Scourge - A Medical Thriller (The Plague Trilogy Book 3) (2 page)

1

“The detonations were the beginning,” Sam said. “The virus had appeared in South America and Hawaii before then, but we thought it was a fluke, the kind of aberration of nature that pokes its head out sometimes. A Spanish flu virus once appeared in the early twentieth century, killed three percent of the world’s population, and then disappeared without a trace. There are things in nature we just don’t understand, and sometimes they show us glimpses into that unknown, as if we can touch it.

“So after Hawaii, procedures were put in place, FEMA better trained on containment,
and the Centers for Disease Control set up better communication with the World Health Organization and the United Nations. We saw that there really weren’t individual nations any longer. Humans could travel as far as they wanted, faster than ever. A virus could appear in Bangalore and be in Manhattan by the end of the day. The speed of our travel has made us susceptible to contagion in a way we weren’t meant to be. Hunter-gatherers didn’t infect other bands of hunter-gatherers with their antigens. They were spread too widely. So when the poxvirus hit, the strain we now call Agent X, we weren’t prepared for the speed it could travel.

“There
are two measures to the spread of an antigen: R-naught and T scores. They both describe the same phenomenon, how fast a virus can spread. Ebola has an R-naught of one, meaning each person infected generally infects one other person during the contagious stage of the disease. Traditional smallpox is five. Agent X, the mutated strain of
Variola major
, has an R-naught of twenty, making it the most contagious disease in history. Only measles, with an R-naught of eighteen, compares. So after Hawaii, at the CDC where I worked as a virologist, I began running infection grids to predict the spread of Agent X if it ever appeared again. Another virologist there, Dr. Ngo Chon, worked with me to come up with the simulations. We discovered that human beings would have to live farther than fourteen days apart if we were going to slow the spread of the virus. That meant that one infected group had to be farther than two weeks’ travel away from other hosts. Two weeks was long enough that the infected host would become immobile before coming in range to infect others. Living two weeks apart was practically impossible. We couldn’t come up with a scenario where Agent X wouldn’t spread to every population center in the world within three months.

“That’s when the detonations occurred
—four of them. It wasn’t clear at the time who was responsible. I only saw bits and pieces of the larger picture. Two men tried to kill me, for reasons I still don’t fully understand. Something to do with the fact that I was one of the virologists deemed most likely to develop a vaccine, which they couldn’t allow. Six other virologists were on their list, as well as administrators and physicians, and they’re all dead. I’m the last surviving virologist that this… organization… deemed a threat. And on top of the detonations, liquefied
Variola
was dumped from planes on other cities, onto large groups that had congregated for whatever reasons.

“After the detonations, martial law was declared in the United States
, not just the four cities affected, but the nation as a whole. The problem with that is that the military is meant to fight off national threats, not act as a police force. When the military become the police, the citizens, by definition, become the national threat. Curfews were imposed. Thousands of people who wouldn’t comply were arrested and held in military brigs. It wasn’t chaos yet, but chaos was coming. I just wasn’t paying attention. Chon and I were busy experimenting with liquid nitrogen. Agent X mutates quickly, so we thought that if we could slow the virus down, slow its mutations down, we might be able to develop a vaccine from the husks of the weakened virus.

“
That autopsy after the liquid nitrogen experiments was at the CDC in the BS4 lab, the most secure laboratory in the world. I sat out in the hallway in a blue spacesuit, just staring at the linoleum and preparing myself for what I was about to find inside the autopsy room. We had been experimenting nonstop for so long, I’d lost hope. That autopsy was it. If it didn’t work, I wasn’t going to try again.

“I entered the autopsy room and found
Chon and a pathologist named Tomomi Yashima standing by in their own spacesuits. The suits are connected by a hose to the walls, providing fresh, sterile air to the suits, in contrast to the negative air pressure inside the lab, which would supposedly keep any antigens out of the suits. It’d never been tested on a live antigen, but the theory calmed us down. Most of the scares that happen inside a Biosafety Level Four laboratory happen because of nervousness or carelessness, not because of the danger inherent in working with hot agents. So any placebo that would calm and comfort the scientists and aides in the lab got implemented. I think that’s all the negative air pressure was, a pacifier so we wouldn’t think too much about exactly what we were doing.

“ ‘You ready for this?’ Chon asked me.

