Pestilence: A Medical Thriller Read online

  She thought about her mother’s apple pie. Every last Sunday of the month, her mother made fresh apple pie with peach-apples, a type of apple mixed with a peach grown by a local farmer. They were a bit softer and sweeter than normal apples and had a tanginess she’d never tasted in anything else. Her mother made her pies with brown sugar and then scooped vanilla ice cream on top while the pie was still hot, and they would eat on the porch or in the backyard.

  When her mother passed away from the brain tumor, Katherine had tried to make the pie for her two sisters, her brother, and her father, but it always turned out either too crisp or too soggy. No one enjoyed it, but Katherine wouldn’t stop making it. She got up early once a month to go to the farmer’s market for a batch of peach-apples and then started the pie from scratch.

  Brakes squealed behind her. They weren’t loud, like someone was going fast and then had to quickly stop, but they built up in pitch, as if someone were going slowly and had rolled by in front of the house where she was hiding.

  She didn’t move or even breathe. Keeping entirely still, she felt a tickling on her leg. Glancing down at her ankle, she saw a spider the size of a quarter resting on it.

  Katherine put her hand over her mouth to make sure she didn’t scream. The spider crawled again, and instead of going over, it went up her leg. She bit down hard on her lip and closed her eyes. Squealing, she swatted at her ankle and then opened her eyes to see the spider was gone.

  The car revved its engine and then drove away.

  Katherine jumped to her feet and opened the gate. She didn’t see anyone. She sprinted to the middle of the road, but couldn’t see the car anymore. As she was about to run up to the house where she’d been hiding, she stopped. What exactly could they do for her? The phones had been cut off, and no police were available. Who would come and help her?

  But at least she would be away from him. She walked up to the porch and knocked on the door. She got no answer at first, and so she rang the doorbell and then knocked again. A light went on inside the house, and then another. A middle-aged man in a black robe opened the door. Behind him, peeking out over his shoulder, was a beautiful blonde with large, fake breasts.

  “Please,” Katherine said, “I’m in tr—”

  The blood spattered on her face. She felt numb as the man’s corpse collapsed backward into his wife, who hadn’t even realized what had happened yet. Blood and gore was all over her nightgown and her chest, and as the body fell, she caught it and brought it down. When she saw the gaping hole in his head, she screamed.

  “No!”

  Katherine quietly took in the scene. It didn’t seem real to her, as if it were happening to someone else far away and she were only watching, like a waking dream. She turned, and Ian was in the street.

  Katherine’s mind was reeling. In one moment of absolute, pure rage, she felt out of control. She ran out into the street and shouted, “You want to kill me? Then fucking kill me!”

  He lifted his weapon, and she thought she was going to die. But she didn’t care. Right then, she was helping a man who was little more than an animal and was worried that God would judge her for it. She thought it better to die. She lifted her arms and closed her eyes, waiting for the bullet to tear into her. But it never came.

  She opened her eyes as Ian slammed the butt of the gun against her jaw, knocking her out cold.

  36

  Samantha put on latex gloves and a full biohazard suit. She combed the supply closet for sodium hypochlorite and found some tucked away on a shelf. She also found a syringe and vial for testing as well as some swabs and a small packet of alcohol.

  She stripped down to her bra and panties and then slipped the blue suit over herself. The plastic faceplate was free of any smudges or fingerprints. It was brand-new.

  Placing the boots on her feet, she realized they were too large. She tried cinching them with rubber bands. They were still loose, but would have to do.

  She slipped the crinkly booties over her boots and then pulled on the suit’s thick black gloves and tucked her sleeves into them. Taking a deep breath, she closed her eyes for a moment before opening them and going out into the corridor.

  Duncan was standing outside the room. He seemed to want to say something but didn’t. Maybe because he knew she was going to do it no matter what, or maybe because he, too, thought it was the right thing.

  “Where are the Rangers?” she asked.

  “I called Clyde and had them reassigned. You’re clear for a few hours until they send some others.”

  Sam was silent a moment. “Thanks,” she finally said.

  “You’re welcome.”

  “Find a coffee for me, will ya?” She didn’t want one, but she knew it might occupy his mind long enough for her to get the blood. Entering the room, she shut the door behind her, then tore off the tape on the floor that was holding down the canopy.

  Slipping underneath, she came up next to her sister and placed her hand on her shoulder. Jane gave her a weak smile and placed her hand over the glove.

  Sam swabbed her sister’s left bicep with a cotton swab and alcohol.

  “Close your eyes,” she said.

  “You still remember, huh?” Jane said.

  Samantha thought back to a doctor’s office they had been in when she was twelve and Jane eight. The doctor needed to give her vaccinations, and Jane sprinted out of the room and ran into the parking lot. Their father had to chase her and bring her back. Holding her down, they finally got the injection in by telling her to close her eyes, and Jane passed out.

  “What do you do when they have to give you an IV?” Sam asked.

  “They’ve never had to. I avoid the damn things as much as possible.”

