sweatshirt. She’s wearing plaid flannel pajama bottoms, her “comfy trousers,” but she won’t waste time changing out of them.
“I’m not stopping. I can’t. I’m running out of time to get help, right? Aren’t they saying the virus works fast?”
“You’ll be here soon and we’ll get you help. I’ll stay on the phone with you. Or would you prefer to drive with two hands? Feel free put me on speakerphone or drop me if you need to, if it feels safer. I’m watching out my front window. I can wait on the roadside as well.”
“No!” Natalie shouts and sounds to be on the verge of hysteria. “Do not go outside until I get there.”
Ramola dashes to the linen closet and grabs two towels and slings them over her shoulder. Then it’s back to the kitchen for a bottle of water and the half-full hand-soap bottle next to the sink before returning to the front door. She slips her bare feet into her jogging sneakers.
“Rams, what’s all that noise? You’re not going outside are you?”
“No. I’m gathering things, waiting by the door, stepping into my trainers.”
“You don’t still call them ‘trainers.’” Natalie’s voice goes little again, and it breaks Ramola’s heart.
“I do because that’s what they are.” Ramola unzips the overnight bag, places the water and soap inside and resumes her window watch. “I won’t go outside until I see you. That is a promise.” Ramola opens her phone’s text screen and scans through the group chat with Jacquie and Bobby, and pauses on the message about a patient already being feverish within an hour. The presentation of symptoms with this new virus is astronomically fast compared to a normal rabies virus. A typical rabies patient, when untreated, won’t exhibit symptoms for weeks, sometimes even months. Beginning its journey at the bite or exposure site the virus slowly travels to the brain via the sheathings of the nervous system, progressing at a rate of one or two centimeters per day. Once symptoms present (fever, nausea, dizziness, anxiety, hydrophobia, delirium, hallucinations, extreme agitation), it means the virus has passed through the patient’s brain barrier, which is the medical point of no return. If rabies enters the brain, there is no known cure, and the virus is nearly 100 percent fatal.
Lisa told me one patient of hers is one hour post exposure, fever and aches already.
One bloody hour. Natalie is indeed running out of time.
There are muffled bumps or knocks coming from the phone’s speaker and Natalie sounds like she’s at the bottom of a well. “Still there, Rams? I put you on speaker.”
“Yes, I’m here.”
“Do we need to switch cars? I’ve kind of bled on this one.”
“That’s not necessary as—” She stops from launching into an explanation of how the virus is transmitted via saliva and not transmitted through blood. There isn’t even a blood test to determine if you have been infected. Multiple tests have to be performed on saliva, spinal fluid, and hair follicles on the base of the neck looking for rabies antibodies and antigens.
Ramola bounces on her heels, willing her friend’s car to pull into the lot. “Usually I don’t have to encourage you to drive over the speed limit, but you have my permission to do so, Natalie, as long as you—”
“I stabbed the guy. Right between the shoulder blades. I think I killed him, but I was too late to save Paul.” Her “Paul” is a sputtering whisper, and then she explodes into semi-intelligible shouting and screaming.
Ramola tries to be reassuring, soothing, without lying that everything will be all right. “I know sorry isn’t enough, doesn’t come close to covering it, but I am so terribly sorry. You’re almost here, yes? Then we’ll get you help—there you are now. Brilliant. Park next to the walk and we’ll swap seats. I’m stepping out the door now.” Ramola does not wait for Natalie to respond and stuffs her phone into her overnight bag. She looks once into her empty townhouse to make sure she isn’t leaving something important behind. Her laptop is closed, marooned in the middle of the kitchen table. She doesn’t need it but a wave of sadness swells as she has the urge to call her mum and dad to say sorry for giving them the rush off the call earlier.
Ramola opens the front door and darts outside into the overcast and cooling day.
Natalie’s white mid-sized SUV weaves through the small parking lot, tires squealing at the final turn, and jerks to a stop perpendicular to the end of the walkway. Ramola runs to the car. There is a consistent breeze and fallen leaves scurry madly in front of her feet.
The driver’s-side door opens. Nat
alie growls with pain and swears.
Ramola calls out, “Do you need help?”
“I got it. I’m out.” Natalie stalks around the car’s front, her right hand on the hood for balance. Her belly is significantly bigger than when Ramola last saw her at the baby shower. Natalie cradles her left arm, bent up at the elbow. Her sleeve is dark with blood from forearm to wrist. Her face is slack, haunted, and all red eyes. She says, “This is really bad.”