“His voice sounded otherworldly in his spacesuit, like he was talking through one of those old cell phones that resembled bricks. Even with the negative air pressure, the scent of the autopsy room permeated the suits, and I had a suspicion Chon breathed through his mouth. Every autopsy smells like human feces. ‘Yeah,’ I said. ‘But if it doesn’t work…’

“ ‘It’ll work,’ he replied, nodding to Dr. Yashima.

“The pathologist, a Japanese transplant who’d only been out of medical school a few years, had been promoted rapidly with the deaths of two senior pathologists on the CDC staff, men who had died after infection with pox, before we understood how contagious it really was. I could tell she was uncomfortable, but I knew she would do her job.

“In front of us on a metal gurney lay the body of a recent victim of the virus. Smallpox has devastating effects on the body
, and it’s something you can never grow accustomed to seeing. It was a white male, and his skin elevated away from the dermis with thick, oozing pustules, creating a texture that looked like a cobblestone road. Over half his face, the skin had filled with fluid, resembling a sack. The sack, had he lived longer, would have grown to cover his entire head, but he died from exsanguination before that could happen. Even now, we’re not entirely certain what a patient infected with smallpox dies of. Usually it’s something secondary like exsanguination, asphyxiation, kidney failure… but how the virus actually kills, no one really knows.

“ ‘Cross your fingers,’ Chon said.

Dr. Yashima had a puzzled look on her face, and I realized she didn’t understand the expression. ‘It means hope for the best,’ I said. She grinned underneath the thick, transparent faceplate before turning to the metal tray next to the gurney. Several stainless steel tools lay before her on a blue towel. She took a large scalpel and turned to the cadaver. Her eyes shifted from Chon to me. I nodded and said, ‘Go ahead, Tomomi.’ She inserted the scalpel just underneath the cadaver’s nipple, and then cut along the chest. The cut looped up to the shoulder and then straight down the center. Her hands moved like a sculptor’s, carving away at her mound of clay, no wasted movements, just pure concentration.

“When she stopped cutting, a Y
had been carved into the cadaver’s chest. Tomomi peeled up some skin and reached her fingers underneath. I pushed my fingers into the cut as well, and we pulled. The dermis came off like skin from fried chicken. We peeled it down to his stomach and flopped the excess to the sides. Dr. Yashima then took out a tool that resembled garden shears and snapped off the cadaver’s first rib, then his second, then his third. She went all the way up one side and down the other until all the ribs formed a pile on the linoleum floor. Using the scalpel, Dr. Yashima then flipped up the breastplate like a Tupperware lid.

“Instantly, a river of thick, black blood flowed out of the cadaver, over the gurney, and onto the
floor. Dr. Yashima took a ladle off the tray and began scooping the blood into a bucket underneath the gurney. I reached in and pulled the man’s lungs up, then his kidneys. Pustules made them look like carved-up sponges. The liquid nitrogen hadn’t worked, hadn’t even come close to working. We had failed again.

“ ‘Back to the drawing board?’ Chon said.

“I stared into the body cavity and the infected blood that had drowned the man. ‘No, not for me, Ngo. This isn’t working. There’s something we’re missing. Or maybe it’s too smart for us.’

“
Chon rolled his eyes and said, ‘You’re anthropomorphizing again.’

“
He was right, but I couldn’t help it. The virus adapted. It anticipated our movements, learned from our experiments. How could I not give it human traits, malice and human motivations?

“
‘What else is there?’ he said. ‘We gotta keep hammering the LN. It’s the only thing that’s slowed it down.’

“ ‘
Does this look
slowed down
to you, Ngo? We’re not an inch closer to developing a vaccine.’ He exhaled, a small puff of fog covering his faceplate for a fraction of a second before the pumped-in air cleared it. ‘I’m done,’ I said, taking a step away from the table. ‘I’m going to help the people I can actually help. I need to get outta the lab and into the field.’

“
Of course, I didn’t realize at the time what was happening in the field. The four detonations and the planes that had released the liquefied virus were a distraction. The intent of the explosions was much crueler. Smallpox, in liquefied form, could potentially get trapped in clouds. The clouds would move, releasing rain and pouring down virus over entire cities. The poxvirus can live for nearly a day outside of a host. It wouldn’t take long for it to infect massive swaths of people. And that’s exactly what happened. Except that it had a modification that led to something I never could’ve dreamed…”

“I was busy at the time. A man I barely knew had me promise to watch his daughter. He was dying of the pox and he killed himself to prevent other
s from getting infected through him. So I promised him. His daughter was twelve, Jessica Burke, and she lived with me and my mother until my mother passed four months ago. I took care of my mother, fed her, bathed her, spent time with her. In a lot of ways, it was like taking care of a child. I didn’t mind. I loved my mother and no one else would take her, though I have two siblings. When she passed, it felt like a little bit of me died, too, that part that held on to childhood memories. Every day I wake up, even now, and I expect that world, the world of my childhood, to appear before me. But instead, I get this one.” She paused.

