The Nightmare Scenario (14 page)

From the outside, the hospital looked surprisingly well kept, compared to the ramshackle shops and homes surrounding it. The square buildings were painted light yellow and didn’t show a single speck of dirt. The entrance was an arched opening leading into a sparkling set of glass double-doors. Rebecca was reassured. This was a hospital equipped well above the standards typical of rural undeveloped-world hospitals.

Justin led her up a flight of stairs and down a surprisingly clean corridor with a spotless polished floor.

“At least the hospital seems to be in good shape,” Rebecca commented.

“Um… not really. This is First Class.”

“First Class?”

“Yes. For the rich. It’s not all like this. You’ll see.”

They entered a spacious room, easily 300 square feet, with only two beds and two nurses attending each patient. Rebecca froze when she saw the first patient. She had seen the effects of the illness on the village corpses, and she’d imagined what the people would have looked like during their last days, but those images had been nothing compared to the real thing.

The man in the nearest bed was coughing violently, spraying blood. His eyes were bloodshot and glassy and there was coagulated blood in his earlobe. There was a purplish discoloration, difficult to make out in contrast to his dark-brown skin, running in a ring around his neck, like a yoke of death. When the coughing stopped, the man started breathing, or tried to. There were no real breaths, just a quick, shallow panting, gurgling through splutters of blood. There was no way this man was getting enough oxygen. He was suffocating slowly. The panic in his eyes said so as clearly as the symptoms.

“This one isn’t going to make it,” said Justin.

“Yeah, I can see as much,” responded Rebecca.

“He might, though,” he said, pointing to the other patient.

This man also had coagulated blood in and around his ears, but none of the other symptoms. He was delirious with fever, mumbling continuously. Pearls of sweat were forming on his forehead more rapidly than the nurse could wipe them off, and his sheets were soaked. But his breathing was regular. Rebecca could tell even at a distance that there was no blood or tissue damage inside his lungs.

The nurse was giving him an injection.

“Anti-viral?” asked Rebecca.

“Yes,” responded Justin. “Amantadine.”

“Is it effective?”

“Who knows at this stage?” he sighed, shrugging.

They moved through the hospital, inspecting the rooms, and the patients in them, one by one. They passed through Second Class, which was similar to First Class, but dirtier, with a patient density more like what one would find in a regular western hospital.

When they came to Third Class, however, Rebecca had a shock. The contrast could not have been starker. The first room she saw looked more like a backpacker hostel dormitory on Khaosan Road in Bangkok than a hospital. It was filled with two-story wooden beds, packed so tightly that the single nurse could barely squeeze between them. The mattresses, if you could even call them that, were thinner than a typical doormat. Just inside the door was a metal bedpan, rusted well beyond the point where it could be properly cleaned. Judging from the amount of excrement in it, it wasn’t emptied between uses. It was among the worst facilities she’d ever seen, and she’d been around quite a bit. The only place she could remember that had been even remotely similar was in Somalia. But that was a field hospital, in the midst of a civil war.

As she surveyed the room, it wasn’t the amount of sick people that took her by surprise, but the gruesomeness of their symptoms. She quickly did the math. Most of these people wouldn’t make it. She suddenly felt nauseous and gagged. She steadied herself against the doorframe, slowed her breath and regained
control over her body. She had seen plenty of horrific conditions in her life, but there was something about the utter hopelessness in this room that made her feel sick. Regardless of the reason, vomiting inside the suit was not a good idea, even in controlled conditions. She had seen it happen.

She forced herself back to a state of calm determination. She was in charge now. What happened from now on was all on her.

She reentered the room and started assessing the patients, carefully observing the symptoms and their prevalence. She passed one man who was different from the others. He had deep cuts across his chest, neck and face, and was hemorrhaging badly.

“This is not the flu,” she noted.

“No, that’s correct. He was in a traffic accident; came in yesterday.”

“He needs blood,” she exclaimed.

“Yes, unfortunately there is none,” said the Justin. “There were two people in the collision and apparently they only had enough blood for one of them. This guy drew the short straw. The only thing we can do is give him morphine to make his death less painful.”

“Drew the short straw? Was less wealthy, you mean?”

