by David Kazzie
“The washcloth, then,” he said.
Katie Sanders nodded, pressing a tight fist against her lips and closing her eyes. Adam could tell she was trying to keep her wits about her even as her psyche was fracturing like glass. She left the room, leaving Adam alone with Terry Sanders. He could hear a brief discussion in the living room as the children sought a status update on their father.
Adam took in the room while he waited for his putative nurse to return. It was a standard beach cottage bedroom, sparsely furnished with a rarely used chest of drawers and a flat-screen television mounted in the corner. A penciled rendition of a Holden Beach map hung over the bed.
He checked on the patient again, pressing the back of his hand against Terry’s cheek. Still scorching hot, like the man was chewing on a lit match. Adam couldn’t recall ever encountering a patient with a fever this high. As he pulled his hand back, Terry started seizing, as if his whole body was experiencing a massive internal earthquake. Adam gently rolled him over onto his side and held him there as his body quivered and heaved, flopping around like a fish in the bottom of a boat. It stretched on interminably. In all his years as a physician, Adam had never seen a seizure go on for so long, had never seen one so violent. Finally, mercifully, it ended, leaving Terry Sanders on his back, his eyes open and glassy and staring at the ceiling.
“Terry?” Adam said. Then again, very loudly this time, Adam no longer concerned with whether he might frighten Mrs. Sanders or her children: “Terry?”
No response. Not a twitch.
Terry Sanders was dead.
INTERLUDE
FROM ATC RECORDINGS OF SKYDANCE AIRLINES FLIGHT 337
August 7
8:53 p.m. Pacific Daylight Time
310 Miles South-Southwest of Los Angeles International Airport
L.A. Center – Skydance three-three-seven heavy, we’re gonna have EMS out to meet you.
Skydance 337 – Three-three-seven, L.A. Center, it’s getting worse.
L.A. Center – Repeat that, three-three-seven heavy.
Skydance 337 – Franks is dead.
L.A. Center – What about Meadows?
Skydance 337 – I feel like shit, Tower.
L.A. Center – Hey, three-three-seven heavy, check your airspeed. What about Meadows?
Skydance 337 – Roger. Meadows is asleep. Can’t seem to wake him up.
L.A. Center – Three-three-seven heavy, your airspeed is a little low. How are the passengers?
Skydance 337 – [WHEEZING COUGH] Jesus. Hurts. It’s quiet back there. Not sure if that’s a bad or good thing.
L.A. Center – You listen, we’re gonna take care of you, three-three-seven. You’ll be on the ground in forty minutes. But you’ve got to give me a little gas here. Put the nose down a bit, just a hair.
Skydance 337 – Gonna climb a bit.
L.A. Center – Negative, three-three-seven heavy, negative. Oh, fuck!
Skydance 337 – [WHOOP! WHOOP! STALL WARNING. WHOOP! WHOOP! STALL WARNING.]
L.A. Center – Nose down, three-three-seven.
Skydance 337 – We’re stalled, we’re stalled! [LONG SPELL OF COUGHING]
L.A. Center – Ease up on the stick, three-three-seven. You’re making it worse!
Skydance 337 – [Unintelligible]
L.A. Center – Nose down, Jesus Christ, three-three-seven, nose down.
Skydance 337 – I don’t feel good. [Unintelligible]
At 8:55 p.m. PDT on August 7, Skydance Airlines Flight 337, carrying 238 passengers and crew, disappeared from radar.
5
Dr. William Ponce thought he’d known what it meant to be truly scared.
He thought he’d been scared when his son Alex, then three, had choked on a chunk of apple, the little boy pawing at his throat, his face turning red and then blue, as if Ponce was being treated to the worst fireworks display of all time, the pyrotechnics show someone might see on his first night in hell. But as awful as it was, the episode had lasted less than twenty seconds, ending when his wife Molly had delivered just the right force of slap to dislodge the malicious chunk of fruit and send it flying across the room. Alex was a typical sixteen-year-old now, having no memory of how close he’d come to dying before his fourth birthday.
