by J F Bone
“Inside,” Kramer said, “you will find a small anteroom, a shower, and a dressing room. Strip, shower, and put on a clean set of lab coveralls and slippers which you will find in the dressing room. You’ll find surgical masks in the wall cabinet beside the lockers. Go through the door beyond the dressing room and wait for me there. I’ll give you ten minutes.”
“We do this both ways,” Kramer said as he joined her in the narrow hall beyond the dressing room. “We’ll reverse the process going out.”
“You certainly carry security to a maximum,” she said through the mask that covered the lower part of her face.
“You haven’t seen anything yet,” he said as he opened a door in the hall. “Note the positive air pressure,” he said. “Theoretically nothing can get in here except what we bring with us. And we try not to bring anything.” He stood aside to show her the glassed-in cubicle overhanging a bare room dominated by a polished steel post-mortem table that glittered in the harsh fluorescent lighting. Above the table a number of jointed rods and clamps hung from the ceiling. A low metal door and series of racks containing instruments and glassware were set into the opposite wall together with the gaping circular orifice of an open autoclave.
“We work by remote control, just like they do at the AEC. See those handlers?” He pointed to the control console set into a small stainless steel table standing beside the sheet of glass at the far end of the cubicle. “They’re connected to those gadgets up there.” He indicated the jointed arms hanging over the autopsy table in the room beyond. “I could perform a major operation from here and never touch the patient. Using these I can do anything I could in person with the difference that there’s a quarter inch of glass between me and my work. I have controls that let me use magnifiers, and even do microdissection, if necessary.”
“Where’s the cadaver?” Mary asked.
“Across the room, behind that door,” he said, waving at the low, sliding metal partition behind the table. “It’s been prepped, decontaminated and ready to go.”
“What happens when you’re through?”
“Watch.” Dr. Kramer pressed a button on the console in front of him. A section of flooring slid aside and the table tipped. “The cadaver slides off that table and through that hole. Down below is a highly efficient crematorium.”
Mary shivered. “Neat and effective,” she said shakily.
“After that the whole room is sprayed with germicide and sterilized with live steam. The instruments go into the autoclave, and thirty minutes later we’re ready for another post-mortem.”
“We use the handlers to put specimens into those jars,” he said, pointing to a row of capped glass jars of assorted sizes on a wall rack behind the table. “After they’re capped, the jars go onto that carrier beside the table. From here they pass through a decontamination chamber and into the remote-control laboratory across the hall where we can run biochemical and histological techniques. Finished slides and mounted specimens then go through another decontamination process to the outside lab. Theoretically, this place is proof against anything.”
“It seems to be,” Mary said, obviously impressed. “I’ve never seen anything so elegant.”
“Neither did I until Thurston’s Disease became a problem.” Kramer shrugged and sat down behind the controls. “Watch, now,” he said as he pressed a button. “Let’s see what’s on deck—man or monkey. Want to make a bet? I’ll give you two to one it’s a monkey.”
She shook her head.
The low door slid aside and a steel carriage emerged into the necropsy room bearing the nude body of a man. The corpse gleamed pallidly under the harsh shadowless glare of the fluorescents in the ceiling as Kramer, using the handlers, rolled it onto the post-mortem table and clamped it in place on its back. He pushed another button and the carriage moved back into the wall and the steel door slid shut. “That’ll be decontaminated,” he said, “and sent back upstairs for another body. I’d have lost,” he remarked idly. “Lately the posts have been running three to one in favor of monkeys.”
He moved a handler and picked up a heavy scalpel from the instrument rack. “There’s a certain advantage to this,” he said as he moved the handler delicately. “These gadgets give a tremendous mechanical advantage. I can cut right through small bones and cartilage without using a saw.”
“How nice,” Mary said. “I expect you enjoy yourself.”
