by David Bajo
Dmir creased his brow, confusion disguised as concern.
“To answer the first question you should’ve asked,” said Mendenhall, just loudly enough for the patients and the nearby EMTs and nurses at the station, “I cleaned, sutured, and medicated the ballistics. They cannot be moved yet. Getting shot—even in the arm or leg—is highly traumatic. The wound is nothing compared to what happens to the whole nervous system—but you know that.”
She lowered her voice, offered Dmir an inclusive raise of her eyes.
“Moving the others would also compromise the stability of the first two. By attrition.”
Dmir straightened a bit, though still appearing stooped, in costume. Mendenhall remembered the music from the show with the purple dinosaur. The show had been good for her. She had been too serious as a girl, too concerned with real life.
“But it’s your call.”
“Attrition,” said Dmir.
“Yes. Attrition. The same thing that produced those three new containments.”
Pao Pao moved down one patient, creating some distance from Dmir but widening the flank in this battle.
“Look it up,” said Mendenhall. “You’ll like it. Hysteria is highly contagious. It flies.” She sensed Pao Pao’s warning glance. She backed off, drew a discreet breath. “I’ll clear the wall for you. As soon as we outpatient the ballistics.” She raised her voice. “You concur?”
Dmir looked at his watch.
“Two hours,” Mendenhall said before he could speak. “Tops.
You can make the arrangements with Nurse Pao Pao.” They both turned toward Pao Pao, who was looking flatly at Dmir. “Or I can do that for you.”
Then she realized what exactly was new about him, the freshness.
He had come in—after containment. Dmir never stayed past five—
not like real doctors. He had night air about him, cocktail hour.
His watch glittered. She could almost feel his pulse, measure its increase.
She remembered what she had hated about the purple dinosaur, the hate that made her want the show, need it. She would solve math problems during the episodes, lists of them, filling pages, all corners and margins, both sides, her fingers smeared with pencil lead. During songs she would draw the periodic table, delineate the inert gases, all subgroups. Babysitters stood horrified, their expressions not unlike those on the faces of the EMTs and nurses now watching her step once toward the station before cutting away from all of them, stepping to her patients.
Her patients. The longest anyone could be her patient was about two hours; then they were either discharged or assigned to the proper specialist. She had repeats—drunks, addicts, prostitutes, some ballistics. But ER repeats eventually disappeared. Into their lives, her mentor had told her, the lives they choose. See it that way.
Dmir lingered. Pao Pao was starting to leave, then halted between them. Mendenhall squinted at Dmir.
“What? What more?”
“Who’s Cortez?” he asked.
“Who wants to know?”
“We,” he said, “we want—”
“That was from my aunt. That was personal.”
Pao Pao spoke, her voice low, her look flat, but there was relish in the angle of her head, the motion of her fist toward the floor between Dmir’s shoes. “Cortez is her dog.”
Dmir looked to Mendenhall for verification.
“Cortez,” Pao Pao repeated. “A terrier, about the size of your Clarks. A little Scottie. Cortez. Cortez the Killer.”
“The Killer?” Dmir raised his brow, not sure which woman to address.
“From the song.”
“What song?”
“You don’t know anything, Dmir. You don’t know anything about anything,” Mendenhall said. “Tell Thorpe to stay off my personal messages.”
“You relayed information. Outside containment.”
“I told my aunt I was safe and sound. It was for her. You tell Thorpe it was a lie. I feel anything but safe and sound. With him up there. I lied to my aunt for the sake of his containment. Because if I had sent her the truth she would be coming for me.”
“Cortez, too,” said Pao Pao.
They left Dmir in unison.
Mendenhall visited the first ballistic, joining Pao Pao bedside the bed. Kae Ng. Twenty-three. His name and age read like something from the periodic table. She looked at his slender wrists and knew he was only fifteen.
He was looking at her in a flirty way. He was high on the stuff she had given him. His black hair fell over his eyes, and he smiled with one side of his mouth. He peeked once at his shoulder, at the dressing she had applied.
“Can I have the bullet?” He had a smooth, low voice.