And as the chief pathologist for the U.S. Army’s Medical Research Institute for Infectious Disease, he was quite familiar with fear – it was part of the job description. He was fifty-five now, having spent nearly two decades at Fort Detrick in Maryland, working alongside some of the most lethal agents known to man. He still remembered popping his Ebola cherry, his first trip inside Biosafety Level 4 now twenty-five years gone by, when he’d participated in the necropsy of a monkey that had died of Ebola Zaire, the most terrifying organism he’d ever encountered (until two days ago, at least). As they’d examined the liquefied tissue inside that poor monkey (and he still thought about that monkey a quarter century later), his heart had pounded at his chest wall like a meth-fueled jackhammer, threatening to fracture him from the inside out, the virus-laden blood seeping out of the ruined corpse as they worked on it. But that had been restrictor plate racing, the fear capped by the spacesuit he wore, the precautions they took, the strict protocols in place to prevent any breach of the integrity of the equipment or the facility.
He remembered all the stupid things he’d once worried about, like tearing his suit inside Level 4, disappointing his new bosses at USAMRIID, even panicking inside the spacesuit, which occasionally happened to newbies in 4. Every now and again, a rookie would rip off the space helmet inside the hottest of the lab’s hot zones because they’d convinced themselves they were suffocating even though subsequent testing showed the oxygen had been moving freely inside the suit.
In his two-plus decades assigned to USAMRIID, he’d never developed spacesuit fever, as they called it, but he did dream about the viruses, big, bright dreams of accidental sticks from needles dripping with Ebola-tainted monkey blood, or taking a face-full of the black vomit that accompanied the end stage of Marburg infection. Then he’d wake up, bathed in sweat but a dozen miles from Level 4, his bedroom quiet but for the gurgle of the fish tank. He didn’t even mind the dreams so much; it was, he supposed, his mind’s way of letting off steam, relieving the pressure of working in Level 4.
Only now though, as he sipped his coffee alone in USAMRIID’s main conference room, a Baltimore Orioles mug clutched in a trembling hand, did he know what it meant to be truly afraid. The difference, he realized on that humid August morning, was that this wasn’t a trip inside Level 4 from the safety of the Racal spacesuit, where the fear was of the hypothetical, always a What If question. This was something else entirely, a presence, consuming him from the inside out, eating away at his sanity, threatening to destroy his ability to think coherently before he could even attempt to do anything about this mess. It had transcended the hypothetical into the very fucking real. A real American city, population 1.5 million – the Bronx, for Chrissakes! – had become, for all intents and purposes, an open-air Level 4. It was out there right now, spreading from person to person, and there was nothing he could do about it.
The twenty-six-inch monitor in front of him, emblazoned with the seal of the President of the United States, flickered briefly and then showed a long view of the White House Situation Room. President Crosby’s chair at the head of the table was empty, but every other chair was occupied, their occupants chit-chatting about This Important Problem or That Important Problem. He recognized some of the faces from their appearances on the various cable and online news outlets, but the only person he knew by name was Kevin Butler, the White House Chief of Staff, seated just to the left of the President’s chair. Butler was leafing through a dossier that had been delivered to the White House in a screaming caravan of black Suburbans, hand-carried by the USAMRIID director himself.
Ponce could just make out his reflection on the screen, and it was not a flattering one. He hadn’t shaved in two days, and he haired up like a Yeti. The circle
s under his eyes were dark and getting darker. Exhaustion held him tightly in its grip, but the fear kept him awake, a never-ending electric charge. As he took a deep breath to calm himself, he heard the sound of a door opening; all twelve men and women around the conference table leapt to their feet as President Nathan Crosby swooped into the room.
Crosby cut an impressive figure, well over six feet tall, still handsome despite three rough years in office, his only concession to the advancing years a bit of gray edging up his temples. Ponce didn’t like him, thought he was a dipshit, someone who’d cruised into office on a relentless wave of campaign ads blasting his predecessor for what he had been unable to do, not anything Crosby had actually planned to do. Ponce didn’t hold politicians in very high esteem to begin with, but this guy, the former governor of Oklahoma, really took the cake with his anti-vaccination stance, his tirades against evolution, his general tolerance for stupidity because Ponce believed stupid people had put Nathan Crosby into office. Not that his predecessor had been any better. When you got right down to it, the country was a bit of a mess, wobbling from one recession to another like a lost child (even though no one wanted to use the word ‘depression’). Crosby was up for re-election in November; he was in a statistical dead heat with his scrappy Democratic opponent.
