The Genius Plague

CHAPTER 4

I sat in the waiting room of the Baltimore Washington Medical Center, wondering how long it would take before they would tell me anything. The hospital vending machines accepted my credit card, and I loaded up on peanuts, barbeque-flavored potato chips, and Snickers bars, the first food I’d eaten all day. Outside, it started to snow.

As soon as Paul collapsed, Shaunessy had dialed 911, and an ambulance appeared in an impressive five minutes. Paul had regained consciousness by then, and complained loudly that he was fine while the EMTs strapped him to a stretcher and loaded him into the back of the ambulance. Another EMT asked me questions. I told him everything I knew about where Paul had been and what he might have come into contact with, but it wasn’t much.

Shaunessy drove me and followed the ambulance to the hospital. She offered to stay, but I insisted that she leave, after I borrowed her phone again to call my parents and sister. I had already milked her kindness far more than seemed reasonable, and I didn’t know whether Paul’s blood was going to wash out of her blouse. An hour and a half had passed since then, and all my inquiries at the front desk had been met with the patient response that I would be told as soon as they knew anything.

Finally, they called my name, and I was introduced to a Dr. Mei-lin Chu. She looked nearly as young as me, but I assumed she must have graduated from medical school and been through a residency. Her long hair was slipping out of the clip that held it out of her face, and she looked tired.

“Is he conscious?” I asked.

“He is,” she said. “He’s lucid and responds appropriately to questions, though he seems vague about the details of his trip. I’m concerned he doesn’t remember more.”

“What happened to him? Do you know?”

“Your brother has fungal pneumonia. At some point while he was in South America, he breathed in some spores, and they lodged in his lung tissue and started to grow. We’ve taken a biopsy from his lungs to determine just what type of fungus is involved. Do you know what he might have come into contact with while he was down there?”

I laughed, and she looked at me quizzically. “Didn’t he tell you?” I said. “He’s a mycologist. He probably touched, sniffed, and sampled a thousand of the rarest fungi he could find.”

“We’ll know more once the labs come back. Fungal infections can be quite serious if untreated, but in most cases, we have good results. I’ll tell you more as soon as I know it.”

And with that, she was gone, leaving me to wait again. Two hours later, after I’d eaten enough candy and chips to feel pretty sick myself, Dr. Chu returned.

“It’s called paracoccidioidomycosis,” she said, the word flowing off of her tongue as easily as breathing. “The good news is, it’s fairly common in that part of the world, so we know how to treat it. However, this a serious illness, one with some pretty serious side effects if it’s not addressed.”

Her small hands gestured in quick motions as she spoke. “The fungus takes root in the lung tissue and starts sending out microscopic tendrils, called mycelia, between the cells of the lungs. The immune system attacks it, but this releases fluid and blood from the surrounding vessels, which can inhibit the alveoli—the structures that exchange oxygen for carbon dioxide—from functioning properly.”

“But he’s going to be okay,” I said.

She nodded. “The worst of it is past. We’ll have to keep him here for a few more days, though. We’re giving him an antifungal drug called amphotericin B intravenously, and we need to monitor him. Even after we release him, he’ll need to stay in bed, and he’ll continue to have a fever and a nasty cough for at least a week. I’m prescribing him voriconazole, another antifungal drug that he can take orally. But—this is important—he’s going to have to keep taking it for at least three years.”

“Wait—years?”

“Years. I told him, but I’m telling you, too, because it’s important. Fungus is hard to eradicate. It can come back, and if it does, it’s usually a lot worse than the first time around. You can end up with a chronic lung infection, or it can spread into joints or into the lining of the brain. You don’t want to mess around with it. He needs to take the medication.”

She shook my hand and walked away before I could even thank her. She spoke so quickly, the whole exchange had taken less than a minute. Eventually, they told me I could see him. I wandered back through halls that smelled like latex and cleaning agents and found him propped up in bed, as pale as the walls, a gently beeping IV in his arm.

“Hey,” I said. “You gave us a scare there. How do you feel?”

He coughed wetly. “I’m fine.”

“You’re not fine. You dropped like a rock in the middle of the airport pick-up zone and you’ve got fungus growing out of your lungs. Not to mention almost getting yourself killed down there.”

“The hazards of international travel.” He shrugged. “Really. I feel fine.”

“More like the hazards of extreme mycology,” I said. “I told you to stay away from the magic mushrooms.”

“Yeah, yeah. So just how are you getting out of here without a car?”

“I’ll have to call a taxi.”

“That’s what I get for trusting my little brother to get me home.”

“Oh, so now you’re blaming this on me?”

Paul grinned. “You’ve got to get yourself a real job one of these days, so you can afford a real car.”

That reminded me that my Nissan was still in the NSA parking lot, gathering a layer of snow. I was going to have to figure out how to get a tow truck in there to pull it out, and I feared that the cost to fix it would be more than I could afford, and probably more than the car was worth.

