Pestilence: A Medical Thriller Read online

  The village elders had begged her to perform the surgery, and she’d spent just enough time as an emergency room physician and surgeon to operate without killing the man.

  She removed the gallbladder and closed the incisions, hoping that no sepsis would occur. The man was rushed 211 miles to the nearest hospital for follow-up care and antibiotics. Sam found out later that the man had survived. He even sent her some homemade trinkets, including a giraffe carved out of yellow wood.

  Now, she wasn’t certain that joining the CDC had been the right decision. But she knew the history of infections was the history of the world, and sometimes, she felt there was no greater calling in medicine than to stop the spread of disease.

  Microorganisms were responsible for the shaping of antiquity. People thought that history had variables that could be rearranged to predict with some accuracy how history flowed. One country falls to dictatorship, and a certain result follows. Another country inflates its currency, and a specific result was expected. But Samantha knew that wasn’t true. Humans had always been at the mercy of beings too small to see them, except through powerful instruments.

  The Emperor of the Byzantine Empire, Justinian the First, had the misfortune of being attributed with the worst plague in history. He expanded the reach of the Byzantine Empire, and by all historical predictions, the Byzantines should have conquered the known world, much as the Romans had. But a simple plague brought the empire to its knees and halted expansion, which allowed the Muslim nations to grow stronger.

  The Mongols used to infect their enemies with Plague by catapulting infected persons over the gates of cities they had besieged. The cities would surrender, then the Mongols destroyed them and enslaved their people. Hundreds of cities were conquered this way, and entire nations had been forced to change the way they traded and conducted their politics and economics, based on avoiding confrontation with the Mongols.

  And the Black Plague of Europe forever changed the balance of power between the great nations, causing, in some way, everything that came after it in Europe and consequently affecting every territory under the British crown.

  People were the slaves of bugs a million times smaller than particles of dust.

  And the worst of them was the poxvirus, which was so deadly and contagious that humanity worked to abolish it. Humans understood they could not co-exist while this virus was still alive in nature. But it had returned and had become unlike anything anyone had seen. Samantha estimated that it had a 99.9998 percent mortality rate. She knew of only one person who had survived infection, but she had been so badly scarred by the virus that she was blind, deaf, and unable to walk because the infection had destroyed her nerves and blood vessels. Sam would rather have died.

  The door to hematology opened, and the young doctor stood there, his safety goggles pushed up onto his forehead. He handed a printout to Samantha.

  40

  Lt. General Clyde Olsen sat in a hard plastic chair inside the medical trailer and watched as several of his men communicated with bases across the state. More cases of the poxvirus were being reported, and he didn’t know how that had occurred. Everyone with symptoms had been hospitalized. The only explanation was that some people hadn’t gone to the hospital, but they would all be dead long ago. They wouldn’t have had a chance to infect many others. But the numbers he was getting were off the charts. Some people, somehow, had escaped.

  Ten reported cases in Sacramento, twelve in San Francisco, thirteen in Los Angeles, six in Oakland—the list went on and on. He was losing control of this thing. At least the state was locked down. None of these people would be going anywhere.

  The phone rang. A private line was connected to his desk in the trailer. He picked it up and said hello.

  “Clyde, it’s Lancaster. What the hell’s going on out there?”

  “We’ve hit a bit of a snag, sir. Just a minor setback.”

  “The reports I’m getting are saying there’s over seventy new reported cases up and down the state.”

  “That sounds about right.”

  “So what the fuck happened?”

  “Frankly sir, what we all suspected would. The pathogen got out somehow. Unless some people either couldn’t or wouldn’t admit themselves to the hospital and continued the spread, this thing escaped under our watch.”

  “Damn fucking hippie nature loving cocksuckers…”

  Clyde didn’t respond and waited until General Lancaster finished swearing. He cursed for a good ten seconds before calming down and leaving silence between them.

  “Get it locked down. Now.”

  “Yes, sir. And one more thing, sir.”

  “Yeah.”

  “There’s some concern that if the infected are still among the gen pop, they could cause an outbreak within the containment facilities.”

  “Yeah, and?”

  He was silent for a moment, shocked by Lancaster’s statement. “And there are thousands of people there, sir. Including our own men. They’d be like cows in a slaughterhouse.”

  “Exactly, confined to a slaughterhouse.”

  “You can’t be serious.”

  “Clyde, you think I like this decision? You think this is a fucking good time for me? It tears my guts out to make these calls, but someone has to make them. Our top priority is to contain that virus. We cannot allow it into any other state. Do you understand that, Clyde? Nothing else matters.”

  “Yes, sir. I understand.”

  “Good. Now, for these new cases, the hospitals will probably be overwhelmed soon. Create another facility for use only for the infected. No one else can be admitted there. Have anyone watching them in full biohazard gear. No accidents.”

  “Yes, sir. It’ll get done.”

  “I know it will.”

  41

  Ian sat in the passenger seat of the Audi and tested his knee. He placed his left foot over his right and pressed down. Then he lifted the leg at the back of his injured knee. The lower part of his leg separated about two inches. Nothing was holding it in place.

  “So other than delivering meals to the homeless,” he said, “what do you plan to do with your life?”