The President leaned over to Butler and whispered something; both men laughed. This made Ponce’s blood boil and all but confirmed what he was worried about. They were not taking this outbreak seriously.
“Dr. Ponce?” Butler said. “President Crosby will hear your report now.”
“Good morning, Mr. President,” Ponce said, clearing his throat. He pressed a button on a small remote, transmitting the three-dimensional scan of the virus to a 50-inch LED screen in the Situation Room, adjacent to the videoconference screen. The virus, which they had code-named Medusa, looked like a long curlicue, not terribly dissimilar to a snake, coiled and ready to strike.
“I wish I had better news, sir,” Ponce said. “This is the Medusa virus you see on the monitor, magnified about fifty thousand times. The mortality rate is in excess of ninety-five percent, perhaps even higher. We’ve got fifty-six confirmed cases. Fifty-one are dead, and the other five are circling the drain.”
“How far has the outbreak spread?” Butler asked.
“We’re not entirely sure about that,” Ponce said. “The CDC is tracking unconfirmed reports of the illness in eleven states, but the epicenter of the outbreak appears to be in the Bronx. Until we can confirm that, probably in the next day or so, the CDC and USAMRIID both recommend quarantining the affected areas. There’s still time to limit the loss of life. Anyone infected with the virus probably doesn’t feel well enough to travel far.”
“Quarantines?” Butler bellowed. “Dr. Ponce, do you have any idea how much of a cluster fuck quarantines will be?”
“But sir-”
“Nearly two million people live in the Bronx alone,” Butler said, his voice tinged with annoyance. “People will fucking panic. We can’t go around screaming that the sky is falling like happened with the swine flu thing. We have to step carefully here. The President is in a sensitive position.”
Oh, shit, Ponce thought, the picture crystallizing in front of him like the virus coming into clear focus under the scope. This wasn’t just a matter of them not taking him seriously. They were viewing this outbreak through the prism of politics, the number of votes that this would cost him if he made a misstep. Ponce recalled the H1N1 outbreak back in 2009, which, in the end, had claimed only about 30,000 lives – a blip on the radar as far as pandemics went. But that hadn’t been during an election year. Crosby’s Democratic challenger had been hammering him as soft, indecisive, a political development along the lines of the Three Little Pigs threatening to blow down the Big Bad Wolf’s house. Now, Ponce knew, Crosby was worried that if he overreacted to this outbreak, he’d be a dead man walking come the first Tuesday in November.
“Mr. President,” Ponce said, going over Butler’s head and directing his plea directly to the big guy, “I can assure you that this is not going to be like the swine flu thing.”
It was a calculated risk, a big one; he’d emasculated Kevin Butler (and it had felt pretty good), but he’d pushed all his chips to the center of the table on this hand. If this didn’t work, there was nowhere else to go. Ponce kept his gaze squarely on Crosby, but he could sense Butler cooking with anger.
“How is the virus transmitted?” asked Crosby.
“We’re working on that, sir,” Ponce said. “Direct exposure to blood and bodily fluids, we know that. I’m virtually certain it’s airborne, but I don’t have confirmation of that yet.”
The words were out of Ponce’s mouth before he could stop himself. He had intended to fudge the fact, he had intended to lie his ass off about it because it was the right thing to do. Lie about it, lie about it to the President of the United States so they would take him seriously until he could positively confirm something he knew to be true anyway.
“You haven’t confirmed this is an airborne strain?” Butler asked, jumping back into the discussion.
Ponce wanted to punch himself in the face for his stupidity; he felt like he was outside his own body, staring down at the big, stupid idiot, the idiot with the M.D. and double doctorates in virology and pathology.
“No, sir, but we will this afternoon at the latest, and I think we need to err on the side of caution given how deadly the infection has proven to be.”