Ramola nods and clears her throat of whatever wavering, tearful greeting or response she cannot and will not give her friend. She says, “Come here. We need to get that sweatshirt off and clean where you were bitten.” She flips the towels onto the car’s roof, drops her overnight bag to the ground, and retrieves the water and soap bottles.
Natalie does as instructed, hissing as she peels the sleeve away from her wounded left arm.
“Bend your arm like this, make a muscle for me.” There’s a ring of small, ragged puncture wounds, surrounded by puffy, angry red skin. Natalie did not lose a chunk of herself; the man bit and released.
“Do we have time for this?”
Ramola doesn’t know, but she also doesn’t hesitate. She squeezes soap directly onto the wound and smears it around. “The rabies virus is not hardy and cleaning greatly reduces the likelihood of infection.”
“But this isn’t a regular rabies virus.”
“No, it isn’t.” Ramola, a full head shorter, flashes a look up into Natalie’s tear-stained face. Natalie doesn’t return the look. She nervously scans the lot and its surrounding environs.
In the distance, a burst of dog barks is followed by a chilling high-pitched wail of a coyote. Prior to moving to this Boston suburb, Ramola never anticipated that coyotes were animals she might encounter. Their calls are oddly commonplace at night. She’s never heard one cry during daylight hours, though.
Ramola chances a look over her shoulder at the townhouse complex. A curtain flutters in Frank Keating’s front window.
Natalie says, “A rabid fox attacked Paul’s moving car.”
Foxes were Ramola’s favorite animals as a child. She once famously scandalized a sitting room full of wine-drinking adults (her parents included, though they both were laughing as they admonished her) when she walked out of her bedroom, stuffed-animal fox in tow, intending to ask for a glass of water, but instead inexplicably announcing to the party that all fox hunters were toffs or tossers.
Ramola tries to banish an unbidden image of an adorable red fox, frothing and turned stumbling monster. She says, “We’re just about done.” Ramola flushes the wound with the bottle of water. She then wraps one towel around Natalie’s forearm. “I have a sweatshirt in—”
“I’m not cold. We need to go.” Natalie opens the passenger-side door and gingerly climbs inside.
Ramola strips off her gloves and tosses them to the ground on top of the bloodied sweatshirt, denying the urge to gather the contaminated material for proper disposal. She quickly dumps her bags into the backseat, and while doing so, she spies Natalie’s own fully packed emergency overnight bag on the floor behind the passenger seat. Ramola grabs the second towel from the roof and runs around the rear of the car to the driver’s door and opens it. She does a quick-and-dirty job of wiping the steering wheel, driver’s seat, and the door’s interior panel. She drops the towel to the pavement and climbs inside. The wipe-down job was not sufficient; the steering wheel feels damp in her hands. She can deal with her own risk of exposure later, after they get to the hospital. She admonishes herself for not wearing two sets of gloves. The exposure risk is minimal, given rabies is not blood-borne and the virus typically dies once the infected saliva dries, but at the same time, she needs to be smart, vigilant.
She’s sitting too far away to safely manipulate the pedals. Ramola blindly fumbles with the lever beneath the seat, attempting to slide herself forward. Ramola feels her own level of panic rising as Natalie whispers, “We need to go, we need to go.”
Ramola is about to give up and scoot her butt forward and sit at the edge of the seat when she finally pushes the lever down and the seat glides forward. She says, “All right. All right, here we go.” She turns the key in the ignition and there’s a terrible grinding sound from the engine, which is already running. Ramola’s hands fly off the steering wheel as though having received an electrical shock.
Natalie says, “Maybe I should drive.”
“Dammit. Sorry, sorry.” Ramola shifts into drive and the SUV lunges forward. The vehicle is bulky and unwieldy in comparison to her nimble little compact, but she manages to guide it through the lot and onto Neponset Street. There are no other vehicles on the usually busy road. The Honey Dew Donuts, rows of small businesses, and the residences lining or facing the street are darkened and appear to be empty.
“How are you feeling?”
“Just peachy.” Natalie holds her swathed left arm atop her belly.
Ramola pulls the seat belt across herself and buckles it. “Right. Yes. What I mean to ask—”
Natalie says, “I’m sorry. I’m just so scared. Thank you for being here, taking me to the hospital, thank you . . .” She trails off, stares out her window, shaking her head and wiping away tears with her right hand.
Ramola has the urge to reach out and pat Natalie’s shoulder or thigh, but she keeps both hands on the steering wheel. “Of course I’m here for you, and I will be here for you all day.” The sentiment is as odd and awkward as it sounds.
Ahead, the traffic light at Chapman Street turns red. Ramola eases off the accelerator and Natalie says, “Tell me you’re not stopping.”
