Authors: Matt Darst
The driveway to the emergency room was already full of prospective patients, crying and rocking and holding open wounds. The waiting room—a fitting name, as everyone was waiting and no one was being attended to—was worse.
The lieutenant took one look at the emergency room, and he ordered the troops to establish a triage center. These people needed attention. Fast.
It was a noble thought. But the officer didn’t think properly about containment. He didn’t follow the protocols for dealing with a biohazard. He didn’t secure the facility.
Heston had dealt with contagion before, albeit with dogs and cats. The reality is the methods for dealing with people are very similar to dealing with animals: assess the risk, establish a quarantine, observe the infected, and, if necessary…
Heston chose not to think of the last step, at least not yet.
Assess the risk.
Three-quarters of the patients waiting for aide were victims of massive bites, human bites. They told stories of friends, family members, and neighbors complaining of bites days or hours earlier. Then they recounted how those same friends, same family members, and same neighbors in turn bit them. Some were ill with fevers and intense migraines. Others lapsed into unconsciousness. Some seemed to be in the early stages of kidney and renal failure.
There are generally three vectors for transmission of a communicable disease: intermediary organisms, like fleas or mosquitoes, contaminated food or water, or close proximity.
Close proximity, like bites.
Biting can be a form of host manipulation, the modification of behavior by a parasite or pathogen. Biting is an assured way to spread contagion.
None of the military or medical personnel had ever witnessed rabies, but Heston had. He saw rabies first hand, usually farm hounds coming into contact with a rabid bat or raccoon. Rabies is a virus. It finds a home in the salivary glands of its victims. The host can’t swallow, its mouth froths with contagious saliva.
But that’s not the trick. This is: the virus needs to spread, and it has evolved to ensure this. Rabies infects the brain, inducing tension and, ultimately, violent behavior, including biting. With each bite, the microbe proliferates.
Oddly enough, rabies even may have given birth to the werewolf myth.
Unfortunately, rabies is 100% fatal unless treated within 24 hours by a vaccine, a series of painful shots. It can only be detected if the host is caught and its head removed so the brain can be tested.
Establish a quarantine.
Heston approached the lieutenant as he supervised his work from the top of an armored personnel carrier. The officer nodded with self-satisfaction as his soldiers ushered the wounded into tidy little groups. “Lieutenant, I need to have a word.”
The lieutenant looked peeved, but he jumped from the carrier in two bounds and ushered Heston to the rear of the vehicle. “Shouldn’t you be in there, assisting the wounded?”
Yes, Heston should, and he would, if this kid took the right precautions. “We need to set up a quarantine. We need to secure this facility.”
The lieutenant frowned. He wasn’t the smartest cadet, but he was smart enough to realize that fact. He set aside his pride. “What do you need, Doctor?”
Doctor. The title stuck with Heston at that point. He would never be known as anything but a doctor. He would never again care for animals. He would never again do the work he truly loved.
Heston ordered another level of triage, isolating those bitten from the rest, starting in the waiting area where patients waited…impatiently. “Separate anyone with a bite,” he directed a sergeant. “Anyone with a scratch. Make sure no one leaves. No one infected can leave. Detain anyone who resists.”
Infected. He said it. It had been just an assumption…until he gave it voice.
Observe the infected.
Heston moved quickly through the emergency room, the lieutenant and a dozen guardsmen in tow. It was empty, not an anesthesiologist, nurse practitioner, intern, or doctor to be found.
They entered the elevator, Heston pushing the button marked “two.” The second floor, the intensive care unit. The entrance to Hell.
Before the elevator doors opened, they could already smell the death. The stench made them cover their mouths; it made them gag.
The doors opened.
The lieutenant had never witnessed—not in all of his manuals and textbooks, not in all of his war games—anarchy and torment of this magnitude.
The ICU was completely full, its hallway cluttered and clogged with gurneys and by people….dead people. Dead people, patients and medical staff, shambling about, gnawing and tearing at other people who were already dead or would be dead soon.