“I couldn’t ask for better equipment,” he replied noncommittally. With deft motion of the handler he drew the scalpel down across the chest and along the costal margins in the classic inverted “Y” incision. “We’ll take a look at the thorax first,” he said, as he used the handlers to pry open the rib cage and expose the thoracic viscera. “Ah! Thought so! See that?” He pointed with a small handler that carried a probe. “Look at those lungs.” He swung a viewer into place so Mary could see better. “Look at those abscesses and necrosis. It’s Thurston’s Disease, all right, with secondary bacterial invasion.”
The grayish solidified masses of tissue looked nothing like the normal pink appearance of healthy lungs. Studded with yellowish spherical abscesses they lay swollen and engorged within the gaping cavity of the chest.
“You know the pathogenesis of Thurston’s Disease?” Kramer asked.
Mary shook her head, her face yellowish-white in the glare of the fluorescents.
“It begins with a bronchial cough,” Kramer said. “The virus attacks the bronchioles first, destroys them, and passes into the deeper tissues of the lungs. As with most virus diseases there is a transitory leukopenia—a drop in the total number of white blood cells—and a rise in temperature of about two or three degrees. As the virus attacks the alveolar structures, the temperature rises and the white blood cell count becomes elevated. The lungs become inflamed and painful. There is a considerable quantity of lymphoid exudate and pleural effusion. Secondary invaders and pus-forming bacteria follow the viral destruction of the lung tissue and form abscesses. Breathing becomes progressively more difficult as more lung tissue is destroyed. Hepatization and necrosis inactivate more lung tissue as the bacteria get in their dirty work, and finally the patient suffocates.”
“But what if the bacteria are controlled by antibiotics?”
“Then the virus does the job. It produces atelectasis followed by progressive necrosis of lung tissue with gradual liquefaction of the parenchyma. It’s slower, but just as fatal. This fellow was lucky. He apparently stayed out of here until he was almost dead. Probably he’s had the disease for about a week. If he’d have come in early, we could have kept him alive for maybe a month. The end, however, would have been the same.”
“It’s a terrible thing,” Mary said faintly.
“You’ll get used to it. We get one or two every day.” He shrugged. “There’s nothing here that’s interesting,” he said as he released the clamps and tilted the table. For what seemed to Mary an interminable time, the cadaver clung to the polished steel. Then abruptly it slid off the shining surface and disappeared through the square hole in the floor. “We’ll clean up now,” Kramer said as he placed the instruments in the autoclave, closed the door and locked it, and pressed three buttons on the console.
From jets embedded in the walls a fine spray filled the room with fog.
“Germicide,” Kramer said. “Later there’ll be steam. That’s all for now. Do you want to go?”
Mary nodded.
“If you feel a little rocky there’s a bottle of Scotch in my desk. I’ll split a drink with you when we get out of here.”
“Thanks,” Mary said. “I think I could use one.”
“Barton! Where is the MacNeal stain!” Kramer’s voice came from the lab. “I left it on the sink and it’s gone!”
“It’s with the other blood stains and reagents. Second drawer from the right in the big cabinet. There’s a label on the drawer,” Mary called from the office. “If you can wait until I finish filing these papers, I’ll come in and help you.”
“I wish you woul
d,” Kramer’s voice was faintly exasperated. “Ever since you’ve organized my lab I can’t find anything.”
“You just have a disorderly mind,” Mary said, as she slipped the last paper into its proper folder and closed the file. “I’ll be with you in a minute.”
“I don’t dare lose you,” Kramer said as Mary came into the lab. “You’ve made yourself indispensable. It’d take me six months to undo what you’ve done in one. Not that I mind,” he amended, “but I was used to things the way they were.” He looked around the orderly laboratory with a mixture of pride and annoyance. “Things are so neat they’re almost painful.”
“You look more like a pathologist should,” Mary said as she deftly removed the tray of blood slides from in front of him and began to run the stains. “It’s my job to keep you free to think.”
“Whose brilliant idea is that? Yours?”
“No—the Director’s. He told me what my duties were when I came here. And I think he’s right. You should be using your brain rather than fooling around with blood stains and sectioning tissues.”