  “I wanted to be an environmentalist. Work at a non-profit, something like that.”

  “What for?”

  She kept her eyes on the road. “Someone like you wouldn’t understand.”

  “Someone like me?”

  “You don’t care about anything but yourself.”

  “Probably true, but let me tell you a little secret about your Mother Earth. She doesn’t care about anything but herself, either. She’s constantly trying to kill us with earthquakes and volcanoes and tsunamis and disease… She’s not our friend, and she’s not in need of saving. If I stripped you naked and dropped you anywhere over ninety percent of this planet, you would be dead within one day.” He twisted his injured knee to the side, and a sharp pain shot up his leg.

  “The earth is apathetic,” she said. “It’s not malicious.”

  “Surveys were done in 1904 in New York, asking people what they were scared of. The number one thing was black lung, tuberculosis, and number two was famine. They didn’t mention viruses or asteroids or heart disease or car accidents because they didn’t know about them. Now think a century from now what knowledge we’ll have and what the answers would be to the same survey. It’ll be things we don’t even know about. That’s nature. It runs on death. If anything, I’m more in tune with it than you are.”

  Ian pulled out his phone and checked his list. There had been an update on this one. Samantha Bower was initially last on his list since he was going to fly back to Atlanta, where she lived, once everyone in California had been taken care of. But the update stated that she was in Los Angeles.

  “What did this doctor do?” she asked.

  “I told you, it’s nothing they’ve done. It’s what they will do.”

  “That doesn’t seem fair.”

  “Fair? What are you, six years old? Haven’t you learned
that lesson yet?”

  She spent most of the ride in silence. Occasionally, Ian asked her questions, which she answered with only single sentences or yes and no. He eventually stopped trying and stared out the window.

  He knew Los Angeles well. It was all glimmer and shine on the surface, but underneath was a dark heart that beat in harmony with the worst aspects of men. The city’s essence was one of use—everyone was used by someone else. And the city never seemed to run out of people. So it had an endless supply of people to drain and discard. The vampire city, his father had called it when Ian told him he was moving back there after his stint in the military.

  “I lived here once,” he said, not taking his eyes off the passing landscape before him. “Twice, actually. First, maybe fifteen years ago, when I was a young kid. I saw a man get shot in the middle of the sidewalk during the day. At least a dozen people saw it. The person closest to him as he died on the cement looked at him less than five seconds before stepping over him… I’ve never forgotten that. They’ll all step over you in the end, Katherine. Everyone.”

  She glanced over, and he was fidgeting with a small statue of Saint Cyril in his hand. “What is that?”

  He glared at her and, for a moment, forgot who she was. Then he remembered and put the trinket back into his pocket. “Nothing. She’s supposed to be at the hospital up here. Stop in front and wait for me.”

  42

  After their meal, which was eaten by candlelight, Howie, his daughter, and Mike got back into the jeep. The streets seemed quieter than before. Maybe because the moon was tucked away behind the clouds. He’d always noticed that people were louder when the moon was full. He was glad it wasn’t full that night.

  They drove through Malibu, to Thousand Oaks, and then up through Bakersfield. The farther they drove from Malibu, the fewer choppers were in the distance. Howie drove near Interstate 5, where he saw nothing but normal vehicles. A couple of roadblocks were up, but if you knew the area they were easy to avoid. Didn’t do your research before coming here, did you bastards? Howie thought.

  “They didn’t quarantine up here,” Mike said. “Why would they just do Malibu?”

  Howie didn’t respond. He was busy trying to find a way back onto the interstate. When he came across an entrance that was blocked by signs indicating the onramp was being repaired, he ignored them and drove up. He didn’t see any damage anywhere.

  “Where you going?” Mike asked.

  “Up through Nipton and into Las Vegas. And then as far away from here as I can get.”

  “I don’t know anyone in Vegas. Do you?”

  “No. But I have a brother in Seattle. Maybe we’ll go out there after and figure out what the hell is going on.”

  The city disappeared behind them a short while later, and they were on I-15, heading through the desert near Joshua Tree National Park. The dunes and rock formations were interspersed with patches of forest, and he stopped outside one at a gas station. People were getting gas and snacks like they would on any normal day. Howie watched them and felt sorry for them. In a moment of fear that was coming, when they heard a pounding on the door, they would comprehend they were helpless to stop it. And it would terrify them.

  They walked around and stretched their legs, and Howie realized he didn’t have any money to pay for gas.

  “What’re we gonna do?” Mike said. “It’s pay first.”

  Just behind them, a man pulled up in a silver BMW and got out. He swiped his card and put the nozzle into the tank, then went around to the side of his car to check for scratches while the tank filled. Howie looked to Mike.

  “We have to do it,” Howie said.

  “Beat up some innocent guy and take his wallet?”

  “Yes.”

  “I’m not doing that.”

  Howie thought of his daughter. “We need to get over the state line. We’re in trouble, Mike.”

  “Let me handle it.”

  Mike walked over to the man, “Hey, you’re not going to believe this, but both of us forgot our wallets. I promise you we will send down a check if you could help us out right now and fill up our tank. We’re in really—”

  “Fuck off, asshole,” the man said as he came around the car and finished his exterior check. As he passed Howie, he grimaced.

