The West River Road is deserted, except for a few eighteen-wheelers. I cross the river at the interstate and start back along the east side. Three miles along, in the middle of farmland, the smell of burned flesh rolls in the window.
Cows, close to the pasture fence. I stop the car and get out. Fifteen or sixteen Holsteins. By straining over the fence, I can see the bullet holes in their heads. Somebody herded them together, shot them one by one, and started a half-hearted fire among the bodies with neatly cut firewood. The fire had gone out; it didn’t look as if it was supposed to burn long. Just long enough to attract attention that hadn’t come yet.
I’d never heard that cows could get human diseases. Why had they been shot?
I get back in my car and drive the rest of the way to Emerton Memorial.
This side of town is deathly quiet. Grass grows unmowed in yard after yard. One large, expensive house has old newspapers piled on the porch steps, ten or twelve of them. There are no kids waiting for school buses, no cars pulling out of driveways on the way to work. The hospital parking lot has huge empty stretches between cars. At the last minute I drive on through the lot, parking instead across the street in somebody’s empty driveway, under a clump of trees.
Nobody sits at the information desk. The gift shop is locked. Nobody speaks to me as I study the directory on the lobby wall, even though two figures in gowns and masks hurry past.
CHIEF OF MEDICINE, DR. RANDOLF SATLER
. Third floor, east wing. The elevator is deserted.
It stop at the second floor. When the doors open a man stands there, a middle-aged farmer in overalls and work boots, his eyes red and swollen like he’s been crying. There are tinted windows across from the elevators and I can see the back of him reflected in the glass. Coming and going. From somewhere I hear a voice calling, “Nurse, oh nurse, oh God…” A gurney sits in the hallway, the body on it covered by a sheet up to the neck. The man in overalls looks at me and raises both hands to ward off the elevator, like it’s some kind of demon. He steps backward. The doors close.
I grip the railing on the elevator wall.
The third floor looks empty. Bright arrows lead along the hallways: yellow for
PATHOLOGY AND LAB SERVICES
, green for
RESPIRATORY THERAPY
, red for
SUPPORT SERVICES
. I follow the yellow arrow.
It dead-ends at an empty alcove with chairs, magazines thrown on the floor. And three locked doors off a short corridor that’s little more than an alcove.
I pick the farthest door and pound on it. No words, just regular blows of my fist. After a minute, I start on the second one. A voice calls, “Who’s there?”
I recognize the voice, even through the locked door. Even after seventeen years. I shout, “Police! Open the door!”
And he does. The second it cracks, I shove it hard and push my way into the lab.
“Elizabeth?”
He’s older, heavier, but still the same. Dark hair, blue eyes…I look at that face every day at dinner. I’ve looked at it at soccer matches, in school plays, in his playpen. Dr. Satler looks more shaken to see me than I would have thought, his face white, sweat on his forehead.
“Hello, Randy.”
“Elizabeth. You can’t come in here. You have to leave—”
“Because of the staph? Do you think I care about that? After all, I’m in the hospital, right, Randy? This is where the endozine is. This place is safe. Unless it gets blown up while I’m standing here.”
He stares at my left hand, still gripping the doorknob behind me. Then at the gun in my right hand. A seventeen-year-old Smith & Wesson, and for five of those years the gun wasn’t cleaned or oiled, hidden under my aunt’s garage. But it still fires.
“I’m not going to shoot you, Randy. I don’t care if you’re alive or dead. But you’re going to help me. I can’t find my son—”
your son
“—and Sylvia Goddard told me he’s mixed up with that group that blew up the bridge. He’s hiding with them someplace, probably scared out of his skull. You know everybody in town, everybody with power, you’re going to get on that phone there and find out where Sean is.”
“I would do that anyway,” Randy says, and now he looks the way I remember him: impatient and arrogant. But not completely. There’s still sweat on his pale face. “Put that stupid thing away, Elizabeth.”
“No.”
“Oh, for…” He turns his back on me and punches at the phone.
“Cam? Randy Satler here. Could you…no, it’s not about that…No. Not yet.”
Cameron Witt. The mayor. His son is chief of Emerton’s five cops.
“I need a favor. There’s a kid missing…I know that, Cam. You don’t have to lecture
me
on how bad delay could…But you might know about this kid. Sean Baker.”
