Miriam kept her eyes down as Captain Henry finished his rant.
“They teach you all that at West Point?” asked Major Banks.
Captain Henry stopped, turned around, and pointed to the ancient battle outposts perched high atop the valley. “No… your Alexander the Great did. Isn’t that right, Miriam? Y’all are just going to wait us out.”
Miriam was accustomed to speeches by Captain Henry and every other American officer she had worked under for the previous four years. That’s why she hated them, all of them; all of them except Major Banks. At least that’s how Banks saw it.
The three walked through the front doors of Paktya Regional Hospital as 10 workers gathered around the front desk stood to greet them. Miriam walked around the entrance wall to her little desk space and sat down. No one had a computer or traditional office equipment. One long row of fluorescent lights lit the corridor between the front desk and the ER. The recovery bay was halfway down the other corridor. It was an open room with 20 beds which was usually filled to capacity.
“Doctor Mahmoud just went down to ER,” said Abdul, the front desk manager.
“ANA?” asked Captain Henry.
“No, not Afghan National Army this time. An elder,” Abdul answered.
Piping hot green tea was served in the same unwashed cups used every day prior, as Major Banks sipped to be gracious while sorting through patient records.
“How’s our isolation ward this morning?” Banks asked to no one in particular.
Abdul tried to answer but quickly gave up and looked over to Miriam and rattled off several phrases in Pashtu.
“All three tularemia patients are resting comfortably. He thinks the room is a bio-containment ward so no one has gone in to see them yet today.”
“Have they been fed?” asked Banks, now slightly agitated.
Abdul shook his head. Major Banks and Captain Henry stood quickly as did Miriam. Banks reached for a new set of examination gloves and a sterile face mask. Henry did the same. Miriam pulled her necklace off, unhooked the clasp, and let the solitary glass bead slide off into her hand as she put the bead into the decorative glass vase on her desk. The vase was filled with hundreds of glass beads that supported the stems of her artificial flowers. She removed a tiny metal flask, dabbed a splash of oriental spice perfume on the inside of her wrist and poured the rest of the flask into a plastic iced tea bottle she had taken one day from the DFAC dining facility after a working lunch.
Miriam’s flowers were the only colors in a very dreary hospital.
“Abdul, send Doctor Mahmoud down to the isolation ward as soon as he’s out of the ER.”
“Yes, Dr. Banks.”
Two armed guards with the ANA stood outside the door of the isolation ward as Banks, Henry and Miriam entered. The guards followed but stopped just inside the door. Three ragged members of the Taliban were lying in their beds, two heads positioned against one wall, one head against the other. The beds were simple metal twin beds moved over from the Afghan barracks.
“A few days ago we collected some respiratory secretions and blood from each of you,” Major Banks said as he paused for Miriam’s translation.
“I don’t know this word… secretions?” Miriam asked before she translated.
“Fluids.”
As Miriam spoke the Taliban patients wouldn’t look her in the eyes even though she was wearing the hijab head scarf.
“I got the results back from our hospital lab in Bagram. Each of you has tularemia, or rabbit fever. The lesions you see on your skin are also inside your intestines and in your lungs. That’s why you’re having trouble breathing. It feels like pneumonia. You run a fever while you experience chills. You feel cold. Your body aches”
Each of the three looked at their own skin ulcers as Miriam spoke.
“One case of tularemia is rare. Three cases could be an epidemic. I need to ask you some questions. I need to find out where you were and what you were doing when you became sick.”
As Miriam translated, the oldest Taliban patient rolled over on his side and faced the back wall away from Major Banks.
Major Banks and Captain Henry noticed the attitude. This was not going to go well.
“I have brought medicines with me. If I give you these medicines, you will live. Now that we know what this is, we no longer need to isolate you. The hospital can use normal biosafety level precautions now. But if you refuse the medicine, then your organs will shut down. You will lose weight. The lesions on your hands will form inside your eyes… then your eyes may burn in their sockets with ulcers that will boil like acid… until you die.”
The youngest Taliban patient sat up quickly in bed and spoke directly to Miriam.
“He says that he has a wife and a young son and that he is willing to die but prefers not to die today. He is willing to take the medicines,” Miriam said.
Abdul opened the door to the isolation ward and delivered Dr. Mahmoud as instructed. Mahmoud was slight of build and his youth was punctuated with an obnoxious laugh and endless nervous tension. Nothing was calming about Dr. Mahmoud as he walked into the ward, fresh from pronouncing a Zazai tribe elder dead in the ER after a less than urgent ambulance ride.
“Tell them Dr. Mahmoud will give them ciprofloxacin twice daily through an IV for 10 days. After that, they can go home, but they’ll need to take more pills,” Major Banks said to Miriam as he looked up to see Mahmoud.
Miriam translated as much as she understood as Dr. Mahmoud started visiting with his patients. The oldest Taliban patient rolled over and covered his heart with his hand as the Afghan doctor walked by. Mahmoud touched his shoulder.
“Zar ba yi ter lasa kri, my brother, get well soon.”
Then Banks, Henry and Mahmoud left the isolation ward and walked toward the emergency room followed by Miriam.
“What was all that bull about their eyes boiling like acid?” Captain Henry said trying to hold back a laugh.
“Sometimes pictures are worth a thousand of Miriam’s words.”
“Doctor Banks?”
“Yes, Dr. Mahmoud.”
“This tularemia… is it contagious?”
“Francisella tularensis is very infectious. It’ll knock your socks off. Less than 10 microbes of the bacteria and you’re infected. We haven’t seen any proof that it’s contagious, as in from me to you. But it’s still a Category A bioterrorism agent like the plague and anthrax.”
“So then it can be transferred from one person to another, Dr. Banks?”
“Not that we know of. There’s a difference between infectious and contagious. It’s only on the Cat A list because it could be lethal and widespread if it got into the food or water supply. So far, the bad guys haven’t figured out how to make an infectious aerosol for it.”
Captain Henry stopped in the hallway. He was not entirely satisfied with the major’s reasoning.
“So three Taliban thugs show up in our hospital with rabbit fever, and we’re going to chalk it up to random happenstance?”
“To the contrary, I suspect the three of them feasted on some infected and undercooked meat in one of their four-star Hilton caves, captain. But you’re probably correct.”
“Sir?”
“I’m guessing it was rabbit.”
Banks, Henry, Mahmoud and Miriam walked into the ER where Banks removed a box of ciprofloxacin and IV kits that had been flown in from Bagram Air Base.
The radio in the ER crackled to life. Mahmoud answered the call using the handheld microphone as Banks and Henry prepared the medication.