  Sam withdrew a vial of the black-red blood, and it splashed up as it filled the tube. She capped and sealed it, then ducked under the canopy and went over to a sink. She washed both the bag and the vial of blood with water and then the sodium hypochlorite. She placed the vial in the bag and threw the syringe into a biohazard trash bin.

  “I’ll be right back,” Sam said.

  No showers were set up for decontamination, so Sam had to use the one in the room. When she finished washing the suit, she stepped out and went to the supply closet to get dressed.

  The hematology department was on a different floor, and she carefully carried the plastic container in both hands as she went to the elevators. A custodian was on there with her, and he was humming to himself. It seemed so out of place for the moment that Sam couldn’t help but watch him. He smiled at her as he stepped off onto his floor.

  Hematology was empty up front. Sam walked behind the front desk and toward the back. Sitting at a table with various vials, tubes, and microscopes set up in front of him was a man with orange hair and a goatee. He was writing on a notepad, and Sam walked in and placed the plastic bag down on the table.

  “You need to test this,” she said. “For an unknown pathogen resembling smallpox.”

  The man was confused for a second, and then his eyes widened. “Holy shit, you brought that here like that?”

  “Test it now, please. I’ll be back in a couple of hours.”

  “There’s different kinds of smallpox virion, and most are morphologically indistinguishable from the others. I can’t tell you what I’d be looking at.”

  “You have to do negative staining. Do you have an electron microscope here?”

  “Well, yeah, but I would need some sort of scab or skin sample from an infected patient to do it.”

  “You have two people infected upstairs. I’ll get you the skin sample. You just get everything ready.”

  As she was walking out, the doctor said, “Hey, who the hell are you anyway?”

  “I’m with the CDC… and I’m that patient’s sister.”

  37

  After speeding away in the jeep, Howie was going so fast that he nearly lost control and tipped over on a sharp turn. He slowed down and noticed the sky. No choppers. He glanced to his daughter in t
he passenger seat and saw that her hand was on his knee.

  “You okay?” he said.

  “Yeah. Mike looked after me.”

  Howie glimpsed in the rearview. “Thanks,” he said.

  “No problem.”

  After driving in silence for a few more minutes, Howie realized he was hungry. An Italian place called Cosimo’s was up near the intersection, and he pulled around back and parked in the handicap section.

  “I don’t think they’ll mind,” he said, looking at his daughter.

  “What’re we doing here?” Mike said.

  “You guys hungry?”

  “Starving.”

  “Let’s go. I’ll whip something up.”

  The restaurant was open. They walked in through the front door, and Jessica went to turn on the lights, but Howie told her not to. They would have to eat in the dark.

  “See if you can find some candles, though,” he said.

  Walking to the kitchen, Howie saw food still out on the tables. A dish of gelato had melted and was soaking the tablecloth. Everyone had gotten out of there in a hurry.

  Mike came with him as Jessica lagged behind. The lights in the kitchen as well as the grill and oven were still on. He turned them off and went to the fridge on the other side of the room. Taking out some beef, pasta, and vegetables, he then found the olive oil and cooked macaroni with sauce.

  Mike stood in the corner and chewed on some bread with butter. “Where we heading?”

  “I don’t know. I was thinking out of the state. See if whatever’s happening here is happening there, too.”

  “I heard all the highways are closed. How you planning on getting out?”

  “We got a jeep. We’ll fill her up and try the desert.”

  “You want to risk driving through the desert on one tank of gas?”

  “I don’t know what to do, Mike. I’ve never been in this situation before. If you got a better idea, by all means, share.”

  Mike took another bite of the bread. “I was in Iraq.”

  “I didn’t know that.”

  “No, you wouldn’t. We had taken this small town, called Karim. The insurgents, that’s what we were forced to call them, they had taken the town, and we got it back. It took four days. Two days of no sleep. Some o’ the guys took amphetamines to stay awake, and it did things to their minds. No sleep and drugs aren’t the best solution to anything, but we were young. So we take the town. And we decide we don’t know who’s with them and who’s with us, so we impose a curfew and patrol the streets. Anyone suspected of working with the insurgents was rounded up, and we turned this mosque into like a camp for them.

  “At first, the people were happy. They hated the insurgents more than we did. One guy told me they were all Arabians, and what the fuck did he care about Arabians. But after a while, we started acting… different. I don’t know what it is or why it happens, but once you got power over someone, you start treating ’em different. Like they ain’t even human. A lot of horrible things started happenin’, especially with the women.”

  He swallowed and placed the bread down on the counter. His eyes were lost, staring into nothing as he spoke, and Howie didn’t interrupt him.

  “So after a little bit, the people started fighting us. They thought they’d just exchanged one conquering army for another. And that’s when the suicide bombings started. We took an entire village that loved us and made it so they would rather blow themselves up than live with us. That’s what happens. That’s what’ll happen here, and lots of people are going to get killed.”

  Howie didn’t say anything for a while as he coated a pan in olive oil, and then he turned to the stove and fired it up. He didn’t know what to say, so he cooked instead, and Mike went to another fridge down a hallway.

