David watched with me as the image illuminated the screen. When Dana's abdomen film filled the screen, David and I both stared at it in shock.
David touched his fingers to his mouth. "No way."
I nodded slowly. "Way."
David shook his head. "I've never seen that. I mean, in a textbook, yes, but . . . man. Bad deal."
The image on the monitor was hypnotizing. I'd never seen someone present with that gas pattern, either. I couldn't even remember seeing it in a textbook.
"They've been talking a lot on the radio this morning about that virus in Germany. They say it's spreading all over. It looks like war on the television. People panicking in the streets. Scary stuff."
I frowned. "I heard that when I dropped off the girls this morning."
"You don't think the patient has it, do you? They're not really saying exactly what it is, but that," he said, gesturing to the monitor, "is impossible."
"You know as well as I do that we see new stuff all the time."
David stared at the image for a few seconds more, and then nodded, snapping out of his deep thought. "Hayes is ready when you are."
I grabbed a lead apron, slid my arms through the armholes, and then fastened the tie behind my back as I walked to the reading room to fetch Dr. Hayes.
As expected, he was sitting in his chair in front of his monitor in the dark, speaking quietly into his dictation mic. I waited patiently just outside the doorway for him to finish, and then he looked up at me.
"Dana Marks, twenty-three years old, presenting with abdominal pain and significant weight loss since Wednesday. Some hair loss. No history of abdominal disease or heart problems, no previous abdominal surgeries, no previous abdominal exams."
Dr. Hayes pulled up the image I'd just taken, and squinted his eyes for a moment. "How significant?"
"Nineteen pounds."
He looked only slightly impressed until the image appeared on the screen. He blanched. "Oh my God."
"I know."
"Where has she been?"
"She hasn't traveled recently, if that's what you mean. She did mention being attacked by a drunk after a party Tuesday night."
"This is profound. Do you see the ring of gas here?" he asked, pointing to the screen. His eyes brightened with recognition. "Portal venous gas. Look at the biliary tree outline. Remarkable." Dr. Hayes went from animated to somber in less than a second. "You don't see this very often, Scarlet. This patient isn't going to do well."
I swallowed back my heartbreak for Dana. She either had a severe infection or something else blocking or restricting the veins in her bowel. Her insides were basically dead and withering away. She might have four more days. They would probably attempt to take her to emergency surgery, but would likely just close her back up. "I know."
"Who's her doctor?"
"Vance."
"I'll call him. Cancel the UGI. She'll need a CT."
I nodded and then stood in the hall while Dr. Hayes spoke in a low voice, explaining his findings to Dr. Vance.
"All right. Let's get to it," the doctor said, standing from his chair. We both took a moment to separate ourselves from the grim future of the patient. Dr. Hayes followed me down the hall toward the exam room where Dana waited. "The girls doing okay?"
I nodded. "They're at their dad's this weekend. They're going to meet the governor."
"Oh," the doctor said, pretending to be impressed. He'd met the governor several times. "My girls are coming home this weekend, too."
I smiled, glad to hear it. Since Dr. Hayes's divorce, Miranda and Ashley didn't come home to visit nearly as much as he would have liked. They were both in college, both in serious relationships, and both mama's girls. Much to the doctor's dismay, any free time they had away from boyfriends and studying was usually spent with their mother.
He stopped, took a breath, held the exam-room door open, and then followed me inside. He hadn't given me time to set up the room before he came back, so I was glad the upper GI was cancelled.
David was shaking the bottles of barium.
"Thanks, David. We won't be needing those."
David nodded. Having seen the images before, he already knew why.
I helped Dana to a sitting position, and she stared at both of us, clearly wondering what was going on.
"Dana," Dr. Hayes began, "you say your problem began early Wednesday morning?"
"Yes," she said, her voice strained with increasing discomfort.
Dr. Hayes abruptly stopped, and then smiled at Dana, putting his hand on hers. "We're not going to do the upper GI today. Dr. Vance is going to schedule you a CT instead. We're going to have you get dressed and go back to the waiting room. They should be calling you before long. Do you have someone with you today?"
