When she pulled into the parking lot shortly after sunset and got a look at the facility, her first impulse was to double-check the address. It was a one-story structure that looked more like a strip-mall urgent care clinic than a hospital, but then with a total population in the county of less than thirty-five thousand, there was little need for more. Serious cases could be transported by helicopter or ambulance to any number of first-class medical providers in the region. Still shaking her head in disbelief, she got out and retrieved the duffel bag that contained everything she would need to set up a field-expedient bio-lab. She could work with less—and often had, but never on American soil.
The emergency room was strangely subdued. There were no patients waiting to be seen and just a handful of staff, along with two men wearing the khaki and black uniforms of Dare County Sheriff’s deputies. As she stepped inside, something—she had no idea what—triggered a twinge in the back of her throat that made her eyes water. The sensation was like biting on aluminum foil. She had to swallow several times to keep from breaking into a coughing fit. After a few seconds, the feeling began to abate, but she made a mental note of the episode nonetheless. There was something here, something unusual, a smell perhaps, that was unlike anything she had ever experienced before.
“Are you the CDC?”
She turned in the direction of the voice and spotted a slim, middle-aged man with hair gone prematurely gray and a salt-and-pepper beard, wearing a long white lab coat.
“That’s right.” She held up her credentials, hoping that the gesture would keep the man from offering to shake her hand. “Are you Dr. Foster?”
He gave a relieved sigh. “Thank goodness, you’re here. What do you need? We’re a pretty bare bones operation here, but—”
“About that. Dr. Foster, why weren’t the patients airlifted out of here?”
Foster’s eyebrows drew together in a frown. “Given the unusual nature of their symptoms, I made that call. The patients appear to be in…stable condition. I thought moving them might pose an unnecessary risk of exposure to others.”
“You don’t sound too sure, Dr. Foster.”
“I’ll be honest, Doctor…?”
“Fogg. Sara Fogg.”
“I’m in way over my head, Dr. Fogg. I’m the first to admit it. That’s why I called you.”
Sara looked around the ER, aware that their conversation was being observed with great interest by everyone present. A doctor with the humility to admit his own inadequacy was a rare thing in her experience, and Foster was being very public about the admission. “Tell me what you know. Start at the beginning.”
He motioned for her to follow, but he walked immediately toward the Sheriff’s deputies. “Early this morning…about ten, right, Jim?”
One of the deputies nodded.
“About ten,” Foster continued, “we got a 911 call from a researcher working out at Fort Raleigh. She said one of her associates had collapsed. By the time the paramedics arrived, there was a second victim.”
“Tell me about the symptoms.”
“Fever, sweating, convulsions, profuse salivation.”
“Salivation? They’re drooling?”
Foster nodded. “That was how they presented initially. By the time they got here, there were other… Well, you’ll have to see that for yourself. When one of the first responders began showing the same symptoms, I knew we were dealing with something contagious.”
That was news to Sara. “How long after exposure?”
Foster glanced at the deputy. “Five minutes?”
The man shrugged. “More like two.”
Sara’s mind raced to keep up. Viral or bacterial contagions took days, sometimes weeks, to incubate. That meant they were looking at something else, a toxin perhaps. But what was the vector? “Anyone else?”
“No. But everyone who has had any direct contact with the patients is here. Under quarantine. That includes all of us.”
Her respect for the doctor went up another notch. For someone who felt out of his depth, he had already started making good decisions. Without further discussion, he led her to the hospital’s laboratory. It was only slightly better equipped than a high school science classroom. She quickly set up her own gear and then donned a biohazard safety level-four environment suit. She felt a little self-conscious in the suit. It was unlikely that the hospital had BSL4 suits, so Foster and the rest of the staff had probably been treating the patients using standard isolation precautions: disposable paper scrubs, surgical masks and gloves. However, it was the nature of infectious disease that caregivers were often at the greatest risk, so taking precautions, even those that seemed extreme, wasn’t simply a matter of self-preservation. If all the doctors died, then there would be no one left to fight the outbreak.
The Tyvek over-garment was similar to the suits used by her colleagues at the CDC research laboratory in Atlanta, but it was meant for one use only. Once she sealed herself in, she would have about a half an hour until her self-contained air supply was exhausted. After that, the suit would be useless, but one assessment visit would be enough to determine whether the hospital’s isolation protocols were sufficient. If they were not, she would have to declare a hot zone, and that would initiate a much more comprehensive response from the government.
When she finished putting on the suit, she asked Foster to take her to the patients. As the two of them, accompanied by a pair of nurses, made their way to the isolation ward, he filled her in on their identities. “First patient is Jason Harris. Twenty-three year old male, grad student at NC State. I’m afraid I haven’t been able to get his medical history yet. An eyewitness on the scene says that he was fine one minute, and then fully symptomatic the next.”
“Eyewitness?”
“Dr. Ellen Dare, his thesis advisor. She’s the one that called 911. She’s here, if you want to talk to her.”
“She’s not symptomatic?”
