Pestilence

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.

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.

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.