A chuckle crawled up Kathleen’s throat and escaped before she could bite it back. “Oh, is that what they call leaving the poor to die in their own filth these days? ‘Government funding’? Maybe I should go tell everyone in the waiting room to go home and sleep it off.”
“I wish you wouldn’t.”
The voice was female, and unfamiliar. Kathleen and Phil turned.
The woman behind them was stunningly beautiful, enough so as to appear to have wandered out of Central Casting and into a medical drama. Her long black hair was pulled into a ponytail, and she was dressed practically, not calling any attention to her curves. She didn’t need to. Even if she hadn’t been the kind of lovely that launched a thousand ships, the fact that she was flanked by a pair of men large enough to have been professional wrestlers would have commanded a certain amount of attention from anyone who saw her.
The third man was of slightly less imposing build, being roughly the height of a normal human being, with dark, tousled hair and a blazer over his button-down shirt. He produced an ID wallet from inside his jacket, snapping it open to show them the badge and snapping it closed again before Kathleen could get more than a glimpse of the credentials inside.
She was about to protest when the man said, “We’re from the government, and our funding is just fine. Please, will you show us your patients?”
Kathleen knew these people were more likely to be from a tabloid looking for a scoop or from a company that thought its products might be somehow responsible for the situation than from the government, but in that moment, she didn’t care. She had people sick, and she knew them: if she didn’t do something, they would go home to “sleep it off,” just like her Gram. They’d all die. Just like her Gram. If trusting these people—if risking them betraying her—meant even a sliver of a chance, then she’d take it.
“This way,” she said, and turned on her heel, motioning for them to follow.
Phil fell into step beside her. “You know they’re probably not with the government. Last time I checked, the American government didn’t base its hiring decisions on ‘could they break kneecaps for the Mob.’”
“I know,” said Kathleen. She felt oddly serene, as if a weight were being lifted from her shoulders. These people wanted her problems? They could have them. Let them pore over the charts and data, let them scowl at lab results that couldn’t possibly exist. She’d go back to the patients. She’d hold their hands and keep them breathing calmly until a treatment was found. “I just don’t care. If there’s a chance that they can help, we’re going to let them try.”
“Excuse me.” It was the woman. Kathleen turned. The woman smiled. “I’m Dr. Circe O’Tree, and this is my associate Dr. Rudy Sanchez. Whether or not you believe we’re with the government, I’m afraid we’re definitely not deaf. I read the report you sent to the CDC while we were on the plane. Can you please walk me through this?”
The shorter man was close behind her, where he would be able to listen as well. Kathleen swallowed a sigh.
“First thing you need to know is that this could be a lot more widespread than we’re seeing,” she said. “People around here don’t think much of doctors, and the symptoms come on vaguely enough that we may have a lot of folks staying home and waiting to feel better until it’s too late.”
Dr. O’Tree frowned. “I heard you say the CDC suspected an environmental cause, due to the family clustering. Have you contacted the police, asked them to check the homes inside the infection zone?”
This time, Kathleen actually laughed. “Oh, because people who don’t like it when they have to go to the doctor are going to react so well when they find the police on their doorsteps. I start sending the cops around, I might as well buy a bulk lot of plots down at the boneyard. No one else will die from this disease, because they’ll all be too busy shooting each other.”
“My apologies, Doctor…?”
Kathleen flushed red. “Dr. Kathleen Abrams. This is my colleague, Dr. Phillip Clines.”
“You’re the head oncologist, aren’t you?” asked Circe. “I saw your name on the directory near the front desk.”
“Yes, but I’m also our … call it ‘cultural ambassador’ to the locals. I grew up here. I know how people think.”
“That’s more important than a lot of people realize, especially when you’re dealing with an isolated population,” said Dr. Sanchez. He sounded almost admiring.
Kathleen relaxed a little. Maybe these people weren’t just here digging for a story after all. “It can be hard to get people who’ve never had the government on their side to understand that doctors aren’t all here to hurt them,” she admitted. “But we’ve made great strides—or at least, we had, before all this. Honestly, I’m hoping the CDC is right and it’s something environmental that just happens to perfectly mimic adult-onset galactosemia.”
“What is galactosemia?” asked Bunny. He put on his best expression of profound puzzlement. “I don’t have a medical background. Use small words.”
“I know someone playing stupid when I see it,” said Kathleen. “But in the simplest of terms, galactosemia is a genetic disorder which stops the body from properly processing galactose.”
“What’s that?” asked Bunny.
“You’ve heard of lactose intolerance?”
“Yeah. I had a buddy in the service who’d get the worst gas you’d ever smelt if he had so much as a piece of cheese. We all used to say that his ass should have been banned as a weapon of mass destruction.”
“Well, lactose intolerance stops the body from properly breaking down lactose. Galactosemia doesn’t do that. Lactose breaks down normally, into glucose and galactose. That’s where the body gets confused. It can’t break down the galactose. It doesn’t know what to do with the stuff, and so it builds up, leading to all sorts of complications. Renal failure, cataracts, cognitive impairment, neurological impairment—”
“You just said that,” said Bunny.
