Despite the window being wide open, the room smells of illness. I’ve stood at the bedside of sick people more times than I can remember, and I’m well familiar with the various odors a human body suffering from poor health can produce. But this smell is unlike anything I’ve experienced before, not even in the first days of the pandemic. It’s a rank, animalistic smell, vaguely reptilian, but with an undercurrent of wet mold and rot. It seems to be worse—thicker, more oppressive—each time I step into Sarah’s room.
Her bedroom is on the second floor, next to her mother’s and mine. Our house is a small two-story out in the country: white paint, black roof, black shutters. We own several acres, not much compared to the amount of farmland surrounding us. I have an office in town, but I spend most of my time making house calls. Or I did. Before. Now the only house I call on is my own.
Sarah’s room is very much that of a girl. Frilly lace curtains on the window, wallpaper depicting kittens wearing tiny human clothes and engaging in children’s activities—jumping rope, playing tag, climbing trees—wooden shelves for displaying her collection of dolls and stuffed animals, a small bookcase containing slender volumes with colorful pictures …Her single bed usually has feminine coverings, but at my insistence it was now covered with thick woolen blankets and old quilts. They hardly fit the room’s décor, but that is the least of my concerns.
“There are too many,” she says. Her voice is raspy but louder now, and I wonder if the coughing did her some good after all. “They’re heavy—and hot.”
When the pandemic first started I wore a gauze face mask while seeing patients. I suppose I should do so now, but I can’t bring myself to cover my face while tending to my own daughter. She needs to see me smile. To a sick person, a doctor’s smile is reassurance, and reassurance is hope. False hope all too often, but better than none at all. Or so I tell myself.
I reach a hand toward her forehead, and I can feel the heat radiating from the flesh before my fingers come in contact with her skin. I don’t let my hand linger long. There is no point. I know how sick she is. I don’t bother with a thermometer. Knowing the precise measurement of her fever’s severity won’t help me reduce it, and knowledge of the number will only increase the despair which already threatens to overwhelm me. And I must remain strong—for her sake. And that of her mother.
“I know the blankets are uncomfortable, dear, but they are supposed to help you sweat out your illness.” I pause, considering. “I haven’t cupped you since this afternoon.”
Her eyes fly open, the first sign of energy she’s displayed since I entered her room. The whites of her eyes are shot through with swollen capillaries, making them seem almost pink.
“No, Papa! I don’t like it!”
“It’s necessary,” I say. I’m lying to her, but I retrieve the needed equipment from my medical bag and I perform the procedure anyway, on the merest chance that it might do some good.
Modern medicine has made great strides in the last half century. Doctors no longer subscribe to outmoded disease models such as miasma or unbalanced humors. Bacteria…viruses…hereditary predispositions…These are the true origins of humanity’s physical ills. But when you have no vaccine, when no treatment proves effective, you’ll grasp at whatever straws are available. So Sarah’s bedroom window is left open to keep foul air from building up in the room. She sleeps under many blankets so that the poison inside her might be drawn out through her pores. And I bleed her to decrease the amount of “bad” blood in her system and encourage her body to replace it with fresh “good” blood. Rationally, I know none of these techniques work, that they can actually do harm to patients if taken to extremes. But what else can I do as a doctor—as a father—when no other options remain to me? I fall back on the old medical beliefs the same way another man might fall back on prayer. In the end, what’s the difference between the two?
By the time I’ve finished taking her blood and cleaned up, Sarah’s eyes are closed and she’s breathing shallowly. Her skin is paler than before, and I fear that I have taken too much.
One drop is too much, you leech.
The voice that berates me is mine, and I hear it only in my head, but the words sting nevertheless.
I assume Sarah is asleep, and I grip my medical bag, turn away from her bed, and head for the door. The instant my hand touches the knob, she says, “Do you hear it, Papa?”
A measure of strength has returned to her voice and that, more than the words themselves, prompts me to turn back around, one hand on the knob, the door still closed.
“Hear what?” I ask.
“The singing,” she says, almost dreamily. Her bloodshot eyes are wide open once more, and she’s looking at something only she can see. Her formerly slack features are fixed in an expression I cannot identify, a strange combination of joy and horror, as if those two emotions are struggling for dominance within her, but neither is able to dispatch the other.
I assume she’s delusional from fever, but I play along.
“What sort of music?”
She frowns, as if she’s having trouble finding the words, but then a smile breaks out on her face as they come to her.
“The screaming kind, Papa.”
The pandemic began in the spring of 1918, when soldiers started returning home from the war. Word was that the disease originated with Spanish soldiers, hence the name Spanish Flu. Of course, we didn’t realize then how bad it would get. The flu was unseasonal and highly contagious, yes, but those of us in the medical profession thought we could deal with it. After all, hadn’t we seen patients through flu epidemics before? And the symptoms were familiar to us: fever, sore throat, exhaustion, headache, aching limbs, bloodshot eyes, cough, vomiting, diarrhea…But that was only the First Wave. In August, the disease grew stronger, and as a result became far deadlier. The normal mortality rate for a flu epidemic is 0.1 percent of those infected, but during the early days of the Second Wave, the Spanish Flu killed up to 20 percent of those infected, and the rate of infection was high, over 50 percent of the population. In addition to the previous symptoms, the infected now experienced hemorrhaging from the mucous membranes—especially the nose, stomach, and intestines; along with bleeding from the ears and petechial hemorrhages in the skin. The majority of deaths were from bacterial pneumonia—a secondary infection—but massive hemorrhaging and edema in the lungs from the flu killed many people as well. Millions died across the world.
