Pandemic (9 page)
Authors: Daniel Kalla
While Anna fluctuated between apologies and rationalizations, Haldane said very little that afternoon. But as days passed, he couldn't stop talking about it with her. He wasn't looking for the contrition Anna offered, or even the energetic sexual solace she seemed to need from him. He wanted guarantees. And while Anna was adamant she had cut off all contact with Julie, she would not give Noah what he sought: assurance that she was, or would soon be, over Julie. Instead, she maintained that she was in love with both of them.
The crackle of static brought him back to the moment. He took a deep breath. "Have you seen her since I left?" he asked. Julie was always "she" or "her" to Haldane.
"No." Anna wavered. "Not face-to-face."
"But you talk to her regularly?" he snapped before his brain could catch up to his mouth.
"She e-mails me."
Haldane resisted the urge to break the receiver in his hand. "And you write her back?"
"They're poems, Noah. Beautiful." She was silent for a long while. "Yes, I write back."
He swallowed. "Anna, I don't want you to write to her."
"I know," she said almost imperceptibly over the static.
Haldane heard his daughter crying in the background. "You better take care of Chloe."
"Okay," she said. "Noah, promise me you will be careful over there. Please."
"Bye, Anna."
He lay back on the bed, staring at the ceiling, ruminating about this last fruitless conversation and all the others that preceded it. Again he felt lost, unsure of how to hold up the crumbling walls of his domestic life. He thought of his daughter suffering through another ear infection without her dad around to comfort her. He thought of his wife. Her large brown eyes. The fragile smile. The bulky T-shirt that only hinted at the smooth, responsive body hidden underneath. And in spite of the torrent of mixed emotions, he realized how aroused he was. He longed to see her face, smell her hair, and clutch her flawless back as her legs wrapped around his waist.
Haldane shook away the conflicting thoughts, jumped off the bed, and grabbed his laptop. He moved the phone out of the way and flipped it open. With a tap of the built-in mouse, data regarding Acute Respiratory Collapse Syndrome filled the screen. Jotting notes as he reviewed the documents, graphs, and charts, he succeeded in distracting himself by studying a world even more chaotic than his own.
The next morning, the WHO team separated. Streicher and Yuen, the nonclinical specialists, went off to review the regional laboratory while McLeod and Haldane headed off to see the front lines in the battle against ARCS.
Walking out of the hotel to the waiting unmarked government sedan, Haldane noticed the first of several Jiayuguan residents sporting surgical masks over their faces. It was an eerily familiar sight from the SARS days.
"People very panicky," their translator and guide explained away the phenomenon from the front seat of the car.
"People very sensible," McLeod aped from the backseat.
They drove past the city limits and continued southward.
"Haldane, I have to tell you," McLeod said, "I don't like this bug."
Haldane laughed. "Are you partial to any microorganism?"
"Not particularly, but I really don't like this one."
The smile left Haldane's lips. "How come?"
"The short incubation period. The rapid respiratory failure in otherwise healthy people. The hemorrhagic pneumonia ... Reminds me of only one other I've seen before."
Haldane shook his head. "Duncan, this is not Ebola."
McLeod nodded. "I know. And it's a bloody shame."
"Oh?"
"Nice and clean killer, Ebola." McLeod nodded in admiration. "But its ruthless lethality is its shortcoming. Kills everything in its path. If this were Ebola, we'd have a few hundred dead farmers and some very cheap farm-land on the market, but the disease would bum itself out for lack of new victims."
Haldane nodded, picking up on McLeod's logic. "Whereas ARCS only kills the significant minority of its victims, allowing the virus to propagate and spread beyond the site of the index cases"
"And spread rapidly."
"That is yet to be determined, Duncan," Haldane said, but he was unconvinced by his own argument.
The car slowed before turning off the main road and onto the driveway of Jiayuguan's regional hospital. They passed through two checkpoints, manned by masked soldiers, and drove into the gravel parking lot in front of the hospital. A cold spitting drizzle fell as Haldane and McLeod hopped out of the car, bundled their jackets, and strode for the front entrance.
Once they cleared the internal security measures, McLeod and Haldane were led into the change room. Haldane had slipped into too many biohazard, or HAZMAT, suits to feel the slightest alarm. As he stepped out through the two sets of sealed doors and into the clinical area, he actually felt relief to be among the appropriate high-level, scientific protective measures and away from the irrational fear he had seen on the streets in the eyes behind the surgical masks.
A hospital guide, fully suited in blue HAZMAT gear like the rest of the staff behind the doors, acted as their translator. The chubby man led the two emerging pathogens experts to a hospital room on the second floor. Haldane was surprised to see that the door was locked. They had to wait for a security guard to let them in. "Why the guards?" Haldane asked the translator.
The translator spoke to the security guard and then turned to Haldane. "The men might still be contaminated," he said in a voice that was muffled by the spacesuitlike hood he wore. He pointed to the guard opening the door. "They take no chances."
Inside, with the door locked behind them, they stood in a bleak windowless hospital room befitting a second-world country. Two beds were hidden behind drawn curtains. On the other side of the room, two men wearing masks, gloves, and shower caps along with standard hospital pajamas sat across from one another on narrow cots and played mahjong with small white domino-like tiles.
"Why are they still here?" McLeod pointed at the healthy-looking men.
"Still might be contaminated," the translator replied.
"'Infectious"', Haldane corrected distractedly. He waved to the two men, who responded with friendly nods, and then he asked the translator. "When did they become sick?"
The translator spoke for several minutes to the two patients in their native Mandarin.
"Watch," McLeod said, shifting impatiently from foot to foot. "I've seen translators do this a thousand times before. They'll gab back and forth for half an hour and then the guy will turn to us and say 'yes' or 'no.'"
