Chapter Five
The phone roused Martin from deep sleep. The clock glowed wo fifteen in the morning. Martin fumbled for the phone. "Hello."
"Mister Martin?"
"Yeah."
"Virologists believe that the Spanish Influenza virus was an avian virus that was mutated in a pig that in turn passed it on to humans."
"Who are you? How'd you get my number?" inquired Martin.
"Just listen to me! The flu, this flu is the Spanish Flu! The government does not want that known. Some sort of government agency has taken over the CDC. We were told that if anybody divulges any information on what is going on, they will be arrested. No member of the CDC is allowed in the labs so we don't know what is going on in there. Some believe that this is a government experiment gone wrong and...."
The conservation was interrupted by a sudden rustling and banging of the phone. Martin could hear some sort of struggle. Then there was silence. Martin listened intently. He heard footsteps and then he heard somebody breathing and then the line went dead. Martin sat in his bed staring into the dark and contemplating what he should do. It wasn't long before he rationalized that he should do nothing because, after all, it was an anonymous caller and he certainly wasn't going to stir up a hornet's nest or besmirch his reputation over something so bizarre. Still Martin couldn't get the conversation out of his mind. He mulled over the conversation. He turned on the lamp next to his bed and retrieved his laptop. He sat in his bed with the computer on his lap, the keys clicking rapidly beneath his fingers. The caller had used the phrase Spanish Flu. Doctor Garcia had talked about the Spanish Flu. Martin performed an internet search and was confronted by page after page of hits. "Well," he thought to himself, "there really is such a thing now let's read up on this thing."
Scrolling through the pages of a website dedicated to the Spanish Flu, Martin read how in 1918 the virus had decimated the armies engaged in World War One. The article went on to explain how every human being alive at the time had breathed in the virus and how over twenty million had died from the virus. He read about the huge impact the virus had on the social structure. He read about how fear and paranoia gripped the large cities of America and Europe. The article pointed out that in 1918 it took five days to cross the Atlantic Ocean and how population centers were much smaller than they are today. The article surmised that if the virus were to reemerge that, with modern jet travel, it is only hours away from any point in the world. The author of the article cited the statistics by various health organizations that if Spanish Influenza emerged again, this time the death toll may be over one hundred million people.
Martin next read an army doctor's account of a young soldier dying from the Spanish Flu. "The young man lay there, delirious from the fever which was one hundred and five degrees. His face was a ghastly purplish color from the cyanosis that we see with this disease. He was begging for his mother, (who of course was not present), to bring him water. His whole body would quiver in rapid convulsions as the high fever gave him the chills. The poor soul's body would lurch upward as his chest was wracked by a persistent and painful, shallow barking cough. I shall never forget the awful sound of that cough.
On the last day of his life he began to produce a frothy white phlegm which was tinted red with blood. At the moment of his death the man convulsed and sighed loudly. The body relaxed as the sigh faded into a low gurgling sound. The strange white foam issued from the corners of his mouth and nostrils as death turned his complexion from blue to an ashen gray. It was as quick and ghastly a death as I have ever witnessed, worse yet than the comparative mercifulness of the gas."
"My God." thought Martin. He was struck by the violence of the virus' attack on its victims. "That sure sounds like what Doctor Garcia was describing." He muttered to himself. Next Martin looked up a phrase that was in the article, Cyanosis. He found it immediately. The term was in yet another article about the Spanish Flu. The whole term was Heliotrope Cyanosis. Reading on Martin discovered that Heliotrope Cyanosis is a condition that occurs in some diseases that attack the lungs. It basically means that the lung function is diminished to such a degree that they cannot supply enough oxygen to the body. This condition results in the bluish coloration of the skin. "Geez...this thing is really nasty." thought Martin. Towards the end of the article he found information on how virologists are hunting for an intact virus in order to see just why this virus was so deadly. To date only partial viruses have been analyzed. But the latest evidence indicates that the virus underwent a regeneration of the A strain of influenza from avian to swine to human.
"What the heck does that mean." mumbled Martin. Martin performed yet another search and a large number of sites appeared. Martin clicked on the first one. The site appeared on the monitor and Martin read how Influenza A is carried by and infects birds, pigs and people. Martin sat on his bed in the dark room leaning close to the glowing monitor, mesmerized by the grim story before him; the story of how influenza regenerates itself by mutating as it moves from species to species. The virus steals RNA from each host. This mutates the virus, making the immune defenses ineffective against the new and unrecognized virus. The article went on to speculate that this may have happened between a bird virus and a pig virus. The new virus from this regeneration then went on to mix between a pig and a human. The latest timeline studies of the Spanish Flu point towards the possibility that the virus began in an army base in Belgium where both pigs and people began to get sick. The article also pointed out that this is why so many pandemics of influenza get their start in the Guangdong province of China. For here domestic fowl, pigs and people live together in intimate proximity.