One of the soldiers retched.
One of the monsters heard him.
It went for the lieutenant, sinking its teeth into his left hand between the forefinger and the thumb before being beaten off him by the Guardsmen. It reeled five or six feet and found its balance, and it came at them again.
Heston furiously pressed buttons. The first floor button. The button to close the doors, the button with the arrows pointing to each other.
The thing gasped as it approached, eyes wide and eager. The soldiers laid down suppressing fire to no avail. The bullets tore into the creature’s chest and gut, but still it drew nearer. Its odor choked Heston. It groped for them.
And the elevator doors closed.
When the doors opened again, Heston half expected to see the creature waiting for them. But the elevator had successfully descended to the first floor. Heston punched the elevator alarm to hold it in place. The creatures would have to take the stairs.
They went to work immediately, closing off the wings, chaining the stairwells. Patients worsening in the waiting area were escorted to the emergency room. They were given beds. That’s all Heston and his team could do.
When patients started to die and come back to life in the ER, when the screaming started as the creatures attacked those who were dying, Heston came to a conclusion: The bites were fatal. No, worse than fatal.
Assess the risk, establish a quarantine, observe the infected, and, if necessary…
Euthanize.
Anyone suspected of an infection was permitted to enter the hospital. All others were escorted out. Then the doors were locked.
The lieutenant had one question for Heston: “Am I going to become one of those things?”
Probably.
The lieutenant shook his head. He razed the building. Then he raised his pistol. It was in his mouth in a flash. His brains were on the pavement in another.
**
Why is Heston telling Wright all this? He doesn’t know. Maybe he needs to talk to someone about science. Hard science.
The church doesn’t just frown upon science, it vigorously dissuades it and anything approaching it. The practice of medicine isn’t allowed to move beyond traditional treatments. The church doesn’t believe in R&D. Electron microscopes, and other tools with the potential to unlock the secrets of life, are illegal, and those who wield them or seek to find alternative answers are criminals.
Or maybe he thinks it just doesn’t matter. They will likely die out here. Why not share what he knows? And if he dies and Wright lives, maybe he’s left a trace of himself—or what was his living self—for posterity’s sake.
Or maybe Heston feels guilty. On that fateful day eighteen years ago, he provided dozens with a release from death, but he stole the life from dozens more. Maybe it’s an opportunity to confess his sins to someone who might actually care, someone other than the pastor in the church who pinned a medal on his chest and printed an M.D. on his letterhead.
Because in hindsight, there was no need to execute the few who suffered from the rakes of monster fingernails but showed no signs of mauling. Of course, Heston didn’t know that scratches weren’t a vector.
He didn’t learn more about transmission until his future wife was attacked later that year.
Ms. Heston (nee Brodie) was assaulted at a retreat on the banks of the Ohio River. A ghoul dragged itself from the depths and scored her arm deep with a swiping paw. She was brought to the ER, where Heston was the attending physician. He took one look into her beautiful, frightened eyes and made the decision right then and there to break protocols.
He secreted her away in the empty oncology wing, strapped her to a gurney and sedated her. He hooked her to an IV and pumped her full of antibiotics. He watched over her for hours, biding his time stroking her face, whispering to her, “Everything will be okay.”
The hours became days and still the wound did not fester nor did her vitals change.
Three days later, he released her with strict orders to visit him daily for the next seven days. She stopped by unannounced on day eight. Again on days nine and ten. They made a date and the rest fell into place.
It’s no matter. His lack of data then is hard to square with the deaths of so many innocents at Baptist East, many of them children.
Wright is not jarred by Heston’s story. Everyone has a story, and she expected a microbe. She expected it to exploit the host. She even expected transmission through a bite.
But it can’t be that simple. If it was that simple, the story would be over.
There are too many unanswered questions.
Which microbe?