“You do have it.”
He raised an eyebrow.
“I left it in. We usually leave them in. They’re sterile. We only take them out on TV.”
He seemed disappointed.
“I know,” she told him. “The only reason I joined ER was for the bullet. So I could be that doctor who pulled it out and plunked it into the pan. That sound, you know? That finality. That cure. But it doesn’t go that way. It never goes that way. It just melts inside you.”
“Someone could use a nap,” said Pao Pao.
16.
In Pathology, Claiborne had the ventilation on full. Mendenhall could tell because the air was especially quiet. The vents did that, hushed the lab. Claiborne had once showed her the effect using a tuning fork he kept on his desk. He struck the fork—A, he told her. There was no sound. Then he fired the vents and struck the note again. The pure note emerged amid the gather of the ambient vents. So now maybe he had the vents on full for the music, which was a quiet violin solo drawing long single notes. But the lab was chilled, and the bodies remained on the steel, death grins forming.
Claiborne stood over Verdasco, looking from the young, beautiful body to an overhead display, then back to the body. Mullich was absent, but Mendenhall could see that he had set up shop in one of the lab’s corners. Charts hung over his table, four showing drawings of the bodies in their respective found positions, floating.
Four others appeared as blueprints of the spaces; one displayed the entire hospital cut into floors. The building had three basements, two more below this one. The one just below she had been to once or twice. The third was new to her.
Silva stood at Mullich’s desk, bending slightly to make entries on the architect’s laptop. The drawings of the bodies had lines through them. The drawings of the rooms and hospital had faint spirals on them shot through with blue dashes. A large chart beside the laptop was scrolled out on the desk.
The cold, thin air. The silent motions of Silva and Claiborne.
They could have been on the moon.
Claiborne straightened to face Mendenhall. His mask was down. She started to speak, but he checked her with a look. She snapped on fresh gloves, exaggerating the last pull of elastic.
“I was right,” she said. “Wasn’t I? Trauma through the bronchus in Fleming. In Verdasco,” she nodded toward the body, “through the brain stem and thorax.”
“More or less,” said Claiborne.
She sensed Silva’s approach.
“Trauma,” said Mendenhall. “So, trauma.”
Claiborne shook his head. “Viral. Everything points to viral.
Maybe fungal. I never rule that out too soon. But viral is the way to go. Hemorrhagic and sudden. Thorpe’s fear.”
“Thorpe’s hope, you mean.”
Claiborne closed his eyes and took a breath. There was a draw on the violin. “I want you to be right, Dr. Mendenhall. Like I want to be eating Thai with my wife. But he is right. You know it, too.”
She thought, searched past the fatigue. She looked at Silva’s face, relieved to find the tech’s mask down, furtive lips and nose, eyes lifted. “No. I don’t know it.”
“Look, Doctor.” Claiborne opened his hands, his arms. “You are very good at what you do. You made the call right away. You saw it.”<
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She looked at the clean bodies, their skin reflecting the aimed light. “There should’ve been more bleeding, less isolation. Even in something fast. Dengue fever, even. Any VHF.”
“That’s what I thought. After you sent your predictions. So I searched. . . . I found this.” Claiborne changed Verdasco’s overhead to show a scan of his brain. Mendenhall saw a faint cloud along the edge of Verdasco’s frontal lobe.
“And this.” Claiborne changed the scan to Verdasco’s left kidney.
Another cloud.
“Those are pretty vague.”
Claiborne shook his head. “They just got started. Then he died.”
Silva stepped closer, almost getting between them. Mullich would have found that interesting, would have drawn the triangle, noted its slightness.
“We found similar hemorrhaging in the others,” Silva said. “In other major organs. Dozier’s liver and brain, Fleming’s kidneys and brain. Thorpe confirmed something similar in Peterson’s brain and lungs.”
“You mean incipient hemorrhaging.” Mendenhall eyed Verdasco’s display as she spoke, trying not to lessen her tone.
“Don’t fight this,” said Claiborne. His gaze was that same look again, the one he gave her on the trail before he increased his pace.