“So, what happened down there?” I said.

“What do you mean?”

“Come on, Paul. I know more about your ordeal from watching the news than I do from you. Who attacked you? Why? How did you escape?”

Paul related what little he knew, about military-looking men in a Brazilian Navy patrol boat who had attacked for no obvious reason. How he and a girl had made it to shore and walked for miles through trackless jungle to civilization. He was vague about that part of the journey, saying only that they had survived on mushrooms and gotten lucky.

“To tell you the truth, that part of it is a blur,” he said. “I remember getting to shore, but I don’t remember a whole lot after that. I guess I must be blocking it out.”

It seemed odd to me that he would block out a trek through the jungle, but not the violent murder of a dozen people, but I didn’t say anything. “How’s the girl you escaped with?” I asked instead.

Paul looked pained. “Maisie!” he said. “She’s probably sick, too.”

“Did you travel back with her?”

He shook his head. “She left the same day, but she lives in California. Wine-growing country. We took different flights.”

I stood at the window. The sun was just starting to rise, reflecting brightly off the snow and giving the room a pinkish hue. “Doctor Chu was concerned that you couldn’t remember everything that happened to you in Brazil,” I said.

“I remember fine,” Paul said. “I just don’t want to think about it. She wanted a list of the biological agents I’d come into contact with, and I told her those numbered in the millions. I have no idea what actual species of fungus it is.”

“How does a fungus in your lungs mess with your brain badly enough to knock you unconscious?”

He shrugged. “Interfered with my oxygen supply, I guess. The changing air pressures from the flight probably didn’t help.”

“Breathing isn’t exactly optional, you know.”

He nodded gravely. “I’ll try to keep that in mind.”

Paul reached a hand over to his jeans, which were folded beside his bed. He fumbled with them, trying to get his fingers into the pocket.

“What are you looking for?”

“My phone. I want to give Maisie a call, make sure she’s all right. Any spores I breathed, she probably did, too.”

“They don’t want you to use cell phones anyway. Here,” I said. I took the handset from the phone on the wall and stretched it over to him, the cord just barely reaching.

“Can you dial it for me?” he asked.

He pulled a torn piece of paper out of his wallet, and I dialed the number that had been written on it in a rounded, feminine hand. I heard the phone ringing on the other end.

“Yes, I was hoping to reach Maisie Berquist,” Paul said. I slipped out into the hallway to give him some privacy. With nothing else to do, I visited the bathroom. When I returned, I was surprised to see that he was already off the phone.

“Your girlfriend doesn’t want to talk to you anymore?” I said. I was going to add a jab about the challenges of long-distance relationships, but I stopped when I saw his face.

I couldn’t really say he had gone pale, since he was already as pale as a living human being could be. But his expression had the kind of shock in it that made me think the blood would have drained from his face even if he hadn’t been sick. “Are you okay?” I asked. “Should I call a nurse?”

He opened his mouth and paused, as if his lips and tongue wouldn’t obey his instruction to speak. He bit his lip and swallowed. Finally, he said, “She’s dead.”

I stared at him. “Maisie? What happened?”

“Fungal infection, just like me.” Paul’s voice was even, but there was a sharp edge to it. “I talked to her sister. Maisie started coughing on the plane, apparently, but she didn’t seem as dramatically sick as I did—no blood, no passing out. By the time she started coughing hard enough that they were worried, she was at home. They called 911, but the ambulance didn’t get there in time. She was gone”—he took a shaky breath—“before the EMTs even arrived. Her lungs stopped working, and she couldn’t breathe. Her sister tried to make it sound more peaceful than that, but I could tell it was pretty horrible.”

I put my hand on his arm, too shocked to know how to respond. “I’m so sorry,” I said.

“I barely knew her. We met five days ago.”

“Still,” I said. “You went through an ordeal together.”

“She was so strong. She ran triathlons. She was healthier than I was.”

I shrugged. “Sometimes that doesn’t tell the whole picture. Maybe she had some other medical problem, something that made her susceptible.”

“I can’t believe it,” Paul said. “She lived through a terrorist attack and a fifty-mile trek through thick jungle, only to die at home of a lung infection.”

His breathing was faster, more labored. “Take it easy,” I said.

“It should have been me. I was the one picking up mushrooms all the time. If somebody was going to die of a fungal infection, it should have been me.”

I stood by his bedside, impotent. “Do you know when the funeral will be?” I asked, falling back on practicalities.

“It doesn’t matter. Even if I’m out of the hospital by then, I wouldn’t go. It’s too far, and nobody there knows me. I’m not even a friend, not really.”

“Maybe not. But you survived together.”

Paul’s voice drifted, as if he were somewhere other than the Baltimore Washington Medical Center. “Only she didn’t,” he said.