by Daniel Kalla
“Come down, Mateo,” Emilio calls up the stairs to his son. “Now! Breakfast is ready. And we’re going to be late.”
“I don’t want to eat, Papá!” the eight-year-old replies.
That’s unusual, Emilio thinks as he stands at the sink and runs cold water over his throbbing finger. Not only is Mateo always hungry, but he’s also the most compliant kid. Sometimes, Emilio worries that his son is too accommodating—always doing as he’s told and never complaining. He would like to see more defiance from Mateo. But not this morning. “Too bad. Papá cocinó esto,” Emilio yells over his shoulder. “Now you’re going to eat it.”
His wife, Isabelle, is already at the church helping her sister with the last-minute preparations. Isabelle will kill us if we’re late. After all, Mateo is the ring bearer for his aunt’s wedding.
It takes another five minutes and two more shouts before Mateo finally appears in the doorway to the kitchen. The first thing Emilio notices is his son’s white shirt. It’s stained in several places with slick yellowish blotches that resemble grease.
“Mateo Flores!” Emilio barks. “Mamá just washed and ironed that shirt. What did you get all over it?”
“It’s not my fault, Papá,” Mateo says as he begins to unbutton his shirt.
Emilio suddenly notices how pale his son looks. He takes a step closer. “What’s the matter, buddy?”
“My chest hurts. My back, too.” Mateo slips off his shirt. “And I don’t know what these are.”
Emilio can only gape at his son’s exposed chest. Fluid-filled sacks the size of golf balls—some even bigger—cover much of his skin. And Mateo’s back is worse. A steady trickle of yellow fluid runs down and soaks the back of his pants.
CHAPTER 41
Amber answers the door with a phone to her ear. “Come in,” she mouths to Lisa as she turns back toward the living room.
Lisa has only taken a few steps inside the house when her niece comes flying down the hallway toward her. Lisa crouches down and spreads her arms. Olivia jumps into the embrace.
“I’m not scared, Tee!” Olivia trumpets as Lisa straightens and spins her around.
“Scared of what?” Lisa asks, kissing her niece’s forehead.
“The needle.”
“Of course you aren’t. You’re way too brave for that. Bet you won’t even flinch.”
Olivia drops back to the ground. “What’s ‘flinch’?”
Lisa flings her arm back, leans away, and contorts her face into an expression of exaggerated fear.
Olivia giggles. “I definitely won’t flinch.”
Amber approaches holding out the phone to Lisa. “Can you talk?”
“Who is it?” Lisa asks, reaching for the phone.
“Dad.”
Lisa’s hand freezes where it is.
“Come on,” Amber whispers. “He just wants to say hello.”
Reluctantly, Lisa takes the phone. She walks down the hall and into the kitchen before she brings it to her ear. “Hi, Dad.”
“Liberty!” Ian Dyer says. “I mean Lisa, of course. Old habits die slowly when you’re this old.”
She hasn’t heard her father’s voice in over two years, maybe three, but he sounds as robust and animated as ever. “How are you?”
“I’m fine, muffin. Good as ever. The upside of the farming life. All the fresh air and GMO-free food keeps even ancient bodies like mine going.”
“Mom sounds good, too. I spoke to her a few days ago.”
“You did, did you?” A familiar accusatory edge creeps into his tone, and Lisa realizes her mom must not have mentioned the call.
“Just a short chat. About nothing, really,” she says, falling back into the old habit of trying to protect her mom from her dad’s ire.
“Your mother never tells me anything,” he says with a laugh. “Who can blame her?”
But she knows him too well to buy the self-deprecating routine. It is so typical of her father. He has to be in charge of every situation. The moment he perceives he has lost that control, he lashes out. While he was never physical with any of the family during Lisa’s childhood, they all lived in fear of his emotional lability. When he threw one of his frequent tantrums, he would scream at the top of lungs, spewing words that could slice like a whip. Other times, he used silence as a weapon—refusing to speak to or even acknowledge Lisa for weeks on end after some perceived slight or other.