Ponce’s words hung in the air as his audience considered them.
“These viruses,” Crosby said, “they’re not typically airborne are they?”
“No, sir,” Ponce said, his shoulders sagging.
“These outbreaks burn themselves out, isn’t that right?” Crosby asked. “That’s why Ebola has never blown up and wiped us out, why it stays in those African villages.”
“No one is really sure why-” Ponce offered.
“But they do, right?”
“Yes, sir, but I’m incredibly concerned this may not burn-”
“As am I, Dr. Ponce,” Crosby said. “As am I. That’s why I want to leave the management of these outbreaks to the local health departments. It’s our belief they’re in the best position to implement the appropriate protocols to contain the outbreak.”
“But sir,” Ponce said, again trying to establish a beachhead against the formidable defenses in the room.
“Dr. Ponce,” Butler said, finding a second wind, “you’re familiar with the phrase, ‘the cure is worse than the disease’?”
“Of course.”
“We believe a quarantine is premature at this time and in fact could do more harm than good,” Butler said. “People will panic. We’ll have looting, riots. It’ll devastate the economy, and that’s not something we can afford right now.”
Dr. Ponce couldn’t believe his ears. He ran his hands back and forth through his hair, thick and gray and wild, racking his brain for some way to get through to these morons. He was blowing it. This was the most important presentation of his life, and he was absolutely blowing it! With panic replicating in his core like the very virus he was trying to combat, he flipped through the file on the table in front of him, looking for something, anything that might shake these guys up. There, he thought, putting his hands on a photograph in the file.
“Look here,” he said, holding the eight-by-ten photograph up to the camera. “Look at this. This is Dr. Amanda Rutledge. She was on staff at the New York City Health Department in the Bronx. Her husband, Peter Rutledge, worked for the Yankees. Three days ago, Mr. Rutledge began showing symptoms of Medusa and died twelve hours later.”
The President held up a finger as if he were going to say something, but he remained silent.
“When they opened him up,” Ponce continued, “they discovered evidence of tremendous hemorrhaging and organ liquefaction,” Butler said. “His lungs were a mess, just totally fucking vaporized.”
Yes, he had just dropped the F-bomb t
o the President of the United States.
“Mr. President, this is the part you need to know, that I need you to understand,” Ponce said, as if he were lecturing a kindergartner. He had probably crossed the line over to insubordination, but he didn’t care. He could have told President Crosby that Dr. Rutledge’s boss, the director of the Bronx district, had died this morning, or he could have told him the two CDC doctors who had traveled to New York were both infected with Medusa and would be dead by lunchtime. He could have told him they’d be burying millions of Americans in the next month, but that seemed too surreal, too much to grasp. Instead, he zoomed in up-close. All politics are local.
“Dr. Rutledge died yesterday, as did her three children, ages nine, eleven and fifteen,” Ponce said, his eyes squarely on the President, ignoring everyone else in the room. It no longer mattered what they thought; all he had to do was convince Crosby, the big kahuna. Crosby had two boys of his own, roughly the same age as the elder Rutledge children. If Ponce couldn’t penetrate the formidable political armor, perhaps he could get through to the man as a father; it was the last arrow in his quiver.
“They all died horrible, horrific deaths,” Ponce said, panicked. “Scared shitless. Begging for their mom, who they didn’t even know was dead. Screaming, burning with fever, coughing up blood and lung tissue, bleeding from the eyes and ears until they had seizures, big massive seizures that all but fried their central nervous systems.”
For a moment, like a flash of heat lightning in the distance, Ponce thought he saw the tiniest crack in the President’s political visage, the ordered and carefully prescribed face of calm and leadership that he showed the world. For a moment, Butler thought he’d won the man over, that they might have a chance to stop this thing before it got out of control.
Ponce sat stone still, watching the President carefully. Crosby’s hands were clenched together in a fist, tapping his lips nervously. Butler leaned in close, whispered something to the President, who nodded.
“Dr. Ponce,” Butler said. “At this time, the President is going to leave incident management in the hands of the locals. The President, however, wants hourly reports on the situation, more if the situation warrants.”