“During that autopsy, Dr. Yashima opened the cranium and studied the brain. That’s the first time anyone had seen the lesions. She took photos
, and later that day when I sat in my office, staring out the windows at the sky as I did all the time, she brought the photos in.”

Mitchell pushed the digital recorder closer to her. “Tell me about the lesions.”

2

Samantha grew uncomfortable and shifted in her seat. Out on the horizon, a bird drifted by, or maybe just a piece of debris.
Garbage filled the streets now, and heaping piles of trash in parking lots or even the middle of the freeway weren’t uncommon.

“The lesions first appeared as black dots, almost like leopard spots,” she said. “
The metencephalon and frontal lobes were most affected. In the cerebral cortex, there’s a layer of what’s called ‘white matter,’ but it didn’t look white in this patient. It was nearly black. The white matter is what controls connections between different regions of the cerebrum. If something wanted to take control of a human being, those are the regions that would have to be affected, shut down our higher reasoning, turn us into mindless animals. As the three of us stared at the lesions, we didn’t know what they were. I thought maybe it was hemorrhaging in the brain unique to that patient, but then something happened that changed that.

“That night, I went home. I live in a suburb
of Atlanta, and when I was gone, my neighbor watched Jessica. She was a kind, elderly woman whose kids didn’t call or visit her anymore, so she was happy to spend time with Jessica. When I got home, the two of them were sitting on the patio, drinking juice and laughing, watching the sun set like nothing in the world was wrong. I sat down next to them in a chair, my body exhausted to the point that I nearly fell asleep as they asked me questions about my day. I tried to answer as many as I could, but I had to tell them I was just too tired and had to go to bed.

“I went upstairs and got ready for bed. Water
was only on for two hours each morning in an attempt to conserve it, so I couldn’t take a shower, but I used some from buckets to get a towel wet and run it over my body. Then I lay down on the bed, and I was gone. I don’t know how long I slept, but I remember what woke me: a scream; a brutal, primal scream.

“Jessica
, her eyes wide with terror, ran into my room as I jumped out of bed. I thought perhaps something had happened to her or our neighbor, maybe burglars, which had become prevalent without a decent police force, but then I heard the scream again. The sound emanated from the house across the street. ‘Wait here,’ I said.

“I grabbed the revolver out of my closet before throwing on some shoes and running outside.
No one else was outside. No one cared that a woman was screaming. I knew the home. It belonged to a family: parents, Eric and Beth, and their two children. I dashed up the porch steps and pounded on the door. ‘Beth? You okay?’ Another scream, and then the sound of crashing wood and breaking glass. But this scream cut off, as though the person’s mouth had suddenly been covered. I looked around the neighborhood. Even now, no one was coming out. Calling the police was useless. They would take two hours to get out there if they came at all. I tried the doorknob and the door was locked, but a window on the porch leading to the front room opened when I pulled up on it.

“I stuck my head in and said, ‘Beth? You okay?’ Still no response
, so I shouted, ‘I’m coming in, and I have a gun.’ I don’t know why I said I had a gun, maybe to scare away any potential attackers, maybe only to make myself feel better. I don’t know, but when I entered the home, a tingling sensation went up my back. I stood in their front room and scanned the surroundings. There were toys on the floor, family photos on the walls, food still out on the dining room table, two grilled cheese sandwiches only half eaten. I wrapped both hands around the gun and held it low, my finger over the trigger guard like I’d been taught in my concealed-carry class. I crossed the front room, the dining room, and the kitchen. I opened the back door and peeked out. The moonlight reflected off a glass coffee table on the back porch, and several hardcover novels lay on the glass. Other than that, the backyard was empty. Going back into the house, I saw the stairs leading up to the second floor. I was about to leave and call the police when I heard a thud, and then banging, pounding against a wall or a door. I swallowed, thinking a burglar had definitely broken in and was holding the family hostage. The police wouldn’t be here in time. I was the only hope.