Martin stopped reading. He sat there in the dark, his face illuminated by the flickering facts. He sat there, his mind racing as he tried to absorb the enormity of what was unfolding before him. If this new bug in Miami was, in fact, Spanish Influenza, then the world sat on the eve of the greatest pandemic it has ever known. This plague would make the Black death of the middle Ages look like viral child's play. Then Martin panicked when he considered what the caller had told him about what was occurring at the CDC. Martin became distressed when he wondered how the caller got his number. He began talking to himself in earnest. "OK, OK calm down...this can't really be happening. I mean how the heck would this thing get here...oh no! No way! Not the cocaine!" Martin's excitement grew as the picture began to crystallize before him. Then a thought stabbed at his very heart and this thought sent shock waves of pure horror through his body. "Pigs!" he cried out loud. "The dead pig in Haiti! The pig farm that supposedly brought a curse when that guy stole a pig. It wasn't a curse! It was the flu! The flu was there! The guy in Haiti said foreigners owned the farm...I bet they were Arabs, just like the owners of the Canarian and the suppliers of the coke. Oh my God! This is a terrorist attack! They're bringing the virus into the country in cocaine!" Martin leaped up; his laptop tumbled off of his lap onto the bed. He ran his hand through his hair the way he always did when he was trying to think. "OK...OK...calm down. Let's look at this one step at a time and see where we're at." Martin decided that he should visit Doctor Garcia at the hospital once again. He fell back onto the bed.
Martin awoke with a start. The sun was pouring through the blinds of his bedroom. He sat up and looked at the alarm clock. It was eight forty five. Martin quickly dressed and headed out to the hospital. Upon his arrival at the hospital he was confronted by a crowd of sick people lined up along the wall outside the Emergency room. Martin walked into the stuffy emergency room and was immediately struck by the amount of people there too. So many people were crammed into the room that people were sitting and lying on the floor. Most were obviously very sick. A chorus of dry barking coughs made Martin's skin crawl. He walked up to the reception desk and was shocked to see that the receptionist's face was concealed behind a surgical mask.
"May I help you?" she asked.
"Yes could you please tell me when Doctor Garcia is on duty? I'm Bruce Martin with the Biscay
ne Sun; I was here the other day to speak with her."
"I remember you," she said as she looked up. "You really need a mask in here." Standing up she said, "One moment please," and she disappeared behind a partition. A moment later she reappeared and said flatly "Someone will be with you shortly." She sat back down and began to work on the computer signaling her disinterest in any further conversation. "Thanks." said Martin. He stood nervously listening to the coughing and blaring television. It was over fifteen minutes before the doors opened and a middle aged doctor appeared and called Martin's name.
Martin walked up to the doctor. The doctor inquired of him "Mister Martin?"
"Yes."
"Hello, I'm Doctor Morgan." Martin held his hand out to shake the Doctor's. "Not to be rude mister Martin but we don't shake hands these days. It's an excellent means of transmitting this virus. In fact if I were you I wouldn't shake anybody's hand until we can get this thing licked."
"Doctor Morgan, I was hoping to speak with Doctor Garcia, I'm writing an article about this bug."
"Mister Martin I'm afraid that Doctor Garcia has taken ill with this flu. She is very sick. She asked me to allow you to visit her. I really don't have a problem with that but you might."
"What do you mean?"
"As I said she is very ill. Her appearance is disconcerting to say the least. You will have to wear a mask and gloves because the virus will be all around you. You see, we have been so inundated with flu cases that we have dedicated the entire fourth floor to just the flu. If you take precautions though, it is safe to visit. After your visit we will go into a bathroom we have set up to dispose of your masks and glove and to scrub up before leaving. Are you ready?"
"Yes", replied Martin nervously.
"This way please." said Doctor Morgan as he led Martin through the buzzing double doors. In the rear of the Emergency Room were two elevators. One had a sign on it that read in bold red letters "Fourth floor only". Martin began to feel a little nervous. The two men stepped into the elevator and the doors glided shut behind them. The elevator jerked slightly as it began a smooth ascent. There was silence except for the chiming announcement of each floor slipping past the rising elevator. Finally it stopped and the doors slid open. Martin's anxiety level was rising as he stepped into the hallway. In front of the elevators were two carts with boxes of masks, gloves and shoe covers. Martin followed the Doctor's example and suited up. As they walked down the corridor Martin felt very alone as he was one of the few people that knew that this plague was a biological terrorist attack. Walking down the hallway they walked past rooms with opened doors. Martin heard the now familiar chorus of barking coughs orchestrated by the virus that was all around him. The coughing was soon overcome by the volume of his anxious breathing as it reverberated in the mask. They arrived at an opened door.