“I’m not. Only making sure it’s safe to pass through.” Once she’s confident there are no cars approaching from their right, she speeds through the three-way intersection. Ramola chances a look away from the road at Natalie, hoping for a comment if not a joke. Natalie continues to stare out the passenger window.
Ramola asks, “Do you have a headache, or any body aches aside from your arm, of course? Any flu-like symptoms?”
“I have a headache and my throat hurts, but I’ve been yelling and crying nonstop.”
“Are you feeling nauseous? Do you feel feverish?”
“No. No. I feel like shit, but—I don’t know—it doesn’t feel like the ‘flu’ shit. I’m beat-up, and I’m probably just dehydrated.” She adjusts her sitting position, turning her legs toward Ramola, and rubs her belly with her right hand.
“When we get to the hospital, what’re they going to do?”
“You’ll be examined and given the rabies vaccination.”
“They have a new vaccine for this already?”
“They have rabies vaccine but it’s not a new one.”
“Is it safe for the baby?”
“I think it is safe, but I have to admit I don’t know for sure if there are any associated fetal side effects.”
“I want to fucking live, so it doesn’t matter. That’s not true, of course it matters. But I don’t want to die for the—Jesus, that’s so awful of me to say, isn’t it?” Natalie rubs her right hand over her belly.
“No, of course not, and I’ll make sure they do everything they can for you both.”
The SUV crosses over the I-95 overpass. Below, the six north and southbound lanes are void of traffic. Ramola cranes her neck in both directions hoping to see cars but there aren’t any. It’s as though everyone has disappeared. A fleeting thought presents as a whispered question, a question not necessarily in search of an answer but instead posed to underscore disbelief at a suddenly unassailable truth: Is this the end?
Post-college, Natalie and Ramola roomed together in Providence for two years, during which time Natalie tended bar and seemingly read (consumed would be a more accurate verb, here) every YA novel featuring one apocalypse or another. On nights that Ramola visited Natalie at work, the two of them would playfully engage in animated and, judging by the attention of the surrounding bar patrons, entertaining debate about the end of everything. Natalie ins
isted that civilization was as fragile as a house of cards; remove one and it all will come tumbling down. All systems fail, and she claimed with the air of authority reserved for professors emeritus and bartenders, there was a theorem, one named after a famous mathematician (often, much to the mouthful-of-beverage-spitting delight of Ramola, Natalie casually named the theorem after Ian Malcolm, the fictitious mathematician from the book and film Jurassic Park), which proved as more “safeguards” are built into a system, it is not only more likely the system will fail, but, in fact, the system will inevitably fail. Her go-to example was a confusing amalgam of America’s nuclear weapons systems, including the codes within the president’s nuclear football, and the 1983 USSR nuclear false-alarm incident. Ramola opened her rebuttal by admitting humans were fragile little things as individuals, but civilization itself was hardy and resilient. Short of an asteroid or all-out nuclear war, she argued, societies have survived and would continue to survive all manner of calamity. Ramola pointed to countless countries/societies (both modern and ancient) that had suffered horrific natural disasters, catastrophic wars, collapsed economies, and/or dissolved governments whose citizens adapted and persevered. Ramola punctuated her rejoinder with a raised glass and a purposefully cheeky “Life finds a way.”
The sprawling, empty highway below them is not the marker or portent of the end of everything. Ramola chastises herself for briefly indulging in the paralyzing enormity and hopelessness of apocalypse. It’s natural to be scared, of course, but she cannot allow herself to be ruled by fear, which is the source and fountain of irrationality and poor decisions.
Ramola asks, “Do you know at what time, approximately, you were bitten?”
Natalie exhales deeply. Ramola assumes Natalie swallowed a snarky I-wasn’t-looking-at-the-clock response. She says, “Oh Christ, a half an hour ago, maybe?” Before Ramola responds Natalie leans forward and grabs something from the cup holders within the center console. It’s her cell phone, which remains attached to a battery charger plugged into the car’s cigarette lighter. She says, “Paul texted me when he left the grocery store at”—her face glows in the phone’s ghostly light as she manipulates and searches the screen—“11:15. He got home about five minutes later. It wasn’t long, five more minutes or so, before we were attacked, and I—” Natalie pauses and clicks off the phone screen. “I don’t know how long that lasted. It fucking felt like forever, but it was—I don’t know—maybe another five minutes, maybe more, maybe less. The guy bit me before I stabbed him. Yes, definitely before. But then he staggered away into the house and I left, and I just left. Paul was—he was gone. So I had to go. Right? I didn’t want to leave him there, but I had to.”
Survivor Song Page 4