“Upstairs appeared much like the downstairs with the exception of family photos. The walls were bare.
I went to the right first, past a bathroom, and looked into the first room. A child’s room, decorated in posters of sports teams and cartoon characters. Another bedroom was the same but decorated with posters of adolescent boy bands, so I quietly walked the other way to the master bedroom. Inside… I saw something I would never forget.”

Mitchell waited quietly a few moments before
asking, “What did you see?”

Samantha pulled
the sunglasses she had on her head down over her eyes. “I saw Beth’s body. It’d been torn apart, like an animal attack or something. Her organs lay in tatters over the carpet, and blood was spattered everywhere, even on the ceiling. Her face had been ripped away from her skull, and her left arm was missing just below the shoulder. My first thought was that a bear or a cougar had gotten in. We’d never had an animal attack in the neighborhood, but that was my first thought. And then I saw her husband.

“Eric
was bent over near the nightstand, hunched down like a gargoyle on a medieval cathedral. He was holding something to his lips and there was a wet, tearing sound. He didn’t seem to notice me, but the hairs on my neck stood up. Rather than speaking to him, I began backing out of the room, the gun held firmly, when I ran into a floor lamp. It banged against the wall and Eric’s head shot up, though he hadn’t turned around. Slowly, he rose, his face still away from me… and I could see the blood. I didn’t wait for him to look at me after that. I ran down the stairs and out of the house. I heard Eric screaming behind me, just a loud, guttural scream, and I could hear his footsteps as he chased me through the house. I made it out and slammed the door behind me. He pounded against it. The door wasn’t locked. It was more as if he forgot how to open it. As I stood on their porch, the gun aimed at the door, he banged against it for a long time, snarling like a pit bull. As quietly and carefully as I could without falling over, I backed away, down the front steps to the sidewalk, before heading into the street and back to my house.

“ ‘What was it?’ Jessica said as I ran in and locked the door behind me. Concern twisted her beautiful face. She’d been through so much already that the thought of more tragedy filled her with pain and despair. I could see it on her face clear as day.

“ ‘Nothing,’ I said. ‘Just something across the street.’ I grabbed my phone, hurried into another room, dialed emergency services and reported that I thought my neighbor had killed his wife. They said they’d send someone out as soon as a unit was available. I knew that wouldn’t be for hours. Most police officers had quit their jobs. The prospect of dealing with an infected person and taking the virus home to their own families wasn’t worth the paycheck. For whatever reason, some officers chose to stay, but they were few, and the ones who did stay didn’t stay long. As they saw their friends infected, droves of police officers left. A few months after the detonations, an entire city would be lucky if it had ten police officers.

“I ran back out
to the living room and attempted to put on a brave face for Jessica as I stared out the window at Eric and Beth’s house. My thoughts raced. Maybe the pressure of living such an existence had finally caused Eric to snap. Maybe someone else had killed Beth, and Eric just happened to be there when I came in. But that didn’t explain his behavior. He was instantly hyper-aggressive, almost as though he wasn’t human.

“ ‘Sam, what’s going on?’ Jessica
said next to me, and I put my arm around her. I remembered what it was like to be that age, the things that concerned me.
Were my friends talking about me behind my back? Would I have a date for the school dance? Could I get good grades in all my classes?
But that wasn’t what she had to worry about. For her, life had become nothing but survival. No other concern seemed important enough to consider. ‘It’ll be okay,’ I said. ‘The police will be here soon.’ She didn’t respond right away. Instead, we both stared at the home across the street before she said, ‘I don’t like the city. I want to move.’

“ ‘Move where?’ I said, looking down
at her. She pressed herself against me as though I could shield her from whatever was scaring her.

“
‘I don’t care. Anywhere. Just away from the city. Away from all these people.’

“
I bent down and looked her in the eyes, eyes that should’ve been full of life and laughter but instead had settled into hardness and efficiency, a soldier’s eyes in a twelve-year-old girl’s face. ‘You’ll be safe, Jessica. I’m not going to let anything happen to you. Do you understand? Nothing’s going to happen to you.’

“ ‘You don’t know that,’ she said, pulling away from me. ‘You don’t know what’s going to happen. Everybody dies. That’s what will happen. I’m going to die.’

“My hands were still on her shoulders and I felt her body convulse, a tremor of emotion running through her before the tears came. I wrapped my arms around her and brought her in, pressing her body against mine, making certain she felt my warmth. I kissed her on the head and said, ‘You are not going to die. Do you hear me? You are going to live.’