“Pulaski. Sean Pulaski.” He doesn’t even know that.
“Sean Pulaski. Yeah, that one…okay. Get back to me…I told you.
Not yet.
” He hangs up. “Cam will hunt around and call back. Now will you put that stupid gun away, Elizabeth?”
“You still don’t say thank you for anything.” The words just come out. Fuck, fuck, fuck.
“To Cam, or to you for not shooting me?” He says it evenly, and the evenness is the only way I finally see how furious he is. People don’t order around Dr. Randy Satler at gun point. A part of my mind wonders why he doesn’t call security.
I said, “All right, I’m here. Give me a dose of endozine, just in case.”
He goes on staring at me with that same level, furious gaze. “Too late, Elizabeth.”
“What do you mean, too late? Haven’t you got endozine?”
“Of course we do.” Suddenly he staggers slightly, puts out one hand behind him, and holds onto a table covered with glassware and papers.
“Randy. You’re sick.”
“I am. And not with anything endozine is going to cure. Ah, Elizabeth, why didn’t you just phone me? I’d have looked for Sean for you.”
“Oh, right. Like you’ve been so interested and helpful in raising him.”
“You never asked me.”
I see that he means it. He really believes his total lack of contact with his son is my fault. I see that Randy gives only what he’s asked to. He waits, lordly, for people to plead for his help, beg for it, and then he gives it. If it suits him.
I say, “I’ll bet anything your kids with your wife are turning out really scary.”
The blood rushes to his face, and I know I guessed right. His blue eyes darken and he looks like Jack looks just before Jack explodes. But Randy isn’t Jack. An explosion would be too clean for him. He says instead, “You were stupid to come here. Haven’t you been listening to the news?”
I haven’t.
“The CDC publicly announced just last night what medical personnel have seen for weeks. A virulent strain of staphylococcus aureus has incorporated endozine-resistant plasmids from enterococcus.” He pauses to catch his breath. “And pneumococcus may have done the same thing.”
“What does that mean?”
“It means, you stupid woman, that now there are highly contagious infections that we have no drugs to cure. No antibiotics at all, not even endozine. This staph is resistant to them all. And it can live everywhere.”
I lower the gun. The empty parking lot. No security to summon. The man who wouldn’t get on the elevator. And Randy’s face. “And you’ve got it.”
“We’ve all got it. Everyone…in the hospital. And for forcing your way in here, you probably do, too.”
“You’re going to die,” I say, and it’s half a hope.
And he
smiles
.
He stands there in his white lab coat, sweating like a horse, barely able to stand up straight, almost shot by a woman he’d once abandoned pregnant, and he smiles. His blue eyes gleam. He looks like a picture I once saw in a book, back when I read a lot. It takes me a minute to remember that it was my high school World History book. A picture of some general.
“Everybody’s going to die eventually,” Randy says. “But not me right now. At least…I hope not.” Casually he crosses the floor toward me, and I step backward. He smiles again.
“I’m not going to deliberately infect you, Elizabeth. I’m a
doctor
. I just want the gun.”
“No.”
“Have it your way. Look, how much do you know about the bubonic plague of the fourteenth century?”
“Nothing,” I say, although I do. Why had I always acted stupider around Randy than I actually am?
“Then it won’t mean anything to you to say that this mutated staph has at least that much potential—” again he pauses and gulps air “—for rapid and fatal transmission. It flourishes everywhere. Even on doorknobs.”
“So why the fuck are you
smiling
?” Alexander. That was the picture of the general. Alexander the Great.
“Because I…because the CDC distributed…I was on the national team to discover…” His face changes again. Goes even whiter. And he pitches over onto the floor.
I grab him, roll him face up, and feel his forehead. He’s burning up. I bolt for the door. “Nurse! Doctor! There’s a sick doctor here!”
Nobody comes.
I run down the corridors. Respiratory Therapy is empty. So is Support Services. I jab at the elevator button, but before it comes I run back to Randy.
And stand above him, lying there crumpled on the floor, laboring to breathe.
I’d dreamed about a moment like this for years. Dreamed it waking and asleep, in Emerton and in Bedford Hills and in Jack’s arms. Dreamed it in a thousand ridiculous melodramatic versions. And here it is, Randy helpless and pleading, and me strong, standing over him, free to walk away and let him die. Free.