"One minute please." said the Doctor as he disappeared into the room. "Doctor Garcia will see you now."
Martin walked into the room. There on the bed lay the doctor. As Martin approached he was shocked by her appearance. The strikingly beautiful features were gone, replaced by a sallow face. She wore a thin tube under her nose to feed her oxygen but despite that her skin was still colored blue gray from the cyanosis that Martin had read about. He felt quite certain now that the mysterious caller was correct, this did indeed appear to be the most deadly virus in history. The doctor managed a feeble smile. "Did you..." before she could finish her sentence she was wracked by the horrible barking cough. The Doctor's chest heaved as she fought for breath and then she spoke again. "Did you find out what this thing is?" Martin did not want to say that he had been tipped that it was the Spanish Flu so he simply shook his head. "You must find out...nobody's talking." Once again the Doctor was overcome with a coughing spell and once more she struggled for breath. Martin nodded and the Doctor closed her eyes and fell asleep. Martin turned and left the room. Doctor Morgan was waiting for him. "She insisted that I bring you up here. You can remove your gloves and mask at the gowning station. We have set up a surgical scrub station in the bathroom. Use it Mister Martin. Then wash your hands as soon as you can after leaving the hospital."
Martin walked out of the hospital and down the steps. Sitting on a wall next to the steps was a man reading a newspaper. When Martin walked by the man dropped the paper down slightly to reveal his face. "Morning." he said. Martin slowed his pace and responded in kind. "Visiting someone?" asked the man. "A sick friend." responded Martin. "Well I hope she feels better soon." said the man. "Thanks." replied Martin. As he walked away the conversation played back in Martin's mind. "Hey...wait a minute. How did he know that I was visiting a woman?" thought Martin. He spun around and looked at the man who was busy reading his paper again. The paranoia began to creep in again on Martin. He hurried to his car and glanced over his shoulder to see if the man was following him. Much to his dismay the man had disappeared. Martin reached his car and hurriedly locked himself in. He sat there for a moment pondering on what his next move should be, all the while looking nervously around. He remembered that Doctor Garcia had mentioned that the Medical Examiner's office had sent off tissue samples to the Centers for Disease Control. Martin decided to pay the coroner a visit and see what his take was on this virus. Starting his car up Martin drove the couple of blocks to the County Coroner's office.
Martin walked into a small lobby area that contained two worn chairs tucked into a corner. It was obvious that visitors were neither welcomed nor expected here. On the wall was a telephone with a sign over it that read, "Pickup for entry." Martin picked the phone up. After a multitude of unanswered rings Martin hung up and left the building. As he walked to his car he observed a white paneled van pull around the back of the building. Following the van Martin timidly peaked around the corner to see a tall young woman remove a gurney from the van. On the gurney was the unmistakable form of a human body wrapped tightly in sheets.
"Excuse me", said Martin. His unexpected presence startled the young lady who quickly shoved the gurney back into the van. Spinning around she stared nervously at Martin as he approached her. Walking closer to the young woman he could see that the young woman was very pale. Networks of blue veins were visible under her pallid complexion. The sunlight seemed to irritate her and she squinted her eyes which were ringed with dark circles. Locks of long jet black hair spilled from a high pony tail and wrapped around her neck. The young woman, although very different in appearance was strangely attractive. As she spoke only her voiced conveyed any hint of emotion. "This area is off limits", she said in a tone thick with irritation.
"Oh I'm sorry", cowed Martin. "My name is Bruce Martin I'm a reporter for the Biscayne Sun. I was trying to speak with the Medical Examiner. I went around front but nobody picked up the phone."
"Yeah, we're real busy around here these days."
"Because of the flu?" interrupted Martin, staring at the woman. He wondered what somebody so young was doing working at the morgue. While speaking she glared suspiciously at Martin. "Wait right there and I'll see if the M.E. has time to see you."
"Thanks", replied Martin.
A minute later she reappeared. "This way." Martin followed obediently. She led him through a battered door and into a long dim hallway. The odor of death hung heavy in the hall as both sides were lined with corpses on gurneys. The bodies were wrapped in milky plastic, giving them the appearance of ghosts. Martin looked straight ahead, anxious to get out of the hallway. He followed the young lady through another door and stepped into a brilliantly illuminated room. White tiled walls and polished concrete floors enhanced the light's effect upon the room. Along one side of the room were four stainless steel autopsy tables each was occupied. At the far end of the room the coroner was bent over a corpse.
"Doctor, this is the reporter."
As the doctor slowly stood upright Martin could see that he was a tall and thin man. As the coroner walked towards Martin he removed his cap and face shield to reveal the features of a man who appeared exhausted. The doctor
took his blue gloves off with a snap and tossed them into a red bin marked with the biohazard symbol. "Thanks, Angelique."