“It’s good to hear that my two girls—well, three, when you count the little one—are all together now.”
“Yeah, we get to see a lot of each other.”
“That’s wonderful. Must make up for you not ever getting to see your own parents.”
Exhaling slowly, Lisa forces herself to do a quick five-senses exercise. The cutting board The hum of the fridge The light pressure of her watchband The scent of coffee The salty taste of her own saliva. “Olivia’s shooting up like a weed these days,” she says.
“I saw her last week,” he says pointedly. “Such a funny little one. As spunky as you were at that age.”
“You think?”
“Definitely. Just hope she won’t turn out to be as defiant.”
Multiple responses come to mind, but Lisa decides not to engage him.
“Listen, I wanted to talk you about this vaccine,” he continues.
“What about it?”
“Amber tells me you’re planning to give Olivia a shot.”
“I am.”
“And you think it’s a good idea?”
“I do.”
“I heard about the girl who almost died from it.”
“So did I, Dad. In fact, I spoke to her myself.”
“And you want to take the same kind of chance with my granddaughter?”
“It’s not Russian roulette. It’s one reaction among thousands. This meningitis has already killed a lot of kids, including one of Olivia’s classmates.”
“You don’t need to worry about that.”
“And why’s that, Dad?”
“Because we Dyers have good natural immune systems. I never let you or your sister anywhere near those toxic vaccines they tried to foist on you when you were babies. And neither of you ever came down with anything more than a head cold during your whole childhood.”
“And we should take that as proof enough that Olivia is safe from the most dangerous bacteria this city might have ever seen?”
“It is for me.” He huffs. “What do I know? I just raised you from nothing. But you’re the one who went to medical school.”
“That’s right, I did.”
“The most corrupted academic institution on the planet.”
Lisa focuses on her breathing. “Let’s not start—”
“Where the learning is bought and sold by corporate interests, who convince every last one of you that expensive chemicals and invasive surgeries are all somehow preferable to nature itself.”
“Speaking of chemicals, are you taking your medications, Dad?”
“That’s right. There it is again. The arrogance. The I-always-know-better attitude that makes you so damn special. So infallible.”
“I’ve got to go, Dad.”
“Don’t take my granddaughter down with you!”
Lisa hangs up the phone. She rubs her eyes. He will not get to me, she reassures herself, gathering her composure as she heads back into living room.
“How did it go?” Amber asks as she accepts her phone back.
“Nothing changes,” Lisa says.
Olivia tugs at her sleeve. “Are we doing this, Tee?”
“Yes, we are,” Lisa says, more determined than ever. “How about over there on the couch?”
Olivia hurries over to it and sits down. “Which arm do I get it in, Tee?”
Lisa taps her own shoulder. “The left one. That way you’ll still be able to draw right away.”
Olivia yanks her collar down over her shoulder to expose the skin.
“You’re too keen.” Lisa laughs. “I still have to
get the stuff ready.”
Lisa reaches into her handbag and pulls out the supplies Fiona gave her, including the vial of Neissovax, a one-cc syringe with attached needle, and an alcohol swab.
Olivia’s eyes go wide as Lisa pulls the cap off the syringe to reveal the needle underneath. “So big?” she asks.
“It’s actually very small. Won’t be any worse than a mosquito bite.”
Olivia watches with mouth open as Lisa flicks the yellow cap off the vial, plunges the needle in, and sucks up the half cc of vaccine.
“You want to hold Mom’s hand?” Lisa asks.
“Can I?”
Amber kneels beside Olivia’s right side and takes her hand.
Lisa pulls Olivia’s collar back and rubs the alcohol swab over the skin on her shoulder. “I’m going to count to backward from five. You ready?”
“Ready.” Olivia squeezes her eyes shut.
Lisa raises the syringe. She looks over to Amber and, in that moment, sees persistent doubt in her sister’s eyes.