But as bad as that was, it was nothing compared to the Third Wave. In mid-September, the infection rate soared to a staggering 90 percent, and the mortality rate was close to 100 percent for those infected. Businesses, churches, and schools the world over closed their doors, and healthcare workers were overwhelmed. Mass graves were dug with steam shovels and bodies buried without coffins. There had been talk of burning the dead, but fears that the smoke might spread the disease further ended that discussion.
The most disturbing symptoms of the Third Wave are the effects on one’s mind: nightmares and hallucinations of the most hideous nature. These distorted visions and imaginings come to the infected when the disease moves into its final phase, and at that point, death is not far off. And now, it seems such delusions have come to my poor daughter.
It’s late, and I’m exhausted. I haven’t slept much recently, not since sickness entered my home. I fear I may have brought it with me, despite all my precautions, but I try not to think of that. It’s one of the risks a physician must take, a risk that is unfortunately shared by his family.
I enter my bedroom, trying to make as little noise as possible so as not to wake Claire. She’s had a rough time of it these last few days, just as rough as I have, if not more so, and she needs her rest. I place my medical bag on my night stand and slip off my shoes. I don’t bother removing the rest of my clothes, though. I don’t intend to sleep long. Thirty minutes, an hour, no more, then I shall rise to check on Sarah again. Perhaps there is nothing I can do to save her, but I can at least go through the motio
ns until her fate is settled, just as I did for my other patients—all of whom I failed, just as fear I will fail Sarah in the end.
There’s a strangely sweet odor in the air, like flowers on the verge of spoiling, and I find the acrid tang oddly soothing. The window is open in our room, and there’s a slight chill in the air. I’m grateful to slide beneath the covers and move my body up against Claire’s for warmth. The poor thing is cold, though, and I fear I’ve removed too many of our blankets and given them to Sarah. I lean close to my wife, and in a soft voice, ask, “Would you like me to prepare a hot water bottle for you?”
No answer. She might be cold, but the temperature in the room doesn’t seem to be affecting her sleep. I wouldn’t mind some warmth in the bed, but I don’t want to risk waking Claire by leaving the room. Besides, tired as I am—both physically and mentally—I doubt the cold will keep me from sleep. I reach over and take Claire’s hand, careful not to squeeze too hard and disturb her. Her flesh is like ice and the feel of it sends a shiver through me. The flu has become so deadly now, far more so than anyone could ever have imagined, and I fear only a handful of survivors remain in the world. Sometimes I wonder if Claire, Sarah, and I are the last people left alive, and I wonder how much longer we will last. I keep holding onto my wife’s cold hand, and several moments later I drift off into darkness.
I’m walking down a narrow unpaved path that runs between two rows of stone buildings with thatched roofs. The buildings are old and sorely in need of repair, and the path that separates them is barely wide enough to be called a street. The ground here is a sloppy, muddy mess, a foul wet mixture of dirt, feces, and urine, some of it animal, most of it human. My boots are covered with it, but I’m not concerned. Filth is common in this time and place, and no one gives it a second thought. I’m wearing the clothes of my office—a huge black overcoat, black gloves, black pants, broad-brimmed hat (black, of course), and black shit-covered boots. I’m carrying a cane in my left hand, but since I don’t need it for walking, I hold it high enough to keep it out of the street-sludge. But the mask that covers my face is the most distinct feature of my office. Like the rest of my clothing, it’s made of wax-coated leather, and it has a cone-shaped protrusion that resembles a bird’s beak. This “beak” is filled with straw and various aromatic substances—rose petals, mint leaves, camphor, lemon balm, and more—to protect against the miasmatic bad air. Some believe that the mask was designed to resemble the head of a gore crow, a creature that picks at the bodies of the dead. Others say the design is utilitarian and any resemblance to a bird is strictly in the mind of the observer. I cannot say which point of view is the truth, but I know how people look at me when I wear the garments of my profession, and I know what they think. Word of my arrival always precedes me, and despite the fact that I am hired to do my work by the village or town, I find the streets empty and silent. Some view me as a bad omen, a harbinger of death who actually causes the disease he takes coin to treat. Others—usually children—are frightened by my appearance. I cannot say that I blame them. But as I slog through the street-muck, gazing upon the town’s buildings through the glass-covered eyes of my mask, I find myself surrounded by a heavy stillness unlike anything I have ever experienced before. I’m used to quiet, used to being alone, but this is different. The stillness is so pervasive, so absolute, that I cannot help but wonder if I am the only living soul in the entire town.