"Joey, my boyfriend."
"Good," the doctor said, patting her hand.
"Am I going to be okay?" she said, struggling to sit on her bony backside.
Dr. Hayes smiled in the way I imagined him smiling while speaking to his daughters. "We're going to take good care of you. Don't worry."
I helped Dana step to the floor. "Leave your gown on," I said, quickly grabbing another one and holding it behind her. "Slip this on behind you like a robe." She slipped her tiny arms through the holes, and then I helped her to the chair beside the cabinet. "Go ahead and put on your shoes. I'll be right back. Just try to relax."
"Yep," Dana said, trying to get comfortable.
I grabbed her requisition off the counter and followed the doctor to the workroom.
As soon as we were out of earshot, Dr. Hayes turned to me. "Try to talk to her some more. See if you can get something else out of her."
"I can try. All she mentioned out of the ordinary was the bite."
"You're sure it wasn't an animal?"
I shrugged. "She said it was some drunk guy. It looks infected."
Dr. Hayes looked at Dana's abnormal gas patterns on the monitor once more. "That's too bad. She seems like a sweet kid."
I nodded, somber. David and I traded glances, and then I took a breath, mentally preparing myself to carry such a heavy secret back into that room. Keeping her own death from her felt like a betrayal, even though we'd only just met.
My sneakers made a ripping noise as they pulled away from the floor. "Ready?" I asked with a bright smile.
Chapter Two
Scarlet
BY LUNCH, DANA HAD ALREADY been in and out of surgery. Christy told us they only opened her up long enough to see there was nothing they could do, before closing her back up. Now they were waiting for her to awaken so they could tell her she would never get better.
"Her boyfriend is still with her," Christy said. "Her parents are visiting relatives. They're not sure they'll get back in time."
"Oh, Jesus," I said, wincing. I couldn't imagine being away from either of my daughters in a situation like that, wondering if I would make it in time to see her alive one last time. I shook it off. Those of us in the medical field didn't have the luxury of thinking about our patients' personal lives. It became too close. Too real.
"Did you hear about that flu?" Christy said. "It's all over the news."
I shook my head. "I don't think it's a flu."
"They're saying it has to do with that scientist over in Europe. They say it's highly contagious."
"Who are they? They sound like troublemakers to me."
Christy smiled and rolled her eyes. "They also said it's breached our borders. California is reporting cases."
"Really?"
"That's what they say," she said. Her pager buzzed. "Damn, it's getting busy." She pushed a button and called upstairs, and then she was gone again.
Within the hour, the hospital was crowded and frantic. The ER was admitting patients at a hectic pace, keeping everyone in radiology busy. David called in another tech so he and I could cover the ER while everyone else attended to outpatients and inpatients.
Whatever it was, the whole town seemed to be going crazy. Ca
r accidents, fights, and a fast-spreading virus had hit at the same time. On my sixth trip to the ER, I passed the radiology waiting room and saw a group of people crowded around the flat-screen television on the wall.
"David?" I said, signaling for him to join me in front of the waiting room. He looked in through the wall of glass, noting the only seated person was a man in a wheelchair.
"Yeah?"
"I have a bad feeling about this." I felt sick watching the updates on the screen. "They were talking about something like this on the radio this morning."
"Yeah. They were reporting the first cases here about half an hour ago."
I stared into his eyes. "I should leave to try to catch up to my girls. They're halfway to Anderson by now."
"As busy as we are, no way is Anita going to let you leave. Anyway, it's highly contagious, but disease control maintains that it's just a virus, Scarlet. I heard that those that got the flu shot are the ones affected."
That one sentence, even unsubstantiated, immediately set my mind at ease. I hadn't had a flu shot in three years because I always felt terrible afterward, and I'd never gotten one for the girls. Something about vaccinating for a virus that may or may not protect against whatever strain came through didn't sit well with me. We had enough shit in our bodies with hormones and chemicals in our foods and everyday pollutants. It didn't make sense to subject ourselves to more, even if the hospital encouraged it.