“Not in the slightest. She and the second patient started first aid while they waited for EMS. The other girl—Haley Stephens, twenty year old female, undergrad, also at State—was already fully symptomatic when EMS arrived. Miss Stephens was shooting video at the time, but I don’t think there’s anything useful on it.”
“I’ll want to take a look at it anyway.”
They had reached the end of a corridor, but between them and the heavy metal doors that led into the next ward, someone had erected a barrier of thick transparent plastic, held in place with silver duct tape. “Best we could do, I’m afraid.”
“It’s fine,” she assured him.
“There’s a decontamination area on the other side of the doors, where you can remove the suit. Disinfectant shower, biohazard disposal bags. We’re still following our isolation protocols, though I’m not sure how much good it’s doing at this point.”
“Tell me about the third patient.”
“Doug Stovall. Thirty-four year old male. Lives in Manns Harbor, across the sound. Volunteer fire-fighter and paramedic. He was working to stabilize the patients and get them loaded into the ambulance when he went down, too. He was wearing gloves, but given the circumstances, they wouldn’t have made much difference.”
“What do you mean by that?”
“The convulsions are quite severe. The patients were thrashing and biting, so he was certainly exposed to their bodily fluids. But so were the other paramedics, and most of us here, and we aren’t showing any—”
“I’m sorry, did you just say ‘biting?’”
He gave an almost embarrassed nod. “All of them are doing it. We had to use restraints, and even then we don’t dare get too close.”
“You’ve tried sedatives? Tranquilizers?”
“Tried. Failed. They won’t let us get close enough to put in a line.”
Sara didn’t like what she was hearing, but she sensed that the only way to learn more was to actually get a look at the patients. She waited for Foster and the nurses to pull on isolation garments, and then proceeded through
the door.
Beyond the designated decontamination area lay the main hospital floor. Foster guided Sara past the abandoned nurse’s station and into the first room. As soon as the door opened, she could hear low guttural noises, like grunts or snarls of fear. Despite that warning and Foster’s earlier description of the symptoms, she was unprepared for what she saw next.
“Which—?” She couldn’t get the rest of the question out, but Foster seemed to understand.
“That’s Jason Harris. Patient Zero.”
Sara was having trouble reconciling what she now saw with what she had been told about Harris. The gaunt figure strapped to the bed did not look like a young graduate student.
It didn’t even look human.
Harris appeared emaciated, as if starved to the point where his body had devoured every ounce of muscle tissue, leaving little more than a skeleton covered with hairless skin. The skin itself was almost transparent, and underneath it, Sara could see cords of gray muscle and sinew, and a spidery map of blood vessels and nerves. It was as if he was fading out of existence. Yet, despite the evident wasting of his body, Harris was thrashing in his restraints, shaking so violently that the heavy hospital bed was now askew and creeping across the room.
Even stranger was the skeletal deformity.
Jason Harris’s bones—all of them—were unnaturally long, as if they had been softened and stretched like taffy. His arms, fixed to leather straps attached to the bed rails, were almost twice as long as they should have been. Through the papery skin, she could see that the bones were spindle-thin.
“The skeletal deformity.” Sara wasn’t sure what else to call it. “Tell me that’s a pre-existing condition. Acute Marfan Syndrome or something like that?”
“I’m afraid not. All three of them look like this. It’s definitely a symptom of whatever they’ve got.”
“That just isn’t possible. Bones don’t change like that. Not in twelve hours’ time.”
Foster spread his hands helplessly.
Sara realized she was breathing fast, her exhalations fogging the face-plate of her environment suit. Impossible was not an option. She was a scientist, obligated to deal with the facts of the situation, no matter how unbelievable they seemed.
Focus, Sara. Do your job.
She took a deep breath and started forward into the room.
Harris’s head swiveled toward her. His skull was grotesquely long, stretched and distorted like a melting wax effigy. The skin was pulled taut, the lips drawn back from teeth grown so large that even on the abnormally large jaw, they were jammed together crookedly. Some protruding like tusks.
But the eyes…
Although drawn back and nearly covered over by bone growth around the occipital cavity, his eyes looked normal. Bloodshot but otherwise unchanged. In their blue depths, she thought she could see an echo of the human he had once been. As their stares met, she felt the urge to offer whatever comfort and reassurance she could.
Suddenly, with a convulsion so violent that it lifted the bed several inches off the floor, he thrust his head toward her, biting at the air. His teeth gnashed together so forcefully that, even through the barrier of the suit, Sara could hear the enamel chipping away.
Sara had watched a lot of people die over the years. That was the nature of her profession. But she had never seen anything like this. Even if, by some miracle, this young man recovered—and it was her scientific opinion that nothing short of divine intervention could effect that outcome—the changes to his body, and probably to his psyche as well, would be permanent.
She struggled to order her thoughts.
“I’ll need a blood sample,” she told Foster.
The doctor exchanged an unhappy glance with the nurses, but they all knew that it had to be done. As they ventured closer, the patient seemed to grow even more agitated, like a mad dog straining to break free of a chain. Sara felt a rising trepidation. Without a blood sample, there would be no way to even begin looking for a cause, but getting it meant risking exposure, and not just for herself.