Haldane had witnessed the same frustrating happening, but in this case, McLeod was wrong.
"Both men live in the same town fifty miles north of Jiayuguan," the translator said. He pointed to the smaller man on the cot nearest them. "Seven days ago, Xiang got a high fever. In a day, he started to cough. Then he became very, very sick. The oxygen did not help him. He was suffocating on his own mucus." He put both hands on his own throat and pantomimed a choke. "The town's doctor arranged to bring Xiang here, but he told his wife it was probably no good. Here at our hospital, the doctors put Xiang on a life-support machine. After three days, he got much better." The translator snapped his finger to indicate the rapidity of his sudden improvement. "Now, he waits for two days until the doctors say he is no longer
infectious."
The translator glanced at Haldane with a proud nod.
infectious."
The translator glanced at Haldane with a proud nod.
Haldane chuckled and nodded back. "And the other man?" he asked.
"Tan," the translator said, thumbing at the tall, thin man. "He also got sick a week ago. He never became as very sick as Xiang. Only a heavy cough. But..." The translator cleared his throat. "Tan's sister died from the virus three days ago."
"Oh," Haldane said. "Please tell him how sorry we are."
The translator and Tan spoke for a moment. Tan raised a hand and waved it at Haldane, leaving him confused as to the intent of the gesture.
"We want to ask some questions about their illness," McLeod said to the translator.
Through the translator, McLeod and Haldane focused their questions on the early symptoms of the infection. Neither patient had the classic sore throat or vague aches that are the harbingers of the common flu. Their symptoms began with a sudden fever and weakness, followed within hours by agonizing muscle pain, cough, and some degree of respiratory collapse.
Haldane had heard enough to know that whatever caused ARCS was one scary pathogen. It hit quickly. And it hit hard.
After thanking the patients for their time, the translator banged on the door. Released by the security guard, they headed into a stairwell and up to the fourth floor. Haldane had to twice catch the railing when he tripped on the stairs walking in his bulky rubber suit.
On the fourth floor the contingent passed through another set of sealed doors. Though Haldane couldn't read the Chinese lettering, from the bustling activity of the staff at the nursing station he recognized the ward for an Intensive Care Unit. Not as sleek or modern as the North American or European ICUs Haldane had seen, the air was taut with the same sense of urgency. Maybe more so.
After consultation with the nurses, their translator led them to one of the closed rooms that surrounded the nursing station like the spokes of a tire. But this door wasn't locked. As soon as they opened it, Haldane understood why. The patient wasn't going anywhere soon, except possibly the morgue.
As they approached the bed, the translator explained, "This is the doctor. Dr. Zhao Fung."
"Which doctor?". McLeod asked.
But Haldane answered before the translator. "He's the town doctor. The one who looked after the two men we just interviewed."
The translator nodded his head vigorously.
"Shite!" McLeod said. "I thought they told us there hadn't been any intra-hospital spread."
The translator waved his gloved hand. "No hospital in that town. Only the ... clinic ... where he worked. He used the best precautions he had, but..."
Haldane nodded absentmindedly. He was thinking of his colleague, Dr. Franco Bertulli, dying of SARS in a similar room in Singapore after following all the recommended precautions. He remembered how Bertulli joked about his mother encouraging him to go into medicine because she thought it was so much safer than his alternate choice, the police force. In the case of both Bertulli and Fung, the viruses managed to circumvent their protective measures. In the end, medicine turned out to be a very unsafe choice for both doctors.
Dr. Fung looked older than fifty. Behind a deathly pallor, his face was swollen and contused. His oozing lips were as thick as the endotracheal tube sticking between them and leading to a ventilator, or artificial life-support system. Bloody sputum fluttered inside the transparent plastic tube, flapping back and forth with each breath the ventilator forced in and out, like a piece of paper trapped at the opening of a vacuum hose. Bruises covered his flaccid arms. A blanket shrouded the rest of his skin from his chest down, but Haldane knew that he would see similar welts and bruises on any exposed surface. Haldane made the diagnosis from the foot of the bed: disseminated intravascular coagulopathy or DIC. The inflammatory reaction instigated by the virus was chewing up the clotting factors in the patient's blood. As a result, he was bleeding spontaneously under his skin; thus the bruises.
Haldane experienced the same helplessness he had felt in Singapore. The local specialists had done all they could--all anyone could--for their colleague. Standing at the bedside in his rubber suit, Haldane felt embarrassed, as if he were a nosy bystander gawking at the sight of a fatal car crash. He was of no use to the doomed physician. All he could do was try to prevent others from following down the same road. He silently vowed to do just that.
He'd seen enough. He spun and walked to the door. McLeod and the interpreter followed behind. Even McLeod was silent as they headed back to the change rooms where guards supervised their showers to ensure proper decontamination steps were followed.
Once they were dressed their translator led them into a modest gray office, which smelled of herbal tea, on the main floor. The associate director, Dr. Ping Wu, jumped up from his desk and walked around to meet them. Wearing thick glasses and a crisp white lab coat, the middle-aged doctor stood chest-high to his two Western colleagues.
The translator made the introductions, but the diminutive administrator addressed Haldane and McLeod in a slightly accented English. "My English is most poor, but I think I can manage," he said with typical Oriental humility. "I studied four years at UCLA." He waved to the interpreter who turned and left the room.
Haldane and McLeod sat down across the desk from Wu. "My deepest apologies, Doctors," Wu said. "The director, Dr. Huang, is at the provincial capital Lanzhou reporting to the governor. He very much wanted to meet you."
"We appreciate you taking the time to meet us, Dr. Wu," Haldane said.
Wu bowed his head. "It's an honor."
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