by Ann Benson
A bacterial disease caused by the enterobacterium Yersinia pestis, plague is still found in significant pockets throughout the world, specifically in Southeast Asia (Vietnam, China) and the American Southwest. Bacteria are carried by fleas living on rodents and small mammals; large mammals such as deer and cattle are occasionally found to be carriers. If the bacterium is transferred to the flea when it bites the carrier, it multiplies in the flea’s digestive tract until the insect’s stomach becomes engorged with bacteria. Upon biting another animal, the flea regurgitates the microbe into the bloodstream of the bite victim, who is then infected. Disease may also be spread by direct contact with infectious material such as body fluids or contaminated clothing.
Sweat dripped off his face, drenching the front of his turtleneck.
There are three forms of the disease, all caused by the same microbe. In the bubonic form, early symptoms include fever, headaches, minimal swelling of the lymph glands, especially in the neck and groin areas. If untreated the disease progresses rapidly to more pronounced symptoms, including massive swelling of the lymph nodes, with bleeding into the surrounding tissues. Pustules (buboes) form within the nodes themselves and often appear as raised boils on the surface of the node area. There may be marked pain, especially in the joints and extremities. Patients may experience memory deterioration and may exhibit antisocial or uncharacteristic behavior. Profound depression may occur.
Ted touched his neck involuntarily, palpating again, as if his head refused to believe what he already knew in his heart to be true. He read on.
If left untreated bubonic plague frequently develops into pneumonic plague, in which bacteria overwhelm the respiratory system by coating the inside surface of the lungs. In this form the disease is most contagious, for the aspirated sputum and fluid droplets exhaled during normal respiration often carry viable bacteria.
He placed his hand over his mouth as he breathed.
Septicemic plague occurs when the bacteria spread to the bloodstream and vital organs. As the bacteria complete their normal life cycle and die off, large quantities of toxic effluent are released directly into the bloodstream; the kidneys and liver may become necrotic in their attempt to purge the system of toxins. The victim eventually succumbs to toxic shock. The course of this form of plague is usually very rapid, and it is almost invariably fatal.
He was sweating even more profusely now; he wiped his brow with his hand and then wiped his hand on his pant leg. He held up his hand and stared at it, wondering with horror how many millions of bacteria he had just introduced to the fabric of his pants.…
The treatment of choice is a prolonged course of oral and parenteral antibiotics. Most effective are streptomycin, chloramphenicol, and tetracycline. Boils may be lanced to relieve pressure and flushed with sterile saline solution in the bubonic form, but care should be taken that secondary infections do not occur as a result of the surgical procedure. In most cases treatment must be started within seventy-two hours of the development of symptoms to be effective. Serum containing antibodies from previous victims can be used to augment or replace traditional antibiotic treatments.
All patients should be isolated and any patients exposed to the disease should be quarantined until the maximum incubation period has passed (usually three weeks). Health-care providers should use universal precautions when handling tissue or body products from infected or exposed persons.
By international agreement all cases of plague must be reported to the World Health Organization. The U.S. Centers for Disease Control can provide further information via its info-fax system.
Now completely frantic, Ted tried to count backward. With great difficulty he determined that it had been nearly forty-eight hours since he’d started feeling ill. He sat back and closed his eyes, his head pounding as bacteria-laden blood rushed through it. This is wild, he thought, panicking, this is completely insane. This is the twenty-first century, not the Middle Ages! How did this happen?
But Ted already knew the answer to that question. He had screwed up; he was entirely responsible for this mess, and there was a very tangible paper trail to prove it, some of which was not within his immediate control. As a result of his own incompetence he was suffering from a potentially fatal and highly infectious disease, and if he sought treatment through normal channels, the whole scientific community would discover what had happened. He would never be able to reconstruct his orderly, precise life.
He knew he needed treatment; he would probably die without it. But it was impossible for him to go to his assigned physician. He knew he would have to go directly to the Institute’s medical offices and get what he needed without anyone else knowing he had done so.