“But I like to do things like that,” Kramer protested. “It’s relaxing.”
“What right have you to relax,” Mary said. “Outside, people are dying by the thousands and you want to relax. Have you looked at the latest mortality reports?”
“No—”
“You should. The WHO estimates that nearly two billion people have died since Thurston’s Disease first appeared in epidemic proportions. That’s two out of three. And more are dying every day. Yet you want to relax.”
“I know,” Kramer said, “but what can we do about it. We’re working but we’re getting no results.”
“You might use that brain of yours,” Mary said bitterly. “You’re supposed to be a scientist. You have facts. Can’t you put them together?”
“I don’t know.” He shrugged, “I’ve been working on this problem longer than you think. I come down here at night—”
“I know. I clean up after you.”
“I haven’t gotten anywhere. Sure, we can isolate the virus. It grows nicely on monkey lung cells. But that doesn’t help. The thing has no apparent antigenicity. It parasitizes, but it doesn’t trigger any immune reaction. We can kill it, but the strength of the germicide is too great for living tissue to tolerate.”
“Some people seem to be immune.”
“Sure they do—but why?”
“Don’t ask me. I’m not the scientist.”
“Play like one,” Kramer growled. “Here are the facts. The disease attacks people of all races and ages. So far every one who is attacked dies. Adult Europeans and Americans appear to be somewhat more resistant than others on a population basis. Somewhere around sixty per cent of them are still alive, but it’s wiped out better than eighty per cent of some groups. Children get it worse. Right now I doubt if one per cent of the children born during the past ten years are still alive.”
“It’s awful!” Mary said.
“It’s worse than that. It’s extinction. Without kids the race will die out.” Kramer rubbed his forehead.
“Have you any ideas?”
“Children have less resistance,” Kramer replied. “An adult gets exposed to a number of diseases to which he builds an immunity. Possibly one of these has a cross immunity against Thurston’s virus.”
“Then why don’t you work on that line?” Mary asked.
“Just what do you think I’ve been doing? That idea was put out months ago, and everyone has been taking a crack at it. There are twenty-four laboratories working full time on that facet and God knows how many more working part time like we are. I’ve screened a dozen common diseases, including the six varieties of the common cold virus. All, incidentally, were negative.”
“Well—are you going to keep on with it?”
“I have to.” Kramer rubbed his eyes. “It won’t let me sleep. I’m sure we’re on the right track. Something an adult gets gives him resistance or immunity.” He shrugged. “Tell you what. You run those bloods out and I’ll go take another look at the data.” He reached into his lab coat and produced a pipe. “I’ll give it another try.”
“Sometimes I wish you’d read without puffing on that thing,” Mary said.
“Your delicate nose will be the death of me yet—” Kramer said.
“It’s my lungs I’m worried about,” Mary said. “They’ll probably look like two pieces of well-tanned leather if I associate with you for another year.”
“Stop complaining. You’ve gotten me to wear clean lab coats. Be satisfied with a limited victory,” Kramer said absently, his eyes staring unseeingly at a row of reagent bottles on the bench. Abruptly he nodded. “Fantastic,” he muttered, “but it’s worth a check.” He left the room, slamming the door behind him in his hurry.
“That man!” Mary murmured. “He’d drive a saint out of his mind. If I wasn’t so fond of him I’d quit. If anyone told me I’d fall in love with a pathologist, I’d have said they were crazy. I wish—” Whatever the wish was, it wasn’t uttered. Mary gasped and coughed rackingly. Carefully she moved back from the bench, opened a drawer and found a thermometer. She put it in her mouth. Then she drew a drop of blood from her forefinger and filled a red and white cell pipette, and made a smear of the remainder.