I wring out a towel in cold water and put it on his forehead. Then I find ice in the refrigerator in a corner of the lab and substitute that. He watches me, his breathing wheezy as old machinery.
“Elizabeth. Bring me…syringe in a box on…that table.”
I do it. “Who should I get for you, Randy? Where?”
“Nobody. I’m not…as bad…as I sound. Yet. Just the initial…dyspnea.” He picks up the syringe.
“Is there medicine for you in there? I thought you said endozine wouldn’t work on this new infection.” His color is a little better now.
“Not medicine. And not for me. For you.”
He looks at me steadily. And I see that Randy would never plead, never admit to helplessness. Never ever think of himself as helpless.
He lowers the hand holding the syringe back to the floor. “Listen, Elizabeth. You have…almost certainly have…”
Somewhere, distantly, a siren starts to wail. Randy ignores it. All of a sudden his voice becomes much firmer, even though he’s sweating again and his eyes burn bright with fever. Or something.
“This staph is resistant to everything we can throw it. We cultured it and tried. Cephalosporins and aminoglycosides and vancomycin, even endozine…I’ll go into gram-positive septic shock…” His eyes glaze, but after a moment he seems to find his thought again. “We exhausted all points of counterattack. Cell wall, bacterial ribosome, folic acid pathway. Microbes just evolve countermeasures. Like beta-lactamase.”
I don’t understand this language. Even talking to himself, he’s making me feel stupid again. I ask something I do understand.
“Why are people killing cows? Are the cows sick, too?”
He focuses again. “Cows? No, they’re not sick. Farmers use massive doses of antibiotics to increase meat and milk production. Agricultural use of endozine has increased the rate of resistance development by over a thousand percent since—Elizabeth, this is irrelevant! Can’t you pay attention to what I’m saying for three minutes?”
I stand up and look down at him, lying shivering on the floor. He doesn’t even seem to notice, just keeps on lecturing.
“But antibiotics weren’t invented by humans. They were invented by the microbes themselves to use…against each other and…they had two billion years of evolution at it before we even showed up…We should have—where are you going?”
“Home. Have a nice life, Randy.”
He says quietly, “I probably will. But if…you leave now, you’re probably dead. And your husband and kids, too.”
“Why? Damn it, stop lecturing and tell me why!”
“Because you’re infected, and there’s no antibiotic for it, but there
is
another bacteria that will attack the drug-resistant staph.”
I look at the syringe in his hand.
“It’s a Trojan horse plasmid. That’s a…never mind. It can get into the staph in your blood and deliver a lethal gene. One that will kill the staph. It’s an incredible discovery. But the only way to deliver it so far is to deliver the whole bacteria.”
My knees all of a sudden get shaky. Randy watches me from his position on the floor. He looks shakier himself. His breathing turns raspier again.
“No, you’re not sick yet, Elizabeth. But you will be.”
I snap, “From the staph germs or from the cure?”
“Both.”
“You want to make me sicker. With two bacteria. And hope one will kill the other.”
“Not hope. I
know
. I actually saw…it on the electromicrograph…” His eyes roll, refocus. “…could package just the lethal plasmid on a transpon if we had time…no time. Has to be the whole bacteria.” And then, stronger, “The CDC team is working on it. But
I
actually caught it on the electromicrograph!”
I say, before I know I’m going to, “Stop congratulating yourself and give me the syringe. Before you die.”
I move across the floor toward him, put my arms around him to prop him in a sitting position against the table leg. His whole body feels on fire. But somehow he keeps his hands steady as he injects the syringe into the inside of my elbow. While it drains sickness into me I say, “You never actually wanted me, did you, Randy? Even before Sean?”
“No,” he says. “Not really.” He drops the syringe.
I bend my arm. “You’re a rotten human being. All you care about is yourself and your work.”
He smiles the same cold smile. “So? My work is what matters. In a larger sense than you could possibly imagine. You were always a weak sentimentalist, Elizabeth. Now, go home.”
“Go
home
? But you said…”
“I said you’d infect everyone. And you will—with the bacteria that attacks staph. It should cause only a fairly mild illness. Jenner…smallpox…”