The Great Plague—it won’t be referred to as the Black Death until the 18th century—will kill between 30 to 40 percent of Europe’s population before it runs its course, and the world’s total population will be down by 150 million. The human race won’t return to pre-Plague numbers until the 17th century. This disease, spread by something as small and common as a flea, will be considered the worst biological catastrophe in history…until 1918, that is. How I know these things, I cannot say, but know them I do. This knowledge, horrifying as it is, does not concern me overmuch. I am here, in this place, at this time, and I have work to do.
Since no one has come forth from their homes to beckon me to tend to their loved ones, I choose a building at random, step up to the door, and knock, the waxed leather of my glove muffling the sound. I pause for a time, and when no one opens for me, I knock again. Still no response. I stand there for a moment, debating whether to enter without invitation or continue on to the next home. I am paid by the town to treat rich and poor alike, although some in my profession demand extra payment for their services from the patients themselves. I do not believe in taking advantage of the ill and desperate, however, nor do I believe in neglecting them. I try the door, find it unlocked, so I push it open and enter.
The shutters are closed, and it is dim inside. This is, to vastly understate the case, a modest part of town, and the home isn’t large. One main room with a fireplace, wooden table and chairs, and three straw-filled pallets that serve as beds. The dirt floor is covered with rushes that can be swept out and replaced with fresh ones as needed. The smell hits me first, the odor penetrating despite my mask, and the aromatic substances stuffed into its beak do nothing to cut the stench: a gut-churning combination of gangrenous flesh, blood-infused shit, and curdled pus. This is far from the first plague-ridden home that I have entered, but I cannot recall my senses ever being assaulted by so vile an odor before. It is more than merely the stink of sickness. It is the smell of Death itself. Death—and something far worse.
There are three bodies in the room. A man lies on the floor next to an overturned chair at the table, and the woman lies on one of the pallets, cradling a young girl. The man has black hair, the woman and daughter brown. All three are lean of body—the poor do not grow fat—and they are garbed in simple homespun garments of white and brown. There is no way to tell the man’s trade from his home. He could be a cobbler or candle maker or any of a dozen things. But whatever his skills, it’s clear that they provide his family a meager living at best.
I can tell simply by looking that all three have succumbed to the plague, and that there is nothing I can do for them. But my profession requires that I make certain. I am closest to the man—husband and father, I presume—so I step over to him first and begin my examination. His eyes are closed, which is a mercy. I am not superstitious. You cannot be a man who believes there are evil spirits, ill-fortune, and malice behind every unpleasantness life confronts us with and still do this job. And yet, whenever I encounter a corpse with open, staring eyes, I cannot shake the impression that some dark remnant remains within and is peering out at me.
Using my cane so I can avoid coming too close to the body, I poke and prod the man, lifting his arms, turning his head this way and that. Swollen black buboes the size of apples protrude from the man’s neck, weeping thick discolored pus. He’s clothed, so I cannot see if he also has buboes beneath his arms or on his genital area, but the cloth in these places is dark and damp, indicating the presence of weeping tumorous masses beneath. I crouch down to examine the artery in his neck. I won’t risk touching his flesh, even with my gloves on, so I look closely at the artery, holding my breath as I do so. After several moments pass without any visual sign of a pulse, I stand. If the man still lived, I would place leeches on his buboes to drain them, and I would bleed him to rebalance his humors. But there is nothing I can do for him now. I stand and turn away from the dead man, intending to go examine his wife and daughter, though I know I shall find them similarly beyond hope.
But before I can take a step toward the pallet they share, I hear—muffled through my mask—a rustling behind me, as if something is moving among the rushes on the floor. I am not prone to imaginings, but as I began to turn toward the sound, I pray that what I hear is nothing but a misperception born of a weary mind that has beheld too much disease and death in its time.
“If only it were that simple.”
The man has rolled over onto his stomach and now crouches on his hands and knees. He looks up at me, black blood dribbling from his mouth, pus flowing in thick streams from the b
uboes around his neck. But as bad as all this is, his eyes are worse. They are wide open now, but they no longer possess any semblance of humanity. Nor do they resemble the eyes of animals, birds, fish, or insects. They look like nothing I’ve seen before, nothing I’ve imagined, that I could imagine. The word that best describes them is unnatural in its truest, purest sense. Those eyes do not belong to any creature that has ever existed on the face of the world. They belong to something from elsewhere.
“They tried to return during the 14th Century,” the man says, grinning as he speaks, his inhuman eyes shining with dark light, “and they nearly succeeded.”
His voice possesses an echoing, sepulchral quality, and despite my mask, I can hear it as clearly as if he speaks directly into my ear. I notice that the movements of his lips do not match his words, as if his mouth speaks one language and I hear it in another.
“There simply weren’t enough of us back then. Humans, I mean.” A woman’s voice, coming from behind me.
I spin around to see the mother is sitting up on her pallet. Her daughter hangs limp and lifeless in her arms, but the child’s eyes are open, too, and they possess the same unspeakable wrongness as those of her parents’. The child remains motionless as she speaks.
“They failed to reach the Threshold, the point at which it is possible to cross over.”
Moving awkwardly, as if he’s little more than a bag filled with broken sticks, the man stands up, as does his wife, who continues holding their unmoving child.
“Not enough lives to draw on,” the man says.
Through a Mythos Darkly Page 23