Okoye finished my thinking. “Meaning, if you are right, both initial groups were infected intentionally, and in Nevada the pathogen began to move outward. Contagious.”
“It must be. I’d been hoping it wasn’t.”
Okoye nodded unhappily. We were in the elevator. “We always knew it was just a matter of time, that small changes in the DNA of even benign bacteria could amplify toxicity. Ramshaw and Jackson and their virulent mousepox. They created it in a lab and promptly destroyed it.”
“Or Furst,” said Eddie morosely, referring to the researcher at Totalgen, Inc. in Wisconsin who designed an E. coli strain — one of the most common bacteria — to be thirty thousand times more resistant to antibiotics. Furst also destroyed his creation, after an outcry by other professionals. His work proved that small changes could turn common bacteria into super killers.
Okoye sighed. “I’ve started half of our cases on a normal anti-leprosy regimen: rifampin, clofazimine, and dapsone. Too soon to see if it works. On others I’m trying different strategy, broad spectrum combo: penicillin, aminoglycoside, metronidazole.”
I recognized these drugs. “You think it’s related to necrotizing fasciitis? To flesh-eating bacteria?”
Okoye shrugged. “No response there either, Joe.”
Air Force Captain Joaquin Reyes, first official victim at Creech, lay like a space traveler inside a cylindrical patient isolator unit, a high-tech tent of reinforced plastic that looked like a gigantic roll of cellophane and came with built-in hoods, sleeves, and gloves to allow medical staff protection while they worked on a patient.
Bolted to the cylinder was a smaller, squarish airlock through which nurses could pass food and drink to Reyes, and remove body waste.
“The waste is heat sealed and removed for disposal in an autoclave,” Dr. Okoye said.
Air inside the cylinder was kept at negative pressure by pumps, to lower any chance of aerosolization of bacteria if Reyes started coughing.
Between the air pumps and plastic screens, Reyes and I would communicate through three layers of protection. The face looking out, distorted by plastic sheeting, was monstrous, mottled by growths, right eyelid drooping almost shut. The irises were inflamed, red, veined, and watery. Earbuds piped music or TV into him. He balanced a screen-tablet TV on knees poking out from beneath his hospital gown, the skin rife with more sores. The gray hospital socks bulged outward, as if the feet were bandaged. The hands balancing the tablet looked like bandaged paws. Half of his condition seemed to consist of flesh growing, half of it being eaten away.
Before I could speak, Eddie nudged me. Following his gaze, I looked up at the corner TV. CNN was on, and a banner running across the screen read, U.S. DRONES HIT SOMALI TERRORISTS. I saw a global hawk reconnaissance shot of a Somali town, houses wrecked, Technicals burning, bodies sprawled on a street.
U.S. RETALIATES FOR MURDERED SCIENTISTS. DEAD INCLUDE WOMEN AND CHILDREN. OUTRAGE SPREADS ACROSS ISLAMIC WORLD.
As the scene changed to a mob outside the U.S. Embassy in Cairo, I had a sense of the contagion spreading in a different way. There came an overpowering sense of malignant forces converging.
I glanced sharply at Chris. I figured that she’d known the attack was scheduled, and hidden this from us.
But she looked shocked beneath her plastic visor. “I knew they were thinking about it.”
“But why?” I said, aware that Reyes had looked up. The swollen face stared out at me, left eye bulging, like a fish in an aquarium.
Chris said, “Why? They killed Americans. You witnessed it, Joe. How can you even ask why?”
“Because what I saw in Somalia were people trying to protect themselves from infection, same as protocol 80 here, a recently revamped worst-case strategy, buried in a Pentagon drawer.”
“You’re defending them?”
“No, but now we can’t talk to them, can’t learn anything else from them. There’s no proof that they’re even responsible for the infection in the first place.”
“They burned thirty people to death, including healthy ones,” she snapped. “I would think that you of all people would regard retaliation as—”
She stopped abruptly. She turned bright red. At that moment of face-reading honesty, I knew that she’d seen my file. Burke must have shared it. She knew the truth about me.
And then the patient cleared his throat and I concentrated on the wrecked face, and wiped away personal concerns to give full attention to the man lying below.
Even in this first second, if we hadn’t had lab verification, it was obvious, It’s the same thing. He’s not the first patient. He’s fortieth in a growing line.
The nose was eaten away. The nostrils — what was left — seemed raised up. The eyebrows were gone, the neck and wrists a mass of bumps, so joined together in places that they formed the entire surface of his skin.
“Captain Reyes? I’m Colonel Joe Rush, a former U.S. Marine. I’m also a doctor. I’m here to help. I’d be grateful if we talked, if you don’t mind.”
On the wall, someone had hung glassed-in Matisse posters. Jazz instruments, cut-outs. They didn’t lighten the mood. Their cheeriness accentuated the grotesque.
“Marines?” said Reyes in the same ravaged whisper that I’d heard overseas. The same fucking thing.
“Yes, Captain.”
His face showed no emotion. It couldn’t. The muscles had no mobility. But the anger was raw and that was welcome. I’ll take rage in a patient over resignation any day of the week.
“Actually, sir, I mind plenty. No one answers our questions. All we do is answer yours.”
“Ask whatever you want.”
Chris cleared her throat warningly and Okoye looked stern. I knew the drill. Until we know that base personnel weren’t involved in this, we do not share what we know.
Reyes tried to lay the newspaper on his chest but his hands did not function. One section slipped out, drifted to the floor, by the urine container. “What I want? What the hell is happening to us, sir? Me, and my girlfriend. Jana.”
“We don’t know yet.” My eyes flicked to the TV overhead, where CNN was showing the Africa shots again, over and over. Repetition substituting for depth. “But it may have started in Somalia.” Chris’s fingers tightened on my arm. She seemed about to say something, but I rode over any protest. “I’ve just come from there. What you have broke out there first. And a South Carolina couple came down with it, too, after being here recently.”
“Somalia? But that’s where we fly drones!”
I removed Chris’s hand from my suited-over forearm. Her gloves and mine touched. I felt coolness beneath latex. But she wasn’t ordering me to stop, interesting, because shutting me up here was her job.
Reyes struggled to rise inside his cylinder, and succeeded only in raising himself a few inches. “You’re saying this is an attack? Because of our drones?”
I got down on my knees, to be at his eye level. Eddie and I were stationed in Alaska last year, and something that my Iñupiat friends taught me there stuck with me now. In Eskimo culture, you never talk down to a child, or an old person. It accentuates a helpless feeling. I didn’t know whether the same custom applied to dealing with the sick in Barrow, but it seemed a good idea here. I looked into Reyes’s eyes levelly, from a few protected inches away.
“It’s possible. I need your help to try to figure this out. I’ll probably ask a lot of the same questions you’ve answered already, but I may ask new ones, or have a different take on the old answers. Time is crucial.”