“You are the one giving us—including Thorpe—some of the best anticipations. Use them right.”
He motioned to Verdasco’s brain scan, then continued, “We most likely have a virus that produces trauma. We know viruses that do that—induce trauma, shock. This is new, yes. But it’s in the continuum. New means nothing more to me than indication.
Indication to find and identify. It doesn’t mean panic. It doesn’t mean containment. It means work for me. For us.”
Mendenhall could not help inverting his first premise. It was what she did. It was what she had been taught. It was why she had gone to that abandoned file room. She closed her eyes and went there in her thoughts, just for the moment it took her to think out the inversion. Trauma that produces virulent hemorrhaging.
“I know what you’re thinking,” said Claiborne, “and it makes no sense. Not with what we have. Not with time and placement. It all happened here. Inside.”
Mendenhall looked across the lab at Mullich’s displays.
Claiborne followed her gaze.
“He’s doing it right, too,” said Claiborne. “Using you right.
Finding patterns. Hopefully a center.”
Mendenhall looked at Silva.
“No,” said Claiborne. “She’s doing it right, too. Don’t go there.”
“You’ll get me fired.” Silva returned their looks.
“I want you to keep coming down here, Doctor.” Again
Claiborne opened his hands to her. “Because it will help you up there.” He motioned toward the ceiling. “And it’s helping us down here. But not if you’re going to fight every finding. For fight’s sake.”
Mendenhall rubbed her own shoulders, kneaded them, resisting the urge to press her eyes and face. “When does containment end, then? Assuming no more outbreak. Assuming Thorpe disregards those last hystericals.”
“All early cultures and tests are negative. But he staggered the patients. We’ll go home in the morning.”
She nodded as she looked down, felt Silva watching her.
Mendenhall liked how Claiborne called them patients. His patients were neither dead nor alive. Even the dead ones, for him, kept giving.
“Thorpe’s good,” said Claiborne. “Maybe even a good person.
He’s just intense. How he should be—for what he does.”
Mendenhall disagreed, felt it as the beginning of a shudder but let it go. She stayed there and looked at their scans, all of the clouds and lines and patterns. She found solace in the quiet movements of Claiborne and Silva, in the violin and chill and distilled air. But she went into her own world.
Cause of trauma affects treatment. A stab, a bullet, a toxin, blunt force call for distinct treatments. But only in the in-between, the sometimes long-between. First you treat the trauma itself. You hold a hand, say something, apply pressure, anodyne. Last you make sure to treat the trauma again, try to end it. If you don’t, the patient is damaged forever, dies.
And the inverse of Claiborne’s premise—his sound premise, the one they were all working under—stayed with her. Trauma produces virulent reaction.
17.
But circumstance canceled trauma as the first cause. Circumstance allowed for virus as first cause, trauma as result, trauma as cause of demise. Mendenhall needed to do some research, five minutes on her screen. She stood aside in Pathology, still watching Silva and Claiborne. Claiborne, she could see, was getting ready to send the bodies into drawers. He was measuring Verdasco with a laser pen, the numbers scrolling onto the overhead. The thought of returning to her floor depressed Mendenhall.
Silva was starting to close out Mullich’s laptop.
“Wait,” Mendenhall told her, then stepped close.
Silva raised her brow.
“Can I use that?” Mendenhall asked. “Mullich won’t mind. In fact he’d prefer it. So he can see what I’m doing.”
Silva deferred to Claiborne. Claiborne fired his laser pen at Mendenhall’s heart. She touched the red dot.
“I’m not fighting. Look, this way you can see right away what I’m thinking. Please, Dr. Claiborne. It’s nice down here.”
Claiborne returned to his task.
Mendenhall sat before Mullich’s laptop, and Silva went to assist Claiborne. They listened to the single violin. Mendenhall felt her movements slow along with the rest of the room. She breathed, tasted the air as it dried her lips and tongue. The paper scroll beside the laptop was a blueprint of the hospital, a vertical. The ER was the longest rectangle. The roof was two brackets, opened to the sky, the empty blue.