He left the lab and stumbled his way down the poorly lit corridors to the medical offices. Please don’t let anyone see me, he prayed to any god who would listen. His frantic prayer was answered, for he arrived undetected to find the offices completely shut down. He could simply wade right in and help himself to whatever pharmaceuticals he needed. He knew the medications were stored by type, so he went directly to the area in which all the antibiotics were shelved, including those now obsolete and the few that were still slightly effective.
He pawed his way through row after row of pathetically useless vials, and wondered why they were still in storage. Hope springs eternal, he thought. We were so stupid. Why weren’t we more careful in using these drugs? One by one all the antibiotics on which humanity had once depended had become ineffective against the bacteria they’d been developed to control. The days were long gone when a child was brought by a slightly worried mother to a clinic for a strep throat only to be sent home with an armload of antibiotics. Now, he knew, those children died in isolation wards, their bodies completely ravaged by feasting microbes that had made better genetic adaptations for survival than their human hosts.
But this is an old disease, and an old drug might do what I need it to do. The thought reassured him, but only briefly, and then he began to panic again, wondering what he would do if there was no supply of at least one of the drugs he needed. The three antibiotics named in the computer program were more archaic than most. All three had ceased to be effective on most strains of bacteria more than five years ago, and no new supplies were being manufactured. He hoped desperately that some pack-rat pharmacist with a sense of history had stored some for posterity, just to drag it out every now and then to impress some young trainee with the difficulties of archaic treatment regimens. We walked ten miles each way to the pharmacist in the snow and wind every day … or, the more likely scenario, he hoped that someone had been lazy about cleaning out old frozen samples. Oh, dear God, please let there be some still here … it’s my only hope! He would have to do a lot of explaining to obtain the antibodies of a previous victim if the drugs were not available.
Hair of the dog that bit you, he thought, and despite his sheer terror he almost laughed.
Ten achingly long minutes passed before he found three frozen vials of injectable tetracycline in the back of a freezer. His hands were numb and he had to stop to warm them before he risked taking the precious vials out of the unit. If he dropped any one of them, he would probably die, as would Caroline if she were also infected, and perhaps a lot of other people.
He had to rest; his heart was beating rapidly again and his head was feeling even thicker than before. He reflected miserably on the fact that he had gone to a computer for diagnosis and treatment without ever speaking with a human being. Compudoc franchises were springing up as McDonald’s restaurants had just a few decades earlier, their neon green caduceus signs now as recognizable as the Golden Arches once were. He could see the whole horrible scenario in his mind’s eye: thousands of plague victims attached at the wrist to those computerized monsters, their necks swelling, their eyes bulging, sweat pouring off of them and onto the surrounding street or floor, each victim guarded by a merciless Biocop who would shoot before asking questions.
Stop wasting time! he told himself furiously, forcing himself
to stand up. You don’t have any to waste! He grabbed a handful of syringes from a supply cabinet and stuffed all but one in his pocket. He would use that one to inject himself with a good dose of tetracycline as soon as it thawed. This time I’ll be careful to loosen the stopper before too much pressure builds up.… Out of the corner of his eye he spied a bottle of aspirin in a glass cabinet. He grabbed it and stuffed it into his pocket along with the other items. Armed with a complete arsenal against his silent attacker, Ted turned off the light and headed back to the lab again. There were tracks still to be covered.
He could destroy all the evidence of his ineptitude except the list of supplies he had given to Frank, but without the associated computer files, it wouldn’t mean much. He knew he could easily destroy the files and the programs that supported them. Without hesitation he powered up both systems.
He bypassed the operating system completely and went straight to the root directory. God bless the ghost of DOS, he thought gratefully. At the prompt, he typed in:
Delete
He pressed enter. A message came up on the screen.
All files will be deleted! Are you sure? (y,n)
He typed y.