Justin confirmed Rebecca’s assertion by silence.

As Rebecca turned to leave, the nurse picked up a syringe from a rusty metal tray next to the man’s bed.

Rebecca exploded. “Stop! That’s not a sterile needle.” and continued after a moments of pause, turning to the Justin, “Don’t tell me. Sterile needles are only in First Class.”

He shrugged again. “I know what you’re thinking, Dr. Summers, and trust me, I feel the same. Equipment is on its way. We just had no idea it was going to be like this. Anyway, it is not like he’s going to die from HIV.”

Rebecca grabbed Justin’s elbow and marched him out of the room, her face flushed and warm with rage. She said, in a voice upset to the point of almost failing her: “Okay, let me set a couple of things straight. First, from now on, there are no ‘classes’ in this hospital! Secondly, I want the spacious rooms on the top floor packed with beds. We are going to use every square inch we have.

“I want you to assemble the senior staff for a meeting. We need to get our act together before I call in to Geneva.”

Rebecca headed toward the hospital director’s office. This was her office now. The hospital was hers to run. The lives of the people within its doors were now her responsibility. And more than that, she was leading the frontline in the battle against the virus. If it slipped through that line, it would not only be the deaths of people in Tireme that would weigh on her conscience, but countless others.

A consistent overachiever all her life, she wasn’t prone to crises of confidence, but she couldn’t help wondering why Aeolus had put her in charge here. Sure, she was a skilled epidemiologist, but she was a researcher, not a clinician. She had plenty of field experience, but no background as a leader.

Then again, Aeolus was the best in the business, and he wouldn’t have given her this command if there were someone else who was better suited for it.

The thought reassured her. She might not be perfect for the job, but no one was, and she was apparently, or at least so he thought, the best they had.

In an effort to instill in her staff this same feeling of confidence and determination, she turned around and yelled after Justin. “And one more thing, just so everyone is clear. We are going to stop this bitch. Right here! Right now!”

JULY 30
^TH
, 7 PM, 63 IZMAYLOVSKY PROSPEKT, MOSCOW

Y
elena slammed her apartment door shut behind her and hurried to the kitchen. She threw her rain-soaked jacket on the floor and jerked open the refrigerator door with such force that the glass jars of jam in the door clanged against each other and nearly fell out. She reached for a bottle of Stolichnaya and grabbed the closest glass from the sink. It was left over from yesterday’s dinner, still unwashed, with a circle of dried milk in the bottom.

She poured herself a generous measure and downed the vodka in two gulps. She went to throw the glass in the sink, but the calming warmth of the alcohol spread down her throat and around her chest and she changed her mind. Instead, she poured herself another glass. She had to try to calm down before calling Loo and more alcohol seemed to be the easiest way at this point.

She took a deep breath and went to her study. After a couple of minutes navigating switchboards, assistants and students she had Loo on the phone.

“Yelena, how are things?” Loo asked in a distant voice, as if his concentration was elsewhere.

“I think I should be asking you that, Loo. What do we have? I hear it’s quite bad.”

“Yes, Yelena, I’m afraid it is. This is one nasty missus. I’m looking at a plethora of fluorescent green nucleolus right now. She’s replicating much faster than she should. Much faster.”

“I assume you know why I’m calling, Loo.”

“You need samples to start the vaccine work?”

“Correct, and lots of them. Casualties, survivors, you know the drill.”

“Okay, I’ll put someone on it straight away.”

After a moment’s pause, Loo asked, in a voice now focused on the conversation: “Have you spoken to Aeolus yet?”

“No,” Yelena answered through gritted teeth.

“Oh, come on… Not this again.”

“I’m afraid so. No call. Nothing but a mail from his office, formally requesting that our lab commence research on live vaccines. Can you believe the gall of that man!?”

“Yelena, we don’t have time for this…”

“Well, maybe you should tell that to that self-centered, pompous bastard!”

The line went quiet for a long moment as Yelena made a concerted effort to regain her composure. The
only sound was the rain hammering against the window. Loo finally broke the silence.

“Yelena, do you remember how it used to be?”

