Phase Six

by Jim Shepard

  “He’s probably still feeling a lot of the sedation,” Emily told her.

  He gave them no trouble when the nurse technician collected some lung and blood cells, even as invasive as the first procedure was.

  “He probably just needs a little more time to get used to all of this,” Emily added once they were out of the unit and stripping down for the chemical shower. She didn’t sound very convinced.

  “You should see what he’s like with people he doesn’t trust,” Jeannine joked, but Emily just looked at her in response.

  Seems Like Old Times

  He still had his old cell number and she FaceTimed him and he picked up on the third ring. He had a thicker beard and was wearing a white V-neck T-shirt and seemed to be in a room with nothing whatsoever on the walls. “Look who’s calling,” he said. The lack of warmth in his voice pierced her, and she registered that he was still the guy who’d been left in charge of either expanding or tightening her chest.

  “How’ve you been?” she asked.

  “Everybody’s healthy here,” he said. “I assume you’re in the middle of all of this?”

  She’d set up an Instagram account a while ago but never posted anything on it and didn’t know why she would have expected him to have checked it, anyway.

  “Oh yeah,” she said.

  “And is it as bad as some people say it is?” he asked.

  “Oh yeah,” she said.

  “So how can I help you?” he said.

  “Well, it’s nice to see you, too,” she joked.

  “Jeannine,” he said. He rubbed his eyes with his free hand. From what she could see he was slumped across one chair and had his legs up over another. He looked directly at the camera and adjusted his expression. She was sure how hard this was was written all over her face, but he had perfected this look which indicated an unwillingness to notice stuff he found inconvenient. It was the expression she remembered from after Mirko’s death, when he would come home from work and catch her eye and they would go about their routines.

  They had just mutually pulled onto this road of not being together. In the face of her guilt and misery he had gotten more and more passive in his disappointment, like he’d been watching someone else’s kid’s bad behavior. And when he got like that, she had imagined that she’d been being circumspect in her responses, but had only figured out afterward that she’d really just been cold. She remembered once after they’d had sex looking from her bed at one of his shirts in her closet and startling herself with the way it seemed like evidence of their future breakup.

  “Jeannine?” he asked.

  She told him she needed his help with Aleq. She gave him a rundown of the situation, trying to remember everything that was crucial, and he listened and didn’t say anything for a long time until she finally felt like she’d run out of sentences.

  “And I can just walk into a place like that?” he asked.

  “You won’t be in the hot lab,” she said. “You may be interfacing with him on a screen. Or through a headset. Or maybe just advising me.”

  “They don’t have their own people for something like that?” he wanted to know. “Some kind of call list?”

  “I argued for you,” she told him. “And I reminded them that whoever that person is, he has to work well with me.”

  He seemed to be thinking about what she had said and was looking down and away from the camera. The first time she had kissed him, he had just come out of her bathroom and she had been waiting in the hallway. She’d backed him up and braced herself against the wall with both hands. When she pulled out memories like that for herself, she sometimes wondered if she was accessing the same remnant or just throwing together a whole new assembly to accommodate her needs. Once he’d left her, their past had become this ongoing saga for her, and if she’d had more friends, it probably would’ve become part of an oral tradition.

  At one point when she’d maxed out her self-pity during their breakup he had reminded her of a little speech she’d given him after lovemaking only a few weeks into their relationship. While his hands had still been stroking her hips, she’d provided her theory of Relationship Phases, with phase 1 being that first buzz of interest, phase 2 that initial excitement at how much you had in common, phase 3 the exhilaration at your capacity for merger, phase 4 those aspects of the gift you started to take for granted, phase 5 the initial demonstrations with other people that you didn’t have your partner’s back, and phase 6 when you started thinking, Maybe the problem is me.

  She remembered him saying, “That’s the theory you want to run by me right now?” and she’d tried to suggest in response that she’d just been joshing around. But it had changed the temperature between them. For that reason she had brought it up again a few weeks later, and he hadn’t seemed to want to talk about it.

  “So this kid has clearly latched on to you, for all of his wariness, and you don’t feel like you can help him,” Branislav said, and she found herself unable to answer. She remembered finding Mirko in the kitchen one night trying to make a sandwich in the dark. When she’d asked why he hadn’t turned on the light, he’d said, “You hate when I turn on lights.”

  “I need your help,” she repeated. “He needs your help.”

  Branislav looked into the camera again for a while, like once more she had disappointed him in ways he couldn’t have predicted.

  “What am I gonna do?” he finally said. “Refuse to try to save the world?”

  She had no idea what was going on on her face, but he wasn’t looking at it anyhow. “Thank you,” she told him.

  He said, “Just let me know how soon they’ll be here.”