  As soon as he was turned around, Howie wrapped his arm around the man’s throat. He took him down to the ground as Mike grabbed his legs.

  Howie reached into the man’s pants and took out his wallet. He flung it to Mike. “Fill up the fucking tank!”

  The man was struggling, and Howie had to get on top of him to hold him down. He got hit in the face twice before he got his knees around the guy’s ribs and was able to hold his arms down at the elbows.

  “Get the fuck off me!”

  “Sorry. We need to do this.”

  The man was grunting and writhing around like a wild boar. Mike filled the tank, glancing into the gas station to see if anyone was seeing this.

  “It’s full,” Mike said as he climbed in.

  “Don’t follow us.”

  Howie got up and jumped into the jeep. The man in the rearview ran to his car. He reached into his glove compartment and came out with a pistol.

  “Shit!”

  He grabbed Jessica’s head and pushed her down to the floor of the jeep as the first shot nearly shattered their windshield. He slammed on the gas and peeled away as the pop of gunfire went off behind them.

  The man and his pistol chased them only a dozen feet or so as Howie sped down the dark highway.

  43

  Samantha froze. She didn’t take the test results out of the hematologist’s hands for a moment, and the doctor pushed it closer to her. She lifted it and read the page.

  Negative.

  She let out a sigh and felt weak. The results fell out of her hand, and the doctor appeared perplexed. He bent down and picked it up, then returned to the lab before she could thank him. She stood staring at the door, unable to speak, until Duncan roused behind her.

  “What’d he say?”

  “Negative,” she said after a long pause.

  “Wow. Thank the Lord,” he said.

  “I don’t think the Lord has anything to do with this, Duncan.”

  She turned away and collapsed in the chair next to him. Every muscle ached, and her entire body was pulling at her to sleep. Though she’d been only a day without sleep, she felt as if she could pass out at any moment. Her eyelids drooped, and her mind was a slushy mess.

  “Probably a reaction to the weakened virus,” Duncan said. “We need to run the blood for antibodies and see if she’s developed immunities.”

  Sam nodded. “I need to sleep.”

  “Do you want to get her out?”

  “Not yet. Until she recovers, she’s probably the safest here.”

  “They’d booked a hotel for us. You wanna go back there?”

  “Yeah. Lemme say bye to her and let her know. Can you call Olsen and have him pick up the blood for testing?”

  “Sure.”

  Duncan headed downstairs as Sam went back to the quarantine zone. She opened her sister’s door, and Jane was asleep in the darkness, a slight snore escaping her lips. Sam woke her softly and told her the news. They both cried and held each other.

  Deciding to take the stairs to help wake up, Sam felt her legs more acutely than she had in a long time. She felt almost as if they were letting her know they were about to abandon her, and she could no longer rely on them. She placed her hand on the banister for balance.

  As she headed downstairs, she heard the swoosh of papers flying onto the floor and then the thump of something heavy hitting the linoleum. Down the corridor, a man in a pinstripe suit stood over the body of a hospital security guard. Behind the desk, a nurse was leaning far back in a chair, a single hole in her forehead; blood oozed out and down her temples.

  The shooter kicked the officer to make sure the man was dead, and then his head came up, and her eyes met his.

/>   She didn’t know how she knew, but she did. He was there for her.

  As she darted up the stairs, two slugs embedded into the wall where she had been standing, spitting drywall and dust into her face. She pushed her legs as hard as they would go, but she felt as though she were running through sand. Another shot rang in her ears as the round bounced off the metal railing and ricocheted somewhere below.

  She opened the first door she came across and ran down a corridor with patient rooms on either side. She sprinted past a nurse’s station, where a single nurse was sitting behind a computer. The nurse yelled something to her, but Sam couldn’t hear.

  Sam turned to her, still running, and shouted, “There’s a man with a gun!” She couldn’t think of anything else to say that would convey the urgency of the moment. But she ran a bit, and when she glanced back, the nurse hadn’t moved. The door at the end of the corridor opened, and the shooter stepped through.

  Sam ran to the elevators and pushed all the buttons. Out of breath, with panic slowly closing in around her, she wasn’t there. She was back in her house with a man named Greyjoy standing above her, telling her she was about to die. Samantha felt as though she were breathing through a towel.

  One shot, nothing more than a spit, sounded like a plastic cup falling onto linoleum. It zipped past her, close enough that she sensed the wind from the shot. The round exploded the window behind her as one of the elevators opened, and she jumped on. The shooter chased her at a full sprint.

  She pounded the button for the top floor, her injured arm aching beneath the cast, and the doors slowly closed as the man leapt to get his hand in between them. The pull of gravity made her stomach roil as the elevator lifted her higher into the building.

  44

  With no streetlights and a moon that seemed to be hiding from them, Howie had no means to see anything other than the headlights on the jeep. He felt surrounded by a great black nothingness, but the headlights made it appear as though they were barreling through a light tunnel. Jessica was asleep, and he reached over and moved a strand of hair out of her face that was whipping her skin.