“No,” said Kathleen. “Cognitive impairment impacts the mind. There can be massive learning disabilities and delays as a consequence of this condition. Neurological impairment tends to manifest itself as tremors, seizures, other issues involving the interface between body and brain. It’s hard to say which kills more quickly. Infants with galactosemia have very poor survival statistics, especially when it goes undiagnosed or is not immediately taken seriously by the family. If they attempt to treat it like lactose intolerance, and continue breast-feeding or otherwise exposing the children to lactose, they can and will die.”
“But it doesn’t manifest in adults,” said Phil, jumping into the silence that followed her explanation. “There’s just no way. This can’t be galactosemia, because if it were, all these people would have died years ago. Decades ago.”
“All right,” said Dr. Sanchez. “I think that’s enough background to bring us all up to speed. Can we see the patients now?”
Kathleen and Phil exchanged an uneasy glance before nodding.
“This way,” said Kathleen.
* * *
Sick people had a smell. The smell of the sick people packed into their makeshift isolation ward was sweet and cloying, almost sugary. Twelve of the beds were occupied. Four more waited, empty, for their occupants to come.
“I thought there were fifteen cases?” Rudy made the question mild, looking around as if he expected three more patients to simply appear.
“The others are under three years old,” said Phil. “They’re in a sterile ward, intubated. They’ve all stopped breathing on their own. That’s part of why we think this must be something else that mimics galactosemia—it doesn’t move this quickly. Even in children with the condition, we’d expect to have several months between presentation of symptoms and a total system collapse.”
“Thank you,” said Rudy, and produced a pair of gloves from his pocket, moving forward into the room. Circe and Bunny followed, leaving Top standing next to the two doctors.
The team moved from patient to
patient with ruthless efficiency, reading charts, checking pulses, doing everything short of drawing more blood. When they had reached the far side of the room, Rudy looked up and nodded, once.
“These families,” said Top. “What do they all have in common?”
Kathleen jumped. She couldn’t help herself. She’d been so wrapped up in watching the rest of them that she’d managed to virtually forget Top was there.
“They’ve all been living here in town for generations. They’re proud of their self-sufficiency. Don’t like asking for help.”
“Do they attend the same church? You mentioned that they don’t like asking for help. Do they visit a local food bank?” Sensing Kathleen’s reluctance, Top lowered his voice and said, “Help us help you. If there’s an environmental factor, we need to know how to find it. Even if you don’t want to trust us, we’re your best chance at finding a solution for these people.”
“They … don’t go to a food bank, no,” Kathleen said reluctantly. “But there’s a church group that distributes supplies. Things that they say would go to waste, so it’s really a charity to take them.”
“The hospital doesn’t accept any of their donations,” Phil added. “They mean well. They’re also a little fast and loose about the legality of the things they pass around, and we’ve never wanted to risk getting caught in a lawsuit.”
“Understandable,” said Top. “Tell me, does either of you have close contact with the families who receive those donations? Outside of the hospital, I mean?”
“Vince Taylor works at the coffee shop where I stop most mornings,” said Kathleen. “Nice kid. Smart. He’s going places. I know his family gets donations from the church.”
“All right. This may seem like an odd question, but have you seen him drinking bottled water recently?”
“Bottled water? Please. No one around here would waste money on—” Kathleen stopped. There had been that nasty business with the water filters downtown, hadn’t there? They’d stopped cleaning the water properly, and some people had gotten sick. Not bad sick, no, just some minor bacterial infections, but it had been enough to scare a few households into drinking bottled water, at least until the matter was resolved.
“Oh, God,” she said. “I saw Vince with a bottle of water last week. I didn’t even think about it.”
“Was it a brand you recognized? Had you ever seen that kind of water before?”
“I don’t think so, no. I wasn’t really paying attention.”
Top nodded grimly. “People generally don’t. It’s interesting. A man switches from Coke to Pepsi, people will notice. Switch brands of bottled water, and it’s just so much background noise.”
“Was the water poisoned? Was there some sort of federal recall?”
Top and Bunny exchanged a look. “Is Vince Taylor one of your patients?”
“No,” said Kathleen. “And don’t think I didn’t notice you changing the subject. I noticed.”
“That’s fine, ma’am, but right now, I think we need to find Vince and see if he can tell us where he got that water. Preferably before there’s some sort of a public panic.” Top folded his arms. “Can you do that?”
Kathleen was suddenly, terribly reminded of how large these two men were. If they wanted to break her, they could.
But her people needed her. The people she’d grown up beside, the people who believed she could take care of them, they needed her. If these men were government goons sent to make this whole thing disappear, she could work with that. First, she needed to know what “this whole thing” actually was.
“Dr. Clines, please stay here with our guests,” she said, offering Phil a short, tight nod. She wanted him to know that she understood what she was doing. She wanted him to know that she’d be fine.
To her great relief, he nodded back and said, “I’ll notify you if anything here changes.”
“Thank you,” she said. “Gentlemen? Please follow me.”
Rudy glanced up as Top and Bunny filed out of the room. Then he went back to reviewing the chart he was holding, while Circe made notes.