  VI

  Valerie Landry Thrown Back on Her Own Resources

  Most of the first half of the staff meeting had been devoted to how the quarantine was going, and the bottom line had been that it didn’t appear as though their hospital had had the best performance in the region, though it didn’t look like they had had the worst, either. Some hospitals were already in desperate shape. There were some memes from Community Memorial in Hamilton that were tagged “Land of the Lost.”

  Val’s intern from Oklahoma, Ronnie, had been one of the first to get sick, followed by four of the nurses and nine members of the first three boys’ families, and since then, three staff members and two more of the attendings had been infected, and the infectious disease guy was telling everyone that he didn’t feel good, either. Some of the patients had hung on, while the nurse who had performed the initial intubations on Aaron and Kenny had been on a respirator by the middle of the day after her first symptoms and then had been dead before dark.

  Val had liked her, and had teased her about being one of those new moms who the week after she brought her baby home had reconsidered her whole apartment for hazards and had replaced her glass coffee table with an ottoman.

  Sometimes this thing killed very quickly and sometimes it didn’t. It was unnerving that they hadn’t made more progress on why, other than the extra vulnerability created by some obvious preconditions.

  The intensive care unit had, fortunately, recently been updated with a control room and video banks that not only monitored all the rooms but also provided vital signs to let the staff know round the clock who was short of breath, who was hypoxemic, and who was just rolling over, and it had been expanded and given responsibility for all suspected cases. After the first nurse had died, the unit had been closed to patients with any other conditions, and they’d managed to scrounge up enough masks with particulate filters, and the interview room had been converted to a dressing area for those about to enter the unit. There’d been some talk of a guard for the door, but it had turned out that no one who didn’t have to went anywhere near it, anyway, and everyone inside was by this point too sick to try to get out.

  The second half of the meeting was supposed to b
e dedicated to brainstorming solutions for the optimal ways of proceeding, but everyone was constantly distracted with calls from other hospitals and doctors and panicked relatives and other alarming posts and news bits and rumors on their phones. And it was hard not to keep coming back to the mystery of what they were dealing with, and the possibility that it was something they were just failing to recognize and they were all going to look stupid when the obvious explanation turned up. The calls were coming in partially because when they had first started talking about this as a group, the unanimous conclusion had been to throw the problem open to every conceivable medical expert, and now every idea that had occurred to anyone who’d been contacted was pouring in. Val understood the impulse and had fired off a few theories herself to some of her old teachers, since anything felt more proactive than just sitting around baffled and frightened.

  When she had first called around to her friends at other hospitals, they hadn’t seen a single case, but now they were all trying to figure out where to get more resources for the number they were dealing with.

  In the meantime, they were still following the protocols and charting everything they could, including demographic information, the patterns of the presentations, the pulmonary and cardiac findings, and the responses to the various treatments.

  In more normal situations they would have been instructed to stop working on the infected material immediately and to transfer all remaining specimens to the CDC. But this seemed to be already almost everywhere, and so Val imagined that the CDC’s ability to follow up on noncompliance had evaporated. But it was hard to know what was going on anywhere with any certainty.

  And, of course, to make everything worse, the media was in full-on the-sky-is-falling mode 24/7, and that shaded over into scapegoat mode—what had the CDC known, and when had it known it? And had this bug been smuggled into the West by undocumented aliens?—and while Fox News had outdone itself this time around when it came to its public irresponsibility (Were the Democrats trying to mandate that the infected homeless be brought into otherwise safe health centers?), even despite all of that, ten minutes on social media made you nostalgic for the relative restraint of what was left of the mainstream. Checking your Twitter feed took more courage than base jumping, and everyone knew someone who could show them videos so terrifying that the most ubiquitous hashtag had now become something you said to people when they waved these images in front of you: “GTSAM,” pronounced Get-Sam, for “Get That Shit Away from Me.” Whenever you got a moment to yourself you picked up your phone and panicked again.

  A big thunderstorm knocked out the power for a few minutes and everyone in the meeting had to shut the open windows against the rain. Not necessarily what you wanted in a building filled with airborne pathogens.

  “What’s the most serious outbreak of anything the world’s ever seen?” Val’s other intern, Sally, asked out of the darkness, while they all sat there listening to the wind and rain on the glass.

  “Human beings,” the chief attending said. There were some You got that right chuckles.

  “And all outbreaks eventually come to an end,” another attending noted. The infectious disease guy was missing, having just gone into quarantine. There was a little box of Kleenex where he usually sat. No one was sitting near it.

  The chief attending looked around the table. “Remember when one resident getting sick would throw everything into chaos?” he reminisced.

  * * *

  —

  On a break in the cafeteria she sorted through her mother’s most recent complaints. Three grim nurses were at the table beside her, leaning forward over their plastic cups. They were scrolling through their phones and outdoing each other with upsetting stuff they found. Beyond them a staff member was washing the floor.