Please enter your password.
After he complied, there was a moment or two of soft whirring as everything on the hard disk self-destructed. Then the screen went blank, signifying the death of an artificial intelligence. A million dollars’ worth of software development expired in a brief blip of electrons. He repeated the procedure on the second system, without mercy, without remorse.
Then Ted got up and walked unsteadily to the storage unit where he thought he’d seen Caroline store the sample of the fabric, and looked at the shelf where the smaller items were kept. But the fabric still wasn’t there. After fifteen minutes of tearing the unit apart he gave up. He tried to think where Caroline might have moved it. There was no other logical place at the Institute to store it. The remainder of the freezer units were secured because of the toxic nature of their contents. He thought it ironic that of the items that had passed through this lab, that sample, perhaps the least well secured, was among the deadliest. Nearly half of the population of Europe and Asia had fallen prey to bubonic plague in the fourteenth century. And it could happen again, he thought, now that different strains of bacteria regularly shared genetic material encoded for drug resistance. Enraged, he kicked a nearby chair. His foot throbbed miserably, and incoherently blubbering, he sat down.
The parking lot was full when Janie and Bruce arrived at the storage facility in Leeds, so Bruce parked the car just outside the gate on the access road. They retrieved their briefcases from the backseat and walked to the main security area, where Bruce resumed negotiations with the security guard, picking up where he’d left off the day before. He had found out in his earlier call to the facility that Ted had not made contact with them. Still, there was a hopeful sense of anticipation in the air as he and Janie entered the building. One way or the other they would soon know the nature of the beast they faced.
The guard flipped through the pile of papers Bruce had filled out. “I’ve run all the clearances, and I’m happy to say that you’re in good shape. Sorry we couldn’t clear you yesterday afternoon. You understand we can’t be too careful. You can come right through and we’ll bring the items up from the holding area.” He glanced at Janie briefly. “Your companion will have to wait out here, but it shouldn’t take too long. Step this way, please.”
The guard turned and walked toward the entry door to the waiting area. Bruce gave Janie a smile and made the thumbs-up sign; she smiled back at him and mimicked his reassuring gesture. She was immensely relieved to know that the soil samples would soon be in her possession again. And she was filled with gratitude for the way Bruce had helped her; he’d revealed an admirable depth of character in seeing her through her difficulties. She found herself liking and respecting him more every minute.
She stood in the waiting area and fidgeted impatiently as Bruce followed the guard away. She flipped her hair nervously and tucked a few unruly strands behind her ear. Suddenly she was aware of something falling lightly on her chest. She looked down and watched with annoyance as one of her earrings fell to the floor and started rolling away. It tumbled crazily toward the security gate with surprising and alarming speed. Instinctively, Janie stepped forward to stop it, and reached down to pick it up.
It went just a centimeter too far. As soon as her hand crossed the vertical plane of the security gate’s scanner, it read her genetic material and compared the readings to a database of bodyprints. It would record that she had passed through the gate at the precise date and time when the scan had occurred. But unlike the match that occurred when Bruce passed through, the computer found no match for Janie, and became understandably annoyed. Within a few seconds a loud electronic alarm blared, You can’t do that! and the guard whipped around to see what was setting it off. In less than a second he had his weapon drawn and aimed at Bruce, who stood between him and Janie.
“Don’t move, either of you,” he said sternly.
As were all guards at medical facilities, he was trained to assume the worst possibility in each situation and then downsize his reaction as dictated by a cautious analysis of the circumstances. Use your last resort first, they’d told him in boot camp. He pointed his weapon directly at the “intruders,” leaving both Janie and Bruce with no doubt that any sudden move would bring a quick end to both of their lives.
When his captives were immobile enough to satisfy him, the guard said, “Step aside, please, Dr. Ransom.” Though his words were polite, Bruce knew that this man meant business. But he remained calm and stood his ground, stupefying Janie with this dangerous act of protection. He said to the guard, “What are you going to do to her?”