Sara was willing to take that risk, but she wasn’t so sure about asking the others to do so, especially since there was no way of knowing whether the potential benefit outweighed the danger. Before she could voice these reservations however, Foster and the nurses moved in quickly and braced Harris’s upper body. The nurses each grasped an arm while the doctor managed to wrap his arms around the patient’s misshapen forehead.
“Go!” Foster yelled, snapping Sara out of her uncertainty. She moved forward quickly, dismayed to see that, even with three people holding him down, Harris was thrashing so violently a clean stick would be almost impossible. Still, this might be her only chance.
She struggled to fix the rubber band tourniquet in place, just above the elbow, then placed her left forearm atop the patient’s and leaned onto him, adding her weight to that of the nurse. She could still feel him trying to move. Using just her right hand, she worked the plastic sheathe off the syringe needle and brought it close to his arm. She had no trouble finding a vein through the almost transparent skin, but trying to hit it while Harris was struggling against them was a challenge. She held her breath, trying to anticipate his next spasm, and then stabbed the needle into the vein.
The vial started filling up with viscous blood that was so dark it seemed almost black. Harris jerked again, and she had to press down hard on his arm to keep him from shaking the needle out. She needed at least three vials, but it was immediately clear that she would be lucky to get even this one filled. Holding the syringe with her right hand, she cautiously lifted her left and loosened the tourniquet.
What happened next was a blur.
There was a flurry of movement beside her, and then something slammed into her, knocking her backward. There was a sharp inexplicable pain in her hand, but she was more concerned with trying to arrest her fall. She stumbled backward, flailing in vain. She caught a glimpse of something red against the austere white ceiling tiles. Then hands were grasping her, pulling her along the floor, away from the trembling hospital bed. She fought them for a moment, caught in the grip of a reflexive urge to assert some control in the midst of the chaos.
As the panic began to ebb, she started to piece together what had happened. Harris was still restrained, but somehow he had slipped out of Foster’s grip, and that had been enough to send the three medical professionals scrambling. One of them had knocked her down, and then together, they had dragged her away, out of danger.
Sara recalled the pain she had felt, and for a moment she feared she had been pierced by the syringe. The vial lay on the floor, a few feet from the bed, leaking crimson droplets onto the floor but still mostly full.
But did it stick me?
She looked down at her hand and immediately saw that the answer to her question was irrelevant.
A section of the suit, from her fingertips all the way up to her left elbow, had been torn away, exposing her to whatever pathogens were circulating in the air of Jason Harris’s hospital room, but even that was now unimportant. She watched in disbelief as fat drops of blood—her blood—spattered the floor, flowing freely from the semi-circular wound on the side of her hand.
Harris had bitten her.
17
Pinckney, New Hampshire
King sat on the picnic table, gazing into the radiant flames dancing above the fire pit and idly rolling a bottle of Sam Adams Boston Lager between his palms.
“My bachelor party,” he murmured.
It sounded strange in his ears, but no stranger than some other words and phrases that had found their way into daily conversation, like ‘my wedding’ and ‘my fiancée.’ Still, those were things he had willfully embraced with his commitment to Sara. The notion of a bachelor party had not even entered into his mind.
Rook, of course, had been all over it. Yet, much to King’s surprise, the festivities were subdued. Instead of a post-adolescent stag party, this was a quiet, almost introspective gathering of men who
had sacrificed—or at the very least postponed—marriage and family life to make the world a little bit safer for everyone else. Even the normally extroverted and irreverent Rook seemed to get this, though this apparent shift toward maturity probably had more to do with Queen’s influence in his life.
Those two are definitely good for each other, King thought with a grin. I should probably start thinking about his bachelor party.
He glanced up as Knight stepped out of the shadows to join the group. The team’s sniper looked conspicuous in his black designer slacks and white Egyptian cotton shirt, dressed more for a night on the town than a few hours of hanging out around a bonfire. King jumped down from his perch, wincing at the stab of pain in his leg, and crossed over to greet him.
“Dae-jung, I was very sorry to hear about your grandmother.” The offer of sympathies, like everything else about the night, felt strange to him, but Knight returned a grateful smile.
“Thank you, Jack.” Knight seemed oddly serene, which was both encouraging and a little disconcerting. “I’ll probably need some personal time, but it can wait until after the wedding.”
“You don’t even need to ask,” King assured him, and he meant it.
Before he could say more, the rest of the group gathered around to offer their condolences as well, and King faded away, returning to the table to continue nursing his beer. With Knight’s arrival, the roster of King’s friends was nearly complete: Deep Blue, Rook, Knight, Lewis Aleman, George Pierce and Domenick Boucher. There were a couple of other familiar faces—men from Endgame security who were present in a semi-official capacity—but it was, as Rook had planned and as King wanted, an intimate evening with close friends. The only man not present was his father, Peter Sigler—sometimes known as Peter Machtcenko, depending on which identity he was using. King’s feelings toward his father were conflicted enough that he was unsure of whether to count the man as a friend.
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