  Her mother had sent a video of Val’s sister sitting by herself in the living room, weeping. Val wasn’t sure how it was supposed to operate as an accusation, but she texted back, How about next time giving her a hug instead of filming her? After a minute her mother answered, This was after the hug.

  Even on good days Val had never found it easy to reconcile her workload with what were supposed to be her obligations as a family member, and her mother’s and sister’s responses to her quarantine had been to demand hourly updates by text, and then to text her even more when ignored. Her sister often added in links to stories from CNN or the Daily Mail with headlines like “DOOMSDAY IN THE U.K.” The previous Christmas Eve, Val’s mother had sat her down and walked her through all of the various ways in which Val had failed her sister, who had a good job at a PR firm but also periodically got blackout drunk and had found herself one morning a few months before that on the maintenance platform of a highway billboard in a driving rain.

  Lori looked up to her, her mother had reminded her, and just because she hadn’t been very receptive didn’t mean that Val couldn’t be more persistent. Val had responded that it reminded her of that old question of who was more neglected by the doctor’s lifestyle, the doctor or her family, and her mother had said, “Well, in this case, the family.”

  * * *

  —

  Kirk, at least, had eased off on the What’s going on? texts, and his attitude toward panic was that it was mostly for cucks, a word he loved and Val deplored, and that medicine was all about having to do something before you were really ready to do it, and that you just needed to remind yourself that whatever it was you were trying to do could definitely be done.

  She had always had more patience with guys who were self-sufficient, which was how she’d stayed with him for two years. She’d met him on a surgery rotation but they hadn’t gotten together until a few years after that, and she told friends who hadn’t met him yet that he was that guy who had the button on his white rounds coat that read “The Way to Heal Is With Cold Steel.” He was usually even busier than she was. He had also turned out to be, among other things, a spontaneous spelunker, which she’d only discovered on a walk when he had spotted a grassy gap under an overhanging rock and had disappeared into it for so long she’d ended up deciding to meet him later at a nearby coffee shop. He’d texted her, Already 30 ft down! Come on in! and she’d texted back directions to the coffee shop.

  He also considered himself very handy with tools and had built some simple end tables for her and seemed to think that that made them very close. But that was the guy he every so often wanted to be, not the guy he was. And she was the same way. She reminded herself of this blind woman she’d met in med school—and how that had worked had never failed to amaze her—who every day had had this incredibly patient guy appear to pick her up after class to take her where she needed to go, a guy who was clearly over the moon about her. Another class member had said to the blind woman in front of the guy, “That is so sweet,” and the guy had opened his mouth to respond and the blind woman had answered, “We’re not really a thing.”

  * * *

  —

  Almost the entire Friedman family—Aaron, his mother, father, grandfather, and older brother Andrew—had been wiped out; the youngest brother, Abraham, was still hanging on. He was nine. He had no visitors. No one to talk with him or read with him or watch TV with him or hold his hand during the most difficult procedures. One of the saddest aspects of his situation was how quietly he handled the unfairness of it all. It was like whatever was coming, he’d already figured out he was going to be dealing with it alone. He was always on a laptop Val had lent him looking up stuff about the outbreak.

  He was having more trouble breathing and his blood oxygen numbers were getting worse and worse, and when he asked her about it she didn’t lie to him, but she also told him that things might turn around and he might start finding it easier to breathe soon. His numbers were heading in the wrong direction, but some things you kept to yourself. Patients didn’t need to hear everything.

  Instead she gave him a smile, though he was smart enough to interpre
t it. He was watching videos on YouTube of someone exploding groundhogs with rifle fire, and the way he looked at her before he returned his attention to the screen reminded her that she’d probably become the only focus he could find for all of the feelings he had left.

  He asked her not to leave him, so she sat with him for a little while, but her beeper kept going off and she had things to do, so she told him she’d be back soon, and then collapsed for five minutes in the break room. There were six other people in there with her, three of them sound asleep, and everybody had masks on and little hand sanitizer bottles hooked to their belts.

  It was sunny outside, and there was a nice breeze coming in the open windows. Every morning it looked like the garbage in the streets had increased overnight. If all of this hadn’t happened, most colleges would’ve been starting their spring break soon.

  Another text arrived from her sister, and she just stared at it. It was like the other part of her life had broken off in a landslide.

  She spent an hour with two other patients who were holding steady, and when Abraham crashed she was only the fourth or fifth person to get to the room. When she arrived the chief attending was looking at his watch and counting the pulse even though those numbers were up on one of the monitors, and someone called that the kid wasn’t breathing and the chief attending shouted for everyone to get organized and out of each other’s way. Val was standing behind him and when he was finished with his compressions she did hers and then moved to the back of the line of others waiting to take their turn. She did one more set and was in the middle of the line for the next one when they gave up on Abraham and called it, and, after another traumatic minute or two, they turned off the monitors.