“Five… four… three… two…” Lisa jabs the needle through Olivia’s skin before reaching “one” and presses down on the plunger.
“Hey!” Olivia calls out in a mix of pain and amusement. “You tricked me.”
“Yes, I did.” Lisa withdraws the needle and recaps it. “So sue me.”
“Not fair.” Olivia laughs as she rubs her shoulder.
Lisa ruffles her hair. “You were super brave!”
“I was, wasn’t I?”
As Lisa is applying a small bandage to the inoculation site, her phone rings. She extracts it from her purse and, seeing the call comes from her office, answers.
“There’s been another one,” are the first tense words out of Tyra’s mouth.
“Another…” Lisa says, although she already knows. Her eyes dart instinctively over to her niece, who clutches her left shoulder with her other hand.
“Vaccine reaction. And it’s bad, Lisa. Very bad.”
CHAPTER 42
Lisa rides the elevator alone to the rooftop. Hard as she tries, she can’t shake the mental image of Mateo Flores. And she can’t stop thinking of her visit to see him, a few hours earlier, in the children’s ICU.
Mateo wasn’t on the ventilator when Lisa arrived, although he might be on one by now. Most of his body from the neck down was already covered in mummy-like circumferential bandaging. But as the nurse reapplied strips to his arm, Lisa got enough of a glimpse of the transparent, yellowish fluid-filled sack of skin over his shoulder to understand how extensive the blistering must have been. According to the attending doctor, the rash was spreading by the hour. And Mateo had lost so much fluid through the blisters that the ICU team was having troubling keeping his blood pressure from dropping critically low, despite all the intravenous fluids they were pouring into him.
Though he was sedated, Mateo was unbelievably stoic. He didn’t cry once during the dressing change, and he even showed the nurse a shy smile. His parents, however, were inconsolable. His father, Emilio, wasn’t angry like Mia’s dad had been. He simply seemed helpless, begging Lisa for reassurances she couldn’t offer. If she had to choose, she would have opted for anger and blame over his desperation.
The elevator opens, and Lisa steps out into the rooftop bar. Nathan sits at the same high-top table as before. He appears as rattled as Lisa feels. A beer bottle dangles between his fingers as he stares glumly out toward the dark waters of Puget Sound. It’s the first time Lisa has seen him with strands of hair out of place and a shirt that’s not perfectly pressed.
“Hey,” she says as she slides into the chair across from him. “Where’s Fiona?”
He shakes his head. “She wouldn’t leave the warehouse once she heard about the latest kid to react. She’s going through the supply. Testing each batch over again, herself.”
“What does she hope to find?”
Nathan merely shrugs.
“Mia attended a vaccination clinic two days before Mateo did,” Lisa says. “And the two clinics are eight miles apart. We checked the serial numbers. They didn’t get their vaccines from the same batch.”
He takes a long swig of his beer and then asks, “How’s the boy doing?”
“Not great. Mateo’s suffering from toxic epidermal necrolysis, a more extensive form of Stevens-Johnson syndrome, involving the whole body rather than just the mouth or face. It leads to severe blistering and fluid loss. Oftentimes multi-organ failure. Even death.”
“Jesus,” Nathan mutters. “But it’s basically the same reaction as Mia’s?”
“Another manifestation of the same disease, yeah. Both caused by a delayed immune response.” She pauses. “To Neissovax.”
“So Mia’s reaction wasn’t a one-off?”
Lisa shakes her head.
“When the board gets wind of this…”
“Two kids are fighting for their lives, Nathan.”
“There are more important things at stake than money. I get it. But it’s still going to devastate Delaware. The stock price will tumble. People are going to lose their jobs. Their careers.”
Lisa can’t help but wonder if he’s thinking of himself. “This link between Neissovax and the severe skin eruption was bound to come out at some point,” she says. “Maybe this isn’t the worst way to find out.”
“How could it be any worse, Lisa?”