Just as David and I finished up our last batch of portable X-rays in the ER, Christy rounded the corner, looking worn.
"Has it been as busy down here as it's been up there?"
"Yes," David said. "Probably worse."
"Can you still do that port for me?" Christy said, her eyes begging.
I looked to David, and then back at Christy. "The way things are going, if I take that pager, I'll be stuck up there until quitting time. They really need me down here."
David looked at his watch. "Tasha comes in at three thirty. We can handle it until then."
"You sure?" I asked, slowly taking the pager from Christy.
David waved me away dismissively. "No problem. I'll take the pager from you when Tasha gets here so you can go home."
I clipped the pager to the waistband of my scrubs, and headed upstairs, waving good-bye to Christy.
She frowned, already feeling guilty. "Thank you very, very much!"
I passed Chase for the umpteenth time. As the hours passed, he'd looked increasingly nervous. Everyone was. From the looks of things inside the ER, it seemed like all hell was breaking loose outside. I kept trying to sneak peeks at the television but once I finished one case, the pager would go off again to direct me to another.
Just as I had anticipated, once I arrived on the surgery floor, there would be no leaving until David relieved me at 3:30. Case after case, I was moving the C-arm from surgery suite to surgery suite, sometimes moving a second one in for whomever was called up for a surgery going on at the same time.
In one afternoon I saw a shattered femur, two broken arms, and a broken hip, and shared an elevator with a patient in a gurney accompanied by two nurses, all on their way to the roof. His veins were visibly dark through his skin, and he was covered in sweat. From what I could make of their nervous banter, the patient was being med-flighted out to amputate his hand.
My last case of the day was precarious at best, but I didn't want to have to call David up to relieve me. My girls were out of town with their father, and David had a pretty wife and two young sons to go home to. It didn't make sense for me to leave on time and for him to stay late, but I had already logged four hours of overtime for the week, and that was generally frowned upon by the brass.
I walked past the large woman in the gurney, looking nervous and upset. Her hand was bandaged, but a large area was saturated with blood. I remembered her from the ER, and wondered where her family was. They all had been with her downstairs.
Angie, the circulation nurse, swished by, situating her surgical cap. It was covered in rough sketches of hot-pink lipsticks and purses. As if to validate her choice of head cover, she pulled out a tube of lip gloss and swiped it across her lips. She smiled at me. "I hear Chase has been asking about you."
I looked down, instantly embarrassed. "Not you, too." Was everyone so bored that they had nothing better to do than fantasize about my non-love life? Was I that pathetic that a prospect for me was so exciting?
She winked at me as she passed. "Call him, or I'm going to steal him from you."
I smiled. "Promise?"
Angie rolled her eyes, but her expression immediately compressed. "Damn! Scarlet, I'm sorry, your mom is on line two."
"My mom?"
"They transferred her call up a couple of minutes before you came in."
I glanced at the phone, wondering what on earth she would be calling me at work about. We barely spoke at all, so it must have been important. Maybe about the girls. I nearly lunged for the phone.
"Hello?"
"Scarlet! Oh, thank God. Have you been watching the news?"
"A little. We've been slammed. From the few glimpses I've gotten, it looks bad. Did you see the reports of the panic at LAX? People were sick on some of the flights over. They think that's how it traveled here."
"I wouldn't worry too much about it. Nothing ever happens in the middle of the country."
"Why did you call, then?" I said, confused. "Are the girls okay?"
"The girls?" She made a noise with her throat. Even her breath could be condescending. "Why would I be calling about the girls? My kitchen floor is pulling up in the corner by the refrigerator, and I was hoping you could ask Andrew to come fix it."
"He has the girls this weekend, Mother. I can't really talk right now. I'm in surgery."
"Yes, I know. Your life is so important."
I glanced at Angie, seeing that she and the surgical tech were nearly finished. "I'll ask him, but like I said, he has the girls."
"He has the girls a lot. Have you been going to the bars every weekend, or what?"
"No."
"So what else is more important than raising your children?"