This was bad. This was very bad.
* * *
The coffee shop where Vince worked was only a few blocks from the hospital—close enough that it wasn’t unusual to see doctors in their white coats and nurses in their scrubs passing their lunch breaks packed around the tiny tables, desperately trying to consume enough caffeine to stay standing for the rest of their shifts. The place kept hospital hours, staying open late into the night, and profiting accordingly.
The two men behind Kathleen drew considerably more glances than she did, some appreciative, others wary. She looked toward the counter.
Vince wasn’t there.
Kathleen frowned as she walked up to the register and waved for the attention of the woman on duty. “Sandy, when was the last time you saw Vince?” she asked.
“He called in sick Monday and Tuesday, and today, he just didn’t show.” Sandy frowned. “It’s not like him. Anyone else, they’d already be fired, but Vince … You know something I don’t?”
“We have a few of his relatives at the hospital. Looks like it might be food poisoning. He’s probably exhausted and trying to sleep it off, but I’ll go and check on him.” Kathleen forced herself to smile. “I’ll stop by on my way back.”
Sandy brightened, a look of pleased surprise on her face. “You’d do that?”
“It’s no trouble.” Kathleen kept smiling as she turned and walked out of the coffee shop, with Top and Bunny behind her.
The smile died as soon as she was outside.
“The Taylors live about a mile from here,” she said. “I’ll need to get my car.”
“No, you won’t, ma’am,” said Bunny. “We parked on the street.” He pointed to a black SUV that all but screamed government agents, and smirked. “Seemed like the right car for the job.”
“Of course it did,” said Kathleen.
She was now not just leaving with two strange men who might or might not be who they claimed: she was getting into a car with them. If her body was never found, well, that would just about serve her right. But if there was anything she could do to save the people who were filling her hospital, she had to do it. She had to try. That was what she had promised to do when she’d gone away to medical school, and that was a promise she intended to keep.
As if sensing her discomfort, Bunny smiled and said, “We’re pretty good drivers. We almost never get into Vin Diesel–style car chases. And when we do, we always win.”
“Encouraging,” said Kathleen, and followed them to the car.
It was a new model, kitted out with all the bells and whistles that people seemed to expect these days. The seats adjusted themselves automatically when Top started the engine, and the air-conditioning was better than anything Kathleen had experienced as a child. She watched out the window as Top followed her directions to the Taylor house, wondering what her hometown looked like to these strangers, these men who could afford new suits and fancy rental cars and last-minute plane fares.
Growing up poor in Alabama meant hands stained red from the dirt and scabby knees stained the same color by eating pavement. It meant making do and making repairs and making a dollar do the work of ten. It meant pride, because pride might not fill a belly, but it could sure make the sting of hunger seem righteous, like something that had been honestly earned. Kathleen had always hated the rich, happy-looking kids she’d seen on television, because they were nothing like anyone she’d ever met. Where was the red dirt under their fingernails, the stains that could have been earth and could have been blood and were really both at the same time? Where was the hunger, big enough to eat the world? Where was the need?
It was here. It was ever and always here.
They pulled up in front of the Taylor house. It was small, and clean, with a well-weeded vegetable garden out front. Kathleen frowned when she saw Top eyeing it speculatively.
“Sorry there isn’t a truck on cinder blocks o
ut front, to tell you you’ve got the right place.”
He turned his gaze on her. “You’ve got a lot of mad in you. That can be a good thing. But please don’t aim it at me. I’ve never said a thing to make you think I’d be that judgmental.”
Kathleen flushed red. “I’m sorry. It’s been a long week.”
“I’m sure it has.”
They got out of the car, Kathleen leading the way up the narrow path to the front door. She rang the bell, stepping back and waiting. And waiting.
And waiting.
“Let me try,” said Bunny. He stepped past her and twisted the doorknob hard to the side. There was a clicking noise as something inside the lock broke. He pushed the door open, offering Kathleen an apologetic smile. “Looks like it was open.”
“I hope you’re ready to pay for that,” said Kathleen, and stepped past him into the hall.
The smell of sickness stopped her in her tracks.
Sick people had a smell, and that smell hung heavy in this house, sinking into the walls. She took a breath and started forward, Top and Bunny close enough behind her that it should have felt claustrophobic. Instead, she found their presence oddly reassuring, as if by having them there, she could prepare for whatever she might find.
She was not prepared.
The back room—formerly the TV room—had been transformed into a makeshift medical ward, presumably because the family couldn’t afford to send anyone to the hospital, if they even trusted it after the number of people they’d seen admitted over the past week. Four of them were lying there, two on the couch and two on the floor. All four were dead. Kathleen recognized Vince and his sister, Angie; the process of elimination said that the other two must be their parents.
Something scrabbled at the back door. They had locked the dogs out at some point, maybe when they realized how sick they were. That was all that had saved them from being eaten by their own pets, whose domesticated behaviors would eventually have given way in the face of hunger. Kathleen’s stomach did a slow roll. This was so much worse than she could have dreamed. So much worse.