For a brief second, a smile flashed on Yelena’s face as she remembered their weekly Friday night gatherings at the Back Bay Social Club; all the leading virologists at Harvard Med. It was a dear memory, a memory of the time before her fallout with Aeolus.

“All our debates?” continued Loo. “How you and Aeolus insisted that it would be exactly like this – a really nasty influenza?”

“Yes, Loo, those were the days,” Yelena quietly said.

“And how you and Aeolus towered above the rest of us, giants among dwarfs?”

“I don’t know about that…”

“You know, we all found comfort in the fact that, if she came, the two of you would win the fight.”

Yelena was silent. Loo was right. They had been a good team. Once.

“You’ve got to patch things up with him, Yelena. We need the both of you now.”

Yelena sighed. “I’m afraid that’s not up to me, Loo. He’s the one who has the patching to do.”

“I’ll speak to him. The two of you together are an unstoppable force. And this is the time to bring out the best we have.”

“You’re not that bad yourself, you know…”

“For this one, Yelena, I fear that just being good won’t be enough.”

JULY 30
^TH
, 3 PM, SHOC, WHO HEADQUARTERS, GENEVA

“H
ank, are you there?” asked Aeolus into the speakerphone.

“Yeah, I’m just going through a stretch of poor reception, I’m in a car on the way to Fort Detrick.”

“Fort Detrick? You’ll never find a more wretched hive of scum and villainy.” Aeolus spat out the words with disgust.

“Look, Aeolus. I know you don’t approve of their work, but they have some guys who really know their stuff and I want their take on the situation.”

“Hank, you’re wrong. It’s not that I disapprove of their work – I
loathe
their work.”

“When will you take off that tinfoil hat and realize that it’s an
anti
-bio-warfare facility?”

“Nonsense, it’s a bio-warfare facility, and you know it. How would you otherwise explain how the anthrax strain used in the post-9/11 letters originated from there?

“Anyway, at this stage I wouldn’t care if you were on your way to see Dr. Mengele. If they know something useful, no one will be happier than I to hear it.”

“Glad to see you have a practical side beyond all your self-righteous bullshit.”

“Enough of this, Rebecca’s coming on now.”

The screen flickered and a heavily pixilated image of Rebecca appeared.

“Hello. Can you see me? The picture quality here isn’t great.”

“It’s the same here, Rebecca. We’ll see if we can get someone from
Télécoms Sans Frontières
down there to take care of that,” said Walt.

Aeolus took over. “I see you are in a HAZMAT suit, Rebecca, which I find reassuring. My first concern is the safety of the team. What’s the situation with regards to that?”

“Well, Dr. Hughes,” said Rebecca, “‘
Mieux vaut prévenir que guérir
.’ Isn’t that your motto?”

Aeolus smiled. Her American accent was thick and it was clear she’d rehearsed the phrase for this particular purpose. Still, she’d taken the time to find the correct French idiomatic expression “better safe than sorry,” rather than the literal translation. That had to count for something.

“Seriously, we’re in suits because we’re still unsure of the isolation measures required. You might recall that a doctor and nurse got infected and we initially wrote that off as a consequence of inadequate equipment and procedures?”

“Yes.”

“Well, the problem is that the intern you sent from Jakarta has also developed symptoms and he’s pretty sure he’s stuck to the procedures – by which he means mouth cover, plastic gloves, apron and glasses – whenever he was inside the hospital.”

“Conclusions, Ed?” asked Aeolus, testing his new deputy.

“Face masks are not fool-proof; viruses pass through them with ease. They only protect against droplet transmission for twenty minutes until they get moist from the wearer’s breath. Also, glasses don’t help unless they’re tight fitting. Still, these precautions generally reduce the risk of spread, and with this infection rate it must be one virulent little missus.”

“Atta boy,” said Aeolus, nodding in approval. “You’re going to have to maintain proper precautions, Rebecca,” he continued.

“Yes, I understand, but working in these suits is just too impractical. It’s taxing for the team, and several of the new arrivals are choosing lower-level protection. Imagine doing an autopsy in this, it is nearly impossible. It also scares the patients. I want you to authorize moving down to the equipment we use inside Bio-Safety-Level 3 facilities, so no suits.”