How does it exploit the host?
And, most important, how does transmission through a bite explain the potential reanimation of those who died naturally?
Wright starts asking. Which microbe? “Are we dealing with a parasitic virus, a protozoa, or a bacterium?”
Heston shakes his head. Possibly one of the above. Possibly more than one. Possibly something else altogether.
He thinks back to his veterinary practice, remembers CTVT—canine transmissible venereal tumors—a sexually transmitted disease in dogs. It is a tumor not spread by a virus like HPV, but by transmission of the cancerous cells
themselves
. It is a parasitic cancer caused by the mutated cells of a single dog that died 2,500 years ago. It is the longest living mammalian cell line known. The condition could be caused by something similar or very different, but equally unusual. Who knows?
Heston has not reduced the options. He’s increased them.
Strike one
, Wright thinks. “Well, then, how does it exploit the host?”
Diseases have unique methods of taking advantage of their hosts. Heston cites various examples of host manipulation.
Malaria incapacitates so completely the infected are powerless to swat the mosquitoes that feed on them and propagate the disease.
Guinea worm larvae ingested in stagnant water reproduce in the small intestine and then burrow toward the host’s lower extremities, erupting in painful blisters. The infected seek to sooth the pain finding relief by soaking in water and allowing the worms to begin their life cycle anew.
Cholera causes diarrhea, both a symptom and a mode of transmission when fecal matter infects water supplies. Wright is all too aware of the impact. Most of the survivors are.
But Heston thinks that this microbe takes host manipulation to an elevated, but not unprecedented, plane.
“Not unprecedented?” Wright asks.
“Correct,” Heston says. “Zombification occurs every day in nature.”
There it was. Heston said it. The “Z” word, banned by the church-state.
Governments ban words all the time. George Carlin skewered the FCC and the Supreme Court for illegalizing seven “dirty words.”
But this prohibition is different. It is collective, pervading everything from the media to water cooler conversation. It is broad, going beyond the mere word to the concept. Much like China’s bans on discussions of the Falun Gong and of Tibetan Independence, the ban is enforced and enforced strictly. Persons convicted of violations are dealt with ruthlessly.
But, in truth, Heston knew of zombies in nature long before the human outbreak.
He knows of grasshoppers forced to drown themselves in ponds by parasitic hairworms that devour their hosts and control their brains with proteins. The hairworms eat everything but the head, legs, and exoskeleton. After successfully coercing suicide, the worms eject and spread their seed.
He recalls a wasp that lays its eggs in spiders. The larva feed off the spiders and control their brains, like the hairworms do the grasshoppers. Here, though, the invader enslaves the spider, compelling it to abandon its daily web-making and to construct a cradle. There, the surrogate mother sits, allowing itself to be consumed as the larva begin their transformation into wasps.
And the protozoa toxoplasmosis targets cats using mice as the delivery system. The protozoon manipulates mice, making them take risks, risks that ensure they’ll be devoured. Infected mice don’t fear cat urine. Infected mice don’t hide along the edge of a wall. They cross rooms in plain sight.
Heston has some vague ideas about this microbe, but nothing proven, nothing firm.
She senses Heston’s hesitation.
Strike two
. For now.
A frustrated Wright asks her third question. “So, how is the plague transmitted?” She assumes there are two vectors. One must allow transmission through a bite, while the other must reanimate those who died naturally. “What do you think?”
Heston sighs. “There are plenty of ways to explain transmission. Too many ways, really. But here’s your mistake, I think: the theories of transmission need not be mutually exclusive.”
Wright cocks her head.
“Necroanthrophagism”—a term coined by Heston before the rise of the church, meaning, literally, the dead eating their own species—“might be triggered by intimate contact with a revenant, through direct passage of the microbe, superinfection, or the transmission of a deadly bacterial infection. Or it may be initiated by the natural death process of a previously infected host—something lying dormant, possibly even incorporated into the human genome.”