She was interrupted by another spasm of coughing, but she waited until the paroxysm passed and went methodically back to her self-appointed task. She had done this many times before. It was routine procedure to check on anything that might be Thurston’s Disease. A cold, a sore throat, a slight difficulty in breathing—all demanded the diagnostic check. It was as much a habit as breathing. This was probably the result of that cold she’d gotten last week, but there was nothing like being sure. Now let’s see—temperature 99.5 degrees, red cell count 4½ million. White cell count . . . oh! 2500 . . . leukopenia! The differential showed a virtual absence of polymorphs, lymphocytes and monocytes. The whole slide didn’t have two hundred. Eosinophils and basophils way up—twenty and fifteen per cent respectively—a relative rise rather than an absolute one—leukopenia, no doubt about it.
She shrugged. There wasn’t much question. She had Thurston’s Disease. It was the beginning stages, the harsh cough, the slight temperature, the leukopenia. Pretty soon her white cell count would begin to rise, but it would rise too late. In fact, it was already too late. It’s funny, she thought. I’m going to die, but it doesn’t frighten me. In fact, the only thing that bothers me is that poor Walter is going to have a terrible time finding things. But I can’t put this place the way it was. I couldn’t hope to.
She shook her head, slid gingerly off the lab stool and went to the hall door. She’d better check in at the clinic, she thought. There was bed space in the hospital now. Plenty of it. That hadn’t been true a few months ago but the only ones who were dying now were the newborn and an occasional adult like herself. The epidemic had died out not because of lack of virulence but because of lack of victims. The city outside, one of the first affected, now had less than forty per cent of its people left alive. It was a hollow shell of its former self. People walked its streets and went through the motions of life. But they were not really alive. The vital criteria were as necessary for a race as for an individual. Growth, reproduction, irritability, metabolism—Mary smiled wryly. Whoever had authored that hackneyed mnemonic that life was a “grim” proposition never knew how right he was, particularly when one of the criteria was missing.
The race couldn’t reproduce. That was the true horror of Thurston’s Disease—not how it killed, but who it killed. No children played in the parks and playgrounds. The schools were empty. No babies were pushed in carriages or taken on tours through the supermarkets in shopping carts. No advertisements of motherhood, or children, or children’s things were in the newspapers or magazines. They were forbidden subjects—too dangerously emotional to touch. Laughter and shrill young voices had vanished from the earth to be replaced by the drab grayness of silence and waiting. De
ath had laid cold hands upon the hearts of mankind and the survivors were frozen to numbness.
It was odd, she thought, how wrong the prophets were. When Thurston’s Disease broke into the news there were frightened predictions of the end of civilization. But they had not materialized. There were no mass insurrections, no rioting, no organized violence. Individual excesses, yes—but nothing of a group nature. What little panic there was at the beginning disappeared once people realized that there was no place to go. And a grim passivity had settled upon the survivors. Civilization did not break down. It endured. The mechanics remained intact. People had to do something even if it was only routine counterfeit of normal life—the stiff upper lip in the face of disaster.
It would have been far more odd, Mary decided, if mankind had given way to panic. Humanity had survived other plagues nearly as terrible as this—and racial memory is long. The same grim patience of the past was here in the present. Man would somehow survive, and civilization go on.
It was inconceivable that mankind would become extinct. The whole vast resources and pooled intelligence of surviving humanity were focused upon Thurston’s Disease. And the disease would yield. Humanity waited with childlike confidence for the miracle that would save it. And the miracle would happen, Mary knew it with a calm certainty as she stood in the cross corridor at the end of the hall, looking down the thirty yards of tile that separated her from the elevator that would carry her up to the clinic and oblivion. It might be too late for her, but not for the race. Nature had tried unaided to destroy man before—and had failed. And her unholy alliance with man’s genius would also fail.
She wondered as she walked down the corridor if the others who had sickened and died felt as she did. She speculated with grim amusement whether Walter Kramer would be as impersonal as he was with the others, when he performed the post-mortem on her body. She shivered at the thought of that bare sterile room and the shining table. Death was not a pretty thing. But she could meet it with resignation if not with courage. She had already seen too much for it to have any meaning. She did not falter as she placed a finger on the elevator button.