"I have to go."
"Sensitive subject. You've never liked to be told you're doing something wrong."
"It's his weekend, Mother, like it is every other weekend."
"Well. Why does his weekend have to be the weekend I need help?"
"I really have to go."
"Did you at least send dresses with them so their daddy can take them to church? Since he's the only one who seems to care to teach them about the Lord."
"Good-bye, Mother." I hung up the phone and sighed just as Dr. Pollard came in.
"Afternoon, all. This shouldn't take long," he said. He held his hands in front of him, fingers pointing up, waiting for Angie to put gloves on them. "But by the looks of it we're all in for a long night, so I hope none of you had plans."
"Is that true?" Ally, the scrub tech, asked from behind her mask. "About LAX?"
"It happened at Dulles, too," Angie said.
I glanced at the clock, and then pulled my cell phone from the front pocket of my scrubs. I could be written up if someone felt like ratting me out for being on it, but an extra piece of paper in my file was worth it in this case. I pecked out the words Call Me ASAP, and then sent them on to Jenna's phone.
After a couple of minutes with no response, I dialed Andrew. It rang four times, then his voicemail took over.
I sighed. "It's Scarlet. Please call me at the hospital. I'm in surgery, but call me anyway so we can coordinate. I'm coming there as soon as I get off work."
Nathan
ANOTHER EIGHT-HOUR DAY THAT DIDN'T mean a damn thing. When I clocked out from the office, freedom should have been at the forefront of my mind, or should have at least brought a smile to my face, but it didn't. Knowing I had just wasted another day of my life was depressing. Tragic, even. Stuck at a desk job for an electric co-op that made no difference in the world, day in and day out, and
then going home to a wife who hated me made for a miserable existence.
Aubrey hadn't always been a mean bitch. When we first got married, she had a sense of humor, she couldn't wait until it was bedtime so we could lie together and kiss and touch. She would initiate a blowjob because she wanted to please me, not because it was my birthday.
Seven years ago, she changed. We had Zoe, and my role switched from desirable, adoring husband to a source of constant disappointment. Aubrey's expectations of me were never met. If I tried to help, it was either too much, or it wasn't done the right way. If I tried to stay out of her way, I was a lazy bastard.
Aubrey quit her job to stay home with Zoe, so mine was the only source of income. Suddenly that wasn't enough, either. Because I didn't make what Aubrey felt was enough money, she expected me to give her a "baby break" the second I walked in the door. I wasn't allowed to talk to my wife. She would disappear into the den, sit at the computer, and talk to her Internet friends.
I'd entertain Zoe while emptying the dishwasher and prepping dinner. Asking for help was a sin, and interrupting the baby break just gave Aubrey one more reason to hate me, as if she didn't have enough already.
Once Zoe started kindergarten, I hoped it would get better, that Aubrey would start back to work, and she would feel like her old self again. But she just couldn't break free of her anger. She didn't seem to want to.
Zoe had just a few weeks left in second grade. I would pick her up from school, and we would both hope Aubrey would turn away from the computer just long enough to notice we were home.
On a good day, she would.
Today, though, she wouldn't. The Internet and radio had been abuzz since early morning with breaking news about an epidemic. A busy news day meant Aubrey's ass would be stationed firmly against the stained, faded blue fabric of her office chair. She would be talking about it with strangers in forums, with friends and distant family on social networks, and commenting on news websites. Theories. Debates. Somewhere along the way it had become a part of our marriage, and I had been edged out.
I waited in my eight-year-old sedan, first in a line of cars parked behind the elementary school. Zoe didn't like to be the last one picked up, so I made sure to go to her school right after work. Waiting forty minutes gave me enough time to decompress from work, and psych myself up for another busy night without help or acknowledgment from my wife.
The DJ's tone was more serious than it had been, so I turned up the volume. He was using a word I hadn't heard them use before: pandemic. The contagion had breached our shores. Panic had broken out in Dulles and LAX airports when passengers who'd fallen ill during their international flights began attacking the airline employees and paramedics helping them off the plane.