On screen she brought up a recent study of hydrostatic shock.
The accompanying video showed a rectangular block of gel being penetrated by a bullet in super slow-motion. The visual study showed a series of shots, each successive one lowering the caliber of the projectile while increasing velocity. The experiment aimed to demonstrate the value of velocity over the size of the caliber.
The final demonstration showed a missile the size of a shotgun pellet passing through the gel at extreme velocity. On initial impact, a large cone of air instantly expanded the gel block, distorting it into an oval, almost exploding the entire block. Swirls of distorted gel spiraled outward, barely contained by the membrane, forming translucent waves. The pellet exited through a pinpoint at the tip of the cone, and the gel block returned to its original shape, but with coils of air caught along the perimeter and in the corners.
These were trauma lines, vague and distant parentheses around the primary line left by the ballistic path.
It was pretty. It seemed to dance to the long draw of the violin bow sounding above the lab. The gel block was backlit with amber light to accentuate the trauma lines.
“Come see,” said Mendenhall, softly, in case they were listening.
Silva came; Claiborne remained with Verdasco. Mendenhall ran the last video again, the highest velocity.
“It’s hydrostatic shock,” Mendenhall told Silva. She felt the lab tech near her shoulder. “It shows how high-velocity projectiles, even when very small, cause peripheral damage. Extreme damage.”
Mendenhall repeated the demo.
“The body returns to form.” Silva’s voice was plaintive.
“I know that study.” Claiborne spoke without leaving his position, the direction of his voice downward. Mendenhall imagined him behind them, talking to Verdasco. “You’re fighting, Dr. Mendenhall.”
“I’m not.” She ran the video again, pausing at impact, the birth of the spiral. “I’m doing what I should do at this point. My expertise.
What I know that causes peripheral hemorrhaging. Why people die from what should be nonfatal invasion. Why bodies die from impacts to nonvital tissue. Why I ha
ve patients die from getting shot in the shoulder, the thigh, the foot. Why I had one die from a piece of glass through her bicep.”
“Those are extreme velocities,” said Claiborne.
“We live in a world of extreme velocities.”
“We have no ballistic,” replied Claiborne. His voice was even lower, crouching closer to Verdasco. “We have no entry or exit.”
“Okay. Okay. I’m just showing peripheral trauma. Peripheral hemorrhaging as indicator for extreme trauma. Hemorrhaging distant from the point of initiation. Bleeding in the most liquid organs.” Mendenhall pointed to the amber swirls in the corners of the gel block, drawing Silva closer. “Far perimeter clouds in the brain and liver.”
Mendenhall winced at her own words. Metaphor indicated lack of precision, a skip in the equation.
“Far perimeter clouds?” Claiborne knew what she was thinking.
“Okay. Perimeter bruising.” Mendenhall turned away from the screen and looked at Claiborne, waited for him to quit Verdasco.
After a moment he straightened and looked at her.
“That’s what you have,” she told him. “Something—a viral impact, if you want—that causes perimeter hemorrhaging in uninvolved organs. That’s a valid assumption until you find something in those peripheral tissues. Those far tissues. I think you should focus on those samples first. While Thorpe’s people go after the primary hemorrhages.”
“I am Thorpe’s people.” Claiborne looked at Silva. “We are Thorpe’s people.”
“You know what I mean.”
Claiborne joined her and Silva by the laptop. They stood together beneath Mullich’s charts.
“Run it again,” he said, nodding toward the laptop screen. “It’s pretty. My eyes need a break.”
Silva was the one who tapped it into motion. They watched the pellet pass straight through the gel block, the spiral of amber distorting the whole into a sideways tornado.
“I’m helping,” said Mendenhall. “Increasing efficiency.”
“Providing entertainment.” Claiborne took control of the video, his hand dark and slender, freshly peeled from its glove. He made the demonstration run backward and forward, repeating. He darkened the screen, deepening the amber backlight. The impact seemed to bring the gel block to life, morphed it into a cell, quickening, seeking another.