“We’ve already shown that Neissovax is effective against one of the deadliest strains of meningococcus where nothing else works. It might be too essential not to use, despite the risks.”
“Doubt that.” He pushes the drinks menu toward her, but she waves it off. “You’re going to suspend the vaccination campaign?”
“We’ll decide at tomorrow morning’s meeting, but we might have to. At least, until we figure out exactly what we’re dealing with.”
“Doesn’t matter much, anyway.”
“Why’s that?”
“Once word gets out about the second reaction—”
“We have to announce this one. We can’t afford to have another case leak out. We’d lose all credibility.”
“Of course. The point is, even if you do keep the clinics open, who’s going to show up now?”
“We know Neissovax works. And there have only been two reactions among six thousand doses given.”
“One in a million is enough for the anti-vaxxers to jump all over this. But one in three thousand?” He lowers his beer. “Would you vaccinate someone you love with those kinds of odds?”
“I already did.”
“Who?”
“My niece.”
“Ah.”
Lisa realizes the worry she feels is out of proportion to the actual risk, but she can’t stop thinking about Olivia. She’s already called Amber twice to check up on her niece, who’s doing fine according to her sister.
Nathan leans forward. “How are you holding up?”
“Honestly?”
“Yeah.”
“I’ve had better days. Better weeks. Better months, even.”
He smiles, and his blue-gray eyes light with their now familiar charm. “Are you going to stop at years or are we going all the way up to decades?”
“Up to you.” She can’t help but smile back.
“Things OK on the home front?”
“Very quiet.”
“That’s good, right?”
“I’m getting the silent treatment.”
“I remember that.”
Something in his sympathetic gaze releases the emotions that have been stewing inside since her call with her father and her visit with Mateo. “I feel like such a fucking failure, Nathan!”
“This isn’t on you, Lisa.” He reaches out and touches the back of her hand.
“The vaccine is just the tip of it,” she murmurs. “I’m forty-one years old and nothing in my life works right now. Professionally, I’m losing control over the worst infectious outbreak to hit this city. Personally, my marriage is crumbling. My mentor is dying, and I
can’t do anything to help her. I’m estranged from my parents. My own sister doubts me…”
Nathan squeezes her hand. “Can’t really speak to your family or your marriage. Though everyone goes through that kind of turmoil at some point. But I can tell you that you are phenomenal at your job. Compassionate, innovative, and decisive. You’ve been dealt an absolute shit hand. As bad as this crisis is, it would be so much worse without you.”
She stares back at him, wondering why Dominic never offers her such reassurances, and then gives him a small smile.
Nathan’s fingers slip between hers. “Matter of fact, the only good thing to happen to me since I came to Seattle is meeting you.”
Lisa looks down at their interlocking hands. She realizes she doesn’t want the contact to end. Reluctantly, though, she wriggles her hand free. “Thank you, really,” she says without looking at him. “I better go.”
CHAPTER 43
The Outbreak Control Team meeting is well attended, but it feels to Lisa as if the air has been sucked out of the room. The members accept the bleak statistical update for day twelve of the meningococcal outbreak—three confirmed geographical clusters, twenty-three dead, two antibiotic prophylaxis failures, and forty-nine infected—with collective resignation.
Lisa suppresses a yawn. It was another near-sleepless night. Dominic was still petulant, but at least he was talking to her. He even asked about the outbreak. But after her roller coaster of a day, she didn’t have the energy—or, if she was being honest, the patience—to discuss it with him. Besides, the encounter with Nathan at the bar left her too confused and conflicted to want to talk about much of anything with her husband.
Lisa moves to the next slide. “In terms of the vaccine reactions: Mia Meyer has been transferred out of the ICU and is expected to be discharged in the next few days. Mateo Flores is in critical condition and his prognosis is guarded as of this morning.”
Benning holds her hand up. “Our offices are being inundated with calls,” she says, referring to city hall. “Mainly from families of kids who have already received the vaccine.”