“I don’t remember what we did for the next couple of hours, mayb
e just sat in the living room and read, but the time came when the police arrived. A single patrol car manned by one officer, a grossly overweight man who parked in the driveway of the home across the street. He ambled up to the front door and knocked. Waiting a few moments, he knocked again and then tried the door. It opened, and he pulled out his gun and stepped inside.

“ ‘Stay here,’ I said.

Jessica immediately grabbed my arm. ‘No! Don’t go. Stay with me. Stay here, please!’ I bent down and looked into her eyes again, attempting to calm her. But the panic in her eyes had settled in, and she wouldn’t hear anything I said. ‘Jessica, I will be right back. I just need to make sure Beth and Eric are okay. You can watch me from the window.’

“She flung her arms around me. ‘P
lease don’t go.’ But I had to get over there and verify what I had seen. I knew a logical explanation existed, something that would explain it in a way that would remove the ball of anxiety in my gut, so I left and locked the door behind me. I saw Jessica’s face glued to the window before I crossed the street.

“The neighborhood was quiet and still. I wondered if anyone even cared that a police cruiser sat in one of our driveways, the lights spinning and illuminating the street red then blue, red then blue. I
wondered why the officer didn’t just turn the lights off. Probably to alert any burglars of his presence so they could run off and the officer could avoid interacting with a member of the public. I glanced into the cruiser as I passed. A shotgun lay across the backseat, and crumpled on the floor, a yellow biohazard suit that looked like someone tried to shove it under one of the seats. When I got to the porch, I stood there and listened. I couldn’t hear anything from inside. In fact, I intended to wait on the porch when two loud pops went off.
Bang
,
bang!
With each bang, a flash of light through the windows. I still held my own gun but suddenly realized the officer might think I was a prowler and shoot me. So I put it away and stepped off the porch. I stood by the cruiser and waited.

“Nothing happened. Glancing back to my home, I saw Jessica’s terrified face in the window. My first thought went to her
. What would she do if something happened to me? She had no family left, none that she knew of, anyway, and no friends. Government programs like foster care and welfare had all but shut down for fear of spreading the virus. The military saw them as ‘negative externalities’, programs that diverted resources from the real objective of maintaining order and containing the epidemic. Jessica would have nothing and no one. I couldn’t risk that. As much as I wanted to know what had happened, I couldn’t risk harm for her sake. I backed away from the house, never taking my eyes off it. Halfway into the street, I nearly jumped when the door flew open and the officer tumbled out.

“He gripped his
upper arm, panic written on his face as he ran to his cruiser. I could see blood pouring from a wound on his neck and out over the fingers he had around his arm. He placed a call on the two-way radio and then jumped out and ran to the trunk. Flipping it open, he then rummaged through everything back there until he found a first aid kit. His eyes fixed on me—large, wild eyes. ‘I need help,’ he shouted as he rushed toward me. My first instinct was to reach for my gun, but I forced myself to remain calm.

“ ‘I’m a physician. Sit down on the curb
. Let me have a look at your injuries.’

“
He didn’t comply at first, instead he shouted, ‘I need help,’ again. Shock was setting in, and his face was as pale as the moonlight. I grabbed the first aid kit from him and sat him down on the back of the cruiser. I lifted his collar for a better look at the wound and saw the indentations, teeth marks. He’d been bitten, and a chunk of his neck the size of a silver dollar was torn away. ‘What happened?’ I said.

“ ‘Fucker ran at me. Just jumped out. I popped him twice
, but I don’t know if he’s dead. Fucker just ran at me!’ The officer’s eyes told me he was going to lose it. The injuries, though pouring blood, weren’t life threatening: one wound in the neck and another smaller one on the upper bicep. I glanced at the home. I pushed Eric out of my mind to tend to the officer. The first aid kit had plenty of gauze, and I pulled some out to stop the bleeding until emergency services could get there. Ambulances were even scarcer than police. When they were called, most of the time it was because someone was dying from the poxvirus. They would drive past, not even bothering to tell the victims why they wouldn’t stop and help. I had once seen an ambulance allow a man to die in front of his hysterical wife because the driver confused vomiting from flu with vomiting from the pox. The man’s blood was later tested as part of a lawsuit and found clear of infection. That’s almost funny now, someone suing the government for letting a loved one die, considering everything that’s happened.