  Howie watched Mike go to a metal door with a lock on it, and he searched for something to break it open with. After finding a hammer and other tools in a box, he slammed the hammer into the lock until it clinked to the ground. The fridge was a walk-in and he found some beer and brought out six bottles, placing them on the counter. He popped open the first one and took a long drink.

  “Better give me one of those too,” Howie said.

  38

  Katherine only remembered pain against her jaw and then a headache. Next thing she knew, she was in the Audi, and Ian was sitting in the passenger seat. He opened a sports drink.

  “Here,” he said, handing her the bottle.

  She drank the warm drink without protest. After swigging half of it, she stopped to wipe her lips with the palm of her hand. Ian took the bottle and drank some before replacing the lid and putting it on the floor between his feet.

  “You feel okay?” he asked.

  She nodded but didn’t say anything.

  “I need you to drive,” he said.

  “Drive yourself.”

  “I can’t. I’ve injured my leg, and it’s starting not to respond. I need you to drive. There’s just two more.”

  “Do you even care that they had a family? That they’re the ones that are going to find them? I know what that will do to their kids. They won’t ever be the same.”

  “How do you know that?”

  “My mother died of cancer. When she finally passed, I was the one in the hospital with her. She couldn’t talk, but she was trying to say goodbye to me.” She held his gaze. “You think taking lives is a game, but I think you’re scared. I think you’re scared that you’re going to die one day, too.”

  He didn’t react but instead watched the landscape through the windshield. They were in a residential neighborhood, and a car stopped in front of one of the houses. A teenage boy of maybe sixteen stepped out and went to the front door. He carefully placed his key in the lock and opened the door, stopping for a moment to see if anyone heard him. Then he went inside and shut the door behind him.

  “When I first killed someone, I was so scared, I pissed myself. I mean, I literally pissed my pants. I still remember how warm it was going down my leg. I was in Moscow at the time, and it was freezing, but I remember the comforting feeling of how warm it was. After it was done, I went back to the little room I’d been staying at and cried. I actually fucking cried. Like a little girl that had lost her puppy. It tore me up for a long time. But after the second one, I didn’t cry. I thought I should, and I wanted the tears to come, but they never did. I couldn’t do it. By the fifth one, it didn’t feel like anything anymore. And now… it’s actually fun. It’s probably the only fun I have left in my life.”

  “Well, then I feel sorry for you.”

  He took a deep breath, staring off into space. “Start the car.”

  “No.”

  He was quiet for a second. “I said, start the car.”

  “You’ll have to kill me. I’m not helping you anymore.”

  “I won’t kill you,” he said. “I told you I wouldn’t, so I’d stick to my word. But I will kill your father. And then your sisters and your brother. Any man you ever love will one day disappear, and you won’t know if it was because they left you or because I paid them a visit. You’ll live the rest of your life with me hanging over your shoulder, and you’ll never really know if I’m there or not. Now turn on the fucking car.”

  She sat still. No more tears were left. Her emotions were so frayed that she couldn’t even bring up enough passion to plead with him. She turned on the car.

  “Who’s the next one?” she said.

  “A doctor. Samantha Bower.”

  39

  The hospital was as still as a museum after hours. No one spoke, the televisions were all off, and the radio, walkie-talkies, and cell phones were silent. Many of the staff, a nurse had told Samantha, had simply left without clocking out or letting their supervisors know. Something was wrong, and everybody knew it, so they wanted to be with their families. Only a handful of the staff remained, including maybe a dozen doctors. Samantha sat outside hematology to ensure that the doctor running her sister’s negative staining test was one of them.<
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  Duncan had fallen asleep on the chairs in the waiting area. He spread out over three of them without armrests, and Sam had unplugged the television to ensure he didn’t wake up. His eyes had black circles underneath them. He wasn’t as used to sleep deprivation as she was.

  She went down to the vending machines and got a Diet Coke and a small bag of peanuts. Going back to hematology, she took the long route around the corridor to get blood back into her legs. Hospitals all seemed as though they had been designed and decorated by the same person. The linoleum was spotless in parts and as filthy as mud in others. Antiseptic smells mingled with cleaning products and lifeless, sour air. And they all used lighting that, in a certain percentage of the population, caused migraines.

  She had always noticed that they weren’t comforting, and she wondered why that was. Maybe the association with them was so strongly negative that no decorations could ever overcome it. People, of course, only came there when bad things happened. The only exception was childbirth.

  For a time during her medical school rotations, she’d thought about going into obstetrics, but pathology and trauma had called to her. When she had joined the CDC, something about it seemed so thrilling, so cutting edge. There she was, hardly out of medical school, and she was in a village in Chad performing an emergency surgery on someone whose gallbladder had ruptured. Initially, she had gone there to investigate a water-supply contaminate.

  Samantha discovered the source of the contamination was a single well rumored to contain the feces of some children that had defecated in it as a practical joke, causing an E. coli outbreak. She was the only doctor within two hundred miles. A man suffering from poor hydration and malnutrition had drunk from the well, and the E. coli infected his gallbladder and caused it to rupture.