“I’m afraid I have to take you both into custody, sir.”
“Both of us?” he said in disbelief. “What about my clearances?”
The guard looked down the barrel of the weapon and said, “Sir, as you know, access to this facility is strictly limited. Some professional civilians such as yourself may enter once the proper clearances have been secured, but we never allow unprinted individuals to enter. Never,” he repeated for emphasis. “That alarm indicates that the lady is unprinted.”
Bruce was furious. “This is outrageous! I’ve never heard this regulation before.” And just as he was about to protest further, four more Biocops ran into the entry area, their chemical rifles drawn. Janie and Bruce were quickly surrounded.
Soon thereafter they found themselves marching down a long corridor to the far end of one wing of the building, urged on by the hard tips of the rifle barrels on their backs. They entered what looked like an old jail area with barred cells. Janie was placed in one cell, and Bruce in another a few feet away. After closing both cell doors the Biocop walked to a small wall panel just out of reach of Bruce’s cell and inserted a plastic card. He then pressed two buttons, and loud clicking sounds followed from both cell doors. The Biocop came back to each cell and rattled the door to be sure it was locked. As he left the room he said, “I’ll be back later for your belongings.” The main door slammed shut and the thud echoed menacingly through the small, sparsely furnished room.
Janie slumped down against the wall and hugged her knees, stunned at this sudden turn of events. Bruce just stood in his cell with his hands on the bars over his head, saying nothing. The silence between them was like a deadweight.
“Bruce?” Janie said quietly.
He didn’t answer, but looked up and met her gaze with an agonized expression on his face.
“I don’t think we’re in Kansas anymore.”
Eleven
Alejandro had his first audience with King Edward III in the dressing room of the kings private apartment.
Still attired in his dressing robe, a garment of lustrous cloth-of-gold that Alejandro thought a lesser king might covet for his robes of state, the monarch was engaged in his lengthy morning toilette. He waved Alejandr
o into the room without a word, then resumed his tasks, leaving the physician to wait in the corner.
Laid out before him was an assortment of fine garments, handsome shirts with full pleated sleeves, velvet breeches, doublets with intricate borders of pearls and gemstones. The king strode past the array and pointed decisively at his choices, and the servants took the rejected pieces away. Then they brought forth a stream of long stockings and fancy garters and silk underthings, and the handsome monarch scrutinized them with obvious pleasure.
He seems far too jovial for a king burdened with such woes, he thought privately. De Chauliac had said that England was at war, and if the whispers he had heard on his journey from Avignon were true, had nearly been bankrupted by the cost of it.
And then, too, there was the pestilence nipping at the very heels of Windsor.
“Sit down, Doctor,” the king said. “We shall speak as my men dress me.”
Alejandro looked the servants over carefully and decided that none had the look of a minister or advisor who might take offense at being excluded from the discussion of an important matter. The tongues of servants can be easily made to wag for a small price, he thought to himself. He said to the king, “Your Majesty, I think it advisable for us to speak first in private.”
The king regarded him with surprise for a moment or two, and noted the serious look on the physician’s face. “Very well,” he said. He dismissed the servants, and they left the room immediately, the second one closing the door behind him. He gave Alejandro a pointed stare and said, “I am not accustomed to having my morning routine interrupted. I will make an exception owing to your lack of familiarity with our customs. You would be wise to learn mine. Now speak.”
Perhaps not so jovial after all, Alejandro thought miserably, reconsidering the accuracy of his previous observations of the king. This was a far less hospitable monarch than the one who had so warmly received him the night before. He cleared his throat nervously. “Your Majesty,” he began, “I am concerned about the glowing reports you have had from the pope. I fear that His Holiness may have made too much of my skills. In truth, Sire, neither I nor anyone else, de Chauliac included, can cure this pest. I am trained only to prevent infection by isolation. I did not want you to think otherwise.”
