“This is like Lourdes,” Eddie said, over the creaking of hand-cut crutches, the moaning and coughing. He referred to the French town in the Pyrenees where, in 1858, rapt fourteen-year-old Bernadette Soubirous told townspeople that the Virgin Mary, a “beautiful lady,” appeared to her in a vision. Since then, two hundred million pilgrims have visited the site, and five million more come each year, deluded supplicants the way I see it, desperate and praying for miracle cures for their cancers and deformities, prayer against virus, hope against prognosis,
As a boy I’d believed in this trash. But I knew better now. I knew this after what had happened to Karen. I believed in guns, germs, and laboratories now. Not in hope, prayer, or friendly gods.
Wilderness Medicine 101. Get splints on the injured, but the very flesh seemed to be melting off these people. Administer appropriate antibiotics, but we did not know if a microorganism was involved, or whether it would respond. Call for medevac, but that was impossible. What we knew here was even less than in most extreme emergency cases. We knew nothing. Only bits of truth, of possible analysis. To prematurely choose a cause could be fatal. But to do nothing seemed like it would produce the same result.
My earpiece whispered out the low voice of Hassan, the militia leader, over our shared comm-system.
“My brother is in there. He helped your people find special places, the special rocks,” Hassan said.
“Special how?”
“They are old.”
“Old how?”
“They were the rocks near the ruins.”
“What ruins?”
“Roman.”
“Hassan, I don’t know what’s happened, but we’ll do our best to find out.”
“My brother was a wrestler. A powerful man! Look at him now! I have never seen a disease like this!”
“Have any people outside the compound fallen ill?”
“Not yet. I wish to keep it this way.”
Eddie and I shuffled into the compound. Our air filters allowed in some odors now: rot, grease, shit, Lysol.
Hassan’s voice hardened. “You will take tissue samples. You will give the medicines. When you are done, you will strip off all clothes and leave them on the ground. You will be naked. You will not take anyone out with you.”
Uh-oh. “I thought you wanted these people evacuated.”
“We will discuss that later.”
The fighters behind us were spreading out, the Technicals moving right and left as vehicles took up new positions. This adjustment placed the entire compound at the intersecting trajectory of at least fifty pointing guns.
“Hassan, there are too many sick here for just two doctors. I need more.”
“No tricks. Just you.”
“We don’t have enough medication for all these people.”
“Ah! You do know what this sickness is, then? The proper way to treat it! Tell me what they have!”
“We don’t know yet. Hassan, one of these people is your own brother. Don’t you want him to have the best care?”
He cut me off angrily. “Go to work.”
We closed the last few feet. I have to admit, as a doctor I’ve seen many horrible things, but this, the sheer number of people, the mass of deformity, produced in me the greatest revulsion. I wanted to turn away. I was eight years old, with my parents, watching an old wide-screen rereleased 1959 Technicolor movie at the multiplex in Pittsfield, one Easter. The leprosy scene. The sick women coming out of caves in a Mideastern valley, in Ben Hur. Shunned. In rags. Hiding their faces.
As a boy, I had squeezed my eyes shut, not wanting to see those horrible Hollywood special effects. I had asked my mother, when the film was over, Can that happen in Pittsfield? And she had said, No, it’s an old disease. It doesn’t harm people here anymore. It’s from Bible times, Joe.
Bible times.
Well, in Ben Hur the sick did not wear short-sleeved shirts that read TORONTO MAPLE LEAFS and khaki slacks from Costco. They wore clothing from the time when Jesus walked the earth and Roman armies conquered Jerusalem, a time when the existence of bacteria was unknown and the greatest doctors believed illness came from witchcraft or vapors or punishment from gods.
Eddie’s eyes sought mine over our masks. Hassan would hear everything we said. Eddie’s expression contained the message: Hassan’s lying about something.
I nodded. I know. But we do our job.
The first man in line was a white guy who looked about sixty, his back bent, his face swollen, breathing raspy, hair patchy like mange on a dog, mouth eaten away on the left side so severely that I saw white teeth, red gums.
“Colonel?” the old guy rasped. “It’s me.”
I hope I hid my shock. Wilderness Medicine 101. Make them comfortable as possible. And calm as possible. Get information as fast as you can, once they’re calmed.
I managed to keep my voice light. “Hey, who ever figured I’d run into you here, Lionel.”
“Yeah,” he rasped. He tried to smile, looking more like a skeleton. “Big surprise.”
“Lie down.” I indicated a picnic bench. He struggled to do it and I helped. I said, “How long have you been a scientist?”
His words came out slowly, forced. Vocal cords affected. “I went back to school after the Marines. Got my Ph.D. Dumb to come here, huh? But piracy off Somalia ended research here for twenty years, until now. Climate projects. Ocean. Super important work.”
“What’s so important about it?” I asked, looking into the throat. Oh God. Maggots in there.
“Sediment samples help date early man.”
He was as calm as he was going to get. I said, “Well, I’m here to help. Lionel, what’s going on?”
Eddie was lining the others up at the mess tent picnic table, our makeshift exam room. Wilderness Medicine 101. Triage them into groups: the doomed, savable, and healthy. Do it whether you’re working an avalanche, cyclone, or cholera outbreak. Do it and you’ll save the most lives.
“Lionel, can you tell me how this thing started?”
The twisted figure broke out coughing. He raised his left hand to cover his mouth. My horror intensified. The little finger was half gone. The stump of his index finger oozed blood.
But his brain was working, and the words he squeezed out came from an observant scientist who was fighting to maintain self-control, and save his own life. “Two weeks ago everyone was fine. Then Miriam — a grad student — said her fingers tingled. And then Dr. Ross cut his leg with an ax, but he felt nothing. Our faces. My toe. I woke up three days ago and it was half gone.”
I shone light in his eyes, used a tongue depressor on the rotting pink thing in the cave of his mouth. Heartbeat normal. I maneuvered a thermometer in his mouth, but his lips were eaten away so I had to hold it in place.
“Very helpful, Lionel. Miriam was the first to get sick, you say?”
“I think so. But everyone seemed to get it at the same time. Mike Dellman died.” The watery eyes shifted to the body draped over the thorn bushes. “They shot him. He tried to run. I don’t know where he thought he could go.”
“Tingling, you said? Miriam felt tingling. Tingling was the first symptom? What happened next?”
The eaten-away face before me seemed to consider, but it lacked animation. The nerve endings were probably shot. Flies landed on lumps and open sores.
“Next? The patches, skin patches, like cancer my uncle Fred had in Arizona… My nose got thick. I can hardly see.” His panic suddenly crested. “Hard to walk!”
“Very observant, Lionel. Keep it up,” I said, talking to him as if he were still a nineteen-year-old Marine, not an accomplished professor of geology. “Tell me about that rash a bit, will you? Where exactly did that start? Fingers and toes? Or in the central part of your body?”