Martin turned towards the young woman. "Oh, that's an unusual and pretty name. Is it French?", Martin asked in a futile attempt to distract his mind from the macabre scene that surrounded him.
"I dunno. I was named after a vampire."
"Oooooh kaaaay", responded Martin.
"My mom was a huge fan of some TV show in the sixties called Dark Shadows. I was named after a female vampire in that show", explained Angelique.
"What can I do for you Mister?", the doctor asked tersely.
"Martin, Bruce Martin with the Biscayne Sun. I'm writing an article for the paper on this new flu."
"Well, it's about time that somebody showed some interest. This thing is burning through Miami like a wildfire and nobody seems to give a damn."
"Really?" inquired Martin.
"Really", responded the coroner. "I'll tell you why nobody cares. The first victims were all a bunch of druggies and criminals. But then this thing broke out and well, look around you", he said with a sweep of his hand motioning towards the corpses on the tables. "Soccer moms, teachers, teens, it's loose and killing."
"What is it? I mean I know that it is some kind of flu, right? But why is it so deadly? Does anybody have an idea of where this thing came from?"
The coroner popped down onto a stool and ran his hands over his head. He was in his mid-fifties by appearance and was bald except for long gray hair around the back of his head. "Well" he began in a weary voice, "I've sent tissue samples to the CDC and they responded by saying that it is an unidentified type A influenza. Hell I knew that! I get the feeling that I'm being stonewalled. You're the first reporter to come here. This thing has been going for a few weeks and now it really has a head of steam but there is no real interest. The dead increase daily."
"Why?"
"That!" said the Doctor in a suddenly animated voice that half startled Martin, "That is what is so crazy about this bug." The Doctor leapt to his feet and walked along the tables and motioning to a body lying there. "See all of these people on these tables, what do you see that they all have in common? C'mon! Look at them!"
"I'd really rather not", mumbled Martin
"If you want to understand this thing you have to see what it does. Don't be a whimp, you can't catch it. Look at them!"
Martin took a few feeble steps forward and glanced at a body in front of him. It was a middle aged woman. Martin was shocked to see that her chest was opened up. He swooned and gagged as he plopped down onto the stool that the coroner had occupied.
"They were all healthy, in the prime of life!"
"So?"
"So! Influenza usually kills the very young or the elderly but this thing is killing healthy adults in their twenties, thirties, forties. Here's how, it's fascinating! Come here", said the Coroner as he leaned over the woman. "Look at her lungs...they're nearly liquefied. This gives the person a blue appearance from a lack of oxygen."
Martin straightened himself, "Heliotrope cyanosis", he said with a hint of pride at his knowledge.
"Yes! Yes! You, you have done your homework! At first I thought that it was some kind of hemorrhagic fever, dengue or something. I was even afraid that it was H5N1 ya know the bird flu. But this thing is way nastier than H5N1. I've discovered how it kills...it's fascinating, just fascinating. It kills by creating an immunological event known as a Cytokine storm, see that's why the lungs turn to jelly."
"What's a cyto whatever storm?" asked Martin pulling his little notebook and pen out of his shirt pocket.
"A Cytokine storm is, well, in layman's terms it's your own immune system becoming confused. It's basically when your immune system sends hordes of immune cells, such as killer T cells, to the infection sight. But the enormous numbers of immune cells confuse the body's own tissue with the virus and attack the body, destroying tissue, in this case lung tissue. This greatly reduces lung function and allows a secondary bacterial infection to set in. If the storm doesn't diminish enough lung to kill then the secondary pneumonia will kill you. That is why healthy people succumb to this because their immune systems are vibrant enough to initiate the storms. The young and the old get the flu but they seem to be able to pull through if they can avoid the pneumonia, though it is a dangerous illness regardless of who becomes infected."
"Ya have any idea of what the mortality rate is?" inquired Martin as he scribbled furiously in his notebook.
"A solid twenty percent, yes at least twenty percent."
Martin asked, "Is that high?"
The Coroner responded, "Incredibly high."
"I just find it incredible that nobody outside the local medical community is alarmed by this thing. Perhaps a graphic account of what is really going on will initiate some action", Martin speculated.
"Perhaps", said the Coroner as he pulled on two new gloves. He walked over to a corpse and looked at his assistant. "Ready?", he asked Angelique. She produced a small electric saw from a drawer and handed it to the Coroner. Anticipating what was about to happen Martin said in a panic, "I'll see myself out." The Coroner looked at his assistant with a smirk; she just shrugged. Martin rushed through the hallway lined with the dead. He hurried out the back door and into the warm fresh air. Once outside he stopped and breathed in deeply. He turned to the sun and let it wash his face in its radiant warmth. It was good to be alive.