Pestilence

16

Dr. Aneil Deluge walked down the corridor of Saint Anthony’s Hospital in Napa, California. Under his arm, he carried a clipboard with two intake sheets attached. He took the elevator to the quarantine unit on the top floor, which was really nothing more than a portion of that floor cut off from the rest.

The elevators dinged and opened, and he stepped off. The nurse behind the desk smiled at him, and he smiled back without greeting her. He walked the length of the corridor to a room separated from the others. He looked in on the patient through a glass viewing window.

Candice Montgomery was a twenty-four-year-old student at Napa Valley College. She was studying communications and had been a cheerleader for the football team. Deluge hoped she had not been to a game or practice before she’d been admitted to the hospital.

Her symptoms were, at first, indicative of the flu-fever, rashes, headaches, and vomiting. But, in a progression so quick that Deluge was left wondering if she’d been poisoned, her condition deteriorated.

First, she developed small pustules on her skin. Little bumps that looked like kernels of corn had popped up on her flesh. Then her eyes, throat, and nose became irritated and swollen. These symptoms were not entirely alarming to Deluge or the ER staff, but what happened next, they had never seen before.

She broke out in pustules so severely that they covered nearly ninety-five percent of her body. They even broke out inside her throat, on her tongue, and over her eyes. She had gone blind as the pustules ruptured the conjunctiva, iris, and pupil. Heavy scarring had occurred afterward, and he guessed she was permanently blind.

But a more alarming symptom had developed that morning. Her skin appeared to be black. Though full barrier nursing was in place and the risk of infection from an airborne pathogen was low, two nurses and a phlebotomist had turned down his requests that they tend to her. Since he had to suit up and withdraw the blood himself every time, running many tests was difficult. The pustules had made injections extremely painful for her, as well, and she would thrash about whenever the needle went into any part of her body.

The blackness underneath her skin had spread over her entire body, and she appeared as though she’d been charred. One nurse, brave enough to examine her, had revealed to him that Candice’s membranes in her orifices were disintegrating. The soft tissue at the opening of her nose, anus, vagina, and eyes was slipping off her as if they had rotted away.

Candice had been at Saint Anthony’s for eight days, and it only took one day of her symptomology for Deluge to notify the Centers for Disease Control. They had flown out, improved the barriers to prevent further infection, and then left. The man that had been sent, a doctor by the name of Cheney, told Deluge that she was too far gone for treatment and that they should keep her comfortable for the next few days. Nothing else could be done.

Blood tests had confirmed the presence of smallpox, but in a form the hematologist didn’t recognize. The CDC had taken all her infected blood and the test results.

“There must be something we can do,” Deluge had said to Cheney as he was preparing to leave.

“This pathogen is a hundred percent fatal.”

“That’s ridiculous. Nothing’s a hundred percent fatal.”

Cheney glanced at him and then handed him a sheet of paper. “Write down anyone that has interacted with her since she’s been in the hospital. Then speak with her family and see if you can find out who she’s interacted with in the five days before she was admitted here. If any of them are showing symptoms, they have to be admitted with a full barrier set up. If you have any concerns, here’s the number to our local office. They’ll send someone out to help you.”

With that, Cheney left, leaving Deluge to wonder exactly what the hell he had on his hands.

Nancy Claiborne had worked at Saint Anthony’s Hospital for thirteen years and loved every minute of it-even the horrible patients who yelled, threw up on her, and fought. They had once even wrestled a gang member to the ground because he was on PCP and had knocked the doctor out cold.

But her first shift in the quarantine unit was unnerving. Many of the nurses had refused to even go in, but she wasn’t scared. She had dealt with the worst outbreak of flu she’d ever seen and had lived to tell the tale without a scratch.

She was in the locker room, changing into her scrubs. She put on her Crocs and then went out onto the floor. Walking to the elevator, she didn’t really speak to anybody, which was unusual for her. But she wanted her concentration, and the best way to maintain it was to ignore others.

She stepped off on the top floor, and Dr. Deluge was standing in front of one of the patient’s doors. As she came up next to him, she looked into Candice’s room.

“How is she?”

“Stable, I suppose,” he said. “Has she moved or talked?”

“Not since about three days ago.”

“Any vomiting or bowel movements?”

“One bowel movement yesterday, but it was mostly blood.” She shook her head. “Poor girl. She’s my Mathew’s age.”

Deluge rubbed his temples with his thumb and middle finger. “I’m going home. I’ve worked a twenty-hour shift. Keep me apprised of any major updates.”

“Sure.”

As Deluge left, Nancy walked back to the nurse’s station on the quarantined floor and relieved the lone nurse sitting there, surfing the internet. She stretched and then opened solitaire and began playing.

Around midnight, Nancy heard something on the monitor. She paused the video she was watching on YouTube and listened. It sounded like coughing. She rose and walked over to Candice’s room to make sure she was all right. Glancing in, she nearly screamed.

Candice was covered in a thick black blood. The fluid was spurting out of her eyes, ears, and mouth. Nancy wouldn’t say she was vomiting because the heaving reflex was absent. Her blood was just coming out of her body as if being pulled by gravity.

Nancy called the ER. “I need a crash cart and a doctor up here in quarantine right now!”

Unthinking, seeing only a young girl in pain, she ran in.

She pushed past the transparent barrier and turned Candice to her side. A metal bowl near her mouth caught most of the blood, but it was still coming out of her ears. Nancy grabbed a bedsheet and pressed it to her ear canals to try to slow the bleeding.

For a single moment, Candice stopped vomiting and sobbed. “Please help me,” she cried.

Before Nancy could say anything, Candice convulsed violently and jerked onto her back on the bed. She vomited an explosive stream of blood that hit Nancy in the face. It was warm and smelled like foul steak.

Nancy panicked, turning Candice to her side again, allowing her to vomit into the bowl. But so much blood was coming that it filled the bowl and spilled onto the floor.

The door opened, and a crash team was there.

“No,” someone shouted down the hall. One of the trauma doctors, Roger, ran over to the room and looked in. “Don’t go in,” he said. “Gear up first.”

“There’s no time,” Nancy said.

She realized suddenly that the crash team was staring at her. She wondered why, until something wet dripped off her face and onto her hands. She touched her face and came away with the blackness that covered Candice. Until then, she hadn’t registered that the blood on her face was hemorrhagic blood.

“Roger…”

“Get into the shower, now.”

She walked to the bathroom in the corner of the room and washed her face and hands. She started slowly and used a little soap, and then rubbed her hands together furiously. She was using so much soap that the suds covered the sink. She scrubbed violently at her face, and after a short time the skin was raw and pink, and she was crying.

She screamed and ran out of the room. The crash team were in the supply closet where they kept the biohazard gear, and Roger yelled out to her, but she didn’t hear. She was sprinting down the hall. She had to get out of there. The hospital walls were closing in around her, her heart was racing, and she couldn’t breathe. Her chest was tight, and she worried she was having a heart attack.

The elevator took too long to arrive, so she sprinted down the stairs instead. Hysterical, she burst out onto the first floor and ran for the exit.

The sliding doors opened and another nurse, Lance Page, walked in. She tried to run past him, but ended up running into him, nearly knocking him off his feet, and their faces bumped.

“Nancy,” he said as she stood and ran out the door. “Nancy, what’s wrong?”